Spit, Esther (2022) Het managen van diepe cariëslaesies en pulpa-exponaties die ontstaan tijdens het verwijderen van carieus weefsel bij volwassenen: behandelvoorkeuren onder Nederlandse tandartsen. thesis, Dentistry.
Full text available on request.Abstract
Background The last few years, there has been a shift from complete removal of the carious tissue to minimally invasive approaches in which carious tissue is left centrally and the vitality of the pulp should be preserved. The 'International Caries Consensus Collaboration' has released a consensus document in line with this approach. Since the release of this consensus document, previous international studies show that more and more dentists prefer a minimally invasive approach. Literature on the treatment of Dutch dentists is lacking. Objectives The aim of this study is to identify the treatment preferences of Dutch dentists for deep carious lesions and pulpal exposure during the removal of carious tissue in adults. In addition, it will be investigated whether symptoms of the patients and different socio-demographic variables influence the chosen treatment preferences. This information can be used to understand whether more information regarding minimally invasive caries treatment and maintaining pulpal vitality is necessary. Materials and methods An online questionnaire consisting of 23 questions was sent to 750 Dutch dentists by mail. The questions covered socio-demographic data, treatment preference for excavation, treatment preference for pulpal exposure and the use of MTA. Data was collected in REDCap. Descriptive analyses, Cochran’s test, Mc Nemar test and logistic analyses were used for statistical analyses. Results A total of 139 completely completed questionnaires were received. In deep caries lesions without pulpal excposure, the majority of the participants (36-71%) preferred a non-invasive treatment option in teeth without complaints or with (ir)reversible pulpitis complaints; indirect pulpal capping. In the case of a deep caries lesion with pulpal exposure, the majority of participants (51-72%) preferred a non-invasive treatment option for teeth without complaints or with reversible pulpitis complaints; direct pulpal capping. If the element showed irreversible pulpitis symptoms the majority of participants (67%) preferred a non-invasive treatment option; root canal treatment. Gender and university of graduation were significant predictors for the treatment choice among Dutch dentists. For direct pulpal capping, partial pulpotomy or pulpotomy, 35% of participants chose to use Mineral Trioxide Aggregate (MTA) and 29% chose calcium hydoxide (CH). No significant predictors for using MTA were detectable. Conclusions The majority of the participants chose non-invasive treatment methods as the preferred treatment for deep caries lesions and pulpal exposures that occur during the removal of carious tissue in adults. However, when the patient presented irreversible pulpitis symptoms at an exposured tooth, the majority of participants preferred an invasive treatment method. Symptoms of the patient, as well as gender and university of graduation influenced the treatment preferences of Dutch dentists. About one-third of the participants chose to use MTA for direct pulpal capping, partial pulpotomy or pulpotomy. Socio-demographic factors did not influence the use of MTA. It seems useful to provide information about the minimally invasive treatment options and the superiority of MTA over other materials.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | van der Sluis, Prof. em. L.W.M. and Blanksma, dr. N.G. |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 May 2023 11:43 |
| Last Modified: | 09 May 2023 11:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3518 |
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