SynthesisImplementation science : IS2016
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and meta-analysis.
Synthesis in Implementation science : IS, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Deep caries removal strategies: Findings from The National Dental Practice-Based Research Network.Journal of the American Dental Association (1939) · 2022Pooled it
- Interventions for treating cavitated or dentine carious lesions.The Cochrane database of systematic reviews · 2021Pooled it
- Selective, stepwise, or nonselective removal of carious tissue: which technique offers lower risk for the treatment of dental caries in permanent teeth? A systematic review and meta-analysis.Clinical oral investigations · 2020Pooled it
- Barriers and facilitators for provision of oral health care in dependent older people: a systematic review.Clinical oral investigations · 2019Pooled it
- Selective removal of dental caries in permanent teeth: an 18-month clinical trial.Clinical oral investigations · 2025Trial
- 3-year randomized clinical trial to evaluate the performance of posterior composite restorations lined with ion-releasing materials.Scientific reports · 2024Trial
- Selective vs stepwise removal of deep carious lesions in primary molars: 24 months follow-up from a randomized controlled trial.Clinical oral investigations · 2021Trial
- Dentists' knowledge, skills, attitudes and barriers towards minimal intervention dentistry.Brazilian oral research · 2026Article
- Knowledge, attitudes and preferences of parents/guardians regarding dental treatment of their children's primary teeth: a questionnaire cross-sectional study.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2025Article
- Selective caries removal and management of exposed pulp in fully developed and immature teeth with reversible pulpitis: a questionnaire-based study in Greece.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2025Article
- Management of deep carious lesions among Syrian dentists: a cross-sectional study.BMC oral health · 2025Article
- Comparing oral health-related quality of life and satisfaction: root canal therapy vs. extraction for first permanent molars in children - a case-control study.BMC oral health · 2025Article
- Deep caries and pulp exposures management preferences in permanent teeth: A survey amongst Spanish dentists.International endodontic journal · 2025Article
- Inconsistent decision making in dental caries diagnosis and treatment: A case-based questionnaire survey.Health science reports · 2024Article
- AI-initiated second opinions: a framework for advanced caries treatment planning.BMC oral health · 2024Article
- Selective Caries Removal: A Case Report with 21-Year Follow-Up.Case reports in dentistry · 2024Article
- Dental Pulp Response to Silver-Containing Solutions: A Scoping Review.Dentistry journal · 2023Article
- Current Strategies to Control Recurrent and Residual Caries with Resin Composite Restorations: Operator- and Material-Related Factors.Journal of clinical medicine · 2022Review
- COVID-19 as an opportunity for minimally-invasive dentistry: a national cross-sectional survey.BMC oral health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreasing evidence supports selective/incomplete (SE) or stepwise (SW) instead of non-selective/complete tissue removal for deep carious lesions in vital teeth, mainly as pulpal risks are significantly reduced. Our aims were to analyze the proportion of dentists who utilize SE/SW for deep lesions in permanent teeth and to identify barriers and facilitators of utilizing SE/SW.
methodsWe included studies that were original, and reported on the proportion of dentists utilizing SE/SW (quantitative studies), or reported on barriers or facilitators of such utilization (qualitative studies). Electronic databases (PubMed, CENTRAL, Embase, PsycINFO) were searched and screening and data extraction performed by two reviewers. Random-effects meta-analysis and meta-regression were used for quantitative synthesis of the proportion of dentists utilizing SE/SW. Thematic analysis was performed to assess barriers and facilitators on SE/SW utilization. Identified themes were translated into the constructs of the theoretical domains framework.
resultsFrom 1728 articles, nine studies were included, all using quantitative methods. Four thousand one hundred ninety-nine dentists had been surveyed. The mean (95% CI) proportion of dentists using SE/SW for deep lesions was 53 % (44/62 %). More recent studies reported significantly higher proportions (p < 0.05). Reported estimates and thematic analysis found dentists' age and an understanding of the disease caries and the scientific rationale behind different removal strategies to affect dentists' behavior. Guidelines, peers, and the social and professional identity were further associated with the motivation of utilizing SE/SW. Environmental incentives, sanctions, or restrictions, mainly of financial but also regulatory character, impacted on decision-making, as did the specific indication (the patient, the tooth) and the beliefs on how well different treatments perform.
conclusionsAround half of all dentists rejected evidence-based carious tissue removal strategies. A range of factors can be addressed for improving implementation. Future studies should use mixed qualitative-quantitative methods to yield a deeper understanding of dentists' decision-making.
trial registrationPROSPERO CRD42016038047.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.