Crespo-Gallardo Isabel, Martín-González Jenifer, Jiménez-Sánchez María C, Cabanillas-Balsera Daniel, Sánchez-Domínguez Benito, Segura-Egea Juan J
Endodontics Section, Department of Stomatology, (Conservative Dentistry Section), University of Sevilla, Spain.
J Clin Exp Dent. 2018 Dec 1;10(12):e1205-e1215. doi: 10.4317/jced.55395. eCollection 2018 Dec.
The aim of this study was to investigate dentists` knowledge, attitudes and factors regarding the conservative approach in the management of deep caries lesions (DCLs) in teeth with reversible pulpitis.
187 dentists were contacted directly or by mail, and 125 (67%) were finally included in the study. Dentists were requested to answer an open/discursive questionnaire about the routine approach to the diagnosis and treatment of DCLs, including knowledge-related attitudinal items.
Total caries excavation was the preferred treatment option for more than 80% of dentists in case of DCL with reversible pulpitis. Only a small percentage (8%) chose partial caries removal, leaving some carious dentin close to the pulp to avoid pulp exposure. More than a half (51%) of respondents considered that cariogenic microorganisms must be removed or caries would progress. Dentists teaching at the University strongly disagreed with this statement (OR = 4.6; 95% C.I. = 1.3 - 15.8; = 0.017). Good clinical result was the most chosen reason (83%) to choose a specific treatment. Patient's oral health (84%) and patient's age (70%) were the two patient-related factors most taken into account for the choice of treatment.
Total caries excavation is still the most frequently chosen treatment in teeth with DCL and reversible pulpitis. The joint assessment of the answers given by respondents allows to conclude that the new knowledge and concepts about caries lesions and the more conservative approach to DCLs have not still been incorporated by dentists into their usual clinical practice. Caries, deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, reversible pulpitis, treatment decisions.
本研究旨在调查牙医对于患有可复性牙髓炎的牙齿深龋病变（DCL）保守治疗方法的知识、态度及相关因素。
直接联系或通过邮件联系了187名牙医，最终125名（67%）被纳入研究。要求牙医回答一份关于DCL诊断和治疗常规方法的开放式/论述性问卷，包括与知识相关的态度项目。
对于患有可复性牙髓炎的DCL，超过80%的牙医首选完全去龋治疗。只有一小部分（8%）选择部分去龋，保留一些靠近牙髓的龋坏牙本质以避免暴露牙髓。超过一半（51%）的受访者认为必须去除致龋微生物，否则龋病会进展。在大学任教的牙医强烈反对这一说法（OR = 4.6；95%置信区间 = 1.3 - 15.8；P = 0.017）。良好的临床效果是选择特定治疗方法时最常提及的原因（83%）。患者的口腔健康（84%）和患者年龄（70%）是选择治疗方法时最常考虑的两个与患者相关的因素。
对于患有DCL和可复性牙髓炎的牙齿，完全去龋仍然是最常选择的治疗方法。对受访者答案的综合评估可以得出结论，关于龋病病变的新知识和概念以及对DCL更保守的治疗方法尚未被牙医纳入其日常临床实践中。龋病、深龋病变、牙髓盖髓术、牙髓健康、牙医、牙髓治疗、可复性牙髓炎、治疗决策。
