Incomplete dentine caries removal in clinically undetectable lesions

Dental caries is considered a major responsible for teeth loss in all ages in Brazil. When the prevention does not happen in early stages, the outcoming is the compromising pulp vitality, as in the cases of the clinically undetectable caries lesions, and the following extraction. Therefore, it is necessary to establish simple and efficacious ways of treatment to make the reversal of this picture possible. The aim of this work was to asses the restoration treatment with incomplete dentin caries removal (IR) in clinically undetectable lesions (CUL) in deep cavities in permanent molars. Sixteen teeth were filled divided in two groups: eight with conventional restoration treatment (CT) and eight with IR, being half of this sample of CUL. In the CT the carious tissue was totally removed and calcium hydroxide (pulp protection), glass-ionomer cement (lining) and light-cured composite resin were used for the filling; in the IR completely carious tissue was removed from the surrounding walls, but in the pulp wall, the infected dentine was not removed. Glass-ionomer (lining) and light-cured composite resin were used as filling. After an 18-month treatment, the teeth were assessed radiografically and with pulp vitality tests. The results demonstrated that the teeth treated with CT and those treated with IR as well were successful regardless of the lesion being clinically detectable or not, for the patients did not feel painful symptoms during the pulp vitality tests and there was no radiographic image suggesting periapical alteration or an increase in caries lesion under the fillings. According to these results, we can conclude that the incomplete removal of dentine caries can be an alternative to teeth treatment with clinically undetectable lesions, specially in the cases with the possibility of pulp exposition, reducing time and costs of treatment, making it possible to treat a larger number of patients.