The Effectiveness of the Partial Caries Removal as a Treatment Option in Deep Carious Lesion Management- Review

Abstract

Background: Dental caries is a widely prevalent disease, burdening billions of individuals and causing significant healthcare costs. The treatment of deep carious lesions approaching a healthy pulp presents a significant challenge to the practitioner. The traditional management of carious lesions indicates the removal of all infected and affected dentin providing intact tissues for the restoration that carried risks exposing or even breaching the pulp, to minimize that risk alternative concepts of caries removal provided such Stepwise technique and Partial caries excavation technique. Objectives: To evaluate the effectiveness of the partial caries removal technique by analyzing previous literatures discussing the management of deep carious lesions in permanent and primary teeth. The data were collected from five randomized control trails, four systematic reviews, one critical review and two retrospective studies that comparing between partial caries removal and other techniques in deep carious lesions management and the clinical and radiographical outcome of this technique and also the survival of restorations and the risk factors associated with the partial caries removal. Results: Partial caries removal is preferable to complete caries removal in the deep lesion to reduce the risk of carious exposure. There is no need to reopen a cavity and perform a second excavation for pulp vitality to be preserved. There was no adverse events relating to soft demineralized dentin left on the pulpal wall of the cavity were observed ,making partial caries removal advantageous, particularly in the treatment of caries in proximity to the pulp. Partial caries removal restorations showed high rates of clinical and radiographical and the failure due to patient related factors such as high caries rate. Conclusion: With the limitation of the study, the partial caries removal technique show high success rate both clinical and radiographical. It's reduced the incidence of pulp exposure and preserves tooth vitality. Partial caries removal can be considered as a treatment option in deep carious lesion management in primary and permanent teeth.

Evaluation of the Remineralizing Effect of Natural Versus Synthetic Materials on Deep Carious Dentin

“…Stepwise excavation has also been advocated to avoid the high cost of invasive root canal treatment, which requires expensive equipment, supplies and highly trained dental health staff. These factors limit access to dental care in countries where financial, human and structural resources are scanty (11) .…”

Postoperative Hypersensitivity and Digital Radiographic Assessment of a Zinc Modified Versus a Conventional Glass Ionomer Cement in Deep Carious Lesion: Randomized Controlled Clinical Trial

“…It showed high success rate both clinically and radiographically. (11,12) In our study, we use two different type of high viscosity glass ionomer as with the Minamata Convention the use of mercury will be phased down and this undoubtedly will influence dental treatment regimens and economic resources (14) . Zinc modified glass ionomer is a new one of metal modified glass ionomer as zinc substitution calcium ions in the crystalline structure of glass ionomer resulted in increasing the density of glass as zinc due to higher atomic dentist of zinc ion.…”