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Preserving pulp vitality: part one - strategies for managing deep caries in permanent teeth


This is the first article in a series reviewing the current literature surrounding the management of deep caries in permanent teeth. Approaches to caries management are continuing to evolve, with more conservative management increasingly favoured. This philosophy has never been more important than in managing the deep carious lesion. Evidence is emerging that the use of selective caries removal to reduce the risk of pulp exposure, in conjunction with calcium silicate cements, can be successful in maintaining pulp vitality, delaying the restorative cycle and prolonging the lifespan of the tooth.

Key points

  • Non-selective caries removal is currently not recommended in the management of deep carious lesions.

  • Selective caries removal should be considered ahead of a stepwise approach.

  • Selective caries removal minimises the risk of pulp exposure and improves pulp survival in the short-to-medium term.

  • Calcium silicate cements show potential in the management of deep caries.

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Correspondence to David Edwards.

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Edwards, D., Stone, S., Bailey, O. et al. Preserving pulp vitality: part one - strategies for managing deep caries in permanent teeth. Br Dent J 230, 77–82 (2021).

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