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
