Does the Depth of the Cavity and the Activity of the Lesion in Primary Molars Influence in the Success of the Restoration?

Objectives: The aim of this clinical trial was to test if the activity and the depth of occlusal carious lesions in primary molars influence the the clinical outcome (restoration survival, pain, fistula/abscess), following selective carious removal.
Methods: Children aged 4 to 6 years old presenting at least one occlusal cavitated carious lesion without pulp exposure, abscess or fistula were included. Bitewing X-rays were taken and assessed by an independent examiner who classified the cavities in medium (involving up to half of dentine n=25) or deep lesions (involving more than half of dentine n=20). A calibrated examiner clinically judged the cavities with respect to activity using a pre-tested lesion activity scoring system (k = 0.90) in low (n=24 )and in high activity (n=21) lesions. High-viscosity glass ionomer (Equia Forte, GC America) restorations were placed after selective caries removal up to hard (n=16) or leathery/soft dentine (n=29) and were assessed by an independent examiner using the ART criteria.
Results: Children mean age was 4.37 (±0.67). The mean evaluation time was 13.3 (±4.5) months. Three restorations failures were observed (94% of success rate) in teeth presenting the following characteristics: 2 cavities of the medium and 1 of the deep group, from which 2 were judged as being of high activity and 1 of low activity post-excavation. All cavities were excavated up to leathery/soft dentine, except one. There was only one report of pain (deep group) and no fistula was observed.
Conclusions: Both cavity depth and caries lesion activity seem not to influence the restoration’s survival, the report of pain and the observation of fistula/abscess on a short term 1-yr basis. Moreover, selective caries removal was effective in preserving tooth vitality.