Comparative evaluation of step-wise caries excavation and indirect pulp capping for vitality preservation in young permanent teeth: An in vivo Study

Management of deep carious lesions in young permanent teeth poses a significant clinical challenge due to the risk of pulpal exposure and subsequent loss of vitality. Therefore, this study evaluates and compares the clinical and radiographic outcomes of Step-wise Caries Excavation (SWE) versus Indirect Pulp Capping (IPC) in young permanent molars with deep carious lesions. Hence, a randomized controlled trial was conducted with 40 children aged 8-13 years, having 40 permanent molars with deep carious lesions, randomly allocated to either SWE (n=20) or IPC (n=20) groups. Clinical and radiographic evaluations were performed at baseline, 1 week, 3 months and 6 months. At 1-week follow-up, both groups showed similar success rates (95% in SWE versus 95% in IPC, p=1.000). Thus, we show that IPC is more effective than SWE in preserving pulp vitality in young permanent teeth with deep carious lesions, offering a less invasive and more economical treatment approach.