Abstract
Considering extensive caries lesions, a variety of techniques are used for caries removal. However, there are controversies in literature about the real need for the total removal of this tissue, since the inner portion of dentin, affected by dental caries, is able to remineralize when suitable cavity sealing is carried out. Since, sealing promotes the disruption of metabolic circuit of remaining microorganisms, preventing the progression of the lesion, many studies have recommended the partial removal of carious tissue. Therefore, the aim of this study was to present the scientific evidence in literature on the clinical applicability of total or partial caries removal and to discuss the variants that influence the results of each one of these treatments.
Highlights
The treatment of extensive caries lesions, in teeth with vital pulp, is a challenge for dentists given that the technique used for the mechanical removal of decayed tissue increases the risk of cavity extension and pulp exposure, becoming difficult to determine how much carious dentin must be removed [1,2]
Evaluations were performed in 39 teeth by reopening after 4-7 months. Both groups showed reduction in bacterial counts, with no differences between them. 83% of teeth treated with calcium hydroxide and 96% of teeth treated with adhesive system showed successful treatment after clinical and radiographic evaluation There was no difference between groups
No significant differences between groups were found, this study suggests that acid etching in the affected dentin prior to adhesive restoration can, directly or indirectly, have an inhibitory effect on the cariogenic activity caused by residual bacteria
Summary
The treatment of extensive caries lesions, in teeth with vital pulp, is a challenge for dentists given that the technique used for the mechanical removal of decayed tissue increases the risk of cavity extension and pulp exposure, becoming difficult to determine how much carious dentin must be removed [1,2]. When restorative treatment is indicated, conventional dentistry recommends the total removal of carious dentin to avoid lesion progression [3,4]. This technique is usually performed in two stages in order to reduce the risk of pulp exposure during first excavation and to promote physiological reactions in the pulp-dentin organ for the deposition of tertiary dentine [4]. Some studies have shown that the inactivation of carious lesions is likely to be achieved by sealing the remaining tissue, once it impairs the communication between bacteria and the oral environment, promoting the breakage of substrates [8,9]
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