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Related Experiment Video

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Long-Term Treatment Success Rate after Stepwise Caries Removal: A Registry Study.

Joy Malmberg1, Anders Hedenbjörk-Lager2

  • 1Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden, joy.malmberg@mau.se.

Caries Research
|March 17, 2026
PubMed
Summary

Stepwise caries removal procedure (SWP) shows over 60% success after nine years for deep caries, especially in younger patients and premolars. Factors like age and caries risk influence outcomes.

Keywords:
Big dataDeep caries managementRegistry researchStepwise caries removal procedureTreatment success rate

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Area of Science:

  • Dentistry
  • Dental Public Health
  • Caries Management

Background:

  • Deep caries lesions pose a significant challenge in restorative dentistry.
  • Assessing the long-term efficacy of minimally invasive caries removal techniques is crucial for clinical practice.
  • The Stepwise Caries Removal Procedure (SWP) aims to preserve tooth structure while managing deep caries.

Purpose of the Study:

  • To evaluate the treatment success rate of teeth managed with the Stepwise Caries Removal Procedure (SWP).
  • To analyze factors influencing the long-term outcomes of SWP using a large registry dataset.

Main Methods:

  • Retrospective analysis of longitudinal data from the SKaPa registry (January 1, 2013 - April 1, 2022).
  • Inclusion criteria: SWP-treated teeth with at least one follow-up visit; exclusion: endodontic treatment or extraction.
  • Statistical analysis included Kaplan-Meier survival analysis (p<0.01) and descriptive statistics.

Main Results:

  • 111,771 teeth were analyzed, with molars being the most frequent group (71.5%).
  • A treatment success rate exceeding 60% was observed at 110 months for deep caries lesions treated with SWP.
  • Younger age was significantly associated with a higher survival rate (p=0.00).

Conclusions:

  • SWP demonstrates a favorable overall treatment success rate of over 60% after nine years, even for teeth with initially poor prognoses.
  • Tooth group (premolars showing better prognosis), patient age (under 40), and caries risk (low/medium) are significant factors impacting SWP outcomes.