Selective caries removal and management of exposed pulp in fully developed and immature teeth with reversible pulpitis: a questionnaire-based study in Greece

Abstract

Purpose: Guidelines recommend implementing selective or total caries removal for managing deep carious lesions without discriminating between fully developed and immature teeth. This questionnaire-based study aimed to explore the perspectives of Greek dentists regarding the management of deep caries and exposed pulp in immature and fully developed teeth with reversible pulpitis. Methods: The questionnaire presented two cases: one of a fully developed permanent tooth and one of an immature permanent tooth, both with deep caries and clinical signs of reversible pulpitis. Photographs, radiographs, and clinical symptoms were provided to assess dentists’ treatment strategy preferences. Data analysis was conducted using SPSS 28, Chi-square, Fisher’s exact tests and logistic regression analysis with significance set at p < 0.05. Results: A total of 453 dentists responded. More than half of the respondents preferred total caries removal for mature teeth. MTA and other bioceramics emerged as the favored materials for indirect and direct pulp capping. In the case of the immature tooth, 44% of the respondents shifted from the total to selective caries removal treatment option. However, there was a discernible shift towards more aggressive vital pulp treatment options, like pulpotomy (26%). Conclusion: Treatment preferences are influenced by the tooth developmental status, vary significantly and there is no clear preference for a more conservative approach to preserving as much healthy pulp tissue as possible.