Laslami Kaoutar, El Kharroubi Soukaina, Moudrif Mohamed, Marzougui Ameni, Drouri Sofia, Chemlali Sihame, Benkiran Imane
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Hassan II University of Casablanca, Morocco, ORCID: https://orcid.org/0000-0001-6070-9001.
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Hassan II University of Casablanca, Morocco, Phone: +212 634748577, e-mail:
J Contemp Dent Pract. 2024 Aug 1;25(8):751-757. doi: 10.5005/jp-journals-10024-3716.
To find out which management methods are preferred by dentists in the private sector of Casablanca for a deep carious lesion or a pulp exposure during carious tissue removal in adult patients.
A questionnaire consisting of 25 questions was sent to 300 randomly sampled dentists in Casablanca. Only specialists in conservative dentistry and endodontics and general practitioners were included. There were three clinical scenarios allowing to approach the therapy recommended by each practitioner according to the proposed pulp diagnosis, these three different scenarios were based on preoperative symptomatology: Healthy pulp, reversible pulpitis, and irreversible pulpitis. Data entry and analysis were carried out using Epi7 and the results were statistically analyzed.
The survey was answered by 214 dentists,145 women and 69 men. Approximately 74.3% of the respondents always establish a pulp diagnosis before carious tissue removal. Approximately 56.54% use partial carious tissue removal techniques. During pulp exposure, 79.25% of the practitioners opted, respectively, for a direct pulp capping (DPC) in the case of healthy pulp and 46.7% in the case of reversible pulpitis, while no practitioner chose DPC in the case of irreversible pulpitis. In addition, 3.31, 27.83, and 4.23% opted for pulpotomy in cases of healthy pulp, reversible and irreversible pulpitis, respectively. Glass ionomer cement (GIC) and calcium hydroxide (CH) are the materials of choice for dentists in cases of partial caries removal. In the case of DPC, dentists use CH and Biodentine™ in particular.
Partial carious tissue removal techniques are not adopted by the majority of dentists. When faced with irreversible pulpitis, most dentists (93.33%) go directly to endodontic treatment in the case of deep carious lesion without pulp exposure. While 204 dentists (95.33%) preferred root canal treatment (RCT) too in the case of deep carious lesion with pulp exposure. The use of bioactive materials should be encouraged in the management of deep caries lesions and pulp exposure, Biodentine™ and MTA were chosen by 96 of the practitioners.
Traditionally, the treatment of deep caries has been destructive, with removal of all carious dentin; however, the promotion of biologically based minimally invasive treatment strategies has been recommended to selectively (partially) remove caries and reduce the risk of pulp exposure. How to cite this article: Laslami K, Kharroubi SE, Moudrif M, et al. Management of Deep Caries Lesions: A Study among Dentists in the Private Sector of Casablanca, Morocco. J Contemp Dent Pract 2024;25(8):751-757.
了解卡萨布兰卡私营部门的牙医在成人患者龋组织去除过程中遇到深龋病变或牙髓暴露时更倾向于哪种管理方法。
向卡萨布兰卡随机抽取的300名牙医发送了一份包含25个问题的问卷。仅纳入保守牙科和牙髓病学专家以及全科医生。有三种临床场景，可根据所提出的牙髓诊断来探讨每位从业者推荐的治疗方法，这三种不同场景基于术前症状：健康牙髓、可复性牙髓炎和不可复性牙髓炎。使用Epi7进行数据录入和分析，并对结果进行统计学分析。
214名牙医回复了调查问卷，其中145名女性和69名男性。约74.3%的受访者在龋组织去除前总是进行牙髓诊断。约56.54%的人使用部分龋组织去除技术。在牙髓暴露时，79.25%的从业者在健康牙髓情况下分别选择直接盖髓术（DPC），在可复性牙髓炎情况下选择率为46.7%，而在不可复性牙髓炎情况下没有从业者选择DPC。此外，在健康牙髓、可复性和不可复性牙髓炎情况下分别有3.31%、27.83%和4.23%的人选择牙髓切断术。玻璃离子水门汀（GIC）和氢氧化钙（CH）是牙医在部分龋去除情况下的首选材料。在DPC情况下，牙医特别使用CH和BioDentine™。
大多数牙医不采用部分龋组织去除技术。面对不可复性牙髓炎时，大多数牙医（93.33%）在深龋病变且无牙髓暴露的情况下直接进行牙髓治疗。而在深龋病变伴有牙髓暴露的情况下，204名牙医（95.33%）也更倾向于根管治疗（RCT）。在深龋病变和牙髓暴露的管理中应鼓励使用生物活性材料，96名从业者选择了BioDentine™和MTA。
传统上，深龋的治疗具有破坏性，要去除所有龋坏牙本质；然而，有人建议推广基于生物学的微创治疗策略，以选择性地（部分）去除龋坏组织并降低牙髓暴露的风险。如何引用本文：Laslami K, Kharroubi SE, Moudrif M,等。深龋病变的管理：摩洛哥卡萨布兰卡私营部门牙医的一项研究。《当代牙科实践杂志》2024；25(8):751 - 757。
