Main

Thompson V, Craig RG et al. J Am Dent Assoc 2008; 139: 705–712

This paper describes the classical stepwise or two-step excavation and contrasts this with the 'even more controversial' one-stage partial caries removal. For both methods, the importance of achieving a seal between the restorative material and cavity is emphasised. This is in order to exclude substrate from those cariogenic bacteria that have been electively left over the affected dentine. When putting the case for partial caries removal, they cite Kidd's much quoted assertion 'Why re-enter?'. This article does not adopt the austere methodology of limiting its analyses to only randomised control trials used in the 2006 Cochrane Database Systematic Review and meta-analyses on this subject. The authors conclude that 'Apparently, dentists need more evidence...' before they embrace such strategies that are the antitheses of traditional surgical ablation.