Trial reportClinical oral investigations2021
Selective vs stepwise removal of deep carious lesions in primary molars: 24 months follow-up from a randomized controlled trial.
Trial report in Clinical oral investigations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02232828 (Selective or Stepwise Removal of Deep Caries in Deciduous Molars), which is not on this map. Cited by 14 papers, 4 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.
Selective or Stepwise Removal of Deep Caries in Deciduous Molars: A Multi-center Randomized Controlled Trial
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Comparative success of minimally invasive treatments for cavitated caries in primary teeth: a network meta-analysis.BMC oral health · 2025Pooled it
- Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Cost-Effectiveness of Treatment Decisions for Early Childhood Caries in Infants and Toddlers: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled 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
- Fluorescence as a Quantitative Indicator of Cariogenic Bacteria During Chemo-Mechanical Caries Excavation with BRIX 3000 in Primary Teeth.Journal of functional biomaterials · 2025Article
- Silver diamine fluoride differentially affects dentin and hypomineralized enamel permeabilities.Dental materials : official publication of the Academy of Dental Materials · 2025Article
- Dental Decision-Making in Pediatric Dentistry: A Cross-Sectional Case-Based Questionnaire Among Dentists in Germany.Medicina (Kaunas, Lithuania) · 2024Article
- Selective versus stepwise removal of deep carious lesions: A meta-analysis of randomized controlled trials.Journal of dental sciences · 2023Article
- Current Strategies to Control Recurrent and Residual Caries with Resin Composite Restorations: Operator- and Material-Related Factors.Journal of clinical medicine · 2022Review
- Article
- Pathophysiology of Demineralization, Part II: Enamel White Spots, Cavitated Caries, and Bone Infection.Current osteoporosis reports · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFor well-defined deep (> 2/3 dentin extension) carious lesions, selective (SE) or stepwise (SW) carious tissue removals have been recommended, while there is limited comparative evidence for both. We compared SE and SW over 24 months in a randomized controlled trial.
methodsA two-arm superiority trial was conducted comparing SW/SE in primary molars without pulpal symptoms but well-defined deep lesions. Seventy-four children (1 molar/child) aged 3-9 years were recruited. In a first step, peripheral carious tissue was removed until hard dentin remained, while in proximity to the pulp, leathery dentin was left. An adhesive compomer restoration was placed and restorations re-examined after 6 months. In SW, re-entry and removal to firm dentin was conducted pulpo-proximally, followed by re-restoration. Molars were re-evaluated for a total of 24 months. Our primary outcome was success (absence of restorative/endodontic complications or pulp exposures). Secondary outcomes included total treatment and opportunity costs and restoration quality, assessed using modified USPHS criteria.
resultsAfter 24 months, 63 molars (31 SE, 32 SW) were re-assessed. Four failures occurred (2 exposures in SW; 2 pulpal complications in SE, 1 of them leading to extraction, p > 0.05). Restoration integrity was satisfying in both groups (USPHS A/B/C in 21/8/0 SE and 23/7/0 SW, p > 0.05). Treatment and opportunity costs were significantly higher in SW than SE (mean 171 ± 51 vs. 106 ± 90; p < 0.001).
conclusionsAfter 2 years, SE and SW showed similar efficacy for managing deep carious lesions in primary molars. The higher costs for SW should be considered during decision-making. CLINICAL SIGNIFICANCE: In primary molars with well-defined deep carious lesions SE was less costly and similarly efficacious like SW. From a cost and applicability perspective, SW may need to be indicated restrictively, e.g., for very deep (> 3/4 dentin extension) lesions only.
trial registrationClinicalTrials.gov Identifier: NCT02232828.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.