This Cochrane review of interventions to treat carious lesions conventionally considered to require restorations in primary or permanent teeth with vital pulps included 27 RCTs. Compared with conventional treatment there were lower numbers of failures with the Hall technique and selective excavation (SE) in primary teeth and with SE and stepwise removal in permanent teeth.
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This review of the efficacy of 3 caries removal strategies (complete, selective and stepwise) in primary teeth included 8 RCTs suggesting a lower risk of pulp exposure with selective and stepwise approaches.
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16 low quality RCTs were included in this review of the effect of calcium hydroxide lining on clinical success in treatment of deep carious lesions. 6 RCTs contributed to the meta-analysis suggesting no beneficial effect.
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This review of stepwise or partial caries removal for deep caries suggesting included 5 studies ( 2 RCTs) of limited quality. Findings suggest better pulpal outcomes with these approaches compare with traditional treatment.
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This review of caries excavation strategies identified 28 studies including 19 RCTs. None were considered to be at low risk of bias . The results suggest that not attempting to remove all softened or stainable dentine could reduce the risk of complications
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The traditional management of caries by the removal of all softened demineralised dentine before a filling is placed is being increasingly challenged. This updated Cochrane review aims to assess the effects of stepwise, partial or no dentinal caries removal compared with complete caries removal for the management of dentinal caries in previously unrestored primary and [read the full story…]
