Objective: To determine the differences in treatment strategies and material preferences for deep dentine carious lesions (DDCLs) management among general and specialist dentists.
Methods: Dentists working in universities, oral and dental health centers, or private practice were administered a 14-item web-based questionnaire regarding demographic and occupational characteristics, approaches to DDLCs, pulp capping methods, and preferences for restorative materials. The data were examined using descriptive statistical analysis and Pearson’s chi-square tests.
Results: The study enrolled 298 general and 265 specialist dentists among whom 67.1% were female and 73.3% were aged 25 to 35 years. Total excavation and permanent restoration of DDCLs were the commonly preferred treatments (67.0%), although the pediatric dentists tended toward selective caries removal in these lesions. Mineral trioxide aggregate was used more regularly by the pediatric dentists and endodontists. The pediatric dentists exhibited statistically significantly lower preference for canal treatment than general dentists and endodontists as treatment option for mature teeth with DDCLs (p<0.05).
Conclusion: Conservative treatment approaches and material preferences of specialists and general dentists in DDCLs are generally different. The age of dentists, the time since their graduation, place of work and the number of patients they have seen daily may affect the approaches and preferences.
- Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016;28(2):58-67.
- Kassebaum N, Smith A, Bernabé E, Fleming T, Reynolds A, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380-7.
- Koopaeei MM, Inglehart MR, McDonald N, Fontana M. General dentists’, pediatric dentists’, and endodontists’ diagnostic assessment and treatment strategies for deep carious lesions: a comparative analysis. J Am Dent Assoc. 2017;148(2):64-74.
- Crespo-Gallardo I, Martín-González J, Jiménez- Sánchez MC, Cabanillas-Balsera D, Sánchez- Domínguez B, Segura-Egea JJ. Dentist´ s knowledge, attitudes and determining factors of the conservative approach in teeth with reversible pulpitis and deep caries lesions. J Clin Exp Dent. 2018;10(12):e1205.
- Duncan H, Galler K, Tomson P, Simon S, El‐Karim I, et al. European Society of Endodontology position statement: management of deep caries and the exposed pulp. Int Endod J. 2019;52(7):923-34.
- Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod. 2011;37(5):581-87.
- Sales GC, Marques MG, Rubin DR, Nardoni DN, Leal SC, Hilgert LA, et al. Are Brazilian dentists and dental students using the ICCC recommendations for caries management? Braz Oral Res. 2020;34:e062.
- Vural UK, Gökalp S. Treatment method and restorative material preferences of dental practitioners. Eur J Gen Dent. 2016;5(1):19.
- Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-7.
- Kakudate N, Yokoyama Y, Sumida F, Matsumoto Y, Gordan VV, Gilbert GH. Dentists’ practice patterns of treatment for deep occlusal caries: findings from a dental practice-based research network. J Dent. 2019;84:76-80.
- Chisini LA, Conde MCM, Correa MB, Dantas RVF, Silva AF, Pappen FG, et al. Vital pulp therapies in clinical practice: findings from a survey with dentist in Southern Brazil. Braz Dent J. 2015;26(6):566-71.
- Schonlau M, Ronald Jr D, Elliott MN. Conducting research surveys via e-mail and the web: Rand Corporation; 2002.
- Segura-Egea JJ. Complete excavation or removal of carious tissues to hard dentin: Overtreatment. J Oral Res. 2017;6(2):30-1.
- Chin J, Thomas M, Locke M, Dummer P. A survey of dental practitioners in Wales to evaluate the management of deep carious lesions with vital pulp therapy in permanent teeth. Br Dent J. 2016;221(6):331-8.
- Stangvaltaite L, Schwendicke F, Holmgren C, Finet M, Maltz M, Elhennawy K, et al. Management of pulps exposed during carious tissue removal in adults: a multi-national questionnaire-based survey. Clin Oral Investig. 2017;21(7):2303-9. Li
- M, Hu X, Li X, Lei S, Cai M, Wei X, et al. Dentist-related factors influencing the use of vital pulp therapy: a survey among dental practitioners in China. J Int Med Res. 2019;47(6):2381-93.
- Martín-Jiménez M, Martín-Biedma B, López- López J, Alonso-Ezpeleta O, Velasco-Ortega E, Jimenez-Sanchez M, et al. Dental students’ knowledge regarding the indications for antibiotics in the management of endodontic infections. Int Endod J. 2018;51(1):118-127.
- Javaid A, Asad M, Khan S, Berkth M. Practice of dental pulp protection methods among various teaching institutions in Pakistan. J Pak Dent Assoc. 2016;25(1):16-20.
- Demarco FF, Corrêa MB, Cenci MS, Moraes RR, Opdam NJ. Longevity of posterior composite restorations: not only a matter of materials. Dent Mater. 2012;28(1):87-101.
- Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA. Longevity and reasons for failure of sandwich and total-etch posterior composite resin restorations. J Adhes Dent. 2007;9(5):469-75.
- Li J, Liu Y, Liu Y, Söremark R, Sundström F. Flexure strength of resin-modified glass ionomer cements and their bond strength to dental composites. Acta Odontol Scand. 1996;54(1):55-8.
- da Rosa W, Lima V, Moraes R, Piva E, da Silva A. Is a calcium hydroxide liner necessary in the treatment of deep caries lesions? A systematic review and meta-analysis. Int Endod J. 2019;52(5):588-603.
- Schenkel AB, Veitz-Keenan A. Dental cavity liners for Class I and Class II resin-based composite restorations. Cochrane Database Syst Rev. 2019(3): CD010526.
- Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K, et al. Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig. 2017;21(1):191-8.
- Schwendicke F, Paris S, Tu Y-K. Effects of using different criteria for caries removal: a systematic review and network meta-analysis. J Dent. 2015;43(1):1-15.
- Nascimento GG, Correa MB, Opdam N, Demarco FF. Do clinical experience time and postgraduate training influence the choice of materials for posterior restorations? Results of a survey with Brazilian general dentists. Braz Dent J. 2013;24(6):642-6.
- Croft K, Kervanto-Seppälä S, Stangvaltaite L, Kerosuo E. Management of deep carious lesions and pulps exposed during carious tissue removal in adults: a questionnaire study among dentists in Finland. Clin Oral Investig. 2019;23(3):1271-80.
- Shabahang S. Treatment options: apexogenesis and apexification. J Endod. 2013;39(3):26-9.
Delikan, E., Ertürk-Avunduk, A., & Aksu, S. Approaches of General and Specialist Dentists to Deep Caries Management: A Cross-Sectional Study from Turkey. J Dent Indones. 2021;28(2): 94-104