PDF(Pubmed)
Abstract：
BACKGROUND: Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry.
METHODS: A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching.
RESULTS: This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For \"early lesions\" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants.
CONCLUSIONS: This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.
METHODS: A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching.
RESULTS: This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For \"early lesions\" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants.
CONCLUSIONS: This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.
摘要：
背景：在英国（UK）的儿科牙科中，龋齿学教学中的现有证据并不一致。许多牙科学校并没有始终如一地教授龋齿管理的生物学方法，过时或复杂的方法被教导超出普通牙科医生的权限。此范围审查旨在绘制有关儿童和年轻人龋齿管理的现行指南。这是工作包的一部分，旨在为英国范围内的儿科牙科龋齿管理课程的共识和开发提供信息。
方法：使用CochraneLibrary对电子数据库进行了同行评审文献的搜索，MEDLINE通过PubMed,TRIP医学数据库和WebofScience。对灰色文献进行了手工搜索(引用证据来源，全球组织的网站和谷歌网络搜索™(谷歌有限责任公司，加州,美国）。独立筛选数据库的结果，同时由两名审稿人。获得全文，和审稿人开会讨论对数据库和手工搜索的任何分歧。
结果：本综述确定了16个适合纳入的指南。质量鉴定后,选择了8个进行合成和解释。除非在前牙的特定情况下，否则关键主题包括转向选择性龋齿去除和避免完全龋齿去除。对于有和没有空洞的乳牙和恒牙的“早期病变”，一些指南推荐了生物管理，包括特定地点的预防和裂缝密封剂。
结论：这篇综述绘制了当前儿童和年轻人的龋齿学指南，发现了文献中的空白，包括早期龋齿病变的分类和早期空化病变的处理。确定进一步探索的领域包括将生物龋齿管理纳入治疗计划，选择性龋齿去除和牙髓切除术是否是专科级别的治疗，需要转介。这些结果将为英国的共识建议提供信息，使用Delphi方法。
方法：使用CochraneLibrary对电子数据库进行了同行评审文献的搜索，MEDLINE通过PubMed,TRIP医学数据库和WebofScience。对灰色文献进行了手工搜索(引用证据来源，全球组织的网站和谷歌网络搜索™(谷歌有限责任公司，加州,美国）。独立筛选数据库的结果，同时由两名审稿人。获得全文，和审稿人开会讨论对数据库和手工搜索的任何分歧。
结果：本综述确定了16个适合纳入的指南。质量鉴定后,选择了8个进行合成和解释。除非在前牙的特定情况下，否则关键主题包括转向选择性龋齿去除和避免完全龋齿去除。对于有和没有空洞的乳牙和恒牙的“早期病变”，一些指南推荐了生物管理，包括特定地点的预防和裂缝密封剂。
结论：这篇综述绘制了当前儿童和年轻人的龋齿学指南，发现了文献中的空白，包括早期龋齿病变的分类和早期空化病变的处理。确定进一步探索的领域包括将生物龋齿管理纳入治疗计划，选择性龋齿去除和牙髓切除术是否是专科级别的治疗，需要转介。这些结果将为英国的共识建议提供信息，使用Delphi方法。
