IV SIE international Congress 2020
Lars Bjørndal

Lars Bjørndal

Born in 1963, graduated in 1988 as a dentist from the University of Copenhagen, Denmark.
In 1992: Ph.D. thesis on the topic: Caries progression in enamel and the pulp-dentin organ using thin undemineralized tooth sections.
In 2011: Dr. Odont. Thesis entitled: Endodontic treatment: reason, prevention and quality-shaping factors.
From 1993-1998: Assistant professor at the Department of Cariology and Endodontics, University of Copenhagen.
1999-2001: received specific postgraduate endodontic specialist courses in collaboration with the universities in Copenhagen, Denmark, Malmö and Gothenburg, Sweden.
From 1998: Associate professor at the University of Copenhagen, Denmark, and Head of Endodontic. In 2012 LB was visiting Scholar at Loma Linda University, US.
From 2012: Head of the Special Clinical Unit receiving referrals at the Institute of Odontology, University of Copenhagen, Denmark. One day weekly LB is in clinical practice devoted endodontic referrals. LB has been past Secretary in the Scandinavian Endodontic Society (SES) from 1999-2001.
In 2007 and 2016 LB hosted the SES biennial congress in Denmark. LB is second time President of the Danish National Endodontic Society (2014), and country representative for the European Society of Endodontology (ESE), as well as a certified member of ESE. Besides numerous national post-graduate General Dental Practitioner hands-on courses covering endodontic treatments, LB has been giving lectures in Europe, India, Asia, North and South America. The topics have been within the field of deep caries lesion pathology, treatments and quality-shaping factors concerning endodontic treatments. LB has authored and co-authored numerous international and national articles, including book chapters and reviews, and is at present reviewer in several international Journals. Editor of Textbook of Endodontology, WiIey, Blackwell 3. edition.

MANAGEMENT OF DEEP AND EXTREMELY DEEP CARIES – WHEN SHOULD WE AVOID OR PERFORM PULP INVASIVE TREATMENTS?

Friday, 11 Nov

12.50 am

A 5-yr follow-up randomized clinical multi-centre data has shown that a less invasive carious removal strategy has a significantly better outcome, than a non-selective carious removal strategy, in terms of preventing pulp exposure (Bjørndal et al. 2017, JDR). In case of a pulp exposure, only 9% of the analyzed capped pulps from the above trial were assessed as successful, indicating a low prognosis for conventional pulp-capping procedures in well-defined deep carious lesions in adults. This raises some questions; was the degree of pulp inflammation too advanced? Was the methodology performed poor? The penetration depths of the carious lesion may be an important prognostic factor? In many of the previous capped teeth, from where we have our current data, surprisingly little information is given about the prehistory of the carious lesion depth. It is well-known that the outcome seems different when pulp capping is performed within an infected environment (i.e. a cariously exposed pulp) as oppose to a traumae scenario. Although, the available evidence is sub-optimal, it seems reasonable to hypothesize that capping an initial infected environment, provides the risk of a lower success than capping a traumatically induced pulpal exposure. High demands of the pulp capping protocol will be required when infected pulps are to be capped versus capping the sound pulp. The standard and principles on when we should avoid or perform pulp invasive treatments is presented following the current Position Statements from European Society of Endodontology on Deep caries management.

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