{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:52:13Z","timestamp":1790398333342,"version":"4.1.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2017,4,14]],"date-time":"2017-04-14T00:00:00Z","timestamp":1492128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Danish Regions"},{"name":"The Danish agency for Science, Technology and Innovation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p>Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1\u201326.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up ( ClinicalTrials.gov NCT00187837 and NCT00187850).<\/jats:p>","DOI":"10.1177\/0022034517702620","type":"journal-article","created":{"date-parts":[[2017,4,14]],"date-time":"2017-04-14T13:47:19Z","timestamp":1492177639000},"page":"747-753","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":130,"title":["Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up"],"prefix":"10.1177","volume":"96","author":[{"given":"L.","family":"Bj\u00f8rndal","sequence":"first","affiliation":[{"name":"Department of Odontology, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Fransson","sequence":"additional","affiliation":[{"name":"Faculty of Odontology, Malm\u00f6 University, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bruun","sequence":"additional","affiliation":[{"name":"Department of Odontology, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Markvart","sequence":"additional","affiliation":[{"name":"Department of Odontology, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kj\u00e6ldgaard","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"N\u00e4sman","sequence":"additional","affiliation":[{"name":"Department of Oral 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