This review comparing stepwise removal (SWR) and selective removal (SCR) of deep carious lesions in primary and permanent teeth included 9 RCTs. The findings suggest that SCR may be more succesful than SWR but they should be interpreted cautiously because of the limited number of studies for some outcomes.
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This review of techniques and materials used for the management of deep caries in immature permanent teeth included 12 RCT papers. The findings suggest high success rates for pulpotomy, but only a small number of papers were available for other techniques.
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This Cochrane review of interventions to treat carious lesions conventionally considered to require restorations in primary or permanent teeth with vital pulps included 27 RCTs. Compared with conventional treatment there were lower numbers of failures with the Hall technique and selective excavation (SE) in primary teeth and with SE and stepwise removal in permanent teeth.
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This review of the efficacy of 3 caries removal strategies (complete, selective and stepwise) in primary teeth included 8 RCTs suggesting a lower risk of pulp exposure with selective and stepwise approaches.
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16 low quality RCTs were included in this review of the effect of calcium hydroxide lining on clinical success in treatment of deep carious lesions. 6 RCTs contributed to the meta-analysis suggesting no beneficial effect.
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This well designed trial compares the impact on pulp vitality of step wise verses traditional caries removal. after 5 years. THe findings suggest significantly improved outcomes with the step wise approach.
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This review of stepwise or partial caries removal for deep caries suggesting included 5 studies ( 2 RCTs) of limited quality. Findings suggest better pulpal outcomes with these approaches compare with traditional treatment.
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This review of caries excavation strategies identified 28 studies including 19 RCTs. None were considered to be at low risk of bias . The results suggest that not attempting to remove all softened or stainable dentine could reduce the risk of complications
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There is good evidence for the effectiveness of fissure sealants in the prevention of caries (Dental Elf 8th April 2013) and some evidence for its use in the treatment of carious lesions. There is also evidence for the effectiveness of partial rather complete caries removal (Dental Elf 13th Apr – 2014).The aim of this study [read the full story…]
The aim of this study was to compare 24-month pulp health outcomes of partial caries removal (PCR) and total caries removal (TCR) with composite restoration in primary molars. Children (3–8 years), in good general health and amenable to treatment, with at least one molar with acute, deep carious lesion into dentine were included. The teeth [read the full story…]
