Table 1.
Published randomized controlled trials comparing different excavations of dentin caries in deciduous molars
| Study | Study type; setting; country | Participants (age); teeth; lesion | Intervention (number of teeth) | Control (number of teeth) | Follow-up, drop-out | Pulp exposure (PE) |
|---|---|---|---|---|---|---|
| Pulp symptoms (PS) | ||||||
| Failure (F) | ||||||
| Caries progression (CP) | ||||||
| Leksell et al. 1996 [11] | Multicenter parallel-group RCT; university and clinics; Sweden | 116 (6-16); 134 primary molars; caries with ‘risk of pulp exposure’ | Stepwise (64) (‘remaining innermost layer of carious dentin’ left); re-entry after 8-24 weeks | CR (70) (‘hard’) | 24 weeks, 4.3% yearly | PE: 18% stepwise, 40% CR |
| PS: Non-exposed teeth remained asymptomatic | ||||||
| F: 0% stepwise, 0% CR | ||||||
| Foley et al. 2004 [12] | Split-mouth RCT; university; Scotland | 44 (3-9); 120 primary molars; dentin caries | Selective (36) restored with BCC and GIC; one-step (43) restored with just GIC | CR (41) | 24 months, 11% yearly | PS: More abscesses in BCC group |
| F: 23% GIC, 33% BCC, 22% CR | ||||||
| CP: Caries increase highest in CR | ||||||
| Ribeiro et al. 1999 [13] | Parallel-group RCT; university; Brazil | 38 (7-11); 48 primary molars; dentin caries without risk of pulp exposure | Selective (24) (‘partially removed, soft and moist dentine left’) | CR (24) (dye) | 12 months, 0% yearly | PS: 0% selective, 4% CR |
| F: 0% selective, 4% CR | ||||||
| CP: 25% selective | ||||||
| Orhan et al. 2010 [14] | Parallel-group RCT; university; Turkey | 123 (4-15); 154 (94 deciduous and 60 permanent) molars; caries >3/4 dentin | Stepwise (50) (‘thin layer of soft tissue left’); Stepwise (49); re-entry after 3 months | CR (55) | 12 months, 0% yearly | PE: 6% selective, 8% stepwise, 22% CR |
| PS: 0% selective, 2% stepwise, 5% CR | ||||||
| F: 0% selective, 2% stepwise, 5% CR | ||||||
| Magnusson and Sundell, 1977 [15] | Parallel-group quasi-RCT; university; Sweden | 62 (5-10); 110 primary molars; caries ‘considered for stepwise excavation’ | Stepwise (55) (‘soft layer of dentin over the pulp’); re-entry after 4-6 weeks | CR (55) (‘until hard’) | No follow-up | PE: 11% stepwise, 53% CR |
| PS: 5% stepwise, CR not followed-up | ||||||
| Heinrich et al. 1991 [16] | Parallel-group RCT; university; Germany | 125 (6-7); 125 primary molars; deep caries | Stepwise (52) (‘slightly soft’); re-entry after 6-8 weeks | CR (52) (‘hard with explorer’) | 16 months, 12% yearly | PE: 15% stepwise, 31% CR |
| PS: 6% stepwise, 13% CR | ||||||
| F: 6% stepwise, 13% CR | ||||||
| Lula et al. 2009 [17] | Parallel-group RCT; university; Brazil | 30 (5-8); 36 primary molars; caries >1/2 dentin | Selective (18) (‘only superficial necrotic dentin removed from the pulpal and axial walls’) | CR (18) (dye) | 6 months, 5.7% yearly | PE: 0% selective, 22% CR |
| PS: 0% selective, 7% CR | ||||||
| F: 0% selective, 14% CR | ||||||
| Phonghanyudh et al. 2012 [18] | Bi-centered parallel-group RCT; dental hospitals; Thailand | 276 (6-11); 276 primary molars; caries ≥1/3 | Selective (92) (‘soft carious tissues at EDJ completely removed, without further removal of carious dentin’) | CR (92) | 12 months, 2.5% yearly | PE: 0% selective, 2% CR |
| PS: 1% selective, 2% CR | ||||||
| F: 18% selective, 14% CR restoration failure | ||||||
| CP: No caries progression in any group | ||||||
| Franzon et al. 2014 [19] | Split-mouth RCT; university; Brazil | 51 (3-8); 124 primary molars; Caries in ‘inner quarter of dentin’ | Selective (61) (‘leathery’) | CR (67) | 24 months, 2.0% yearly | PE: 2% selective, 28% CR |
| PS: 10% selective, 0% CR |
BCC: black copper cement, CR: complete caries removal, EDJ: enamel-dentinal junction, GIC: glass ionomer cement, RCT: randomized controlled trial.