TY - JOUR
T1 - Treatment of deep carious lesions by complete excavation or partial removal A critical review
AU - Van Thompson, Thompson
AU - Craig, Ronald G.
AU - Curro, Fredrick A.
AU - Green, William S.
AU - Ship, Jonathan A.
PY - 2008/6
Y1 - 2008/6
N2 - Background. The classical approach to treatment of deep carious lesions approaching the pulp mandates removing all infected and affected dentin. Several studies call this approach into question. Types of Studies Reviewed. A search of five electronic databases using selected key words to identify studies relating to partial versus complete removal of carious lesions yielded 1,059 reports, of which the authors judged 23 to be relevant. Three articles reported the results of randomized controlled trials. Results. The results of three randomized controlled trials, one of which followed up patients for 10 years, provide strong evidence for the advis: ability of leaving behind infected dentin, the removal of which would put the pulp at risk of exposure. Several additional studies have demonstrated that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either die or remain dormant and thus : pose no risk to the health of the dentition. Clinical Implications. There is substantial evidence that removing all vestiges of infected dentin from lesions approaching the pulp is not required for caries management.
AB - Background. The classical approach to treatment of deep carious lesions approaching the pulp mandates removing all infected and affected dentin. Several studies call this approach into question. Types of Studies Reviewed. A search of five electronic databases using selected key words to identify studies relating to partial versus complete removal of carious lesions yielded 1,059 reports, of which the authors judged 23 to be relevant. Three articles reported the results of randomized controlled trials. Results. The results of three randomized controlled trials, one of which followed up patients for 10 years, provide strong evidence for the advis: ability of leaving behind infected dentin, the removal of which would put the pulp at risk of exposure. Several additional studies have demonstrated that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either die or remain dormant and thus : pose no risk to the health of the dentition. Clinical Implications. There is substantial evidence that removing all vestiges of infected dentin from lesions approaching the pulp is not required for caries management.
KW - Alternative restorative treatment
KW - Deep caries
KW - Deep carious lesions
KW - Indirect pulp capping
KW - Partial caries removal
KW - Pulpal exposure
KW - Stepwise excavation
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U2 - 10.14219/jada.archive.2008.0252
DO - 10.14219/jada.archive.2008.0252
M3 - Review article
C2 - 18519994
AN - SCOPUS:46649110949
SN - 0002-8177
VL - 139
SP - 705
EP - 712
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 6
ER -