{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:04Z","timestamp":1787014324111,"version":"build-2736575974"},"reference-count":72,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to compare pulp survival following selective caries removal (SCR) and full pulpotomy treatment in teeth with extensive caries over 3\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This two\u2010arm, exploratory randomised controlled trial included vital mature permanent teeth with extensive primary or secondary caries diagnosed radiographically as being at least 75% or more into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were randomly allocated to receive either SCR or full pulpotomy. All teeth were reviewed clinically and radiographically at 6\u2009months, 1\u2009year, and 3\u2009years post\u2010treatment. Log\u2010rank tests and Cox proportional hazards regressions were used to compare the outcomes of SCR and pulpotomy, adjusting for clustering using a robust variance estimator. Cost\u2010effectiveness analysis was carried out using the healthcare system and societal perspectives. Significance level was set at 5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 3\u2009years, 44\/58 teeth (75.9%) in the SCR group and 37\/55 teeth (67.3%) in the full pulpotomy group were reviewed. A total of 13 teeth in the SCR group (29.5%) and 4 teeth in the pulpotomy group (10.8%) required further intervention with root canal treatment (RCT) or extraction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). Survival rates were 74% for SCR and 89% for pulpotomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). Overall, 79.0% of teeth treated with either SCR or pulpotomy survived without requiring further intervention over the 3\u2010year period. In this study with more than two\u2010thirds of the enrolled teeth classified as extremely deep lesions, pulpotomy was more cost\u2010effective than SCR in the management of extensive caries above a willingness\u2010to\u2010pay threshold of $917 and $928 to avoid one tooth extraction or RCT from the healthcare system and societal perspective, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Full pulpotomy demonstrated greater effectiveness than SCR in avoiding further intervention over a 3\u2010year period in teeth with extensive caries, of which the majority were extremely deep lesions. Further long\u2010term studies and broader health economic evaluations are warranted to guide clinical decision\u2010making and policy development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT04672070<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iej.70068","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T11:24:07Z","timestamp":1764069847000},"page":"439-453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Three\u2010Year Clinical and Economic Evaluation of Selective Caries Removal and Full Pulpotomy for Extensive Caries: An Exploratory Randomised Controlled Trial"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5017-9736","authenticated-orcid":false,"given":"Jill Jing 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Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8876-0578","authenticated-orcid":false,"given":"Jeen Nee","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry National Dental Centre Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3191-5046","authenticated-orcid":false,"given":"Yu Fan","family":"Sim","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2546-9652","authenticated-orcid":false,"given":"Victoria Soo Hoon","family":"Yu","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University of Singapore  Singapore Singapore"},{"name":"National University Centre for Oral Health  Singapore 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