Primary tooth vital pulp therapy techniques taught in dental schools in Saudi Arabia: a cross-sectional study
1Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, 11545 Riyadh, Saudi Arabia
2College of Dentistry, King Saud University, 11545 Riyadh, Saudi Arabia
3Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, 11545 Riyadh, Saudi Arabia
DOI: 10.22514/jocpd.2023.082 Vol.47,Issue 6,November 2023 pp.86-93
Submitted: 01 March 2023 Accepted: 12 May 2023
Published: 03 November 2023
Worldwide, dental schools employ varying approaches to teaching vital pulp therapy (VPT) for primary teeth. However, little is known about the VPT techniques taught in dental schools in Saudi Arabia. Therefore, this study aimed to describe the approaches of VPT for primary teeth taught in undergraduate dental schools in Saudi Arabia. A nationwide cross-sectional study was conducted between January and June 2022, using an online questionnaire distributed to pediatric dentistry faculty members at all dental schools in Saudi Arabia. The questionnaire collected information on socio-demographic characteristics, educational background, work setting, and VPT teaching approaches. Descriptive statistics and logistic regression models assessed the association between participants’ characteristics and the VPT techniques taught. Seventy-seven faculty members from 17 out of 27 dental colleges in Saudi Arabia participated in the study. Most respondents reported teaching indirect pulp capping (95%), with glass ionomer cement and calcium hydroxide being the most popular materials. Only 11 participants (14%) taught direct pulp capping, with mineral trioxide aggregate and calcium hydroxide being the most commonly used materials. Pulpotomy procedures were taught in all dental schools, with formocresol being the most commonly used medicament (84%). No significant associations were found between faculty member characteristics and the likelihood of teaching indirect pulp capping. However, older age categories had a significantly higher chance of teaching direct pulp capping (trend odds ratio: 2.27, p = 0.02). In conclusion, most faculty members (95%) reported teaching indirect pulp capping using glass ionomer cement and calcium hydroxide for primary teeth. Only 14%of the respondents taught direct pulp capping, and the use of mineral trioxide aggregate for direct pulp capping appears to be increasing. Formocresol was the most commonly used pulpotomy medicament. Further research is needed to investigate factors that influence the teaching of VPT for primary teeth in Saudi Arabia.
Calcium hydroxide; Direct pulp capping; Indirect pulp capping; MTA; Pulp therapy; Pulpotomy
Ayman M. Sulimany,Mannaa Aldowsari,Saad Bin Saleh,Faisal F. Almajhdi,Omar A. Al Ajlan,Ibrahim M. ALSayyari,Khalid M. Alshehri,Hebah M. Hamdan. Primary tooth vital pulp therapy techniques taught in dental schools in Saudi Arabia: a cross-sectional study. Journal of Clinical Pediatric Dentistry. 2023. 47(6);86-93.
 Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, et al. Expert consensus on dental caries management. International Journal of Oral Science. 2022; 14: 17.
 Alshammari FR, Alamri H, Aljohani M, Sabbah W, O’Malley L, Glenny AM. Dental caries in Saudi Arabia: a systematic review. Journal of Taibah University Medical Sciences. 2021; 16: 643–656.
 Al-Shahrani N, Al-Amri A, Hegazi F, Al-Rowis K, Al-Madani A, Hassan KS. The prevalence of premature loss of primary teeth and its impact on malocclusion in the Eastern Province of Saudi Arabia. Acta Odontologica Scandinavica. 2015; 73: 544–549.
 Duncan HF. Present status and future directions—vital pulp treatment and pulp preservation strategies. International Endodontic Journal. 2022; 55: 497–511.
 Svante Twetman, Avijit Banerjee. Caries risk assessment. Risk assessment in oral health: a concise guide for clinical application (pp. 89–100). Springer: Cham. 2020.
 AAPD. Pulp therapy for primary and immature permanent teeth. The Reference Manual of Pediatric Dentistry (pp. 415–423). American Academy of Pediatric Dentistry: Chicago, Ill. 2020.
 Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, et al. Use of vital pulp therapies in primary teeth with deep caries lesions. Pediatric Dentistry Journal. 2017; 39: 146–159.
 Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database of Systematic Reviews. 2018; 5: CD003220.
 Bossù M, Iaculli F, Di Giorgio G, Salucci A, Polimeni A, Di Carlo S. Different pulp dressing materials for the pulpotomy of primary teeth: a systematic review of the literature. Journal of Clinical Medicine. 2020; 9: 838.
 Sahin N, Saygili S, Akcay M. Clinical, radiographic, and histological evaluation of three different pulp-capping materials in indirect pulp treatment of primary teeth: a randomized clinical trial. Clinical Oral Investigations. 2021; 25: 3945–3955.
 Gizani S, Seremidi K, Stratigaki E, Tong HJ, Duggal M, Kloukos D. Vital pulp therapy in primary teeth with deep caries: an umbrella review. Pediatric Dentistry Journal. 2021; 43: 426–437.
 Dunston B, Coll JA. A survey of primary tooth pulp therapy as taught in US dental schools and practiced by diplomates of the American Board of Pediatric Dentistry. Pediatric Dentistry Journal. 2008; 30: 42–48.
 Monteiro J, Ní Chaollaí A, Duggal M. The teaching of management of the pulp in primary molars across Europe. European Archives of Paediatric Dentistry. 2017; 18: 203–208.
 Ni Chaollai A, Monteiro J, Duggal MS. The teaching of management of the pulp in primary molars in Europe: a preliminary investigation in Ireland and the UK. European Archives of Paediatric Dentistry. 2009; 10: 98–103.
 Hincapié S, Fuks A, Mora I, Bautista G, Socarras F. Teaching and practical guidelines in pulp therapy in primary teeth in Colombia —South America. International Journal of Paediatric Dentistry. 2015; 25: 87–92.
 Walker LA, Sanders BJ, Jones JE, Williamson CA, Dean JA, Legan JJ, et al. Current trends in pulp therapy: a survey analyzing pulpotomy techniques taught in pediatric dental residency programs. Journal of Dentistry for Children. 2013; 80: 31–35.
 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Journal of Clinical Epidemiology. 2008; 61:344–349.
 Bergoli AD, Primosch RE, de Araujo FB, Ardenghi TM, Casagrande L. Pulp Therapy in primary teeth—profile of teaching in Brazilian Dental Schools. Journal of Clinical Pediatric Dentistry. 2010; 35: 191–195.
 Ali H, Raslan N. Direct pulp capping (DPC) in primary molars using (3Mix-MP) and the characteristics of the carious lesion as predictor factors for its success: a randomized controlled trial. European Archives of Paediatric Dentistry. 2021; 22: 633–642.
 Chatzidimitriou K, Vadiakas G, Koletsi D. Direct pulp capping in asymptomatic carious primary molars using three different pulp capping materials: a prospective clinical trial. European Archives of Paediatric Dentistry. 2022; 23: 803–811.
 Dimitraki D, Papageorgiou SN, Kotsanos N. Direct pulp capping versus pulpotomy with MTA for carious primary molars: a randomized clinical trial. European Archives of Paediatric Dentistry. 2019; 20: 431–440.
 Garrocho-Rangel A, Esparza-Villalpando V, Pozos-Guillen A. Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: a systematic review. International Journal of Paediatric Dentistry. 2020; 30: 536–546.
 Pulikkotil SJ, Veettil SK, Vineet Dhar BD. Effectiveness of formocresol and ferric sulfate as pulpotomy material in primary molars: a systematic review and meta-analysis with trial sequential analysis of randomized clinical trials. Quintessence International. 2019; 50: 2–15.
 Tseveenjav B, Furuholm J, Mulic A, Valen H, Maisala T, Turunen S, et al. Survival of primary molars with pulpotomy interventions: public oral health practice-based study in Helsinki. Acta Odontologica Scandinavica. 2021; 79: 636–641.
 Roberts JF, Attari N, Sherriff M. The survival of resin modified glass ionomer and stainless steel crown restorations in primary molars, placed in a specialist paediatric dental practice. British Dental Journal. 2005; 198: 427–431.
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