European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026
Clinical decision-making in pulp therapy of primary teeth among Tunisian dental practitioners: a cross-sectional study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chouchene F, Moeulhi M, Masmoudi F, Baaziz A
Аннотация
PURPOSE: To assess clinical decision-making patterns in pulp therapy of primary teeth among Tunisian dental practitioners and explore the influence of diagnostic uncertainty on treatment selection.
METHODS: A cross-sectional, scenario-based survey was conducted among 263 dental practitioners in Tunisia (March-August 2025), including general dentists and specialists involved in paediatric care. A structured questionnaire based on the American Academy of Pediatric Dentistry (AAPD) guidelines presented three standardised clinical scenarios with increasing diagnostic complexity: asymptomatic deep caries, mechanical pulp exposure, and progressive pulpal disease. Participants selected treatment options which were compared to guideline-recommended management.
RESULTS: Most participants were early-career practitioners (85% ≤5 years of experience). A consistent tendency towards more invasive treatment was observed. In asymptomatic deep caries, pulpotomy was the most frequently selected option (51.1%) followed by indirect pulp treatment (26.2%). For mechanical pulp exposure, 78.7% of participants selected pulpotomy instead of direct pulp capping. In progressive pulpal disease, pulpectomy was the most frequently selected option (44.1%). Rubber dam isolation was inconsistently applied (6.8% systematic use), and calcium silicate-based materials were used in only 22.1% of pulpotomy procedures. Speciality status significantly influenced treatment selection across all scenarios (p≤0.004).
CONCLUSION: Clinical decision-making in pulp therapy was strongly influenced by diagnostic uncertainty, leading to a general tendency towards overtreatment and limited adherence to minimally invasive principles. These findings highlight a persistent evidence-practice discordance, and underscore the need to integrate uncertainty-based reasoning into paediatric dental education.
METHODS: A cross-sectional, scenario-based survey was conducted among 263 dental practitioners in Tunisia (March-August 2025), including general dentists and specialists involved in paediatric care. A structured questionnaire based on the American Academy of Pediatric Dentistry (AAPD) guidelines presented three standardised clinical scenarios with increasing diagnostic complexity: asymptomatic deep caries, mechanical pulp exposure, and progressive pulpal disease. Participants selected treatment options which were compared to guideline-recommended management.
RESULTS: Most participants were early-career practitioners (85% ≤5 years of experience). A consistent tendency towards more invasive treatment was observed. In asymptomatic deep caries, pulpotomy was the most frequently selected option (51.1%) followed by indirect pulp treatment (26.2%). For mechanical pulp exposure, 78.7% of participants selected pulpotomy instead of direct pulp capping. In progressive pulpal disease, pulpectomy was the most frequently selected option (44.1%). Rubber dam isolation was inconsistently applied (6.8% systematic use), and calcium silicate-based materials were used in only 22.1% of pulpotomy procedures. Speciality status significantly influenced treatment selection across all scenarios (p≤0.004).
CONCLUSION: Clinical decision-making in pulp therapy was strongly influenced by diagnostic uncertainty, leading to a general tendency towards overtreatment and limited adherence to minimally invasive principles. These findings highlight a persistent evidence-practice discordance, and underscore the need to integrate uncertainty-based reasoning into paediatric dental education.