Randomized Clinical Trials on Deep Carious Lesions:5-Year Follow-up
| Autor: | Lars Bjørndal, Merete Markvart, Marianne Thordrup, Marianne Kjaeldgaard, Helena Fransson, Peggy Näsman, Irene Dige, Gitte Bruun, Anders Hedenbjörk-Lager |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty 5 year follow up Adolescent Dentistry Dental Caries Dental Pulp Capping law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial stomatognathic system law Tooth pulp stimulation medicine Dentin Journal Article Humans 030212 general & internal medicine Dental Pulp Exposure General Dentistry Pulp exposures Randomized Controlled Trials as Topic business.industry 030206 dentistry Middle Aged Prognosis Surgery stomatognathic diseases medicine.anatomical_structure Treatment Outcome Pulpotomy Pulp (tooth) Female Carious lesion business Previously treated Follow-Up Studies |
| Zdroj: | Bjørndal, L, Fransson, H, Bruun, G, Markvart, M, kjældgaard, M, Näsman, P, Hedenbjörk-Lager, A, Dige, I & Thordrup, M 2017, ' Randomized Clinical Trials on Deep Carious Lesions : 5-Year Follow-up ', Journal of Dental Research, vol. 96, no. 7, pp. 747-753 . https://doi.org/10.1177/0022034517702620 |
| DOI: | 10.1177/0022034517702620 |
| Popis: | Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1-26.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up ( ClinicalTrials.gov NCT00187837 and NCT00187850). |
| Databáze: | OpenAIRE |
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