Comparison of Partial and Complete Caries Excavation in Permanent Teeth: An 18 Months Follow-up

Abstract

Objective: To compare performance and survival of composite restorations in primary teeth using partial caries removal (PCR) versus complete caries removal (CCR). Methodology: In this trial, 70 permanent molars having deep caries lesions were selected and divided equally into CCR and PCR groups. The study duration was Jan-2018 to Jan-2020. In CCR group, complete dentin removal was done and confirmed by applying dentin detector dye for 10 seconds. In PCR group, visual & tactile criteria were followed for dentin removal. After dentin removal all cavities were filled using RMGIC cement resin. Follow-up was done at 06, 12 and 18 months. Results: Mean age in CCR group was 23.4+5.5 years and 25.6+4.9 years in PCR group. Male patients were 19 and 17 in CCR and PCR groups respectively (p= 0.59). Regarding lesion type, 25 patients in CCR were having occlusal and 5 having Occluso-proximal lesion. In PCR group, 27 teeth were diagnosed with occlusal lesion and 3 with occluso-proximal lesion (p=0.44). At 18 months’ follow-up, success rate was 100% in CCR group and 93.3% in PCR group (p=0.49). Pulp exposure occurred in 23.3% procedures in CCR group and none in PCR group. Conclusion: Partial caries removal has nearly similar success rates as that of complete caries removal and is associated with significantly less pulp exposure rate as compared to CCR. Keywords: Deep carious lesions, Partial caries removal, Complete caries removal, Randomized clinical trial

Deep Carious Lesions Management with Stepwise, Selective, or Non-Selective Removal in Permanent Dentition: A Systematic Review of Randomized Clinical Trials

“…Therefore, the remaining 5 articles met the eligibility criteria and were included in this study ( Table 1 ). The designs presented were: 5 randomized clinical trials [ 14 , 15 , 16 , 17 , 18 ] developed between 2010 and 2021 (k = 1). The flowchart diagram with the study selection process is shown in Figure 1 .…”

“…Table 2 , Table 3 and Table 4 show the characteristics of the included studies. The Ethics Committee approved all articles [ 14 , 15 , 16 , 17 , 18 ] that were selected before starting and registered for data protection. One was a single study [ 14 ], whereas the others presented guidelines for the study design.…”

“…The Ethics Committee approved all articles [ 14 , 15 , 16 , 17 , 18 ] that were selected before starting and registered for data protection. One was a single study [ 14 ], whereas the others presented guidelines for the study design. The articles evaluated and proposed excavation techniques to treat deep carious lesions to guarantee greater longevity.…”

“…Regarding the inclusion and exclusion criteria from the studies, similar clinical parameters were found in order to select and include patients. As for the teeth included in the study, three studies [ 15 , 16 , 18 ] performed management only on permanent molars, while other studies [ 14 , 17 ] also performed management on incisors/canines/premolars/molars. Management protocols were divided into nonselective caries removal and partial caries removal (selective/stepwise).…”

“…The materials were selected and used in all included studies considering whether they were total or partial caries removal. Except for two clinical studies [ 14 , 15 ], the remaining studies accurately referred to information about the materials applied, which were: liner (calcium hydroxide, Dycal ® ), provisional restoration (glass ionomer cement, Ketac Molar ® ), and definitive restoration (Herculite ® Tetric N-Ceram resin; Ivoclar Vivadent or amalgam). The clinical follow ups were considered in terms of short-term, from 1 to 18 months [ 14 , 17 , 18 ], and long-term (5 years) [ 15 , 16 ].…”