Proportion of dentists selecting selective or stepwise removal · Dentists surveyed about deep carious lesions in permanent teeth
In Oen 2007, 18% of surveyed dentists selected selective or stepwise removal.
12 findings from 1 review
Proportion (%) 18 [11, 27]
1 study · 85 participants
GRADE not reported
Proportion (%) 21 [12, 34]
1 study · 53 participants
GRADE not reported
Proportion (%) 62 [55, 69]
1 study · 171 participants
GRADE not reported
Show 9 more findings
Proportion (%) 71 [65, 77]
1 study · 252 participants
GRADE not reported
Proportion (%) 99 [95, 100]
1 study · 199 participants
GRADE not reported
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and meta-analysis. 2016 All outcomesUnited States · Seale and Glickman 2007 (all 376 conference dentists; source mislabels as 'endodontists', but only 102 were endodontists)
Proportion (%) 59 [54, 64]
1 study · 376 participants
GRADE not reported
Proportion (%) 51 [44, 58]
1 study · 212 participants
GRADE not reported
Proportion (%) 68 [64, 71]
1 study · 622 participants
GRADE not reported
Proportion (%) 50 [47, 53]
1 study · 799 participants
GRADE not reported
Proportion (%) 35 [32, 38]
1 study · 812 participants
GRADE not reported
Proportion (%) 45 [26, 55]
1 study · 108 participants
GRADE not reported
Proportion (%) 49 [45, 52]
1 study · 661 participants
GRADE not reported
Disease-free survival · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes
1 finding from 1 review
Disease-free survival: Pandey 2018 reported 83% (superselective) vs 91% (selective) at median 36 months, not significant (P=0.69); unable to analyse (variable follow-up); 32 participants (1 RCT).
1 study · 32 participants
Very low
Adverse events associated with treatment · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes
1 finding from 1 review
Total mortality · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes
The review found no eligible studies for this question.
1 finding from 1 review
Recurrence · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes
The review found no eligible studies for this question.
1 finding from 1 review
Locoregional recurrence · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes
1 finding from 1 review
Locoregional recurrence: data not presented usably and inconsistent; Pandey 2018 no difference (3/12 vs 3/20); Rastogi 2018 lower recurrence with superselective (Kaplan-Meier P<0.05); 72 participants (2 RCTs).
2 studies · 72 participants
Very low
Pulp exposure during caries removal · Children with dentine caries in primary and permanent teeth
Partial caries removal was reported to reduce pulp-exposure risk by 77% versus complete caries removal (RR 0.23; ungraded).
1 finding from 1 review
RR 0.23 [0.08, 0.69]
2 studies
GRADE not reported
Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars
Partial caries removal reduced the reported risk of pulp exposure versus complete caries removal in primary teeth (RR 0.24; ungraded).
1 finding from 1 review
RR 0.24 [0.06, 0.90]
262 participants
GRADE not reported
Pulpal disease (signs/symptoms of pulp necrosis) · Children with dentine caries in primary and permanent teeth
The reported estimate did not show a clear difference in pulpal disease after partial versus complete caries removal (ungraded).
1 finding from 1 review
RR 0.27 [0.05, 1.60]
3 studies
GRADE not reported
Proportion of dentists utilizing SE/SW for deep carious lesions · Dentists managing deep carious lesions in permanent vital teeth
Across nine surveys of 4199 dentists, a pooled 53% (95% CI 44% to 62%) chose selective or stepwise (evidence-based) carious tissue removal for deep lesions in permanent teeth, with very high heterogeneity (I2=96%) and no formal certainty rating (ungraded).
1 finding from 1 review
Barriers and facilitators of SE/SW utilization · Dentists managing deep carious lesions in permanent vital teeth
Dentists' use of selective or stepwise removal was shaped by their age and understanding of caries, professional guidelines, peers and professional identity, financial and regulatory incentives, and beliefs about how treatments perform, identified by thematic analysis mapped to the TDF and Behavior Change Wheel (ungraded).
1 finding from 1 review
Thematic analysis mapped to the Theoretical Domains Framework and COM-B/Behavior Change Wheel; factors span knowledge (dentists' age, understanding of caries), skills, social influence (peers, practice networks),…
9 studies
GRADE not reported
Temporal change in the proportion of dentists utilizing SE/SW · Dentists managing deep carious lesions in permanent vital teeth
The proportion of dentists choosing selective or stepwise removal rose significantly over time, by about 1.6% per calendar year (meta-regression, p<0.05), a trend the authors described as borderline (ungraded).
1 finding from 1 review
Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
It is very uncertain whether non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).
3 findings from 1 review
Lesion progression · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
1 finding from 1 review
Pulp exposure rate · Patients with deep carious lesions in permanent (mainly posterior) teeth
Minimally invasive caries removal was associated with a lower mean pulp exposure rate than conventional removal (1.2% vs 8.1%), but the difference was not statistically significant (Wilcoxon, p = 0.068); certainty of evidence was not graded.
1 finding from 1 review
Mean pulp-exposure percentage (unweighted study-level mean, 4 studies) MIT 1.2% vs CT 8.1% (Wilcoxon = 0.0, p = 0.068; not statistically significant)
4 studies · 791 participants
GRADE not reported
Treatment success (caries lesion arrest or restoration survival) · Patients with deep carious lesions in permanent (mainly posterior) teeth
Minimally invasive caries removal showed a marginally higher mean restoration success rate than conventional removal (83.6% vs 75.4%), but the difference was not statistically significant (Mann-Whitney U, p > 0.05); certainty of evidence was not graded.
1 finding from 1 review
Mean success-rate percentage (unweighted study-level mean, 7 studies) MIT 83.6% vs CT 75.4% (Mann-Whitney U = 0.2, p > 0.05; not statistically significant)
7 studies · 1305 participants
GRADE not reported
Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy
In one RCT, selective caries removal had a 3.44 higher probability of failure than complete caries removal.
1 finding from 1 review
Treatment failure (annual failure rate) · Children with deep dentine caries in primary molars restored with composite resin (indirect pulp treatment; pulpotomy only if pulp exposed…
Complete caries removal with composite resin had an annual failure rate of 6.8% in primary molars (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).
2 findings from 1 review
Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
It is very uncertain whether selective carious tissue removal (selective excavation, SE) changes failure of therapy compared with hall Technique (sealing with a preformed metal crown) (very low certainty).
2 findings from 1 review
Efficiency, costs or cost-effectiveness · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
1 finding from 1 review