The management of deep carious lesions and the exposed pulp in fully developed and immature teeth with irreversible pulpitis: a questionnaire-based study among Greek dentists

Abstract

Objectives: The study aimed to identify the preferred management techniques used by dentists in Greece for treating deep carious lesions or pulp exposure during the removal of carious tissue in teeth with irreversible pulpitis. Additionally, the study sought to explore how patient-related factors (such as age and symptoms) and operator-related factors (like material choice and the use of antibiotics) influence these management decisions.

Materials and methods: The questionnaire, developed by five investigators, was divided into two parts: the first gathered respondent demographics, and the second presented clinical scenarios of deep carious lesions, requesting treatment strategies, materials used, and antibiotic prescription practices. The scenarios described patients with intense spontaneous pain and very deep carious lesions, differentiated by age and tooth development status.Data collection was via Google Drive, with analysis performed using SPSS 28, Chi-square, and Fisher's exact tests, with significance set at p < 0.05.

Results: The study polled 453 Greek dentists about their treatment choices, for deep carious lesions in mature and immature teeth with irreversible pulpitis The majority favored root canal treatment for mature teeth, however quite a few opted for partial or cervical pulpotomy. MTA emerged as the preferred capping material, emphasizing its biocompatibility. Hemostasis management varied, with saline and sodium hypochlorite as popular choices. In cases of immature teeth, a shift towards vital pulp therapy was evident, reflecting a preference for preserving healthy pulp to avoid complex procedures.

Conclusions: Challenges identified include varying treatment preferences, the significance of bleeding control in vital pulp therapy, and the limited use of antibiotics for irreversible pulpitis. While the study has limitations, including sample size and potential biases, its findings offer valuable insights into the decision-making processes of Greek dentists.

Clinical relevance: Future research and ongoing education within the dental community could contribute to standardizing treatment approaches and optimizing outcomes for patients with deep carious lesions and irreversible pulpitis.

Keywords: Deep carious lesions; Greek dentists; Irreversible pulpitis; Root canal therapy; Vital pulp therapy.