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Article: Complete or ultraconservative removal of decayed tissue in unfilled teeth

TitleComplete or ultraconservative removal of decayed tissue in unfilled teeth
Authors
Issue Date2009
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0045-0421
Citation
Australian Dental Journal, 2009, v. 54 n. 3, p. 274-276 How to Cite?
AbstractBackground: The treatment of deep dental decay has traditionally involved removal of all the soft demineralized dentine before a filling is placed. However, this has been challenged in three groups of studies which involve sealing soft caries into the tooth. The three main groups either remove no caries and seal the decay into the tooth, remove minimal (ultraconservative) caries at the entrance to a cavity and seal the remaining caries in, or remove caries in stages over two visits some months apart to allow the pulp time to lay down reparative dentine (the stepwise excavation technique). Objectives: To test the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp), progression of decay and longevity of restorations irrespective of whether the removal of decay had been minimal (ultraconservative) or complete. Search strategy: The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed and EMBASE databases were searched. The reference lists in relevant papers were checked. Selection criteria: Randomized controlled trials and controlled clinical trials comparing minimal (ultraconservative) caries removal with complete caries removal in unrestored permanent and deciduous teeth. Data collection and analysis: Outcome measures recorded were exposure of the nerve of the tooth (pulp) during caries removal, patient experience of symptoms of pulpal inflammation or necrosis, progression of caries under the filling, time until the filling was lost or replaced. Due to the heterogeneity of the included studies the overall estimate of effect was calculated using a random-effects model. Main results: Four studies met the inclusion criteria; two stepwise excavation studies and two ultraconservative caries removal studies. Partial caries removal in symptomless, primary or permanent teeth reduces the risk of pulp exposure. We found no detriment to the patient in terms of pulpal symptoms in this procedure and no reported premature loss or deterioration of the restoration. Authors' conclusions: The results of this systematic review reject the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp) irrespective of whether the removal of decay had been minimal (ultraconservative) or complete and accepts the null hypothesis of no difference in the progression of decay and longevity of restorations. © 2009 Australian Dental Association.
Persistent Identifierhttp://hdl.handle.net/10722/90591
ISSN
2015 Impact Factor: 1.272
2015 SCImago Journal Rankings: 0.482
References

 

DC FieldValueLanguage
dc.contributor.authorBurrow, Men_HK
dc.contributor.authorRicketts, Den_HK
dc.contributor.authorKidd, Een_HK
dc.contributor.authorInnes, NPTen_HK
dc.contributor.authorClarkson, JEen_HK
dc.date.accessioned2010-09-17T10:05:22Z-
dc.date.available2010-09-17T10:05:22Z-
dc.date.issued2009en_HK
dc.identifier.citationAustralian Dental Journal, 2009, v. 54 n. 3, p. 274-276en_HK
dc.identifier.issn0045-0421en_HK
dc.identifier.urihttp://hdl.handle.net/10722/90591-
dc.description.abstractBackground: The treatment of deep dental decay has traditionally involved removal of all the soft demineralized dentine before a filling is placed. However, this has been challenged in three groups of studies which involve sealing soft caries into the tooth. The three main groups either remove no caries and seal the decay into the tooth, remove minimal (ultraconservative) caries at the entrance to a cavity and seal the remaining caries in, or remove caries in stages over two visits some months apart to allow the pulp time to lay down reparative dentine (the stepwise excavation technique). Objectives: To test the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp), progression of decay and longevity of restorations irrespective of whether the removal of decay had been minimal (ultraconservative) or complete. Search strategy: The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed and EMBASE databases were searched. The reference lists in relevant papers were checked. Selection criteria: Randomized controlled trials and controlled clinical trials comparing minimal (ultraconservative) caries removal with complete caries removal in unrestored permanent and deciduous teeth. Data collection and analysis: Outcome measures recorded were exposure of the nerve of the tooth (pulp) during caries removal, patient experience of symptoms of pulpal inflammation or necrosis, progression of caries under the filling, time until the filling was lost or replaced. Due to the heterogeneity of the included studies the overall estimate of effect was calculated using a random-effects model. Main results: Four studies met the inclusion criteria; two stepwise excavation studies and two ultraconservative caries removal studies. Partial caries removal in symptomless, primary or permanent teeth reduces the risk of pulp exposure. We found no detriment to the patient in terms of pulpal symptoms in this procedure and no reported premature loss or deterioration of the restoration. Authors' conclusions: The results of this systematic review reject the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp) irrespective of whether the removal of decay had been minimal (ultraconservative) or complete and accepts the null hypothesis of no difference in the progression of decay and longevity of restorations. © 2009 Australian Dental Association.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0045-0421en_HK
dc.relation.ispartofAustralian Dental Journalen_HK
dc.titleComplete or ultraconservative removal of decayed tissue in unfilled teethen_HK
dc.typeArticleen_HK
dc.identifier.emailBurrow, M:mfburr58@hku.hken_HK
dc.identifier.authorityBurrow, M=rp01306en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1834-7819.2009.01133.xen_HK
dc.identifier.scopuseid_2-s2.0-70350163959en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-70350163959&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume54en_HK
dc.identifier.issue3en_HK
dc.identifier.spage274en_HK
dc.identifier.epage276en_HK
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridBurrow, M=7005876730en_HK
dc.identifier.scopusauthoridRicketts, D=7005987523en_HK
dc.identifier.scopusauthoridKidd, E=7006335486en_HK
dc.identifier.scopusauthoridInnes, NPT=13610392800en_HK
dc.identifier.scopusauthoridClarkson, JE=7102852990en_HK

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