IADR Abstract Archives
1-Year Clinical Follow-up of Selective Caries Removal in Deep Dentin Carious Lesions
Objectives: Objective: This clinical study aimed to observe the success of stepwise removal or one-step excavation techniques in deep dentin caries.
Methods: Method: Forty permanent teeth with caries lesions penetrating to 75% or more of dentin were included. For both one-step excavation and the first stage of stepwise removal, same procedure was applied, in which peripheral dentin was prepared to hard dentin by high-speed diamond and low-speed steel bur. Then, selective removal to soft dentin was carried out using a hand instrument over the pulp. Pure calcium hydroxide followed by zinc-oxide eugenol cement (Alganol, Kemdent®) was placed on pulpal walls of the cavities. Conventional glass-ionomer cement (KetacTM Molar Quik Applicap, 3M ESPE) was used for temporary filling.
Evaluations were performed at the sixth-month according to clinical symptoms and radiographic sings. At the same session, the cavities of stepwise group were re-entered and selective removal was applied to firm dentin via hand excavator. For one-step group, glass ionomer restorations were prepared as the base for final restorations. All cavities in this study were permanently restored with resin composite (G-aenial® Posterior, GC).
Results: At the end of the one-year observation period, pulpal success of this study was 100% for one-step excavation technique while 84.21% was for the stepwise group. As a result of re-entry procedure, pulp exposure occurred on seven of teeth (37%) in the stepwise removal group, while vitally survived after one-year. Failure in this group was due to chronic inflammation of three teeth afterward they were treated with root canal therapy.
Conclusions: Within the limitation of this study, it seemed that one-step excavation technique presented better performance compared to stepwise removal. Additionally, stepwise removal led to pulp exposure more than expected and it maybe better to reconsider re-entry.
Methods: Method: Forty permanent teeth with caries lesions penetrating to 75% or more of dentin were included. For both one-step excavation and the first stage of stepwise removal, same procedure was applied, in which peripheral dentin was prepared to hard dentin by high-speed diamond and low-speed steel bur. Then, selective removal to soft dentin was carried out using a hand instrument over the pulp. Pure calcium hydroxide followed by zinc-oxide eugenol cement (Alganol, Kemdent®) was placed on pulpal walls of the cavities. Conventional glass-ionomer cement (KetacTM Molar Quik Applicap, 3M ESPE) was used for temporary filling.
Evaluations were performed at the sixth-month according to clinical symptoms and radiographic sings. At the same session, the cavities of stepwise group were re-entered and selective removal was applied to firm dentin via hand excavator. For one-step group, glass ionomer restorations were prepared as the base for final restorations. All cavities in this study were permanently restored with resin composite (G-aenial® Posterior, GC).
Results: At the end of the one-year observation period, pulpal success of this study was 100% for one-step excavation technique while 84.21% was for the stepwise group. As a result of re-entry procedure, pulp exposure occurred on seven of teeth (37%) in the stepwise removal group, while vitally survived after one-year. Failure in this group was due to chronic inflammation of three teeth afterward they were treated with root canal therapy.
Conclusions: Within the limitation of this study, it seemed that one-step excavation technique presented better performance compared to stepwise removal. Additionally, stepwise removal led to pulp exposure more than expected and it maybe better to reconsider re-entry.