Comparative evaluation of step-wise caries excavation and indirect pulp capping for vitality preservation in young permanent teeth: An in vivo Study

TL;DR

This study compares two dental treatments for deep cavities in children's molars to see which better preserves tooth vitality.

Contribution

The study provides new clinical evidence that Indirect Pulp Capping is more effective than Step-wise Caries Excavation for preserving pulp vitality in deep caries.

Findings

Both SWE and IPC showed 95% success rates at one week.

Indirect Pulp Capping was found to be more effective in preserving pulp vitality over time.

IPC is suggested as a less invasive and more economical treatment option.

Abstract

Management of deep carious lesions in young permanent teeth poses a significant clinical challenge due to the risk of pulpal exposure
and subsequent loss of vitality. Therefore, this study evaluates and compares the clinical and radiographic outcomes of Step-wise Caries
Excavation (SWE) versus Indirect Pulp Capping (IPC) in young permanent molars with deep carious lesions. Hence, a randomized controlled
trial was conducted with 40 children aged 8-13 years, having 40 permanent molars with deep carious lesions, randomly allocated to either
SWE (n=20) or IPC (n=20) groups. Clinical and radiographic evaluations were performed at baseline, 1 week, 3 months and 6 months. At
1-week follow-up, both groups showed similar success rates (95% in SWE versus 95% in IPC, p=1.000). Thus, we show that IPC is more
effective than SWE in preserving pulp vitality in young permanent teeth with deep carious lesions, offering a less invasive and more
economical treatment approach.