Selective versus stepwise excavation for deep cavities in young permanent teeth
Evaluation of Selective and Stepwise Excavation in Young Permanent Teeth With Deep Caries Lesions (SELECT): A Randomized Controlled Trial in a Practice-Based Research Network
This trial tests whether selective caries removal or stepwise excavation better preserves tooth vitality and reduces complications in 8–19-year-olds with deep cavities in permanent molars or premolars.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 666 (estimated) |
| Ages | 8 Years to 19 Years |
| Sex | All |
| Sponsor | Karolinska Institutet Academic / other |
| Locations | 1 site (Stockholm) |
| Trial ID | NCT06944028 on ClinicalTrials.gov |
What this trial studies
This is a randomized controlled trial conducted within a practice-based research network comparing two minimally invasive ways to manage deep caries in young permanent teeth: selective carious tissue removal and stepwise excavation. Treatments are performed in routine dental practice settings to maximize real-world relevance. Clinical outcomes including tooth vitality and complications are checked one year after treatment, with additional three-year follow-up using dental registry data and records. The goal is to determine which method better preserves teeth and supports long-term dental health in this age group.
Who should consider this trial
Good fit: Ideal candidates are children and adolescents aged 8–19 with a fully erupted permanent molar or premolar showing a deep carious lesion extending to more than two-thirds of dentine but with a radiodense zone separating the pulp and no signs of irreversible pulp pathology, who can attend at least one-year follow-up.
Not a fit: Patients whose teeth show signs of irreversible pulp disease or loss of vitality, have planned extractions, or have medical conditions requiring special dental considerations are unlikely to benefit from these conservative procedures.
Why it matters
Potential benefit: If successful, the preferred method could help dentists preserve tooth vitality, lower the need for more invasive treatments, and improve long-term tooth survival in young patients.
How similar studies have performed: Previous trials of minimally invasive caries removal approaches have shown promising results for preserving pulp vitality, but long-term, head-to-head data in young permanent teeth remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: Children aged 8- 19 years (last December the year they turn 19 years) A fully erupted molar or pre-molar teeth with dental caries (class I or class II) extending to more than 2/3 of the dentine thickness (and on the bitewing radiograph showing a radiodense zone separating the pulp from the demineralized dentine). Bitewing radiograph has been taken as part of the ordinary dental examination Available for recall at least for 1 year. Exclusion Criteria: Extraction is planned of the tooth with deep caries in the future with expected spontaneous gap closure. If the carious tooth shows sign or symptoms of irreversible pulp pathology or loss of vitality including: * Presence of a sinus tract (fistula) * Tenderness to percussion * Buccal tenderness * Severe sensitivity * Evidence of pathology on a periapical radiograph (if radiograph is clinically justified and performed) * No written informed consent. * Medical condition requiring special considerations with regard of the dental management * Dental treatment cannot be performed adequate due to lack cooperation
Where this trial is running
Stockholm
- Folktandvården Stockholm — Stockholm, Sweden (Recruiting)
Study contacts
- Study coordinator: Maria Anderson, PhD
- Email: maria.anderson@regionstockholm.se
- Phone: +46812316538
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.