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If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been\u00a0advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one\u2010visit as indirect pulp treatment or two\u2010visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re\u2010emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp\u2013dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence\u2010based management strategies and education in management of the exposed pulp are critical in the future.<\/jats:p>","DOI":"10.1111\/iej.13128","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T10:31:04Z","timestamp":1555324264000},"page":"949-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":419,"title":["Management of deep caries and the exposed pulp"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2183-6400","authenticated-orcid":false,"given":"L","family":"Bj\u00f8rndal","sequence":"first","affiliation":[{"name":"Cariology and Endodontics Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Simon","sequence":"additional","affiliation":[{"name":"Paris Diderot University Paris France"},{"name":"H\u00f4pital de Rouen Normandie Rouen France"},{"name":"Laboratoire IN SERM UMR 1138 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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