Elderton R J
Department of Conservative Dentistry, University of Bristol, Bristol Dental Hospital, UK.
Int Dent J. 1993 Feb;43(1):17-24.
Traditional restorative dental treatment has many shortcomings and has not been shown to be an effective method for managing caries. In spite of this, many dentists continue to be powered by an aggressive restorative approach which may result in unnecessary treatment and which must now be seen as inappropriate. There is a pressing need for a greater understanding as to the precise criteria that dictate the need for both non-invasive (reversible) preventive measures and invasive (irreversible) restorative treatment. This paper examines these criteria and provides decision trees with respect to the clinical management of carious lesions and teeth with existing restorations, showing when, and what type of, intervention is required. The assessment and management of fissured tooth surfaces receives special attention. It is demonstrated that while many clinical situations warrant clinical intervention, often this should be entirely preventive and of a non-invasive type.
传统的牙齿修复治疗存在许多缺点，并且尚未被证明是管理龋齿的有效方法。尽管如此，许多牙医仍然热衷于激进的修复方法，这可能导致不必要的治疗，而现在必须认为这种方法是不合适的。迫切需要更深入地了解决定非侵入性（可逆）预防措施和侵入性（不可逆）修复治疗必要性的确切标准。本文研究了这些标准，并提供了关于龋损和有现有修复体的牙齿临床管理的决策树，显示何时需要何种类型的干预。裂隙牙面的评估和管理受到特别关注。结果表明，虽然许多临床情况需要临床干预，但通常这应该完全是预防性的且是非侵入性的。
