A questionnaire-based study on the management of deep carious lesions and exposed pulp among members of the Indian conservative dentistry and endodontic societies

Abstract

Aim: Lack of unanimity in decision-making regarding the management of deep caries and exposed pulp has been highlighted by several questionnaire-based studies from various geographic regions. There is no research available in the Indian setting. The aim of the present study was to evaluate the perspectives of the Indian Endodontic Society and Indian Association of Conservative Dentistry and Endodontics members using an online questionnaire. Methods: An online structured questionnaire of 17 questions was mailed to 200 members based on the periapical radiographs of two cases (18 and 55 years of age) highlighting deep carious lesions and normal periapex in a mandibular molar. Each case had three hypothetical scenarios based on pulpal symptoms, i.e., asymptomatic pulp, reversible, and irreversible pulpitis, respectively. Results: A response rate of 65.5% (n = 131) was achieved. Nonselective caries removal was chosen by 40% and 36% of the participants in young patients with asymptomatic pulp and reversible pulpitis. On pulpal exposure, direct pulp capping was chosen by a majority of the members (66% and 54%, respectively) in a young patient. For irreversible pulpitis, pulpectomy was favored by 70%. In an older patient, less vital pulp therapy and more pulpectomy were preferred. The symptoms and patient age significantly altered treatment decisions, as determined by Chi-square and Fisher’s exact tests (P < 0.05). Conclusion: There was a lack of agreement in managing deep carious lesions. There was partial awareness of the management of exposed pulp.