The Vital Pulp Therapy of Permanent Teeth: A Dental Practitioner's Perspective from Saudi Arabia

Mazen D Doumani, Waod A Arnous, Malak F Alsafadi, Heba A Alnazer, Salman M Alanazi, Khaled S Alotaibi, AbdulAziz I Al-Ammari, Mazen D Doumani, Waod A Arnous, Malak F Alsafadi, Heba A Alnazer, Salman M Alanazi, Khaled S Alotaibi, AbdulAziz I Al-Ammari

Abstract

Aims and objectives: The aim of this study was to determine the levels of knowledge and attitude of dental practitioners (DPs) toward vital pulp therapy (VPT) of young permanent teeth in Riyadh city, Saudi Arabia.

Materials and methods: A descriptive cross-sectional study was carried out by taking convenient sample of general DPs and specialist attending Saudi International Dental Conference, Riyadh, Saudi Arabia. A total of 200 DPs administered a structured, self-administered questionnaire to evaluate their knowledge and attitude toward VPT. The questionnaire comprised four parts: Part I: Characteristics of the study participants; Part II: Items related to indications and diagnosis of VPT; Part III: Questions related to the different VPTs for immature permanent teeth; and Part IV: Dental materials used in VPT and restoration. All the data were entered into the statistical analysis software Statistical Package for the Social Sciences version 21.0 (IBM, Armonk, NY) and analyzed by using descriptive statistics of frequency distribution and percentages for the categorical variables.

Results: A total of 193 (men = 57% [110] and women = 43% [83]) DPs participated in this study with a response rate of 96.5%. Less than half of correct responses were observed with (Item 1) related to the duration of complete closure of root apex (43%) and (Item 14) use of sodium hypochlorite to serve as an excellent diagnostic tool to differentiate irreversible from reversible pulpitis. A high percentage of correct responses were seen with the (Item 9) indirect pulp capping--a procedure performed in a tooth with a deep carious lesion without signs or symptoms of pulp degeneration (75%). All other item responses ranged in between 52% and 72%.

Conclusion: DPs showed fair-to-good knowledge and attitude toward VPT of young permanent teeth. In general, there is a need to improve knowledge and attitude of dental professionals about the VPT by attending continuing dental educational programs.

Keywords: Attitude; dental practitioners; knowledge; permanent teeth; vital pulp therapy.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 Journal of International Society of Preventive and Community Dentistry.

Figures

Figure 1
Figure 1
Parts of the questionnaire
Figure 2
Figure 2
Dental specialist participated in the study (%)
Figure 3
Figure 3
The closure of root apex (Item 1)
Figure 4
Figure 4
Knowledge categories across different items (%)

References

    1. Heyeraas KJ, Kvinnsland I. Tissue pressure and blood flow in pulpal inflammation. Proc Finn Dent Soc. 1992;88: 393–401.
    1. Van Hassel HJ. Physiology of the human dental pulp. Oral Surg Oral Med Oral Pathol. 1971;32:126–34.
    1. Yu C, Abbott PV. An overview of the dental pulp: Its functions and responses to injury. Aust Dent J. 2007;52:S4–16.
    1. Sen BH, Piskin B, Demirci T. Observation of bacteria and fungi in infected root canals and dentinal tubules by SEM. Endod Dent Traumatol. 1995;11:6–9.
    1. Park SH, Ye L, Love RM, Farges J-C, Yumoto H. Inflammation of the dental pulp. Mediators Inflamm [Internet] 2015. [Last accessed on 2018 Dec 7]. Available from: .
    1. Cohenca N, Paranjpe A, Berg J. Vital pulp therapy. Dent Clin North Am. 2013;57:59–73.
    1. Ghoddusi J, Forghani M, Parisay I. New approaches in vital pulp therapy in permanent teeth. Iran Endod J. 2014;9:15–22.
    1. Makowiecki P, Trusewicz M, Tyszler L, Buczkowska-Radlińska J. [The vital pulp therapy in permanent teeth] Ann Acad Med Stetin. 2014;60:80–8.
    1. Rosenberg PA, Schindler WG, Krell KV, Hicks ML, Davis SB. Identify the endodontic treatment modalities. J Endod. 2009;35:1675–94.
    1. Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: A systematic review. J Endod. 2011;37:581–7.
    1. Alhabdan YA, Albeshr AG, Yenugadhati N, Jradi H. Prevalence of dental caries and associated factors among primary school children: A population-based cross-sectional study in Riyadh, Saudi Arabia. Environ Health Prev Med. 2018;23:60.
    1. Saber AM, Altoukhi DH, Horaib MF, El-Housseiny AA, Alamoudi NM, Sabbagh HJ. Consequences of early extraction of compromised first permanent molar: A systematic review. BMC Oral Health. 2018;18:59.
    1. Al-Majed I, Murray JJ, Maguire A. Prevalence of dental trauma in 5-6- and 12-14-year-old boys in Riyadh, Saudi Arabia. Dent Traumatol. 2001;17:153–8.
    1. Al-Madi EM, Al Saleh SA, Bukhary SM, Al-Ghofaily MM. Endodontic and restorative treatment patterns of pulpally involved immature permanent posterior teeth. Int J Dent. 2018;2018:2178535.
    1. Pishbin L, Sajadi FS, Mahmoudi M, Shahabinejad H. Knowledge and practice of VPT in young permanent teeth among general dental practitioners in Kerman, Iran. Int J Dent Res. 2018;6:29–34.
    1. Brizuela C, Ormeño A, Cabrera C, Cabezas R, Silva CI, Ramírez V, et al. Direct pulp capping with calcium hydroxide, mineral trioxide aggregate, and biodentine in permanent young teeth with caries: A randomized clinical trial. J Endod. 2017;43:1776–80.
    1. Kundzina R, Stangvaltaite L, Eriksen HM, Kerosuo E. Capping carious exposures in adults: A randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. Int Endod J. 2017;50:924–32.
    1. Linu S, Lekshmi MS, Varunkumar VS, Sam Joseph VG. Treatment outcome following direct pulp capping using bioceramic materials in mature permanent teeth with carious exposure: A pilot retrospective study. J Endod. 2017;43:1635–9.
    1. Wang G, Wang C, Qin M. Pulp prognosis following conservative pulp treatment in teeth with complicated crown fractures: A retrospective study. Dent Traumatol. 2017;33:255–60.
    1. Alex G. Direct and indirect pulp capping: A brief history, material innovations, and clinical case report. Compend Contin Educ Dent. 2018;39:182–9.
    1. Asgary S, Hassanizadeh R, Torabzadeh H, Eghbal MJ. Treatment outcomes of 4 vital pulp therapies in mature molars. J Endod. 2018;44:529–35.
    1. da Rosa WLO, Cocco AR, Silva TMD, Mesquita LC, Galarça AD, Silva AFD, et al. Current trends and future perspectives of dental pulp capping materials: A systematic review. J Biomed Mater Res B Appl Biomater. 2018;106:1358–68.
    1. Holland GR, Trowbridge HO, Rafter M. Protecting the pulp, preserving the apex. In: Torabinejad M, Walton RE, editors. Endodontics, Principles and Practice. 4th edn. Philadelphia, Saunders: 2009. pp. p. 26–34.
    1. Alghaithy RA, Qualtrough AJ. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: A critical review. Int Endod J. 2017;50:135–42.
    1. ADA. Pulp therapy for primary and immature permanent teeth. Pediatr Dent. 2017;39:325–33.
    1. Schwendicke F. Contemporary concepts in carious tissue removal: A review. J Esthet Restor Dent. 2017;29:403–8.
    1. Guerrero F, Mendoza A, Ribas D, Aspiazu K. Apexification: A systematic review. J Conserv Dent. 2018;21:462–5.
    1. Alsadat FA, El-Housseiny AA, Alamoudi NM, Alnowaiser AM. Conservative treatment for deep carious lesions in primary and young permanent teeth. Niger J Clin Pract. 2018;21:1549–56.
    1. Rabi T. Knowledge, attitude, and practice survey of dentists in Palestine toward deep dentin caries removal. Cons Dent Endod J. 2016;1:28–32.
    1. Crespo-Gallardo I, Martín-González J, Jiménez-Sánchez MC, Cabanillas-Balsera D, Sánchez-Domínguez B, Segura-Egea JJ. Dentist′s knowledge, attitudes and determining factors of the conservative approach in teeth with reversible pulpitis and deep caries lesions. J Clin Exp Dent. 2018;10:e1205–15.
    1. Arandi NZ. Calcium hydroxide liners: A literature review. Clin Cosmet Investig Dent. 2017;9:67–72.
    1. Mohammadi Z. Sodium hypochlorite in endodontics: An update review. Int Dent J. 2008;58:329–41.
    1. Demir T, Cehreli ZC. Clinical and radiographic evaluation of adhesive pulp capping in primary molars following hemostasis with 1.25% sodium hypochlorite: 2-year results. Am J Dent. 2007;20:182–8.
    1. Kobayashi M, Inagaki R, Ichikawa K, Niizuma Y, Morisaki H, Kuwata H, et al. Effect of kinematic viscosity on the staining performance of caries detector dyes. Dent Mater J. 2018;38:120–26.

Source: PubMed

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