Management of Deep Caries Lesions: A Study among Dentists in the Private Sector of Casablanca, Morocco.

Abstract

Aim and background: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Clinical significance: 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.