Factors affecting the decision-making of direct pulp capping procedures amongst Turkish dental practitioners

Abstract

To examine the factors affecting the decision-making of direct pulp capping procedures amongst Turkish dental practitioners. Methods: A total of 378 Turkish dentists participated in the survey. The questionnaire comprised three sections. The first part comprised questions regarding demographic features. The second part comprised; questions on how treatment plans change according to factors such as pulp perforation position, number, size, how it occurred, and patient age. The third part composed of questions on the common materials and techniques used in pulp capping treatment. Descriptive statistics was calculated using Pearson's χ 2 test, and the risk assessments of factors affecting the choice of pulp capping decision were computed using logistic regression analysis. Results: 85.18% of participants preferred the pulp capping treatment. When the perforation size was >1 mm, males and university dentists decided more pulp capping treatments than females and private dentists respectively did (P<0.05). While the perforation size factor changed the dentists' decision most (OR=6.85), the patient's age factor least altered the choice (OR=1.38). Gender did not affect the decision of technique and material (P>0.05), but workplace and experience affected the choice of material (P<0.05). Technique did not affect the decision (P>0.05). Conclusion: Turkish dentists prefer invasive treatments when risk factors in pulp capping treatment increase. The possible cause may be to reduce the rate of unsuccessful treatment; thus, ensure the continuity of patient confidence.

Preferred Technique and Material Choice for exposed pulp among dentists practicing in Karachi

“…Therefore, in the literature, the success of DPC has been discussed with great controversy. Moreover, the risk perception for the success of DPC of each dentist isn't similar that leads to different treatment approaches 6 . It is also observed that in clinical circumstances where chances of success of DPC anticipated by the clinician are low, they opt for more invasive surgical approaches, including pulpotomy or RCTs.…”

Knowledge, Attitude and Practice regarding dental pulp treatment in teaching sector of South Punjab

“…These findings are in accordance with other researches. (6,24) It suggested that irrespective of inflammatory response of the pulp CH was the most selected material for direct capping of pulp. Most likely the reason behind this could be, the training of the participants during their clinical education, ability of CH to form reparative dentine and cost effectiveness and continuation of learnt techniques.…”

“…Furthermore, each dentist has different treatment approaches for the success of DPC. (6,7) The choice of dental material predicts the prognosis of vital pulp therapy. Several materials are available for pulp capping procedure.…”

“…Several materials are available for pulp capping procedure. In early 20th century, Calcium Hydroxide (CH) has been the material of choice for DPC (6) but it has a number of disadvantages, like insufficient adherence to dentin, resorption of the material, mechanical weak, risk of micro leakage (8) and liquefaction necrosis of the surface of the pulp due to high pH. (9) Silicate-based materials like Biodentine and Mineral trioxide aggregate (MTA) have also been used for pulp capping.…”

“…However, some studies show no significant clinical difference between MTA and CH. (6) Nonetheless, it possesses some troubling disadvantages such as prolonged setting time and higher material cost. Alternative calcium-silicate-based restorative cement is Biodentine having similar indications as that of MTA.…”