Complete versus incomplete caries removal procedures and their effects on dental pulp in primary teeth – An in vivo study

Abstract

Introduction: Dental caries results from an ecologic shift within the dental biofilm from a balanced population of microorganisms to an acidogenic, aciduric, and cariogenic microbiological population developed and maintained by frequent consumption of fermentable dietary carbohydrates. Total caries removal (TCR) of deep lesion may result in pulpal exposure requiring more invasive treatment. Hence, current pediatric dentistry has shifted to minimally invasive treatment that avoids more complex, time-consuming procedure, and the child’s discomfort. Aim: The aim of this study is to evaluate and compare clinical performance and radiographic changes after complete and incomplete caries removal procedures. Materials and Methods: The study was conducted on 60 primary molars in children aged 6–9 years. Selected 60 primary molars were randomly divided into two groups. Group 1 (PCR): infected dentin was removed, while the affected dentin was maintained on the pulpal wall. Group 2 (TCR): both infected and affected dentin were removed through low-speed carbide bur and hand excavator. Teeth were evaluated at 4 and 6 months clinically and radiographically. Results: The proportion was compared using Fisher’s exact test. The Statistical Package for the Social Sciences version 21 was used for analysis. The level of significance was kept at 5%. Conclusion: The clinical and radiographic success rates of ICR and CCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that the retention of carious dentin does not interfere with pulp vitality. Thus, ICR is a reliable minimally invasive approach that might replace the CCR in primary teeth when correctly indicated.

Keywords

• complete caries removal
• dental caries
• incomplete caries removal
• minimally invasive dentistry