The Prognostic Impact of Symptoms and Lesion Depth in Partial Removal of Carious Tissue

This study examines whether symptoms of tooth pain before dental treatment can predict outcomes after partial removal of decayed tissue from a tooth — a technique used to preserve the tooth's living pulp rather than performing a root canal. This approach, called stepwise or partial caries excavation, is increasingly preferred when decay is deep but the pulp is still healthy, but clinicians have limited evidence on which teeth will do well versus which will ultimately need root canal treatment. Eligible participants are Finnish- or English-speaking adults aged 18 to 50 with a deep cavity in a premolar or molar that shows signs of mild pulpitis or no symptoms at all, with a pulp that still responds to testing. Numerous exclusions apply, including pregnancy, serious medical conditions, prior major fillings, periapical changes on X-ray, or signs of irreversible pulp damage. Participants receive partial caries removal and are followed at multiple intervals to track whether the tooth remains healthy or progresses to need root canal treatment. Root canal procedures are costly, time-consuming, and weaken the tooth structure. If this research identifies clinical predictors of treatment success, dentists can more confidently offer pulp-preserving approaches to appropriate patients — reducing unnecessary root canals and improving long-term tooth survival.