Oen Kay T, Thompson Van P, Vena Don, Caufield Page W, Curro Fredrick, Dasanayake Ananda, Ship Jonathan A, Lindblad Anne
EMMES Corporation, Rockville, Maryland, USA.
Gen Dent. 2007 May-Jun;55(3):197-203.
A survey was conducted within a practice-based dental research network to determine dentists' treatment methods for deep caries lesions and whether the dentists' intended treatment approaches were influenced by their expectations for pulpal exposure. The survey further examined how general dentistry practices have adopted scientific evidence of caries classification, excavation, and capping techniques. Dentists were queried regarding liner use, hypersensitivity considerations, point of endodontic therapy, and anticipated vitality outcomes from Class I resin-based composite restorations over three to five years. Of the 93 practitioner-investigators who were in the network at the time of the survey, 85 (92%) completed it. Of those who responded, 62% said that they would remove all caries when presented with a case in which one would expect pulpal exposure, while 18% would partially remove caries and 21% would initiate endodontic treatment; 17% reported that they would utilize an antimicrobial agent before a liner or bonding agent during restoration. The outcomes projected for tooth vitality over the next three to five years were equivalent regardless of the caries removal approach or the use of a liner/bonding agent. When beginning the preparation, the method of treatment did not change if a pulpal exposure was anticipated, other than a threefold increase in immediate endodontic treatment. When dentists were given a direct pulp cap scenario, the projected use of a liner/bonding agent changed little while the vitality projections decreased. Overall survey findings indicate that approximately 20% of network dentists favor partial caries removal techniques and that deep caries treatment outcome studies are warranted, given the various treatments employed.
在一个基于实践的牙科研究网络内进行了一项调查，以确定牙医对深龋病变的治疗方法，以及牙医预期的治疗方法是否受到其对牙髓暴露预期的影响。该调查进一步考察了普通牙科诊所如何采用龋病分类、窝洞预备和垫底技术的科学证据。询问了牙医关于垫底材料的使用、对牙齿敏感的考虑、根管治疗的时机，以及预期的I类树脂基复合树脂修复体在三到五年内的牙髓活力转归。在调查时网络中的93名执业调查者中，85名（92%）完成了调查。在做出回应的人中，62%表示当遇到预期牙髓暴露的病例时，他们会去除所有龋坏组织，而18%会部分去除龋坏组织，21%会开始进行根管治疗；17%报告说他们在修复过程中会在使用垫底材料或粘结剂之前使用抗菌剂。无论龋坏组织去除方法或垫底材料/粘结剂的使用情况如何，预计未来三到五年牙齿的牙髓活力转归是相同的。在开始预备时，如果预期会发生牙髓暴露，除了立即进行根管治疗的比例增加了两倍外，治疗方法没有改变。当给牙医一个直接盖髓的病例时，垫底材料/粘结剂的预计使用变化不大，而牙髓活力的预计值下降。总体调查结果表明，约20%的网络牙医倾向于部分龋坏组织去除技术，鉴于所采用的各种治疗方法，深龋治疗结果研究很有必要。
