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Clinical Oral Investigations

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09.07.2018 | Original Article

Management of deep carious lesions and pulps exposed during carious tissue removal in adults: a questionnaire study among dentists in Finland

verfasst von: Katri Croft, Sari Kervanto-Seppälä, Lina Stangvaltaite, Eero Kerosuo

Erschienen in: Clinical Oral Investigations | Ausgabe 3/2019

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Abstract

Objectives

To find out which management methods are preferred by dentists in Finland for a deep carious lesion or a pulp exposed during carious tissue removal in adult patients.

Materials and methods

An electronic questionnaire consisting of 25 questions was sent to 1000 randomly sampled dentists in Finland. The response rate was 32%.

Results

Less invasive excavation strategies (stepwise or selective removal) were preferred by 64% for an asymptomatic deep lesion, while 34% chose nonselective removal to hard dentine. In the presence of an asymptomatic pulpal exposure, vital pulp therapy was preferred, as 71% of the respondents chose direct pulp capping (DPC) or partial pulpotomy, compared to root canal treatment (26%). Mineral trioxide aggregate (MTA) and calcium hydroxide-based materials were both chosen by 40% for vital pulp therapy. In the management of a deep carious lesion, less invasive excavation strategies were significantly associated with having clinical guidelines vs. no guidelines at the practice [odds ratio (OR) 3.5, confidence interval (CI) 1.4–9.0]. MTA was favored over other DPC materials significantly more often by those who had attended continuing education courses during the last 3 years (OR 2.8, CI 1.2–6.5).

Conclusions

Less invasive management strategies have been adopted into clinical practice by the majority of dentists in Finland. There is a need to encourage the use of MTA in the case of a pulpal exposure.

Clinical relevance

The results of this study can be utilized in continuing education, to raise awareness of management strategies supported by present scientific evidence.

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Marthaler TM (2004) Changes in dental caries 1953-2003. Caries Res 38(3):173–181. https://doi.org/10.1159/000077752 CrossRefPubMed

Vehkalahti M, Varsio S, Hausen H (2004) The condition of teeth (in Finnish). In: Suominen-Taipale L, Nordblad A, Vehkalahti M, Aromaa A (eds) Suomalaisten aikuisten suunterveys. Terveys 2000-tutkimus, Publications of the National Public Health Institute B16/2004. Hakapaino, Helsinki, p 77

Stangvaltaite L, Kundzina R, Bolstad NL, Eriksen HM, Kerosuo E (2015) Deep carious lesions and other consequences of caries among 18-year-olds at Public Dental Health Service in Northern Norway: a cross-sectional age cohort study. Acta Odontol Scand 73(6):401–407. https://doi.org/10.3109/00016357.2014.971866 CrossRefPubMed

Barton R, Wall J (1985) Fundamentals in cavity preparation. In: Sturdevant C, Barton R, Sockwell C, Strickland W (eds) The art and science of operative dentistry, 2nd edn. The C.V. Mosby Company, Missouri, pp 100–101

Innes NP, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D et al (2016) Managing carious lesions: consensus recommendations on terminology. Adv Dent Res 28(2):49–57. https://doi.org/10.1177/0022034516639276 CrossRefPubMed

Bjorndal L, Reit C, Bruun G, Markvart M, Kjaeldgaard M, Nasman P et al (2010) Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 118(3):290–297. https://doi.org/10.1111/j.1600-0722.2010.00731.x CrossRefPubMed

Magnusson BO, Sundell SO (1977) Stepwise excavation of deep carious lesions in primary molars. J Int Assoc Dent Child 8(2):36–40PubMed

Maltz M, Garcia R, Jardim JJ, de Paula LM, Yamaguti PM, Moura MS, Garcia F, Nascimento C, Oliveira A, Mestrinho HD (2012) Randomized trial of partial vs. stepwise caries removal: 3-year follow-up. J Dent Res 91(11):1026–1031. https://doi.org/10.1177/0022034512460403 CrossRefPubMed

Carvalho JC, Dige I, Machiulskiene V, Qvist V, Bakhshandeh A, Fatturi-Parolo C, Maltz M (2016) Occlusal caries: biological approach for its diagnosis and management. Caries Res 50(6):527–542. https://doi.org/10.1159/000448662 CrossRefPubMed

10.

Hoefler V, Nagaoka H, Miller CS (2016) Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: a systematic review. J Dent 54:25–32. https://doi.org/10.1016/j.jdent.2016.09.009 CrossRefPubMed

11.

Ng YL, Mann V, Gulabivala K (2010) Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J 43(3):171–189. https://doi.org/10.1111/j.1365-2591.2009.01671.x CrossRefPubMed

12.

Hülsmann M (2016) Epidemiology of post-treatment disease. Endod Top 34:42–63. https://doi.org/10.1111/etp.12096 CrossRef

13.

Al-Nuaimi N, Patel S, Davies A, Bakhsh A, Foschi F, Mannocci F (2018) Pooled analysis of 1-year recall data from three root canal treatment outcome studies undertaken using cone beam computed tomography. Int Endod J 51(Suppl 3):e216–e226. https://doi.org/10.1111/iej.12844 CrossRefPubMed

14.

Randow K, Glantz PO (1986) On cantilever loading of vital and non-vital teeth. An experimental clinical study. Acta Odontol Scand 44(5):271–277CrossRefPubMed

15.

Ou K, Chang C, Chang W, Lin C, Chang K, Huang H (2009) Effect of damping properties on fracture resistance of root filled premolar teeth: a dynamic finite element analysis. Int Endod J 42(8):694–704. https://doi.org/10.1111/j.1365-2591.2009.01570.x CrossRefPubMed

16.

Zelic K, Vukicevic A, Jovicic G, Aleksandrovic S, Filipovic N, Djuric M (2015) Mechanical weakening of devitalized teeth: three-dimensional Finite Element Analysis and prediction of tooth fracture. Int Endod J 48(9):850–863. https://doi.org/10.1111/iej.12381 CrossRefPubMed

17.

Barthel CR, Rosenkranz B, Leuenberg A, Roulet JF (2000) Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 26(9):525–528. https://doi.org/10.1097/00004770-200009000-00010 CrossRefPubMed

18.

Bogen G, Kim JS, Bakland LK (2008) Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc 139(3):305–315. https://doi.org/10.14219/jada.archive.2008.0160 CrossRefPubMed

19.

Alqaderi H, Lee CT, Borzangy S, Pagonis TC (2016) Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: a systematic review and meta-analysis. J Dent 44:1–7. https://doi.org/10.1016/j.jdent.2015.12.005 CrossRefPubMed

20.

Schwendicke F, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D et al (2016) Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res 28(2):58–67. https://doi.org/10.1177/0022034516639271 CrossRefPubMed

21.

Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A, Ship JA, Lindblad A (2007) Attitudes and expectations of treating deep caries: a PEARL network survey. Gen Dent 55(3):197–203PubMed

22.

Weber CM, Alves LS, Maltz M (2011) Treatment decisions for deep carious lesions in the Public Health Service in Southern Brazil. J Public Health Dent 71(4):265–270. https://doi.org/10.1111/j.1752-7325.2011.00258.x CrossRefPubMed

23.

Schwendicke F, Meyer-Lueckel H, Dorfer C, Paris S (2013) Attitudes and behaviour regarding deep dentin caries removal: a survey among German dentists. Caries Res 47(6):566–573. https://doi.org/10.1159/000351662 CrossRefPubMed

24.

Fink A (2014) Epidemiological field work in population-based studies. In: Ahrens W, Pigeot I (eds) Handbook of epidemiology, 2nd edn. Springer, New York, pp 577–611CrossRef

25.

Stangvaltaite L, Schwendicke F, Holmgren C, Finet M, Maltz M, Elhennawy K, Kerosuo E, Doméjean S (2017) Management of pulps exposed during carious tissue removal in adults: a multi-national questionnaire-based survey. Clin Oral Investig 21(7):2303–2309. https://doi.org/10.1007/s00784-016-2023-9 CrossRefPubMed

26.

Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K, Eriksen I, Kuzmiszyn TC, Kerosuo E, Doméjean S (2017) Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig 21(1):191–198. https://doi.org/10.1007/s00784-016-1776-5 CrossRefPubMed

27.

Stangvaltaite L, Kundzina R, Eriksen HM, Kerosuo E (2013) Treatment preferences of deep carious lesions in mature teeth: questionnaire study among dentists in Northern Norway. Acta Odontol Scand 71(6):1532–1537. https://doi.org/10.3109/00016357.2013.775338 CrossRefPubMed

28.

Ricucci D, Loghin S, Siqueira JF Jr (2014) Correlation between clinical and histologic pulp diagnoses. J Endod 40(12):1932–1939. https://doi.org/10.1016/j.joen.2014.08.010 CrossRefPubMed

29.

Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M, Stangvaltaite L, van der Sluis LWM (2017) Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J 50(9):825–829. https://doi.org/10.1111/iej.12793 CrossRefPubMed

30.

Levin LG, Law AS, Holland GR, Abbott PV, Roda RS (2009) Identify and define all diagnostic terms for pulpal health and disease states. J Endod 35(12):1645–1657. https://doi.org/10.1016/j.joen.2009.09.032 CrossRefPubMed

31.

Root canal treatment (online). Current Care Guidelines (2016) Working group set up by the Finnish Medical Society Duodecim and the Finnish Dental Society. The Finnish Medical Society Duodecim, Helsinki 2016. Available in Finnish: http://www.kaypahoito.fi. Accessed 28 March 2017

32.

Hilton TJ, Ferracane JL, Mancl L, Northwest Practice-based Research Collaborative in Evidence-based Dentistry (NWP) (2013) Comparison of CaOH with MTA for direct pulp capping: a PBRN randomized clinical trial. J Dent Res 92(7 Suppl):16S–22S. https://doi.org/10.1177/0022034513484336 CrossRefPubMed

33.

Mente J, Hufnagel S, Leo M, Michel A, Gehrig H, Panagidis D, Saure D, Pfefferle T (2014) Treatment outcome of mineral trioxide aggregate or calcium hydroxide direct pulp capping: long-term results. J Endod 40(11):1746–1751. https://doi.org/10.1016/j.joen.2014.07.019 CrossRefPubMed

34.

Kundzina R, Stangvaltaite L, Eriksen HM, Kerosuo E (2017) Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. Int Endod J 50(10):924–932. https://doi.org/10.1111/iej.12719 CrossRefPubMed

35.

Linsuwanont P, Wimonsutthikul K, Pothimoke U, Santiwong B (2017) Treatment outcomes of mineral trioxide aggregate pulpotomy in vital permanent teeth with carious pulp exposure: the retrospective study. J Endod 43(2):225–230. https://doi.org/10.1016/j.joen.2016.10.027 CrossRefPubMed

36.

Taha NA, Ahmad MB, Ghanim A (2017) Assessment of mineral trioxide aggregate pulpotomy in mature permanent teeth with carious exposures. Int Endod J 50(2):117–125. https://doi.org/10.1111/iej.12605 CrossRefPubMed

37.

Taha NA, Khazali MA (2017) Partial pulpotomy in mature permanent teeth with clinical signs indicative of irreversible pulpitis: a randomized clinical trial. J Endod 43(9):1417–1421. https://doi.org/10.1016/j.joen.2017.03.033 CrossRefPubMed

Titel: Management of deep carious lesions and pulps exposed during carious tissue removal in adults: a questionnaire study among dentists in Finland
verfasst von: Katri Croft
Sari Kervanto-Seppälä
Lina Stangvaltaite
Eero Kerosuo
Publikationsdatum: 09.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 3/2019
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2556-1

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Management of deep carious lesions and pulps exposed during carious tissue removal in adults: a questionnaire study among dentists in Finland

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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