Clinical outcomes of selective removal to soft dentin versus firm dentin for deep caries lesions: a randomized controlled trial up to 5 years.

IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Burcu Gözetici-Çil, Tuba Çetin, Ahmad Bittar, Mutlu Özcan
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引用次数: 0

Abstract

Objectives: This study aimed to compare the success of selective removal to soft dentine (SRSD) with or without calcium silicate (CS) and selective removal to firm dentine (SRFD) in permanent dentition.

Materials and methods: Between November 2018 and March 2020, 165 posterior deep caries lesions in 134 patients were included in the study and randomly assigned into test (n = 101) and control (n = 64) groups. The control group (n = 46) received the treatment of SRFD with CS, while the test group was further randomized into two groups to receive SRSD with CS (n = 45) and SRSD without CS (n = 45). An additional group (PE) consisted of teeth with exposed pulps during caries removal (n = 29). The primary outcome of the study was to assess the vitality of the teeth based on clinical and radiographic examination after five years. The secondary outcome of the study was to evaluate the influence of baseline variables and CS application on treatment outcome. The success rates of different treatment strategies were compared (Pearson chi-squared and Log-rank tests). The impact of baseline variables and treatment strategies on failure and dentin bridge formation was analyzed using binary logistic regression model.

Results: The success rate for SRSD with or without CS (94.1-100%) was significantly higher compared to SRFD (75.8%) and PE (81.8%) after five years (P = 0.012). Failure was less likely for premolars. Cavity type and depth had an influence on dentin bridge formation.

Conclusion: A five-year follow-up in this study demonstrated better clinical outcome for SRSD with or without CS compared to SRFD technique, irrespective of age, pre-op sensitivity, cavity type, radiographic depth and activity of the caries. Application of CS after SRSD in deeper cavities provided better healing in terms of dentin bridge formation.

Clinical relevance: SRSD might be more advantageous over SRFD for the management of deep caries lesions.

选择性去除软质牙本质与硬质牙本质治疗深部龋病的临床结果:一项长达5年的随机对照试验。
目的:本研究旨在比较有硅酸钙(CS)或无硅酸钙(CS)的恒牙列软质牙本质选择性去除(SRSD)和硬质牙本质选择性去除(SRFD)的成功率。材料与方法:2018年11月至2020年3月,将134例165例后牙深龋患者纳入研究,随机分为试验组(n = 101)和对照组(n = 64)。对照组(n = 46)采用SRFD + CS治疗,试验组进一步随机分为SRSD + CS组(n = 45)和SRSD + CS组(n = 45)。另一组(PE)由除龋时牙髓暴露的牙齿组成(n = 29)。该研究的主要结果是评估五年后基于临床和放射检查的牙齿活力。本研究的次要结局是评估基线变量和CS应用对治疗结果的影响。比较不同治疗策略的成功率(Pearson卡方检验和Log-rank检验)。采用二元logistic回归模型分析了基线变量和治疗策略对牙本质桥的破坏和形成的影响。结果:5年后,有无CS的SRSD的成功率(94.1-100%)明显高于SRFD(75.8%)和PE (81.8%) (P = 0.012)。前磨牙失败的可能性较小。牙本质桥的形成受牙本质牙槽类型和牙槽深度的影响。结论:这项研究的5年随访表明,与SRFD技术相比,无论年龄、术前敏感性、腔型、放射深度和龋的活动性如何,有无CS的SRSD的临床结果都更好。在深部牙本质桥的形成方面,在SRSD后应用CS可以提供更好的愈合。临床相关性:SRSD可能比SRFD更有利于治疗深部龋病。
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来源期刊
Clinical Oral Investigations
Clinical Oral Investigations 医学-牙科与口腔外科
CiteScore
6.30
自引率
5.90%
发文量
484
审稿时长
3 months
期刊介绍: The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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