Influence of Selective Caries Removal on Post-Operative Sensitivity in Permanent Molars

Background: Post-operative sensitivity after restoration of deep carious lesions is a common patient-centered concern that may reduce comfort and satisfaction after dental treatment. Complete caries excavation can increase pulpal irritation in deep lesions, whereas selective caries removal preserves affected dentin near the pulp and may reduce early discomfort. Objective: To compare short-term post-operative sensitivity after selective caries removal versus complete excavation in permanent molars with deep carious lesions. Methods: This randomized controlled trial enrolled 60 adults aged 18–45 years with deep occlusal or occlusoproximal caries in permanent molars. Participants were allocated equally to selective caries removal or complete excavation. All cavities were restored immediately using resin-modified glass ionomer cement under standardized clinical protocols. Post-operative sensitivity was assessed using a visual analogue scale at 24 hours, 72 hours, and 7 days. Biting sensitivity and the association between cavity depth and VAS scores were also evaluated. Results: Selective caries removal produced lower VAS scores than complete excavation at 24 hours (2.1 ± 0.9 vs. 3.8 ± 1.1), 72 hours (1.4 ± 0.7 vs. 2.6 ± 0.9), and 7 days (0.6 ± 0.4 vs. 1.2 ± 0.6). Biting sensitivity was also less frequent after selective removal at 24 hours and 72 hours. Cavity depth showed stronger positive correlations with sensitivity after complete excavation. Conclusion: Selective caries removal reduced early post-operative sensitivity compared with complete excavation in permanent molars, supporting conservative excavation for short-term patient comfort.