Deep caries management: EFCD-ESE-ORCA S3-level clinical practice guideline

作者：F. Schwendicke, E. Kosan, Avijit Banerjee, A. Baysan, L. Bjorndal, Laura Ceballos, Henry F. Duncan, S. Herbst, Klaus W. Neuhaus, Anne C. O'Connell, Sebastian Paris, H. Dujic · 发表于：Clinical Oral Investigations · 年份：2026 · DOI：10.1007/s00784-025-06727-1 · 被引用次数：2 · 研究领域：Medicine

To develop an evidence-based S3-level clinical practice guideline for the management of deep and extremely deep caries in vital permanent teeth. An evidence-based medical guideline based on systematically searched and appraised evidence as well as a structured consensus (S3-level) was jointly developed by the European Federation of Conservative Dentistry (EFCD), the European Society of Endodontology (ESE), the Organization for Caries Research (ORCA) and the German Society of Conservative Dentistry (DGZ), following the methodological framework of the Association of Scientific Medical Societies in Germany (AWMF) and the GRADE approach. Four working groups formulated key clinical questions regarding (1) caries removal strategies, (2) cavity liners, (3) management of exposed pulps and (4) materials for direct pulp capping and pulpotomy. Systematic reviews were conducted for each question and evidence was synthesized and graded for quality. A structured consensus process was used to formulate recommendations. In order to encourage its wide dissemination, this article is freely accessible on Clinical Oral Investigations https://doi.org/10.1007/s00784-025-06727-1, International Endodontic Journal https://doi.org/10.1111/iej.70132 and Caries Research https://doi.org/10.1159/000551659 journals’ websites. Evidence supports selective (SE) or stepwise caries removal (SW) over non-selective removal (NSE) to reduce the risk of pulp exposure in deep caries. Routine use of cavity liners afte...