Abstract
Data sources
Searches for studies were made using the databases: Medline, Evidence-based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and OVID's Database of Abstracts of Reviews of Effects.
Study selection
Only studies reported in English with human participants were included. Randomised controlled trials (RCT) and relevant observational studies were included. No other inclusion or exclusion criteria are described.
Data extraction and synthesis
A formal data extraction process is not described and a qualitative description of the included studies is provided.
Results
Ten articles reporting six studies were included. The results of three RCT, one with a followup period of 10 years, provide evidence supporting the practice of leaving behind infected dentine, the removal of which would risk pulp exposure. A number of other studies show that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either remain dormant or die and thus pose no risk to the health of the dentition.
Conclusions
There is substantial evidence that, for caries management, it is not necessary to remove all vestiges of infected dentin from lesions approaching the pulp.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Barthel CR, Rosenkranz B, Leuenberg A, Roulet JF . Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 2000; 26:525–528.
Ricketts DN, Kidd EA, Innes N, Clarkson J . Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev 2006; issue 3.
Maltz M, de Oliveira EF, Fontanella V, Bianchi R . A clinical, microbiologic, and radiographic study of deep caries lesions after incomplete caries removal. Quintessence Int 2002; 33:151–159.
Fairbourn DR, Charbeneau GT, Loesche WJ . Effect of improved Dycal and IRM on bacteria in deep carious lesions. J Am Dent Assoc 1980; 100:547–552.
Bjørndal L, Larsen T . Changes in the cultivable flora in deep carious lesions following a stepwise excavation procedure. Caries Res 2000; 34:502–508.
Paddick JS, Brailsford SR, Kidd EA, Beighton D . Phenotypic and genotypic selection of microbiota surviving under dental restorations. Appl Environ Microbiol 2005; 71:2467–2472.
Author information
Authors and Affiliations
Additional information
Address for correspondence: Dr R Craig, Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, 345 East 24th Street/ 1001S, New York NY 10010–4086, USA. E-mail: rgc1@nyu.edu
Thompson V, Craig RG, Curro FA, Green WS, Ship JA. Treatment of deep carious lesions by complete excavation or partial removal. A critical review. J Am Dent Assoc 2008; 139:705–712
Rights and permissions
About this article
Cite this article
Ricketts, D. Deep or partial caries removal: which is best?. Evid Based Dent 9, 71–72 (2008). https://doi.org/10.1038/sj.ebd.6400592
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6400592
This article is cited by
-
Sealing versus partial caries removal in primary molars: a randomized clinical trial
BMC Oral Health (2014)
-
Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques
British Dental Journal (2013)
-
Minimal intervention dentistry: part 1. From 'compulsive' restorative dentistry to rational therapeutic strategies
British Dental Journal (2012)
