title: Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of partial removal of carious dentine and restoration in a single session (PDR) and stepwise excavation (SW), both of which are treatments for deep carious lesions, in Public Health Services in Brazil.
  
  
  METHODS
  
  
  
  METHODS
  patients ≥6 years old, permanent molars with deep caries lesions (having a radiolucency halfway or more into dentine) and pulp vitality but absence of spontaneous pain, positive percussion test, and periapical alterations. The subjects received either PDR (test group) or SW (control group). The radiological and clinical exams were performed after a mean time of 18 months.
  
  
  RESULTS
  success was defined as pulp sensitivity to cold test and absence of periapical alterations.
  
  
  RESULTS
  Of the 299 treatments performed, 146 were SW and 153 were PDR; 122 were amalgam restorations and 168 resin-composite restorations. There were no differences between the groups regarding the baseline characteristics (i.e. age, gender and family income). After 18 months, 212 evaluations were performed, which indicated 99 and 86% success rates in the PDR and SW groups, respectively (p = 0.016). Reasons for failure were: PDR - 1 pulpitis; SW - 8 pulpitis; 1 osteitis; 4 necrosis; 1 endodontic treatment. None of the baseline variables were significantly associated with the outcomes.
  
  
  CONCLUSIONS
  The retention of carious dentine does not interfere in pulp vitality. Data from this 18-month study suggest that the procedure of reopening the cavity to remove the residual infected dentine is not necessary.
authors.affiliation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil. marisa.maltz@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Maltz
authors.forename: J J
authors.initials: JJ
authors.lastname: Jardim
authors.forename: H D
authors.initials: HD
authors.lastname: Mestrinho
authors.forename: P M
authors.initials: PM
authors.lastname: Yamaguti
authors.forename: K
authors.initials: K
authors.lastname: Podestá
authors.forename: M S
authors.initials: MS
authors.lastname: Moura
authors.forename: L M
authors.initials: LM
authors.lastname: de Paula
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods; D000293:Adolescent; D000328:Adult; D002126:Calcium Hydroxide / Q000737:chemistry; D002648:Child; D003188:Composite Resins / Q000737:chemistry; D003723:Dental Amalgam / Q000737:chemistry; D057087:Dental Atraumatic Restorative Treatment / Q000379:methods*; D003731:Dental Caries / Q000628:therapy*; D003738:Dental Cements / Q000737:chemistry; D003764:Dental Materials / Q000737:chemistry; D003790:Dental Pulp Necrosis / Q000209:etiology; D003791:Dental Pulp Test; D003793:Dental Restoration, Permanent / Q000379:methods; D003804:Dentin / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000737:chemistry; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D011671:Pulpitis / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult; D015035:Zinc Oxide-Eugenol Cement / Q000737:chemistry
chemical_list: D003188:Composite Resins; D003738:Dental Cements; D003764:Dental Materials; C420130:Excite cement; D005899:Glass Ionomer Cements; D008689:Methacrylates; C501891:Tetric EvoCeram; D015035:Zinc Oxide-Eugenol Cement; D003723:Dental Amalgam; D002126:Calcium Hydroxide