A Survey of Trends in Teaching and Practice of Primary Molar Vital and Non Vital Pulp Therapy Among Pediatric Dental Program Directors and Pediatric Dentists
Bibliographic record
Abstract
Objectives: This study provides an update regarding trends in teaching and practice of vital and non-vital pulp therapy in primary molars with deep carious lesions.Methods: Internet surveys were sent to 85 program directors and 6000 pediatric dentists in Canada and the United States. The surveys were designed as modified versions of those published by Primosch in 1997. Three follow-up requests were sent. Results were summarized and analyzed using chi-square tests. Results: 841 pediatric dentists and 19 program directors returned surveys. Among dentists graduating after 2010, 76.5% reported performing an indirect pulp cap for an imminent pulp exposure and 23.5% reported performing a pulpotomy. Graduates from 2000-2009 selected indirect pulp cap and pulpotomy 49% and 51% respectively, and those graduating from 1960-1999, 56.6% and 43.4% respectively (p<.001). The most popular pulpotomy technique among pediatric dentists is MTA (39.2%) followed by formocresol (34.4%). 62% of pediatric dentists reported a change in their pulpotomy medicament since graduation, and 69.9% of those currently using MTA report having used it for 5 years or less. The most commonly taught pulpotomy medicament is MTA (56.3%) followed by formocresol (12.5%). While 95% of program directors teach pulpectomy, only 55% of practitioners perform the procedure in clinical practice (p<.001). In a situation during a pulpotomy in which radicular pulp is hemorrhagic and hemostasis is not achieved, the proportion of dentists who reported initiating a pulpectomy was 36% of 1960-1999 graduates, 31.5% of 2000-2009 graduates, and 22% of graduates 2010-present (p=.002). In the same clinical situation, the proportion of dentists who reported extraction was 26.4% of 1960-1999 graduates, 37.8% of 2000-2009 graduates, and 52.7% of graduates 2010-present (p<.001). Conclusion: There is a shift towards minimally invasive approaches in pulp therapy among pediatric dentists. MTA has marginally overtaken formocresol as the most popular pulpotomy medicament. Although pulpectomy is taught in training programs, fewer dentists perform the procedure in clinical practice, with more opting for extraction for teeth with necrotic or irreversibly inflamed pulps.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".