A PRACTICE-BASED STUDY ON STEPWISE EXCAVATION OF DEEP CARIOUS LESIONSIN PERMANENT TEETH - A 1-YEAR FOLLOW-UP-STUDY

This study reports results from a practice-based study in which deep c arious lesions were treated by general dental practitioners using step wise excavation. The material comprised 94 teeth with deep carious les ions which the clinicians considered would result in pulp perforation if treated by a single and terminal excavation. At the first visit exc avation of the peripheral dentine was completed. The outermost part of the central and necrotic dentine was gently removed with a sharp exca vator. Standardized assessments of the dentine colour and consistency were made before application of a calcium hydroxide-containing base ma terial and temporary filling. The final excavation was completed after a treatment interval al ranging from 2 to 19 months, with a median of 6 months. Reassessments of Me dentine colour and consistency were mad e before complete removal of demineralized dentine. The central dentin e was significantly browner and less softened after the sealing period . After removal of the dark-brownish dentine during the final excavati on, the colour and consistency of the exposed central dentine was foun d to resemble that of the completely excavated peripheral dentine. Onl y five cases resulted in pulp perforation during the final excavation. The high success rate of teeth surviving the final treatment without pulp exposure after 1 year of observation shows that it was possible f or dentists in general practice to administer and manage the treatment of deer carious lesions, a process which may prolong tooth survival c ompared with conventional endodontic techniques.