• Menu
  • Skip to right header navigation
  • Skip to main content
  • Skip to primary sidebar

Biomimetic Dentistry

Less drilling! More healing!

  • Home
  • Literature
    • Thermo Cure
    • Mineralisation
    • Toxicity
    • Biocompatibility
    • Clinical Experiments
    • Compressive Strength and Flexual Strength
    • Core Builds Ups
    • Test Protocols
    • Coating
    • Sealants
  • How To Make
  • Videos
  • News
  • About Us
  • Contact
  • Calendar
  • Home
  • Literature
    • Thermo Cure
    • Mineralisation
    • Toxicity
    • Biocompatibility
    • Clinical Experiments
    • Compressive Strength and Flexual Strength
    • Core Builds Ups
    • Test Protocols
    • Coating
    • Sealants
  • How To Make
  • Videos
  • News
  • About Us
  • Contact
  • Calendar

Effects of using different criteria for caries removal: a systematic review and network meta-analysis

5 January 2015 //  by Biodentistry.eu//  Leave a Comment

Schwendicke F1, Paris S2, Tu YK3.

Author information:

  • 1Department of Operative and Preventive Dentistry, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany. Electronic address: falk.schwendicke@charite.de.
  • 2Department of Operative and Preventive Dentistry, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany.
  • 3Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Abstract
OBJECTIVES:
Conventionally, caries excavation is performed until only hard dentine remains, while more selective and reliable criteria might be available. We aimed at systematically comparing the effects of using different excavation criteria via network meta-analysis.

SOURCES:
Electronic databases were searched for randomised or non-randomised clinical trials (RCTs/NRCTs) evaluating excavation of cavitated lesions.

DATA:
Criteria were divided into six groups: Excavation until pulpo-proximal dentine on the cavity floor was (1) either hard on probing, (2) slightly softened on probing, (3) not stainable by caries-detector-dye, or until (4) self-limiting polymer burs, (5) fluorescence-assisted devices or (6) chemo-mechanical gels indicated termination of the excavation. Evaluation of risk of complications, risk of pain/discomfort, excavation time, and number of remaining bacteria were then undertaken using Bayesian network meta-analysis.

STUDY SELECTION:
28 studies (19 RCTs, 9 NRCTs) with 1782 patients (2555 lesions), most of them investigating primary teeth, were included. Risk of complications was highest when excavating until only non-stainable dentine remained, and lowest when not attempting to remove all softened dentine. Risk of pain significantly decreased if self-limiting chemo-mechanical excavation or fluorescence-assisted lasers were used instead of excavating until all dentine was hard. When not attempting to remove all softened dentine, the time required for excavation was shortest, whilst the greatest number bacteria remained.

CONCLUSIONS:
Not attempting to remove all softened or stainable dentine might reduce the risk of complications. Data regarding self-limiting excavation is insufficient for definitive conclusions. Excavation criteria should be validated against clinically relevant outcomes.

CLINICAL SIGNIFICANCE:
Given current evidence, dentists might not need to attempt excavation until only hard dentin remains in proximity to the pulp. Instead, their choice of excavation criterion or method should be guided by clinical requirements and outcomes.

Copyright © 2014 Elsevier Ltd. All rights reserved.

PMID: 25456612 [PubMed – in process]

Category: Clinical Experiments

Previous Post: « Cost-effectiveness of caries excavations in different risk groups – a micro-simulation study
Next Post: Effects of porous-hydroxyapatite incorporated into glass-ionomer sealants »

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Primary Sidebar

Upload

Click here to upload a picture

Mineralisation In Vivo

Latest News

  • SMART Pedodontic Conference 2023 2 September 2023
  • VIII Scientific and Training Conference of Pediatric Dentistry 2 September 2023
  • Biomimetic Dentistry at Smiles World 2 September 2023
  • Effects of storage media on the flexural strength of GIC 5 June 2020
  • Biomimetic Dentistry in Indonesia 18 January 2020

About

Biomimetic Dentistry is a new way of dentistry which takes advantages of the natural mineralization processes in the mouth without using harmfully products.

Copyright © 2023 · Powered by Ter Hoeven Services