David Ricketts1. 1. Department of Restorative Dental Care and Clinical Dental Sciences, University of Dundee Dental School, Dundee, Scotland, UK.
Abstract
DATA SOURCES: Searches for studies were made using the databases: Medline, Evidence-based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and OVID's Database of Abstracts of Reviews of Effects. STUDY SELECTION: Only studies reported in English with human participants were included. Randomised controlled trials (RCT) and relevant observational studies were included. No other inclusion or exclusion criteria are described. DATA EXTRACTION AND SYNTHESIS: A formal data extraction process is not described and a qualitative description of the included studies is provided. RESULTS: Ten articles reporting six studies were included. The results of three RCT, one with a followup period of 10 years, provide evidence supporting the practice of leaving behind infected dentine, the removal of which would risk pulp exposure. A number of other studies show that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either remain dormant or die and thus pose no risk to the health of the dentition. CONCLUSIONS: There is substantial evidence that, for caries management, it is not necessary to remove all vestiges of infected dentin from lesions approaching the pulp.
DATA SOURCES: Searches for studies were made using the databases: Medline, Evidence-based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and OVID's Database of Abstracts of Reviews of Effects. STUDY SELECTION: Only studies reported in English with humanparticipants were included. Randomised controlled trials (RCT) and relevant observational studies were included. No other inclusion or exclusion criteria are described. DATA EXTRACTION AND SYNTHESIS: A formal data extraction process is not described and a qualitative description of the included studies is provided. RESULTS: Ten articles reporting six studies were included. The results of three RCT, one with a followup period of 10 years, provide evidence supporting the practice of leaving behind infected dentine, the removal of which would risk pulp exposure. A number of other studies show that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either remain dormant or die and thus pose no risk to the health of the dentition. CONCLUSIONS: There is substantial evidence that, for caries management, it is not necessary to remove all vestiges of infected dentin from lesions approaching the pulp.