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Vitale pulpabehandlinger i tænder med profund caries
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0003-4290-2283
Oral Health Center of Expertise in Eastern Norway (OHCE-E), Oslo, Norway.ORCID iD: 0000-0002-5057-8455
Oral Health Care in City of Espoo and Institute of Dentistry, Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.ORCID iD: 0000-0003-2766-6227
Oral Health Centre of Expertise in Western Norway, Vestland Bergen and Institute of Clinical Dentistry, University of Bergen, Bergen, Norway.ORCID iD: 0000-0003-2427-8165
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2023 (Danish)In: Tandlægebladet, ISSN 0039-9353, Vol. 127, p. 36-44Article in journal (Refereed) Published
Abstract [da]

Vitale pulpabehandlinger udføres med henblik på at bevare pulpas forsvarsfunktioner og undgå pulpektomi og rodfyldning, som kan være teknisk udfordrende og ikke altid fører til det ønskede resultat. The European Society of Endodontology (ESE) har publiceret en statusrapport om vital pulpabehandling i tænder med profunde carieslæsioner, som i et vist omfang stemmer overens med de nationale retningslinjer i de nordiske lande. Der er stadig problemer med at vurdere pulpas tilstand i tænder med profunde carieslæsioner. Så længe carieslæsionen ikke har nået pulpa, anbefales behandlinger, der sigter på at undgå pulpaeksponering, fx gradvis ekskavering. Men når pulpa er eksponeret på grund af caries, er der ikke overensstemmelse mellem anbefalingerne fra ESE og de nordiske landes nationale retningslinjer. Dette skyldes sandsynligvis manglende evidens for bedre effekt af én behandling frem for andre samt vanskeligheder med at afgøre, hvornår pulpa er irreversibelt beskadiget. Minimalt invasive behandlingsstrategier med nyudviklede hydrauliske calciumsilikatcementer har vist lovende resultater af vital pulpabehandling med henblik på at undgå rodkanalbehandling. Konceptet er under stadig udvikling, og man må forvente, at de kliniske anbefalinger på sigt bliver ændret. 

Abstract [en]

VITAL PULP TREATMENTS IN TEETH WITH DEEP CARIOUS LESIONS 

Vital pulp treatments (VPT) are performed to preserve the defense functions of the pulp and thus to avoid pulpectomy and root filling which can be technically demanding and not always ends up with the desired outcome. The European Society of Endodontology (ESE) has published a position paper on VPT in teeth with deep carious lesions which partly matches to national guidelines in Nordic countries. There are unsolved difficulties in assessing the pulpal status in teeth with deep carious lesions. As long as the carious lesion has not reached the pulp, treatments performed to avoid pulp exposure, such as stepwise excavation, are recommended. On the other hand, when the pulp is exposed due to caries, the recommendations are somewhat different between the ESE and national guidelines in Nordic countries. This is most probably due to lack of evidence favoring one treatment over the other and due to difficulties in assessing which exposed pulps are irreversibly damaged. Minimally invasive management strategies with recently developed hydraulic calcium silicate cements show promising results of VPTs aiming at avoiding root canal treatment. The VPTs will be further developed and changes to clinical recommendations are anticipated.

Place, publisher, year, edition, pages
Tandlægeforeningen , 2023. Vol. 127, p. 36-44
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-61813OAI: oai:DiVA.org:mau-61813DiVA, id: diva2:1786711
Available from: 2023-08-09 Created: 2023-08-09 Last updated: 2023-10-23Bibliographically approved

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Fransson, Helena

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Fransson, HelenaStangvaltaite-Mouhat, LinaCroft, KatriBletsa, AthanasiaBjørndal, Lars
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