Diagnostic Approaches and Treatment Strategies for Deep Carious Lesions among Dentists in Egypt and Saudi Arabia: A Questionnaire-Based Cross-Sectional Study.
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Abstract
Introduction: The study objective was to assess and compare the use of diagnostic methods, clinical decision-making, treatment strategies, and attitudes of general dentists, pediatric dentists, and endodontists regarding deep carious lesions (DCL) in Egypt and Saudi Arabia.
Methods: A cross-sectional multinational study was conducted in Egypt and Saudi Arabia (January 2023-June 2024). A validated online questionnaire was distributed to 1,000 dentists (734 Egypt; 266 Saudi Arabia), including general practitioners, pediatric dentists, and endodontists. The survey covered demographics, diagnostics, clinical scenarios, treatment strategies, and influencing factors. Data were analyzed using SPSS v26 with descriptive statistics, chi-square tests, and logistic regression (p < 0.05).
Results: A total of 500 dentists responded (response rate of 46.0% for Egypt [338/734] and 60.9% for Saudi Arabia [162/266]). Most participants were general practitioners (60.4%) and female (57.8%), with an average of 9 years of clinical experience. Selective caries removal was preferred by 23.2% of general practitioners, 34.2% of pediatric dentists, and 21.8% of endodontists. Multivariable regression analysis showed that selective caries removal was more likely to be chosen by pediatric dentists (adjusted odds ratio [AOR] = 1.38, p = 0.04), dentists practicing in Egypt (AOR = 2.70, p < 0.001), and those who had attended MID courses (AOR = 1.75, p < 0.001). Endodontists demonstrated greater adherence to evidence-based guidelines (AOR = 3.35, p < 0.001), whereas practicing in Egypt (AOR = 0.43, p = 0.002), having more years of experience (AOR = 0.94, p = 0.001), and attending MID courses (AOR = 0.57, p = 0.03) were associated with lower odds of adherence.
Conclusions: Pediatric dentists, practitioners in Egypt, and those with training in minimally invasive dentistry were more likely to favor selective caries removal, whereas endodontists demonstrated the highest adherence to AAE guidelines and tended to prefer more invasive treatment strategies. Despite strong evidence supporting conservative approaches for managing DCLs in vital teeth, invasive strategies were still commonly reported among respondents. Greater implementation of evidence-based, patient-centered treatment strategies is needed among dentists in Egypt and Saudi Arabia.
期刊介绍：
''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.
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