Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Operative Dentistry

Aim: To compare the success rate after PCR versus SW, to evaluate pain reduction after PCR versus SW in permanent teeth and survival rates of teeth after PCR versus SW. Methods: One hundred and fifteen participants (n=132 teeth), aged 18-47 years, attending the outpatient clinic in Misr International University, Egypt, were enrolled. Premolars/molars with occlusal/occlusal-proximal deep carious lesions (radiographically extending into inner 1/3 dentine) and sensible pulps, without permanent or severe pain, were included. Peripheral carious tissue removal to hard dentine was performed, while pulpo-proximally, soft dentine was left and sealed with glass ionomer restorations. After 3-4 months, teeth were randomly allocated to PCR (n=57), with removal of part of the restoration only, but no further tissue removal, followed by a resin composite restoration; or to SW (n=56), with additional removal until firm dentine remained pulpo-proximally. The primary outcome was success rates of teeth treated by PCR versus SW. The secondary outcome was pain, recorded using a Visual Analogue Scale (VAS, 0-10) at each visit. Also survival analysis (time-to-event) was performed and estimated survival times were calculated. Results: Zero and five pulp exposures occurred during PCR and SW, respectively. Additionally, One SW and three PCR treated teeth required endodontic therapy during 10(5) months follow-up. Patients age or gender, dental arch, tooth type, number of surfaces and presence of pre-operative pain did not have a statistically significant impact (p>0.05/Cox). Success rate was (82.5%) for PCR compared to (75%) for SW (p>0.05/Fisher) with odds ratio of 2.4 (0.5-9.5) at 95% CI. Pain has decreased significantly in both groups compared with baseline (p<0.001/Freidman), without significant differences between groups (p>0.0.05/ Mann-Whitney U). The estimated mean (95%CI) survival rates were 24 (21-27) and 20(18- 23) months for PCR and SW, respectively

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