Treatment of deep carious lesions by complete excavation or partial removal A critical review

Thompson Van Thompson, Ronald G. Craig, Fredrick A. Curro, William S. Green, Jonathan A. Ship

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)705-712
Number of pages8
JournalJournal of the American Dental Association
Volume139
Issue number6
StatePublished - Jun 2008

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Keywords

  • Alternative restorative treatment
  • Deep caries
  • Deep carious lesions
  • Indirect pulp capping
  • Partial caries removal
  • Pulpal exposure
  • Stepwise excavation

ASJC Scopus subject areas

  • Dentistry(all)

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