Review of Systematic Review
Complete caries removal may not be indicated in symptomless deep lesions

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Article Title and Bibliographic Information

Ricketts DNJ, Kidd EAM, Innes N, Clarkson J. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev 2006;3:CD003808.

Level of Evidence

1a

Purpose

This review tested the null hypothesis that there would be no difference between minimal caries removal and complete caries removal with regard to damage or disease of the pulp, progression of decay, or longevity of restorations.

Source of Funding

None noted

Type of Study/Design

Systematic review

Section snippets

Study Selection

Published search criteria developed by the Cochrane Collaboration and adapted for this search were used. The search included MEDLINE and ultimately included searches of key dental journals. Randomized controlled trials, controlled clinical trials, and quasi-randomized trials that compared ultraconservative (minimal) caries removal with complete caries removal prior to restoration were included for review.

Subjects

Studies were limited to patients with untreated primary (nonrecurrent) decay requiring

Commentary and Analysis

This area of research is based on concern over the health of the pulp and subsequent success of the restoration. Implicit in this is the assumption that the remaining caries, shut off from nutrients, will be arrested and thus not cause further loss of tooth structure or infection of the pulp. Given the reviewer's conclusion that there was no detriment to the patient in termsof pulpal symptoms or restoration longevity, it can be inferred that the conservative caries removal leads to caries

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