Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation

Abstract

This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.

Mineral Trioxide Aggregate Apexogenesis: A Systematic Review

“…Stepwise excavation has been described as a viable minimally invasive procedure in permanent teeth as it permits the maintenance of pulp viability and fosters apexogenesis employing CH. [ 31 ] Biodentine is a biologically active cement that has superior material characteristics and provides an intriguing alternative to CH-based biomaterials. It has the potential for direct pulp capping in appropriately selected cases and may promote sustained preservation of the tooth.…”

Comparison of Two Aerosol-Free Caries Removal Methods - A Split Mouth Randomized Clinical Trial

“…Advanced endodontic treatments in these patients include complex root tip closure treatments such as apexification. 7 It has been reported that the apical closure of vital young permanent teeth can be successfully completed with appropriate indirect vital pulp treatments 8 and that avoiding the complete removal of carious lesions close to the pulp reduces the risk of pulp exposure. 9 The chemo-mechanical caries removal (CMCR) method, one of the minimally invasive caries removal methods, was first described in 1975 by Habib et al, who used 5% sodium hypochlorite.…”