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Between September and December 2018 our most popular blogs considered guidelines for non-restorative options for caries management , orthodontic management of the developing dentition and aligners for orthodontic treatment.
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This evidence-based clinical practice guideline on the non-restorative treatments for carious lesions in primary and permanent teeth from the American Dental Association provides 11 recommendations.
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16 low quality RCTs were included in this review of the effect of calcium hydroxide lining on clinical success in treatment of deep carious lesions. 6 RCTs contributed to the meta-analysis suggesting no beneficial effect.
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This Cochrane review of pulp treatments for primary teeth included 87 trials. Pulp treatments were generally successful with many trials having no clinical or radiological failure in either arm.
Mineral trioxide aggregate (MTA) may be the best medicament to apply after pulpotomy. For pulpectomy there was no conclusive evidence that one medicament or technique is superior to another.
This small but well conducted RCT compares the effectiveness of MTA and calcium hydroxide for direct pulp capping material in adult molars with carious pulpal exposure finding better performance for MTA at 3 years.
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This review of endodontic treatments for immature teeth included 7 small RCTs at medium to high risk of bias. They suggest that mineral trioxide (MTA) may provide better clinical outcomes in relation to apical closure but the findings should be interpreted with caution.
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This review of pulp capping in primary and permanent teeth included 11 studies involving a total of 1196 teeth in 922 patients . Most materials did not show superiority compared with calcium hydroxide.
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This review of coronal pulpotomy in permanent teeth demonstrated good survival at 2 years 92% (95%CI; 84 -100). However as the majority of studies were observational they should be viewed cautiously until further high quality RCTs are available.
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This review looks at the benefits and harms of cavity lining. However, only 3 very low quality studies comparing calcium hydroxide lining in primary teeth were identified. Restoration without lining did not significantly affect the risk of failure.
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This review of cavity liners retrieved 14 trials (11 RCTs). The available evidence was limited but some liners seem more suitable to achieve sterile cavities or reduce bacterial numbers than others.
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