Factors influencing treatment decisions in permanent mature teeth with irreversible pulpitis: a questionnaire-based study.

Background: Decision-making in dentistry is a complex process, and this study evaluated factors that influence dentists' approaches in permanent mature teeth with irreversible pulpitis.

Methods: An online questionnaire was distributed to a group of dental practitioners. The questionnaire surveyed dentists' opinions about the management of vital permanent teeth with irreversible pulpitis including a case scenario.

Results: Data from 262 respondents were analysed. Barriers to perform vital pulp therapy (VPT) included presuming it an inappropriate long-term treatment (29.7%), lack of knowledge, insufficient access to materials, inadequate training and lack of confidence. Patient's preference (79.44%) and tooth restorability (91%) were the most frequently reported factors influencing treatment decisions. Dentists aged 25-35 years and who have 1-5 years of experience ranked extraction as a more successful treatment (P = 0.008; P = 0.003, respectively). Non-Australian graduates ranked pulpotomy to be a more successful procedure (P = 0.007), and public sector/hospital practitioners favoured extraction more than practitioners from other sectors (P = 0.003). Postgraduates/specialists preferred pulpotomy (P = 0.012) more than general dentists. Participants' clinical approaches for the management of symptomatic irreversible pulpitis: root canal treatment (45.0%), indirect pulp capping (22.9%), direct pulp capping (15.8%), pulpotomy (17.1%) and extraction (6.3%).

Conclusions: Female, more experienced, overseas-educated dentists and endodontists preferred VPT for irreversible pulpitis in permanent mature teeth more than other participants. © 2024 Australian Dental Association.