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Related Experiment Video

Updated: Oct 5, 2025

Scanning Electron Microscopic Evaluation of Surface Defects of Remover Retreatment File After Single and Multiple Uses
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Stepwise removal compared to complete removal for deep carious lesions.

María Massón1, Andrés Viteri-García1, Francisca Verdugo-Paiva2

  • 1Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos.

Medwave
|January 31, 2022
PubMed
Summary

Stepwise removal of carious lesions may reduce risks like pulp exposure and restoration failure compared to complete removal. However, the evidence supporting this dental caries treatment is currently of low certainty.

Keywords:
EpistemonikosGRADE.complete caries removaldeep carious lesionstwo step caries removalstepwise removal

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Area of Science:

  • Dentistry
  • Oral Health
  • Evidence-Based Dentistry

Background:

  • Traditional carious lesion treatment involves complete removal of decayed tissue.
  • Risks associated with complete removal have led to tissue-preserving techniques like stepwise removal.
  • Uncertainty exists regarding the effectiveness and safety of stepwise versus complete removal.

Purpose of the Study:

  • To compare the effectiveness and safety of stepwise carious tissue removal against complete removal.
  • To clarify clinical decision-making regarding carious lesion management.
  • To synthesize existing evidence on dental caries treatment outcomes.

Main Methods:

  • Systematic review and meta-analysis of existing studies.
  • Utilized Epistemonikos database, searching multiple health information sources.
  • Data extraction, reanalysis of primary studies, and GRADE assessment were performed.

Main Results:

  • Three systematic reviews encompassing five primary studies were analyzed.
  • Four of the included primary studies were randomized controlled trials.
  • Stepwise removal showed potential benefits in reducing pulp exposure and restoration failure.

Conclusions:

  • Stepwise removal may decrease the incidence of pulp exposure and associated diseases.
  • This technique might also lower the rate of restoration failure.
  • The certainty of the evidence supporting these findings is currently low, necessitating further research.