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01-02-2020 | Caries | Review

Selective, stepwise, or nonselective removal of carious tissue: which technique offers lower risk for the treatment of dental caries in permanent teeth? A systematic review and meta-analysis

Authors: Myrna Maria Arcanjo Frota Barros, Maria Imaculada De Queiroz Rodrigues, Francisco Wilker Mustafa Gomes Muniz, Lidiany Karla Azevedo Rodrigues

Published in: Clinical Oral Investigations | Issue 2/2020

Abstract

Objectives

This study aimed to systematically review the literature regarding the risk of selective removal—in comparison with stepwise and nonselective removal—of carious tissue in permanent teeth.

Materials and methods

Controlled clinical trials and cohort studies involving patients with dental caries in permanent teeth were included. Databases used were PubMed, Embase, and Scopus. The test group should be composed of patients undergoing selective removal of carious tissues, and the control group should comprise patients undergoing nonselective removal and/or stepwise removal of carious tissue. Laboratory tests, studies on primary teeth, and studies that used temporary restorations were excluded, as were literature reviews. The primary outcome was overall success of maintaining pulpal health (both clinically and radiographically). Quality of the restoration, pulp exposure, dentin deposition, and microbiological examination were also assessed. A meta-analysis, using the pooled risk ratio (RR) and its 95% confidence interval (CI), was performed to assess the success of maintaining pulpal health, using the different control treatments as a subgroup analysis.

Results

A total of 2333 articles were retrieved, of which 10 were included in the systematic review and four in the meta-analysis. In the qualitative evaluation, the control groups presented a higher risk of pulp exposure in relation to the selective removal. In the meta-analysis, the selective carious tissue removal showed significantly higher overall success (RR, 95% CI 1.11, 1.02–1.21).

Conclusions

The selective carious tissue removal presented higher success of maintaining pulpal health.

Clinical relevance

In permanent teeth, selective carious tissue removal should be performed, as this technique results in lower numbers of pulp complications, such as pulp exposure, as compared with nonselective removal.

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Title: Selective, stepwise, or nonselective removal of carious tissue: which technique offers lower risk for the treatment of dental caries in permanent teeth? A systematic review and meta-analysis
Authors: Myrna Maria Arcanjo Frota Barros
Maria Imaculada De Queiroz Rodrigues
Francisco Wilker Mustafa Gomes Muniz
Lidiany Karla Azevedo Rodrigues
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keyword: Caries
Published in: Clinical Oral Investigations / Issue 2/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-03114-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Selective, stepwise, or nonselective removal of carious tissue: which technique offers lower risk for the treatment of dental caries in permanent teeth? A systematic review and meta-analysis

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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