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J Dent. 2019 May;84:76-80. doi: 10.1016/j.jdent.2019.03.009. Epub 2019 Mar 29.

Dentists' practice patterns of treatment for deep occlusal caries: Findings from a dental practice-based research network.

Author information

Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan; University of Florida College of Dentistry, P.O. Box 100415, Gainesville, FL, 32610-0415, USA. Electronic address:
Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa, 252-0882, Japan.
Daiich Dental Clinic, 5-5-7, Hanazono, Chitose, Hokkaido, 066-0028, Japan.
Matsumoto Dental Clinic, 24-3, Komanomai, Doimachi, Okazaki, Aichi, 444-0204, Japan.
Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Room D3-39, P.O. Box 100415, Gainesville, FL, 32610-0415, USA.
Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Room SDB 109, 1720 Second Avenue South, Birmingham, AL, 35294-0007, USA.



This study quantified and compared practice patterns of treatment for deep occlusal carious lesions among Japanese dentists, and tested the hypothesis that dentist characteristics are significantly associated with the decision to choose an indirect pulp capping (IPC), a form of selective carious tissue removal that involves leaving a thin layer of demineralized tissue over the pulp, that is then covered with a protective liner.


This cross-sectional study was conducted using a questionnaire survey of dentists affiliated with the Dental Practice-based Research Network Japan (n = 297). Dentists were asked to indicate what percentage of time they use three treatment options when treating patients with deep occlusal caries and possible mild pulpitis on a posterior tooth. Response options were "1. Stop before removing all caries and perform an IPC", "2. Remove all caries and proceed with a direct pulp cap", and "3. Remove all caries and proceed with endodontic-related procedures". Percentages of options 1-3 were compared by multiple comparison. Associations between dentist characteristics and a higher percentage of IPC provision (option 1) were analyzed via logistic regression.


Responses were obtained from 206 dentists. Median percentages (interquartile ranges) of options 1, 2 and 3 were 30% (10-59%), 10% (0-30%), and 40% (19-80%), respectively. The differences between option 3 and options 1 and 2 were significant (p < 0.001). In logistic regression analysis, a higher frequency of obtaining evidence from English-language scientific articles was significantly associated with a higher percentage of IPC, with an odds ratio of 2.28 (95%CI: 1.14-4.54).


Endodontic-related procedures remain the most frequent treatment option for deep occlusal caries. Frequent use of evidence-based information in English-language scientific articles was associated with Japanese dentists' preference toward IPC.


Japanese dentists would most frequently choose endodontic-related procedures, followed by IPC and direct pulp capping for treatment of patients with deep occlusal caries with possible mild pulpitis on posterior teeth. Significant association was identified between use of evidence-based information in the English-language scientific literature and Japanese dentists' preference for IPC.


Evidence-based dentistry; Evidence-practice gap; Indirect pulp capping; Occlusal caries; Practice-Based research

[Available on 2020-05-01]

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