Critical appraisal. 2015 Update: Approaches to Caries Removal

Area of Science:

• Dentistry
• Endodontics
• Restorative Dentistry

Background:

• Deep caries lesions in vital teeth frequently lead to pulp exposure during complete caries removal.
• This complication increases treatment complexity and cost, often leaving extraction as the only option.
• Previous appraisals highlighted the need for alternative treatments to preserve tooth vitality.

Purpose of the Study:

• To update the critical appraisal of treatments for deep caries lesions in vital teeth.
• To evaluate newer evidence supporting alternatives to complete caries removal that avoid pulp exposure.
• To identify strategies for preserving tooth vitality and preventing extraction.

Main Methods:

• Systematic review of recent literature, including three systematic reviews and one large randomized controlled trial (RCT).
• Critical appraisal of evidence published since the 2013 review.
• Analysis of treatment outcomes focusing on pulp vitality preservation and avoidance of extraction.

Main Results:

• Newer, higher-quality evidence is now available regarding treatments for deep caries.
• Evidence supports alternative treatment modalities that aim to preserve the vitality of the tooth.
• These alternative approaches can potentially avoid the need for extraction.

Conclusions:

• Alternative treatments for deep caries lesions in vital teeth are supported by recent high-quality evidence.
• Preserving tooth vitality through these methods can reduce treatment complexity and cost.
• These findings offer viable alternatives to extraction for patients with deep caries.