Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: A Systematic Review

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• 作者：Vaughan Hoefler ; D.D.S. ; M.B.A.^a ; ^{vaughan.hoefler@uky.edu" class="auth_mail" title="E-mail the corresponding author} ; Hiroko Nagaoka ; D.D.S. ; M.S.^a ; Craig S. Miller ; D.M.D. ; M.S.^b
• 关键词：Indirect-pulp-cap ; Excavation ; Deep caries ; Stepwise ; Outcome
• 刊名：Journal of Dentistry
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：54
• 期：Complete
• 页码：25-32
• 全文大小：504 K

文摘

A systematic review was performed to compare the long-term survival of deep dentine caries-affected permanent teeth treated with partial-caries-removal (PCR) versus similar teeth treated with stepwise-caries-removal techniques (SWT).

d="absSec_2">Data

d="spar0045">Clinical studies investigating long-term PCR and SWT outcomes in unrestored permanent teeth with deep dentine caries were evaluated. Failures were defined as loss of pulp vitality or restorative failures following treatment.

d="absSec_3">Sources

d="spar0050">PubMed, Web of Science, Dentistry and Oral Sciences Source, and Central databases were systematically searched.

d="absSec_4">Study selection

d="spar0055">From 136 potentially relevant articles, 9 publications utilizing data from 5 studies (2 RCTs, and 3 observational case-series) reporting outcomes for 426 permanent teeth over two to ten years were analyzed. Regarding restorative failures, >88% success at two years for both techniques was reported. For loss of pulp vitality, observational studies reported >96% vitality at two years for each technique, while one RCT reported significantly higher vitality (p < 0.05) at three years for PCR (96%) compared to SWT (83%). Risk of bias was high in all studies.

d="absSec_5">Conclusion

d="spar0060">Successful vitality and restorative outcomes for both PCR and SWT have been demonstrated at two years and beyond in permanent teeth with deep dentine caries. Partial-caries-removal may result in fewer pulpal complications over a three year period than SWT, although claims of a therapeutic advantage are based on very few, limited-quality studies.

d="absSec_6">Clinical significance

d="spar0065">Partial-caries-removal and SWT are deep caries management techniques that reduce pulp exposure risk. Permanent teeth with deep dentine caries treated with either technique have a high likelihood for survival beyond two years.