Gruythuysen R J M
Afdeling Cariologie Endodontologie Pedodontologie van het Academisch Centrum Tandheelkunde Amsterdam.
Ned Tijdschr Tandheelkd. 2010 Mar;117(3):173-80. doi: 10.5177/ntvt2010.03.09176.
The traditional restorative approach to active dentin caries in the temporary dentition is questioned. This paper argues in favour of a causal approach. The causal approach focuses on caries management. Restoration is of secondary importance. Delay or replacement of invasive restorative treatment by a causal approach decreases discomfort for children and promotes oral health over time. A form of causal treatment is the so called Non-Restorative Cavity Treatment. This approach requires that some measures be taken for managing cavitated caries lesions: 1. written informed consent; 2. making the cavity accessible for plaque removal; 3. treating carious dentition with anti-cariogenic agents and/or applying a protective layer to the carious dentition; 4. monitoring the caries process; 5. effective communication about dental health education. Some diagnostic criteria are important for the risk assessment of cavitated lesions: 1. activity of the caries lesion; 2. accessibility of the caries lesion for plaque control; 3. depth of the cavity; 4. condition of the pulp.
the causal approach can arrest the caries process even in advanced stages of decay.
乳牙列中活动性牙本质龋的传统修复方法受到质疑。本文支持采用病因治疗方法。病因治疗方法侧重于龋病管理。修复是次要的。采用病因治疗方法延迟或替代侵入性修复治疗可减少儿童的不适,并随着时间的推移促进口腔健康。一种病因治疗形式是所谓的非修复性龋洞治疗。这种方法要求采取一些措施来管理已形成龋洞的龋损:1. 书面知情同意;2. 使龋洞便于清除菌斑;3. 用防龋剂治疗龋牙列和/或对龋牙列应用保护层;4. 监测龋病进展;5. 就口腔健康教育进行有效沟通。一些诊断标准对已形成龋洞病变的风险评估很重要:1. 龋损的活动性;2. 龋损对菌斑控制的可达性;3. 龋洞深度;4. 牙髓状况。
病因治疗方法即使在龋病晚期也能阻止龋病进展。