What do systematic reviews say?

Selective carious tissue removal (selective excavation, SE) vs Stepwise carious tissue removal (SW)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Permanent and primary dentition
  Cost-effectiveness reported narratively: SE found more cost-effective than SW in permanent (Labib 2019) and primary teeth (Elhennawy 2021); not GRADE-rated.
  2 studies
  GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Stepwise carious tissue removal (SW)

Selective carious tissue removal (selective excavation, SE) probably leads to higher failure of therapy compared with stepwise carious tissue removal (SW) (moderate certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-60 months · Deep lesions, permanent dentition
  OR 2.25 [1.33, 3.82]
  3 studies · 371 participants
  Moderate
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-24 months · Deep lesions, primary dentition
  OR 2.05 [0.49, 8.62]
  2 studies · 126 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Cavitated but not deep lesions, primary dentition
  OR 0.62 [0.21, 1.88]
  2 studies · 204 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-18 months · Deep lesions, permanent dentition
  OR 11.32 [1.97, 65.02]
  2 studies · 179 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  6-36 months · Deep lesions, primary dentition
  OR 4.43 [1.04, 18.77]
  4 studies · 265 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Cavitated but not deep lesions, primary dentition
  Lesion progression reported narratively: Ribeiro 1999 found 6/24 lesions progressed after 12 months; not pooled and not GRADE-rated.
  1 study
  GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Hall Technique (sealing with a preformed metal crown)

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24-36 months · Deep lesions, primary dentition
  OR 1.95 [0.57, 6.63]
  1 study · 72 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24 months · Cavitated but not deep lesions, primary dentition
  OR 8.94 [0.57, 139.67]
  2 studies · 586 participants
  Very low

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  18-24 months · Cavitated lesions, primary dentition
  OR 3.11 [0.11, 85.52]
  2 studies · 82 participants
  Very low

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Cavitated lesions, primary dentition
  Lesion progression reported narratively: Dias 2018 1/27 sealed vs 1/21 SE at 24 months; Hesse 2014 0/17 sealed vs 0/17 SE at 18 months; not pooled and not GRADE-rated.
  2 studies
  GRADE not reported