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Approximal and occlusal caries lesions: Restorative treatment decisions by California dentists.
J Am Dent Assoc. 2016 Feb 9. pii: S0002-8177(15)01037-5. doi: 10.1016/j.adaj.2015.10.006. [Epub ahead of print]
use questionnaire surveys to evaluate treatment philosophies in dental
practices. The aim of this study was to evaluate the management
strategies California dentists use for approximal and occlusal caries
May 2013, the authors e-mailed a questionnaire that addressed
approximal and occlusal caries lesion management (detection and
restorative threshold, preferred preparation type, and restorative
materials) to 16,960 dentists in California. The authors performed a χ2 statistical analysis to investigate the relationship between management strategies and respondent demographic characteristics.
authors received responses from 1,922 (11.3%) dentists; 42.6% of the
respondents would restore approximal lesions at the dentinoenamel
junction, and 33.4% would wait until the lesion reached the outer
one-third of dentin. The preferred preparation type was the traditional
Class II preparation. Dentists who graduated more recently (20 years or
less) were more likely to delay approximal restorations (P < .0001);
49.9% of the more recent graduates would wait to restore an occlusal
lesion until the outer one-third of dentin was involved, and 42.6% would
restore a lesion confined to enamel.
is wide variety among California dentists regarding their restorative
treatment decisions, with most dentists restoring a tooth earlier than
the literature would advise. More recent dental graduates were more
likely to place their restorative threshold at deeper lesions for
approximal caries lesions.
evidence shows that noncavitated caries lesions can be remineralized;
therefore, early restorative treatment may no longer be necessary or
appropriate. Noninvasive and minimally invasive measures should be taken