Non-Cochrane · other · PM27760551
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and meta-analysis.
Schwendicke Falk, Göstemeyer Gerd · Implementation science : IS · 2016 · PubMed · doi:10.1186/s13012-016-0505-4
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
15
current version
GRADE rated
0
No studies
0
Included studies
8
linked below
No studies 0 · 0%Ungraded 15 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Dentists (general and specialist) managing adults or children with permanent, vital teeth with deep carious lesions | 9 studies surveying 4199 dentists (3845 general, 354 specialized) in USA, Brazil, Norway, Germany, and France (n=9 studies) |
| Intervention | Selective (incomplete) or stepwise carious tissue removal (SE/SW) | Selective or stepwise carious tissue removal (SE/SW) |
| Comparison | Non-selective (complete) carious tissue removal | Non-selective (complete) carious tissue removal |
| Outcomes | Proportion of dentists utilizing SE/SW; barriers and facilitators of SE/SW utilization | Pooled proportion using SE/SW 53% (95% CI 44% to 62%; I2=96%); significant increase over time (+1.6% per year); barriers and facilitators mapped to TDF/COM-B |
| Study designs | Original peer-reviewed qualitative or quantitative studies (interviews, focus groups, surveys, or other observational designs) | 9 quantitative studies (8 questionnaire surveys, 1 real-time poll); no qualitative studies were included (n=9) |
| Timing | Not specified (no time restriction applied) | Studies published 2007 to 2016 |
Search date: Not specified. Databases: PubMed (Medline), Embase, Cochrane CENTRAL, PsycINFO, Google Scholar, ProQuest/Dissertations and Theses, DARE, HTA database, NHS EED
Questions and results
Selective or stepwise carious tissue removal vs Non-selective or complete carious tissue removal
Population: Dentists surveyed about deep carious lesions in permanent teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of dentists selecting selective or stepwise removal Oen 2007 In Oen 2007, 18% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 18 [11, 27] | 1 study · 85 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Weber 2013 In Weber 2013, 21% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 21 [12, 34] | 1 study · 53 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Chisini 2015 In Chisini 2015, 62% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 62 [55, 69] | 1 study · 171 participants | Ungraded |
Proportion of dentists utilizing SE/SW for deep carious lesions Population: Dentists managing deep carious lesions in permanent vital teeth Across nine surveys of 4199 dentists, a pooled 53% (95% CI 44% to 62%) chose selective or stepwise (evidence-based) carious tissue removal for deep lesions in permanent teeth, with very high heterogeneity (I2=96%) and no formal certainty rating (ungraded). Source: Fig. 2 (forest plot); Results (Meta-analysis); Abstract · same question in other reviews | Proportion (%) 53 [44, 62] | 9 studies · 4199 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Stangvaltaite 2013 In Stangvaltaite 2013, 49% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 51 [44, 58] | 1 study · 212 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Seale and Glickman 2007 (all 376 conference dentists; source mislabels as 'endodontists', but only 102 were endodontists) Among surveyed endodontists, 59% selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 59 [54, 64] | 1 study · 376 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Schwendicke 2016 (Germany) In Germany, 68% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 68 [64, 71] | 1 study · 622 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal McBride 2010 In McBride 2010, 34% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 35 [32, 38] | 1 study · 812 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Seale and Glickman 2007 (pedodontists) Among surveyed pedodontists, 69% selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 71 [65, 77] | 1 study · 252 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Schwendicke 2016 (Norway) In Norway, 99% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 99 [95, 100] | 1 study · 199 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Schwendicke 2013 In Schwendicke 2013, 50% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 50 [47, 53] | 1 study · 799 participants | Ungraded |
Proportion of dentists selecting selective or stepwise removal Katz 2013 In Katz 2013, 45% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 45 [26, 55] | 1 study · 108 participants | Ungraded |
Barriers and facilitators of SE/SW utilization Population: Dentists managing deep carious lesions in permanent vital teeth Dentists' use of selective or stepwise removal was shaped by their age and understanding of caries, professional guidelines, peers and professional identity, financial and regulatory incentives, and beliefs about how treatments perform, identified by thematic analysis mapped to the TDF and Behavior Change Wheel (ungraded). Source: Table 3; Results (Factors associated with carious tissue removal behavior) · same question in other reviews | Thematic analysis mapped to the Theoretical Domains Framework and COM-B/Behavior Change Wheel; factors span knowledge (dentists' age, understanding of caries), skills, social influence (peers, practice networks),… | 9 studies | Ungraded |
Proportion of dentists selecting selective or stepwise removal Schwendicke 2016 (France) In France, 49% of surveyed dentists selected selective or stepwise removal. Source: Fig. 2 · same question in other reviews | Proportion (%) 49 [45, 52] | 1 study · 661 participants | Ungraded |
Temporal change in the proportion of dentists utilizing SE/SW Population: Dentists managing deep carious lesions in permanent vital teeth The proportion of dentists choosing selective or stepwise removal rose significantly over time, by about 1.6% per calendar year (meta-regression, p<0.05), a trend the authors described as borderline (ungraded). Source: Fig. 3; Results (Meta-analysis); Abstract; Discussion · same question in other reviews | Meta-regression coefficient (% per year) 1.6 | 9 studies · 4199 participants | Ungraded |
Included primary studies 8
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Chisini 2015 Vital Pulp Therapies in Clinical Practice: Findings from a Survey with Dentist in Southern Brazil DOI:10.1590/0103-6440201300409 | this review only | not stated | not extracted yet | not extracted yet |
| Katz 2013 The concepts of minimally invasive dentistry and its impact on clinical practice: a survey with a group of Brazilian professionals. PMID:23550521 | this review only | not stated | not extracted yet | not extracted yet |
| McBride 2013 Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health… PMID:23562351 | this review only | not stated | not extracted yet | not extracted yet |
| Schwendicke 2013 Attitudes and Behaviour regarding Deep Dentin Caries Removal: A Survey among German Dentists DOI:10.1159/000351662 | this review only | not stated | not extracted yet | not extracted yet |
| Schwendicke 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Seale and Glickman 2008 Contemporary Perspectives on Vital Pulp Therapy: Views From the Endodontists and Pediatric Dentists DOI:10.1016/j.joen.2008.02.034 | this review only | not stated | not extracted yet | not extracted yet |
| Stangvaltaite 2013 Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway DOI:10.3109/00016357.2013.775338 | this review only | not stated | not extracted yet | not extracted yet |
| Weber 2011 Treatment decisions for deep carious lesions in the Public Health Service in Southern Brazil DOI:10.1111/j.1752-7325.2011.00258.x | this review only | not stated | not extracted yet | not extracted yet |