Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway

Stangvaltaite‐Mouhat, Lina; Kundzina, Rita; Eriksen, Harald M.; Kerosuo, Eero

doi:10.3109/00016357.2013.775338

Cited by 43 publications

(52 citation statements)

References 21 publications

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“…Namely, response rate, whether the sample is representative of the population studied and the self‐reported nature of the disclosed information. The overall response rate in this current study was low (12.6%), although previous surveys on this topic reported response rates ranging from 4 to 92%. Comparison of demographic factors between the sample population and the national distribution revealed our sample has an over‐representation of dentists whose initial qualification was obtained in Australia .…”

Section: Discussioncontrasting

confidence: 65%

Treatment preferences for deep caries lesions among Australian dentists

Chai

Tay

Chow

et al. 2020

Australian Dental Journal

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Background There is a global disparity in managing deep caries lesions and evidence‐based strategies are not always followed. The aim of this study was to gain insight into current practices of Australian dentists for deep caries management and to determine their procedural and materials choices. Methods An online questionnaire was sent to 1988 randomly selected practitioners across Australia asking their choice of treatment in a tooth showing symptoms of reversible pulpitis and deep caries. A total of 255 (12.6%) practitioners responded. Results About 85% of respondents chose selective caries removal to selective removal (SR) while 15% chose non‐selective removal to hard dentine. Respondents whose preferred approach was SR had greater odds in believing that incomplete caries removal alone would not have any effect on pulp vitality (OR = 5.20) and had greater odds of thinking that peripheral seal was more important than other factors (OR = 3.50). They also had lesser odds of believing that placing a liner would reduce postoperative sensitivity (OR = 0.269) and lesser odds of thinking that removal of all bacteria or carious dentine was important when placing a restoration (OR = 0.196). Conclusion Most Australian dentists reported practising evidence‐based carious tissue removal strategies and accepted the concept of selectively leaving carious dentine under a sealed restoration.

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Section: Discussioncontrasting

confidence: 65%

Treatment preferences for deep caries lesions among Australian dentists

Chai

Tay

Chow

et al. 2020

Australian Dental Journal

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“…Amongst the dentists in northern Norway, who were chosen to implement the study, total excavation was still the method of choice for treating deep carious lesions (Stangvaltaite et al . ); this still seems to be so in the United States and parts of Europe (Oen et al . , Schwendicke et al .…”

Section: Discussionmentioning

confidence: 99%

“…Amongst strictly adult patients, direct pulp capping with CH yielded a rather low success rate (less than 35% after 1 year of follow-up) in a multicentre randomized clinical trial (RCT; Bjørndal et al 2010). Yet, direct pulp capping (with CH) is reported to be the most common method used to treat carious exposure in young adult patients (Oen et al 2007, Stangvaltaite et al 2013.…”

Section: Introductionmentioning

confidence: 99%

Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide

et al. 2016

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Aim The aim of this multicentre, parallel-group randomized clinical trial was to compare the effectiveness of mineral trioxide aggregate (MTA) and a conventional calcium hydroxide liner (CH) as direct pulp capping materials in adult molars with carious pulpal exposure.Methodology Seventy adults aged 18 to 55 years were randomly allocated to two parallel arms:MTA (White ProRoot, Dentsply, Tulsa Dental, Tulsa, OK, USA) (n=33) and CH (Dycal ® , Dentsply DeTrey GmbH, Konstanz, Germany) (n=37). The teeth were temporized for one week with glass ionomer (Fuji IX, GC Corp, Tokyo, Japan), and then permanently restored with a composite resin.The subjects were followed up after 1 week and at 6, 12, 24, and 36 months. The primary outcome was the survival of the capped pulps, and the secondary outcome was postoperative pain after 1 week.Survival was defined as a non-symptomatic tooth that responded to sensibility testing and did not exhibit periapical changes on radiograph. At each check-up, the pulp was tested for sensibility and a periapical radiograph was taken (excluding the radiographs taken at the 1-week follow up). KaplanMeier survival analysis and log-rank test was used to assess the significant difference in the survival curves between groups. Chi-square test was used to assess the association between the materials and preoperative and postoperative pain. Accepted ArticleThis article is protected by copyright. All rights reserved.Results At 36 months, the Kaplan-Meier survival analysis showed a cumulative estimate rate of 85% for the MTA group and 52% for the CH group (p=0.006). There was no significant association between the capping material and postoperative pain.Conclusions MTA performed more effectively than a conventional CH liner as a direct pulp capping material in molars with carious pulpal exposure in adult patients. This study has been registered at ClinicalTrials.gov, number NCT01224925.

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“…In clinical practice, the decision on whether to maintain the pulp or not also varies (Stangvaltaite et al . ), even when important subjective (e.g. symptoms) and objective diagnostic data (e.g.…”

Section: Reviewmentioning

confidence: 99%

Management of deep caries and the exposed pulp

et al. 2019

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Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one‐visit as indirect pulp treatment or two‐visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re‐emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp–dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence‐based management strategies and education in management of the exposed pulp are critical in the future.

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Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway

Abstract: There is no uniform treatment method of deep carious lesions among dentists in Northern Norway.

Cited by 43 publications

References 21 publications

Treatment preferences for deep caries lesions among Australian dentists

Treatment preferences for deep caries lesions among Australian dentists

Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide

Management of deep caries and the exposed pulp

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