Elsevier

Dental Abstracts

Volume 61, Issue 5, September–October 2016, Pages 267-268
Dental Abstracts

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Selective or complete excavation

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Background

Dentists are faced with the choice of doing either a complete excavation or a selective excavation when the patient has deep lesions. With the selective approach, the dentist seals carious dentin under a restoration, which deprives the microbial organisms of their nutritional source and arrests the lesion. This technique has the advantage of producing fewer risks for pulp exposure and complications compared to complete excavation. However, dentists appear to accept pulp exposure as an

Methods

The method included a qualitative approach through the use of semi-structured focus group interviews and a quantitative approach through a survey of 150 individuals regarding the relevance of various treatment attributes. The data gathered were subjected to analysis and combined.

Two convenience samples were used for the focus group discussions. Transcripts of the sessions were made and evaluated using content analysis to shape the design of the quantitative study design. For the survey, a

Results

For the qualitative effort, 12 focus members participated. Nine had had caries treatments previously and none had heard of selective excavation or removal. They all saw complete excavation as a safer and more reliable option. Half experienced fear of endodontic treatment and explained that it was linked to previous dental experiences, their level of trust in their dentist, and the information on treatment options. Ten of the 12 reported they would trust their dentist’s decision. Attributes of

Discussion

It’s important to understand why patients make decisions and what influences their choices. In addition to those factors that were studied, there are other factors, such as socioeconomic status, whether the patient has dental insurance, and dental anxiety, that can influence a dental procedure choice. Patients’ confidence in their dentist appears to be the most decisive factor in making treatment determinations.

Clinical Significance

Most of the patients rejected selective excavation, mainly

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Schwendicke F, Mostajaboldave R, Otto I, et al: Patients’ preferences for selective versus complete excavation: A mixed-methods study. J Dent 46:47-53,2016

Reprints available from F Schwendicke, Dept of Operative and Preventive Dentistry, Charité—Universitätsmedizin Berlin, Aßmannshauser Str 4−6,14197 Berlin, Germany; fax: +49 30 450 562 932; e-mail: [email protected]

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