Abstract
Aim: To investigate restorative decisions made by dentists and to examine what demographic characteristics are associated with the decisions for managing approximal and occlusal lesions. Methods: A questionnaire was randomly sent to 900 Palestinian dentists. It noted the demographic details of the dentists and the years of experience. The questionnaire evaluated the respondents for their treatment decisions regarding approximal and occlusal carious lesions. The data was analyzed using the IBM SPSS statistics for windows. The associations between gender and years of experience of the respondents and their restorative decisions were assessed. Results: The response rate was 58.2%. For occlusal carious lesions, 93.9% of the respondents would postpone operative treatment until the lesion was in dentine (grade 3 to 5). For approximal lesions, intervention was deemed appropriate by 92.6% of the respondents when there was radiographic evidence of a carious lesion reaching the DEJ or deeper. Around 53% preferred to prepare approximal lesions according to the traditional principles of cavity preparation. For both approximal and occlusal lesions, the participants opted for resin composites. Statistically, there was a significant association between the restorative decisions with the years since graduation and gender. Conclusion: The study showed variations between the treatment decisions of Palestinian dentists. The subjects chose conservative treatment plans but still adhered to traditional learned practices especially when cavity preparation for approximal lesions was concerned. The years since graduation and gender played a significant role in the choice of treatment opted for. Resin composites seemed to be a popular choice for treatment.
Highlights
Dentists all over the world face challenges with cases that are at various stages of caries progression for which they have to decide the proper management strategy
Preference for other restorative materials were amalgam 29.8%, glass ionomer cement (GIC) 11.5% and 8.4% would use a combination of composite and RMGI
Questionnaire surveys investigating the restorative treatment threshold and caries management strategies among general practitioners have been used in Norway[8], USA9, UK11, France[10], Croatia[12], Kuwait[13], Iran[14], UAE15
Summary
Dentists all over the world face challenges with cases that are at various stages of caries progression for which they have to decide the proper management strategy. Non-invasive strategies aim to modify the micro environment, shifting the dynamic process toward remineralisation They do not remove dental hard tissue and involve, for example, topical fluorides and other chemical agents for controlling mineral balance, biofilm control measures and dietary control[5]. Micro-invasive strategies predominantly act by sealing the lesion, depriving the bacteria within of fermentable carbohydrates required for acid production They remove the dental hard tissue surface at the micron level, usually during an etching step, such as used in sealing or resin-infiltration techniques[2]. Cavitation indicates the irreversible clinical endpoint of continued mineral loss and requires a surgical approach to restore form, function and plaque control It involves removing a limited amount of gross dental hard tissue, through the use of hand excavators, rotary instruments or other devices. This process is associated with the subsequent placement of restorations[6,7]
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