Evaluation of Pulp Symptoms After Minimal Caries Removal in Treatment of Deep Caries

Evaluation of Pulpal Symptoms Following Minimal Caries Removal Technique in Comparison to Complete Caries Removal in Molars With Deep Caries

The objective of this study is to assess and compare the possible post-operative pulpal symptoms (Spontaneous pain, pain on percussion, swelling, sinus or fistula), incidence of pulp exposure, child acceptance, chair time and radiographic success between two techniques for managing dental caries: minimal caries removal and complete caries removal in primary molars.

Minimal Caries Removal (MCR) technique was described in 2015 by Chompu-inwai et al., as a treatment option for primary molars with deep carious lesions or reversible pulpitis where only soft demineralized dentin around the lateral walls of the carious lesion is removed. The aim of this study is to assess the success of such a technique in managing primary molars with asymptomatic deep caries in terms of; post-operative pulpal symptoms(spontaneous pain, pain on percussion, fistula or sinus), incidence of pulp exposure, child acceptance, chair time and radiographic success.

Inclusion Criteria:

• Primary molar with deep dentin caries involving occlusal &/or occluso-proximal surfaces.
• Absence of clinical signs and symptoms of irreversible pulpitis such as spontaneous pain. Only presence of pain provoked with stimulation, such as complaints of food impaction when eating is allowed.
• Absence of clinical swelling or pus exudates/fistula of soft or periodontal tissues.
• Absence of abnormal tooth mobility.
• Absence of pain on percussion.
• Restorable tooth.

Radiographic inclusion criteria:

• Extension of dental caries one-third or more of the entire dentin thickness.
• No super- imposition of dental caries on the dental pulp.
• No widened periodontal ligament (PDL) space.
• No radiolucency in the peri-apical or furcation areas.
• No pathologic internal or external root resorption.
• No pulp canal calcification or obliteration.

Exclusion Criteria:

1. Patients experience any signs or symptoms of pulpal or peri-apical pathology.
2. Patients with systemic diseases requiring special dental consideration.
3. Unmotivated, uncooperative patients.
4. Patients unable to attend follow-up visits.