{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:34:00Z","timestamp":1794605640353,"version":"4.9.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,5,11]],"date-time":"2010-05-11T00:00:00Z","timestamp":1273536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J Oral Sciences"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:p>\n                    <jats:italic>Bj\u00f8rndal L, Reit C, Bruun G, Markvart M, Kj\u00e6ldgaard M, N\u00e4sman P, Thordrup M, Dige I, Nyvad B, Fransson H, Lager A, Ericson D, Petersson K, Olsson J, Santimano EM, Wennstr\u00f6m A, Winkel P, Gluud C. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 2010; 118: 290\u2013297<\/jats:italic>\n                    .\n                    <jats:italic>\u00a9 2010 The Authors. Journal compilation<\/jats:italic>\n                    \u00a9\n                    <jats:italic>2010 Eur J Oral Sci<\/jats:italic>\n                  <\/jats:p>\n                  <jats:p>Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1\u2003yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1\u2003yr of follow\u2010up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1\u2003yr [31.8% and 34.5%; difference: 2.7%, 95% CI (\u221222.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.<\/jats:p>","DOI":"10.1111\/j.1600-0722.2010.00731.x","type":"journal-article","created":{"date-parts":[[2010,5,11]],"date-time":"2010-05-11T15:04:47Z","timestamp":1273590287000},"page":"290-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":309,"title":["Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy"],"prefix":"10.1111","volume":"118","author":[{"given":"Lars","family":"Bj\u00f8rndal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claes","family":"Reit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitte","family":"Bruun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merete","family":"Markvart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Kj\u00e6ldgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"N\u00e4sman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Thordrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Dige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bente","family":"Nyvad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Fransson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Lager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Ericson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Petersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadranka","family":"Olsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M.","family":"Santimano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Wennstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Winkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gluud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,5,11]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"36","article-title":"Stepwise excavation of deep carious lesions in primary molars","volume":"8","author":"Magnusson BO","year":"1977","journal-title":"J Int Assoc Dent Child"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-9657.1996.tb00513.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003808.pub2"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.12.006"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj069"},{"key":"e_1_2_6_7_2","first-page":"367","volume-title":"Dental Caries: The Disease and its Clinical Management","author":"Kidd EAM","year":"2008"},{"key":"e_1_2_6_8_2","first-page":"225","article-title":"Indirect pulp therapy and stepwise excavation","volume":"30","author":"Bj\u00f8rndal L","year":"2008","journal-title":"Pediatr Dent"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004484.pub2"},{"key":"e_1_2_6_10_2","first-page":"296","article-title":"Capping of the pulp. 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