Residual Dentin Preservation Following Selective Versus Non-Selective Caries Removal: A Split-Tooth Comparison

<jats:p>Background/objective: Minimally invasive dentistry advocates selective caries removal to preserve affected dentin, protect pulpal vitality, and maintain tooth structure. To compare selective caries removal using Brix3000® and polymer burs (PolyBur®) with conventional caries removal in deep dentinal lesions. Methods: Thirty extracted human molars with deep carious lesions were sectioned using a split-tooth design (n = 15). One half underwent selective caries removal with either Brix3000® or PolyBur®, while the corresponding half received conventional caries removal. Caries removal was completed according to predefined visual and tactile endpoints. Residual dentin thickness was assessed radiographically and stereomicroscopically. Operative time, residual infected dentin, and pulpal exposure were also evaluated. Statistical significance was set at p &amp;lt; 0.05. Results: Pulpal exposure occurred in one Brix3000® specimen, two PolyBur® specimens, and four corresponding controls, resulting in final sample sizes of 12 and 11 specimens, respectively. Both selective techniques preserved significantly more dentin than conventional caries removal. Radiographically, residual dentin thickness was greater with Brix3000® than with its corresponding control (p = 0.02), whereas the difference between PolyBur® and its control was not significant (0p = 0.06). No significant differences were found in residual infected dentin between Brix3000® and PolyBur®. Brix3000® preserved significantly more sound dentin but required the longest operative time (p &amp;lt; 0.001). Conclusions: Both selective caries removal techniques preserved more dentin than conventional caries removal. Brix3000® was the most conservative technique, preserving significantly more sound dentin than PolyBur®, although at the expense of longer operative times. These findings support selective caries removal as a minimally invasive approach for managing deep dentinal lesions.</jats:p>