Clinical evaluation of three caries removal approaches in primary teeth: a randomised controlled trial

To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques.

Randomised clinical controlled trial.

Two standard dental clinics in 2 hospitals near Bangkok.

A total of 276 children, aged 6-11, having dentinal caries on the occlusal and/or proximal surface extending at least one-third of dentine without signs and/or symptoms of irreversible pulpitis.

Children were randomly allocated into 3 study groups with different caries removal techniques: Group 1, partial soft caries removal at enamel-dentine junction (EDJ) by spoon excavation; Group 2, complete soft caries removal by spoon excavation; and Group 3, conventional caries removal by steel burs. All cavity preparations were restored with GIC (Fuji IX, GC Corp., Japan).

Clinical and radiographic evaluations were carried out at 6 and 12 months after restoration.

After 12 months, 89, 89, and 88 restorations in Groups 1, 2 and 3 were evaluated. The cumulative survival rates of GIC restorations in Groups 1, 2 and 3 were 83%, 83%, and 89% while the cumulative survival rates of pulp were 99%, 100% and 98% respectively. There were no statistically significant differences in the survival of GIC restorations or pulp in the three groups (p > 0.05).

The clinical and radiographic evaluations after 12 months indicated that partial soft caries removal at EDJ followed by GIC restoration was comparable to that of ART and conventional approaches.