title: Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth.
abstract: OBJECTIVE
  This randomized clinical trial aimed to compare the 24-months survival of composite restorations in primary molars after partial caries removal (PCR) and total caries removal (TCR).
  
  
  METHODS
  Forty-eight children aged 3-8 years with at least one molar with a deep carious lesion were included (PCR; n=66; TCR; n=54). For PCR, excavation was stopped when dentine with a leathery consistency was achieved; in the TCR group, total absence of carious tissue was confirmed using a blunt-tipped probe. Pulpotomy was performed in cases of pulp exposure. Success was assessed by modified USPHS criteria with Alpha and Bravo scores recorded as success.
  
  
  RESULTS
  Pulp exposure occurred in 1 and 15 of the teeth treated with PCR and TCR respectively (p<0.01). The restorations survival rate after 24 months was 66% (PCR) and 86% (TCR) (p=0.03). When teeth that received pulpotomy were analyzed separately, the survival rate was 92% (p=0.09). PCR performed in occlusoproximal restorations demonstrated the lowest success rate (p=0.002). PCR increases 2.90 times the probability of having a restorative failure compared to TCR (p=0.03), after adjusting for cavity type. When pulp exposure and restoration failure were considered as the outcome, there was no significant difference between the two groups (p=0.10) with success rates of 64% (PCR) and 61% (TCR).
  
  
  CONCLUSIONS
  Collectively, deciduous teeth submitted to PCR prevented pulp exposure and, consequently, more invasive treatments; otherwise, PCR yielded lower longevity for composite restoration compared to TCR, suggesting that PCR restorations need to be followed over time, especially when multi-surface restorations are involved.
  
  
  CONCLUSIONS
  Composite restorations on carious remaining tissue require monitoring over time, especially those performed in more than one surface. Even if the restorations present shortcomings over the time, the majority of them are subject to repair, allowing more conservative approaches for teeth with deep caries lesions.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: renatafranzon@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Franzon
authors.affiliation: Department of Preventive and Restorative Dentistry, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: N J
authors.initials: NJ
authors.lastname: Opdam
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: L F
authors.initials: LF
authors.lastname: Guimarães
authors.affiliation: Post-Graduate Program in Dentistry and Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: F F
authors.initials: FF
authors.lastname: Demarco
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Casagrande
authors.affiliation: Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: A N
authors.initials: AN
authors.lastname: Haas
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: F B
authors.initials: FB
authors.lastname: Araujo
mesh_terms: D002648:Child; D002675:Child, Preschool; D003188:Composite Resins / Q000627:therapeutic use*; D003731:Dental Caries / Q000628:therapy*; D003737:Dental Cavity Preparation; D003789:Dental Pulp Exposure / Q000473:pathology / Q000517:prevention & control; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D003804:Dentin / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar / Q000473:pathology; D011672:Pulpotomy; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D003188:Composite Resins
keywords: Clinical trial; Composite resin; Dental caries; Incomplete excavation; Primary tooth