2015 Update: Approaches to Caries Removal

Every day in the United States and around the world, complete caries removal in vital, asymptomatic teeth with deep caries lesions ends in unavoidable exposure of the pulp. As a result, the complexity and cost of treatment increase dramatically, and many patients are left with extraction as their only viable option. This Critical Appraisal updates a previous appraisal (2013). Since that review three, systematic reviews of the literature and one large, randomized controlled clinical trial (RCT) have been published. Thus, newer, higher quality evidence is available that supports alternative treatments designed to preserve the vitality of the tooth and thus avoid extraction.