Trial reportBMJ open2019
Selective versus stepwise removal of deep carious lesions in permanent teeth: a randomised controlled trial from Egypt-an interim analysis.
Trial report in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Deep caries management: EFCD-ESE-ORCA S3-level clinical practice guideline.Clinical oral investigations · 2026Guideline
- Deep Caries Management: EFCD-ESE-ORCA S3-Level Clinical Practice Guideline.Caries research · 2026Guideline
- Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology.Clinical oral investigations · 2022Pooled it
- Interventions for treating cavitated or dentine carious lesions.The Cochrane database of systematic reviews · 2021Pooled it
- Selective removal of dental caries in permanent teeth: an 18-month clinical trial.Clinical oral investigations · 2025Trial
- Effect of photobiomodulation and selective caries removal in deep cavities on postoperative sensitivity, pulp vitality and dentin neoformation: randomized clinical trial and tomographic evaluation.Clinical oral investigations · 2025Trial
- Complete, Selective, and Stepwise Carious Tissue Removal for Deep Carious Lesions in Vital Permanent Teeth: A Systematic Review and Meta-Analysis.Dentistry journal · 2026Review
- Long-Term Treatment Success Rate after Stepwise Caries Removal: A Registry Study.Caries research · 2026Article
- Management of deep caries.British dental journal · 2026Review
- Clinical Challenges and Therapeutic Approaches in Managing Deep Carious Lesions Close to the Pulp in Permanent Teeth: A Narrative Review.International journal of dentistry · 2026Review
- On the necessity of complete caries excavation: a narrative review.Head & face medicine · 2025Review
- Article
- Selective Caries Removal: A Case Report with 21-Year Follow-Up.Case reports in dentistry · 2024Article
- Selective versus stepwise removal of deep carious lesions: A meta-analysis of randomized controlled trials.Journal of dental sciences · 2023Article
- Dental Caries and Its Management.International journal of dentistry · 2023Review
- Improving the Bond Strength of Radiographically Tagged Caries Lesions In Vitro.Materials (Basel, Switzerland) · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare the success, survival and costs of selective versus stepwise carious tissue removal (SE/SW) in permanent teeth with deep (>2/3 dentine depth) carious lesions.
designRandomised controlled, unicentre, clustered two-arm superiority trial.
settingOutpatient clinic of a private university in Cairo, Egypt.
participantsOne hundred and fifteen participants (n=132 teeth), aged 18-47 years, from Cairo, Egypt, were enrolled. Premolars/molars with occlusal/occlusal-proximal deep lesions (radiographically >2/3 dentine), sensible pulps, without spontaneous pain, were included.
interventionsPeripheral carious tissue removal to hard dentine was performed. Pulpo-proximally, soft dentine was left. A glass ionomer (GI) restoration was placed. After 3-4 months, teeth were randomly allocated to SE (n=66), with reduction of the GI into a base and no further tissue removal, followed by a composite resin restoration, or SW (n=66), with full removal of the GI, additional excavation until firm dentine pulpo-proximally, followed by a GI-based composite restoration. Mean follow-up was 1 year. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was success (absence of endodontic/restorative complications). Secondary outcomes were tooth survival and initial and total treatment costs.
resultsZero/five pulp exposures occurred during SE/SW, and seven/five SE/SW teeth required endodontic therapy. Success after 12 months was 89.4% for SE and 84.9% for SW. The estimated mean time free of complications was 23 and 18 months for SE and SW, respectively, without significant differences between SE and SW (p>0.05/Cox). Initial treatment costs were significantly higher for SW (mean (SD): 507.5 (123.4) Egyptian pounds (EGP)) than SE (mean (SD): 456.6 (98.3) EGP), while total costs showed no significant difference (p>0.05).
conclusionWithin the limitations of this interim analysis, and considering the depth of these lesions (>2/3 dentine), SE and SW showed similar risk of failure and overall costs after 1 year. TRIAL REGISTRATION NUMBER: PACTR201603001396248.
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