Babasidou E, Papaemmanouil G, Pantelidou A, Fardi A, Kodonas K, Gogos C
Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Dentoalveolar Surgery, Surgical Implantology and Radiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Eur Arch Paediatr Dent. 2025 May 27. doi: 10.1007/s40368-025-01024-7.
Guidelines recommend implementing selective or total caries removal for managing deep carious lesions without discriminating between fully developed and immature teeth. This questionnaire-based study aimed to explore the perspectives of Greek dentists regarding the management of deep caries and exposed pulp in immature and fully developed teeth with reversible pulpitis.
The questionnaire presented two cases: one of a fully developed permanent tooth and one of an immature permanent tooth, both with deep caries and clinical signs of reversible pulpitis. Photographs, radiographs, and clinical symptoms were provided to assess dentists' treatment strategy preferences. Data analysis was conducted using SPSS 28, Chi-square, Fisher's exact tests and logistic regression analysis with significance set at p < 0.05.
A total of 453 dentists responded. More than half of the respondents preferred total caries removal for mature teeth. MTA and other bioceramics emerged as the favored materials for indirect and direct pulp capping. In the case of the immature tooth, 44% of the respondents shifted from the total to selective caries removal treatment option. However, there was a discernible shift towards more aggressive vital pulp treatment options, like pulpotomy (26%).
Treatment preferences are influenced by the tooth developmental status, vary significantly and there is no clear preference for a more conservative approach to preserving as much healthy pulp tissue as possible.
指南建议对深龋病变实施选择性或完全去龋，而不区分恒牙是完全发育成熟还是未成熟。这项基于问卷的研究旨在探讨希腊牙医对于未成熟和完全发育成熟的恒牙发生深龋且伴有可逆性牙髓炎时的治疗观点。
问卷展示了两个病例：一个是完全发育成熟的恒牙，另一个是未成熟的恒牙，二者均患有深龋且有可逆性牙髓炎的临床症状。提供了照片、X线片和临床症状，以评估牙医对治疗策略的偏好。使用SPSS 28进行数据分析，采用卡方检验、Fisher精确检验和逻辑回归分析，显著性设定为p < 0.05。
共有453名牙医做出回应。超过一半的受访者倾向于对成熟恒牙进行完全去龋。MTA和其他生物陶瓷成为间接盖髓和直接盖髓的首选材料。对于未成熟恒牙的病例，44%的受访者从完全去龋转变为选择性去龋治疗方案。然而，明显转向了更积极的活髓治疗方案，如牙髓切断术（26%）。
治疗偏好受牙齿发育状态影响，差异显著，对于尽可能保留更多健康牙髓组织的更保守方法没有明确偏好。
