Incomplete caries removal in deep lesions: a 10-year prospective study

Area of Science:

• Dentistry
• Endodontics
• Cariology

Background:

• Deep caries lesions pose a significant challenge in restorative dentistry.
• Incomplete caries removal is a controversial technique aiming to preserve pulp vitality.

Purpose of the Study:

• To evaluate the long-term (10-year) clinical and radiographic outcomes of incomplete caries removal in permanent posterior teeth with deep caries lesions.

Main Methods:

• A single-arm prospective study included 32 permanent posterior teeth in 27 subjects at risk of pulp exposure.
• Procedures involved incomplete caries removal from the pulpal wall, calcium hydroxide capping, and sealing with modified zinc oxide-eugenol cement.
• Clinical and radiographic assessments were performed at multiple intervals up to 10 years, with success defined as pulp vitality and failure as the need for endodontic treatment.

Main Results:

• The overall survival rate was 63% at the 10-year follow-up.
• Therapy failure occurred in 10 teeth (fractures, necrosis leading to endodontic treatment, or extraction).
• Teeth with two or more restored surfaces demonstrated a significantly higher failure rate (P=0.01).

Conclusions:

• Incomplete caries removal can achieve pulp vitality in a significant proportion of deep caries lesions over 10 years.
• The technique's success may be influenced by factors such as the extent of tooth restoration.
• Further research is warranted to optimize patient selection and treatment protocols for incomplete caries removal.