The latest reports showing the basics rules of dentine excavation should be changed. Universities are still teaching complete carious removal with the risk of complications like endodontic treatment and fractures. This dogma is not based on evidence. In fact it’s the opposite resent reports (see down!) are showing the lesser you remove the better the short and long term prognoses for young and old patients with low and high risk.
We advice you to remove according ART technique t remove only the very soft layer which can be easily removed with hand excavation tools or plastic excavation drills!
1) Caries Res. 2013;47(2):103-9. doi: 10.1159/000344013. Epub 2012 Nov 28.
Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results.
Maltz M1, Jardim JJ, Mestrinho HD, Yamaguti PM, Podestá K, Moura MS, de Paula LM.
2) J Clin Pediatr Dent. 2014 Spring;38(3):185-92.
Minimally invasive clinical approach in indirect pulp therapy and healing of deep carious lesions.
Opal S, Garg S, Dhindsa A, Taluja T.
3) J Dent. 2015 Jan;43(1):1-15. doi: 10.1016/j.jdent.2014.10.004. Epub 2014 Oct 22.
Effects of using different criteria for caries removal: a systematic review and network meta-analysis.
Schwendicke F1, Paris S2, Tu YK3.
4) J Dent Res. 2012 Nov;91(11):1026-31. doi: 10.1177/0022034512460403. Epub 2012 Sep 14.
Randomized trial of partial vs. stepwise caries removal: 3-year follow-up.
Maltz M1, Garcia R, Jardim JJ, de Paula LM, Yamaguti PM, Moura MS, Garcia F, Nascimento C, Oliveira A, Mestrinho HD.
5) Cochrane Database Syst Rev. 2013 Mar 28;3:CD003808. doi: 10.1002/14651858.CD003808.pub3.
Operative caries management in adults and children.
Ricketts D1, Lamont T, Innes NP, Kidd E, Clarkson JE.