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Selective removal compared to total removal for deep dentin caries

Abstract:

INTRODUCTION Dental caries has been conventionally managed by non-selective removal of carious tissue (total removal), however, the adverse effects of this procedure have promoted the use of conservative caries removal techniques (selective removal), but there is still controversy. regarding its effectiveness. METHODS To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by searching multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, reanalyzed data from the primary studies, performed a meta-analysis, prepared summary tables of results using the GRADE method. RESULTS AND CONCLUSIONS We identified seven systematic reviews that together included seven primary studies, all of them corresponding to randomized trials. We conclude that selective caries removal could decrease the need for endodontic treatment and the risk of pulp exposure in deeply carious teeth, but the certainty of the evidence is low. There is no clarity that selective caries removal reduces the risk of signs and symptoms of pulp pathology and the risk of restoration failure, since the certainty of the evidence is very low.