Effectiveness of Partial Caries Removal in Primary Molars with Deep Carious Lesions. Randomized Clinical Trial

ABSTRACT: For the treatment of deep carious lesions, partial caries removal (PCR) appears to be advantageous over complete caries removal (CCR). However, and in light of insufficient evidence it is difficult to determine if there are differences between both treatments in relation to signs and symptoms of the dentin-pulp complex. The aim of this study was to determine the effectiveness of partial caries removal in deep carious lesions of primary molars. A randomized two-arm parallel controlled trial was performed in 20 participants, 4 to 8 years of age. Participants were randomly assigned to receive partial removal of carious lesions, while the control group was submitted to complete carious lesion removal. The primary outcome variable of treatment success was measured as absence of any clinical and radiographic signs of pulpal pathology. An intention-to-treat (ITT) approach was used for the primary analysis, and the survival rate of each treatment was estimated using Kaplan-Meier analysis. Thirty-eight teeth were included in the study. Seventeen teeth received PCR and 21 CCR. The mean follow-up was 12.6 ± SD 5.0 months for both groups. The clinical success rate was 94.1 % for the PCR and 76.2 % for the CCR (p = 0.132). The estimated survival at 18 months was 92.3 % for PCR and 75.9 % for CCR (p> 0.05). In conclusion and according with this research, PCR did not show to be more effective than the CCR in treatment of deep carious lesions of primary teeth. However, the trend in the results favoring the PCR treatment could justify a future research to confirm or refute our results.