Restorations after selective caries removal: 5-Year randomized trial.

Area of Science:

• Dentistry
• Dental Materials Science
• Caries Management

Background:

• Deep caries lesions pose a challenge in restorative dentistry, requiring careful management to prevent pulp exposure.
• Selective caries removal to soft dentin (SCRSD) is a technique aimed at preserving tooth structure while removing infected dentin.
• The choice of restorative material (amalgam or resin composite) may influence treatment outcomes.

Purpose of the Study:

• To compare the 5-year survival of dental restorations placed after selective caries removal to soft dentin (SCRSD) versus stepwise excavation (SW).
• To investigate if the restorative material (amalgam or resin composite) impacts restoration survival in deep caries lesions.

Main Methods:

• A multicenter randomized controlled clinical trial (NCT00887952) included permanent molars with deep caries.
• Teeth were randomized to SCRSD or SW, with further division by filling material: amalgam (AM) or resin composite (RC).
• Survival analyses using an adjusted Weibull regression model estimated therapy success rates over 5 years.

Main Results:

• 172 restorations were evaluated (95 SCRSD, 77 SW; 61 AM, 111 RC).
• Five-year survival analysis revealed similar success rates for SW (76%) and SCRSD (79%).
• Amalgam and resin composite restorations exhibited comparable survival rates (p > 0.05).

Conclusions:

• Leaving decayed tissue beneath restorations in deep caries lesions does not appear to compromise restoration survival after 5 years.
• Both SCRSD and SW techniques result in similar restoration longevity.
• Amalgam and resin composite demonstrate comparable survival rates, irrespective of the caries removal method employed.