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Selective carious tissue removal using subjective criteria or polymer bur: study protocol for a randomised controlled
Falk Schwendicke1, Soraya Leal2, Peter Schlattmann3
1Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany.
BMJ Open
|December 16, 2018
Summary
This study compares subjective versus objective methods for removing deep tooth decay in primary teeth. Objective removal using self-limiting burs may improve reliability and reduce complications in pediatric dental care.
Area of Science:
- Dentistry
- Pediatric Dentistry
- Cariology
Background:
- Selective carious tissue removal is used for deep lesions in vital primary teeth, leaving softer dentin near the pulp to prevent exposure.
- Subjectivity in assessing dentin hardness can affect treatment reliability.
- Self-limiting burs offer a standardized approach to carious tissue removal.
Purpose of the Study:
- To compare subjective selective carious tissue removal with objective removal using a self-limiting bur (Polybur, Komet) in primary teeth.
- To evaluate the reliability and effectiveness of standardized carious tissue removal in pediatric dental patients.
- To assess complications, extraction needs, child satisfaction, and cost-effectiveness.
Main Methods:
- A community-based, single-blind, clustered randomized controlled superiority trial involving 115 children aged 6-8 years.
- Children were randomized, with all eligible molars treated identically using either subjective or objective carious tissue removal.
- Teeth were restored with glass ionomer cement, and outcomes were evaluated over 36 months.
Main Results:
- The trial is ongoing, with data collection and analysis planned over 36 months.
- Primary outcome is time to complications; secondary outcomes include time to extraction, child satisfaction, and cost-effectiveness.
- Final examination is expected in 2020, with results to be published.
Conclusions:
- Objective carious tissue removal with self-limiting burs may offer a more reliable alternative to subjective methods.
- Further analysis of the trial data will determine the clinical and cost-effectiveness of standardized carious tissue removal.
- The findings will inform best practices in treating deep carious lesions in primary teeth.
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