{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:21:57Z","timestamp":1792300917945,"version":"4.4.0"},"reference-count":24,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,28]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the success, survival and costs of selective versus stepwise carious tissue removal (SE\/SW) in permanent teeth with deep (&gt;2\/3 dentine depth) carious lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Randomised controlled, unicentre, clustered two-arm superiority trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outpatient clinic of a private university in Cairo, Egypt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>One hundred and fifteen participants (n=132 teeth), aged 18\u201347 years, from Cairo, Egypt, were enrolled. Premolars\/molars with occlusal\/occlusal-proximal deep lesions (radiographically &gt;2\/3 dentine), sensible pulps, without spontaneous pain, were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Peripheral carious tissue removal to hard dentine was performed. Pulpo-proximally, soft dentine was left. A glass ionomer (GI) restoration was placed. After 3\u20134 months, teeth were randomly allocated to SE (n=66), with reduction of the GI into a base and no further tissue removal, followed by a composite resin restoration, or SW (n=66), with full removal of the GI, additional excavation until firm dentine pulpo-proximally, followed by a GI-based composite restoration. Mean follow-up was 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcome was success (absence of endodontic\/restorative complications). Secondary outcomes were tooth survival and initial and total treatment costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Zero\/five pulp exposures occurred during SE\/SW, and seven\/five SE\/SW teeth required endodontic therapy. Success after 12 months was 89.4% for SE and 84.9% for SW. The estimated mean time free of complications was 23 and 18 months for SE and SW, respectively, without significant differences between SE and SW (p&gt;0.05\/Cox). Initial treatment costs were significantly higher for SW (mean (SD): 507.5 (123.4) Egyptian pounds (EGP)) than SE (mean (SD): 456.6 (98.3) EGP), while total costs showed no significant difference (p&gt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within the limitations of this interim analysis, and considering the depth of these lesions (&gt;2\/3 dentine), SE and SW showed similar risk of failure and overall costs after 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>PACTR201603001396248.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030957","type":"journal-article","created":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T08:55:17Z","timestamp":1568710517000},"page":"e030957","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Selective versus stepwise removal of deep carious lesions in permanent teeth: a randomised controlled trial from Egypt\u2014an interim analysis"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0737-1421","authenticated-orcid":false,"given":"Mohamed E","family":"Labib","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfat E","family":"Hassanein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makeen","family":"Moussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asmaa","family":"Yassen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falk","family":"Schwendicke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,17]]},"reference":[{"key":"2024052014394611000_9.9.e030957.1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034516639271"},{"key":"2024052014394611000_9.9.e030957.2","doi-asserted-by":"publisher","DOI":"10.1159\/000262431"},{"key":"2024052014394611000_9.9.e030957.3","doi-asserted-by":"crossref","unstructured":"Bj\u00f8rndal L . Stepwise carious tissue removal. In: Schwendicke F , ed. Management of deep carious lesions. 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