Ein verändertes Verständnis zur Ätiologie der Erkrankung „Karies“ spiegelt sich auch in einer drastisch veränderten Therapie kariöser Läsionen wider. So werden Strategien zur Kariesexkavation, bei denen eine vollständige Entfernung kariösen Gewebes angestrebt wird, heute teilweise hinterfragt. Moderne Vorgehensweisen zielen auf eine minimalinvasive Kariesentfernung ab mit anschließender Versiegelung der Kavität.
Abstract
Caries is caused by changes in the environmental conditions of the dental biofilm. Therefore, dental caries is not any longer considered an infectious disease. Todayʼs caries excavation strategies focus on preserving dental hard tissue and pulp vitality with a tight sealing. A distinction is made between non-selective, selective and stepwise caries excavation. In shallow or moderately deep carious lesions, central aspekts of the cavity should be excavated to firm dentine. In deep carious lesions, selective excavation into soft dentine should be performed in the proximity of the pulp. Peripheral dentine areas of the cavity should be excavated to hard dentine in order to ensure proper bonding of the restoration. Some restorative treatments (e.g. liner, Caries Detector®) are increasingly subject of critisism. Alternative procedures for caries excavation such as caries sealing, Hall- technique or non-restorative cavity control add value to the therapeutic spectrum.
Schlüsselwörter
Kariesexkavation - evidenzbasierte Zahnmedizin - restaurative Zahnheilkunde - Pulpaschutz
Key words
caries - evidence-based dentistry - restorative dentistry - pulp protection
