Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners: A Multinational Survey from 16 Countries with Meta-analysis |
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| Affiliation: | 1. Department of Restorative Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkey;2. Department of Endodontics, Niğde Ömer Halisdemir University, Niğde, Turkey;3. Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia;4. Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland;6. Department of Conservative Dentistry, Jordan University of Science and Technology Irbid, Jordan;5. Program Evaluator (Epidemiologist) CHW Hub (Access to Care) City of San Antonio Metropolitan Health District San Antonio, San Antonio, Texas;7. Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Egypt;11. Department of Conservative Dentistry and Endodontics, Faculty of Medicine, University of Novi Sad, Serbia;12. Clinical Practice Limited to Endodontics, Navegantes, Santa Catarina, Brazil;8. Department of Orthodontics and Pediatric Dentistry, Ibb University, IBB, Yemen;10. Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Saudi Arabia;9. Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo, Japan;71. Department of Restorative Dentistry, International Islamic University Malaysia, Malaysia;112. Department of Conservative Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain;123. Department of Therapeutic Dentistry, Kazakh National Medical University by Asfendiyarov, Almaty, Kazakhstan;84. Restorative Department, National Dental Centre Singapore, Singapore;106. Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal;95. Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal;1. US Navy Dental Corps, Fleet Forces Atlantic, Norfolk, Virginia;2. US Navy Dental Corps, Naval Medical Readiness Training Command, Naval Station Norfolk, Norfolk, Virginia;1. Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, Minnesota;2. The Center for Magnetic Resonance Research, Minneapolis, Minnesota;3. Department of Radiology, School of Dentistry, University of Minnesota, Minneapolis, Minnesota;4. Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota;6. Private Practice, The Dental Specialists, Woodbury, Minnesota;5. Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota;7. Private Practice, The Dental Specialists, Roseville, Minnesota;11. Minnesota Dental Research Center for Biomaterials and Biomechanics, Minneapolis, Minnesota;12. Departments of Radiology & Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota;1. Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia;2. Sydney Dental School, University of Sydney, Sydney, New South Wales, Australia;3. University of Sharjah, College of Dental Medicine, Department of Preventive and Restorative Dentistry, Sharjah, UAE;1. Microscope Center, Department of Conservative, Yonsei University College of Dentistry, Seoul, Korea;2. Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul, Korea;3. Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea;4. Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea;6. Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea;5. Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea |
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| Abstract: | IntroductionDirect pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians’ decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC.MethodsThe questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients’ age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software.ResultsA tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P < .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P < .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P < .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P < .05).ConclusionsWhile carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials. |
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| Keywords: | Dental pulp capping questionnaire meta-analysis |
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