Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners: A Multinational Survey from 16 Countries with Meta-analysis

Ömer Hatipoğlu*, Fatma Pertek Hatipoğlu, Muhammad Qasim Javed, Kacper Nijakowski, Nessrin Taha, Christina El-saaidi, Surendar Sugumaran, Yasmine Elhamouly, Milan Drobac, Ricardo Machado, Thiyezen Abdullah Aldhelai, Hiro Kobayashi, Suha Alfirjani, Imran Zainal Abidin, Benjamín Martin-Biedma, Kopbayeva Maira, Wen Yi Lim, Paulo J. Palma, João Filipe Brochado Martins

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Introduction: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians’ decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. Methods: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients’ age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. Results: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P < .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P < .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P < .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P < .05). Conclusions: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.

Original languageEnglish
Pages (from-to)675-685
Number of pages11
JournalJournal of endodontics
Volume49
Issue number6
Early online date23 Apr 2023
DOIs
Publication statusPublished - Jun 2023

Bibliographical note

Funding Information:
The authors deny any conflicts of interest related to this study.

Publisher Copyright:
© 2023 American Association of Endodontists

Keywords

  • Dental pulp capping
  • meta-analysis
  • questionnaire

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