Non-Cochrane · intervention · PM38541128
Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition.
González-Gil Diego, Flores-Fraile Javier, Vera-Rodríguez Vicente, et al. · Medicina (Kaunas, Lithuania) · 2024 · PubMed · doi:10.3390/medicina60030402
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
2
current version
GRADE rated
0
No studies
0
Included studies
11
linked below
No studies 0 · 0%Ungraded 2 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Permanent dentition with deep carious lesions | Permanent (mainly posterior) teeth with deep caries; 1305 restorations across 7 studies |
| Intervention | Selective (minimally invasive) caries removal techniques | MIT (n=7 studies): selective removal to soft dentin, self-limiting chemomechanical technique, partial/incomplete caries removal |
| Comparison | Non-selective (conventional) caries removal techniques | CT (n=7 studies): selective removal to firm dentin, stepwise excavation, complete caries removal |
| Outcomes | Restoration success rate; pulp exposure | Success rate (n=7 studies); pulp exposure (n=4 studies) |
| Study designs | Randomized controlled trials (English language, published 2008 to 2022) | 7 studies (6 randomized controlled trials and 1 retrospective study) |
| Timing | Not specified | Follow-up 1 to 5 years |
Search date: January 2008 to December 2022 (publication coverage period; exact search-run date not reported). Databases: PubMed/MEDLINE (only bibliographic source searched); ResearchGate used solely to obtain some full-text articles
Questions and results
Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal
Population: Patients with deep carious lesions in permanent (mainly posterior) teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pulp exposure rate 1 to 5 years (follow-up varied by study) 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. Source: Table 1; Results (para 1); Discussion; Figures 4 and 5 · same question in other reviews | 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 | Ungraded |
Restoration/treatment success rate 1 to 5 years (follow-up varied by study) 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. Source: Table 1; Results (para 1); Discussion; Figure 3 · same question in other reviews | 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 | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 11
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Jardim 2020 Restorations after selective caries removal: 5-Year randomized trial DOI:10.1016/j.jdent.2020.103416 | 1 other review | not stated | not extracted yet | not extracted yet |
| Jardim 2020 Restorations after selective caries removal: 5-Year randomized trial. PMID:32585263 | 1 other review | not stated | not extracted yet | not extracted yet |
| Ali 2018 Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial DOI:10.1177/0022034518769255 | this review only | not stated | not extracted yet | not extracted yet |
| Ali 2018 Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial. PMID:29738286 | this review only | Pulp exposure rate | not extracted yet | not extracted yet |
| Casagrande 2017 Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a… DOI:10.1007/s00784-016-1832-1 | this review only | not stated | not extracted yet | not extracted yet |
| Casagrande 2017 Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a… PMID:27103587 | this review only | Pulp exposure rate | not extracted yet | not extracted yet |
| Gozetici-Cil 2022 Selective removal to soft dentine or selective removal to firm dentine for deep caries lesions ın permanent posterior teeth: a randomized… PMID:36460919 | this review only | not stated | not extracted yet | not extracted yet |
| Khokhar 2018 Outcomes of Partial and Complete Caries Excavation in Permanent Teeth: A 18 Month Clinical Study. PMID:30166846 | this review only | Pulp exposure rate | not extracted yet | not extracted yet |
| Labib 2019 Selective versus stepwise removal of deep carious lesions in permanent teeth: a randomised controlled trial from Egypt-an interim analysis. PMID:31530615 | this review only | Pulp exposure rate | not extracted yet | not extracted yet |
| Maltz 2018 Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial DOI:10.1007/s00784-017-2221-0 | this review only | not stated | not extracted yet | not extracted yet |
| Maltz 2018 Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial. PMID:28988345 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis. (2025) | 2 | 0.07 |