Self-Limiting versus Rotary Subjective Carious Tissue Removal: A Randomized Controlled Clinical Trial-2-Year Results

Ahmed H Ali, Farah Ben Thani, Federico Foschi, Avijit Banerjee, Francesco Mannocci, Ahmed H Ali, Farah Ben Thani, Federico Foschi, Avijit Banerjee, Francesco Mannocci

Abstract

Background: the aim of this study was to assess the 2-year pulp survival of deep carious lesions in teeth excavated using a self-limiting protocol in a single-blind randomized controlled clinical trial.

Methods: At baseline, 101 teeth with deep carious lesions in 86 patients were excavated randomly using self-limiting or control protocols. Standardized clinical examination and periapical radiographs of teeth were performed after 1- and 2-year follow-ups (REC 14/LO/0880).

Results: During the 2-year period of the study, 24 teeth failed (16 and 8 at T12 and T24, respectively). Final analysis shows that 39/63 (61.9%) of teeth were deemed successful (16/33 (48.4%) and 23/30 (76.6%) in the control and experimental groups, respectively with a statistically significant difference (z score = 2.3, p = 0.021). Of teeth with severe and mild symptoms at T0, 42.9% and 36.7% respectively failed at T24 (p > 0.05). Within the self-limiting group, there was a lower success in premolars compared to molars (p < 0.05).

Conclusion: after 2 years, there was a statistically significant higher pulp survival rate of teeth with deep carious lesions excavated using self-limiting protocols in patients with reversible pulpitis. Molars showed higher success than premolars in teeth excavated using the self-limiting protocol. There was no statistically significant association between the outcome and the severity of symptoms at T0 (ClinicalTrials.gov NCT03071588).

Keywords: Carisolv; caries; chemomechanical gel; clinical trial; computed tomography; microscopy; minimally invasive dentistry; periapical radiograph; pulpitis; rotary excavation; selective caries removal.

Conflict of interest statement

There was no conflict of interest to be declared by authors regarding this research.

Figures

Figure 1
Figure 1
Flow diagram representing patient recruitment and follow-up. At T12 and T 24, teeth that have no response to pulp sensibility tests or have a radiolucency in the periapex or received root canal treatments categorized as failed teeth.
Figure 2
Figure 2
Periapical radiolucency detected by PA radiograph. (a) Periapical radiograph of the lower left first molar with a healthy PDL space at T0 (b) T24 PA radiograph shows healthy periapical tissue. (c) Periapical radiograph of the upper left second molar with a healthy PDL space at T0 (d) T24 PA radiograph shows at the periapex of the tooth a periapical radiolucency.

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Source: PubMed

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