RESEARCH ARTICLE
Viktorija Ašmankevičiūtė-Leminskė and Gediminas Žekonis
Lithuanian University of Health Sciences, Kaunas, Lithuania
Objective: The objective of this study was to compare self-reported treatment preferences related to pulpectomy prior to prosthetic treatment, restoration selection for vital teeth, and impression-taking methods between Lithuanian general dentists (GDs) and prosthodontists (Ps).
Material and methods: A questionnaire-based survey was conducted among 386 dentists in Lithuania, including GDs (62.4%) and Ps (37.6%). Data were analyzed using descriptive statistics and inferential tests (Chi-square and Fisher’s exact test), with a significance level of p < 0.05.
Results: Most indications for pulpectomy were reported similarly by both groups; however, significant differences were observed for extensive coronal structure loss (> 50%) and deep caries, cervical lesions, gingival recession, short clinical crown, insufficient retention, enamel hypoplasia, and external root resorption (p < 0.05). Ps also more frequently reported using indirect restorations, including porcelain-fused-to-metal crowns, lithium disilicate ceramic inlays and onlays, and polymethyl methacrylate crowns. Conventional impressions were more common among GDs, whereas digital or combined workflows were more common among Ps.
Conclusions: Lithuanian GDs and Ps reported broadly similar preferences regarding preservation of tooth vitality, but differed in selected pulpectomy indications, restorative options, and impression-taking methods. These differences may reflect variation in specialist training, clinical experience, and access to prosthetic workflows.
KEYWORDS: General dentists; prosthodontists; pulpectomy; prosthetic dentistry; restorations
Citation: ACTA ODONTOLOGICA SCANDINAVICA 2026; VOL. 85: 408–415. DOI: https://doi.org/10.2340/aos.v85.46336.
Copyright: © 2026 The Author(s). Published by MJS Publishing on behalf of Acta Odontologica Scandinavica Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.
Received: 1 April 2026; Accepted: 7 June 2026; Published: 2 July 2026.
CONTACT: Viktorija Ašmankevičiūtė-Leminskė viktorija.asmankeviciute-leminske@lsmu.lt Lithuanian University of Health Sciences, Kaunas, Lithuania
Supplemental data for this article can be accessed online at https://doi.org/10.2340/aos.v85.46336
Competing interests and funding: The authors report there are no competing interests to declare.
This research received no external funding.
In Lithuania, after completing integrated dentistry studies, a dentist may practice as a general dentist (GD) and provide broad diagnostic, preventive, restorative, endodontic, periodontal, and basic prosthetic care. In contrast, to become prosthodontists (Ps), GDs must complete a 3-year-long residency program; therefore, prosthodontists have more advanced training in prosthetic treatment planning, indirect restorations, occlusion, laboratory-based workflows, and complex oral rehabilitation [1]. Both GDs and Ps can encounter similar clinical situations involving prosthetic rehabilitation of vital teeth; however, treatment approaches and preferences could be influenced by clinical experience, scope of practice, and differences in professional training.
Preservation of pulp vitality has become an increasingly important principle in contemporary dentistry. Current trends emphasize minimally invasive approaches and the use of conservative treatment methods whenever possible, reserving endodontic treatment for cases with clear indications [2–4]. Nevertheless, treatment preferences may vary among practitioners, particularly in borderline cases where treatment indications are not well defined.
Removal of the dental pulp may prevent the development of inflammatory processes following restoration placement and reduce the likelihood of needing to remove the prosthetic restoration for subsequent endodontic treatment. However, this approach is not without drawbacks, as endodontically treated teeth may become more fragile and are associated with loss of proprioception, structural changes, and an increased risk of complications [5, 6].
Patients seek dental treatment not only to restore function but also to achieve satisfactory aesthetic outcomes. In prosthetic dentistry, treatment planning is highly individualized and depends on both clinical findings and patient expectations. Dentists rely on their knowledge, experience, and available technologies to determine the most appropriate treatment approach for each case [7].
Advances in dental materials and techniques have significantly expanded the range of restorative options available. Modern prosthodontics offers a variety of solutions that allow clinicians to balance functional, biological, and aesthetic requirements. The selection of an appropriate restoration depends on multiple factors, including tooth vitality, the amount of remaining hard tissue, occlusal load, parafunctional habits, and aesthetic considerations, as well as the clinician’s skills and experience [8, 9].
Although specialist and generalist differences are expected, identifying the specific areas in which GDs and Ps differ is clinically relevant. Such information may help determine whether variation occurs mainly in expected areas, such as laboratory-based restorations and digital workflows, or also in biologically important decisions, such as pulpectomy of vital teeth before prosthetic treatment. In the Lithuanian context, data are limited regarding how GDs and Ps report approaching pulpectomy indications, restoration selection, and impression-taking methods within the same healthcare and educational environment.
Therefore, the aim of this study was to compare self-reported treatment preferences related to pulpectomy prior to prosthetic treatment, restoration selection for vital teeth, and impression-taking methods between Lithuanian GDs and Ps. By identifying variations in treatment preferences, this research aims to contribute to a better understanding of current practices and to highlight areas where greater consistency or further professional development may improve patient care outcomes.
This cross-sectional study was approved by the Centre for Bioethics at the Lithuanian University of Health Sciences (No. BEC–OF–17). The study was reported in accordance with the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines for online surveys.
A questionnaire was developed based on the study aims and relevant literature sources [10–20]. The questionnaire consisted of nine questions:
A total of 386 dentists participated in the study, including GDs and Ps.
Data were analyzed using Microsoft Excel, SPSS, and R software. Descriptive statistics were applied, and statistical significance was set at p < 0.05.
Participants were recruited using a convenience sampling method. The questionnaire was distributed electronically via professional dental networks, social media groups, and direct communication channels commonly used by dentists in Lithuania. Participation in the study was voluntary and anonymous; thus, self-selection bias may have occurred, with dentists more interested in prosthodontic treatment or continuing education potentially being more likely to participate.
Eligible participants included licensed GDs and Ps currently practicing in Lithuania. Dentists not actively involved in clinical practice or those who did not complete the questionnaire in full were excluded from the analysis.
A total of 386 responses were collected. Incomplete or duplicate responses were excluded prior to analysis.
No formal a priori sample size calculation was performed because the study was exploratory and used convenience-based online recruitment. The final sample included 386 respondents, which was considered sufficient for descriptive analysis and exploratory comparison between GDs and Ps.
Due to the nature of online distribution through multiple channels, the exact number of dentists who received the questionnaire could not be determined; therefore, the response rate was not calculated. This represents a limitation of the study.
The questionnaire (Annex 1) was developed based on the study objectives and relevant literature sources [10–20]. It consisted of nine structured questions covering demographic information, pulpectomy indications, preservation of tooth vitality, restoration selection, and impression-taking methods.
The questionnaire was pilot tested among 10 practicing dentists to assess clarity and comprehensibility. Minor revisions were made accordingly. Because the questionnaire included independent thematic items rather than a unified psychometric construct, internal consistency analysis using Cronbach’s alpha was not considered appropriate. Nevertheless, the absence of formal external validation may be considered a limitation of the study.
Data were analyzed using IBM SPSS Statistics and R. Descriptive statistics (frequencies and percentages) were used to summarize the data.
Comparisons between GDs and Ps were performed using the Chi-square (χ²) test of independence. When expected frequencies were less than five, Fisher’s exact test was applied. A significance level of p < 0.05 was considered statistically significant.
Cramér’s V was calculated as an exploratory effect size measure for statistically significant chi-square associations to describe the strength of association between the practitioner group and questionnaire responses. Effect sizes were interpreted descriptively and were not used as confirmatory evidence of clinical importance.
All statistical tests were two-tailed.
A total of 386 dentists participated in the study, including GDs (n = 241) and Ps (n = 145). The distribution of respondents according to work experience, workplace, and methods of knowledge renewal is presented in Table 1.
GDs more frequently worked exclusively in private practice, whereas Ps more often combined private and public practice. Continuing education was primarily achieved through courses and training in both groups, although Ps reported a higher tendency to engage with scientific literature.
No statistically significant differences were observed between groups for several assessed indications. However, statistically significant differences were observed in several conditions, with varying effect sizes.
The strongest difference between groups was observed for short clinical crown and insufficient retention (p < 0.001, Cramér’s V = 0.41), indicating a strong association and differences in reported treatment preferences.
Moderate associations were found for:
These findings suggest statistically significant differences in how these conditions are interpreted between groups.
A smaller but statistically significant difference was observed for:
This indicates a modest association between practitioner type and treatment preferences.
External root resorption also showed a statistically significant difference (p = 0.003, V = 0.15), although the effect size was weak, suggesting limited practical significance.
No statistically significant differences were found for tooth sensitivity, pain, percussion sensitivity, periodontal pockets, tooth wear, patient preference, or crown discoloration (p > 0.05).
Most respondents in both groups reported attempting to preserve tooth vitality during prosthetic treatment (GDs: 69.2%, Ps: 54.3%), with no statistically significant difference (p = 0.283).
However, a statistically significant difference was observed in preparation strategy (p = 0.009), with GDs more frequently aiming to minimize the removal of hard tissue, while Ps more often considered individual tooth anatomy. The effect size for this difference was small (V ≈ 0.13), indicating limited practical significance despite statistical significance.
Significant differences were observed in the selection of several restorative options.
Moderate associations were identified for:
These findings indicate statistically significant differences in restorative preferences between groups, with Ps more frequently selecting indirect and laboratory-fabricated restorations.
A smaller but statistically significant association was found for:
No statistically significant differences were observed for ceramic veneers, composite veneers, zirconia crowns, or temporary restorations (p > 0.05).
A statistically significant difference was observed in impression-taking methods between groups (p < 0.001), with a moderate effect size (V ≈ 0.35).
GDs predominantly used conventional (analog) impression techniques (79.7%), whereas Ps more frequently used digital (22.8%) or combined workflows (31.7%).
This indicates a statistically significant difference in reported impression-taking methods, with Ps reporting greater use of digital technologies.
The present study demonstrates that GDs and Ps largely agree on most indications for pulpectomy prior to prosthetic treatment; however, significant differences were observed in specific clinical situations. These findings highlight variability in treatment preferences despite a shared theoretical background.
GDs more frequently reported recommending pulpectomy in cases of short clinical crown and insufficient retention. This finding may indicate a greater tendency toward preventive endodontic treatment prior to extensive prosthetic rehabilitation. In contrast, Ps may be more inclined to preserve tooth vitality and consider alternative restorative or prosthetic approaches aimed at improving retention while maintaining pulpal health. Current concepts in minimally invasive dentistry emphasize preservation of vital tooth structure whenever clinically feasible [2, 3, 10].
Differences were also observed in the management of cervical lesions, gingival recession, and enamel defects. Ps more frequently considered these conditions as potential indications for pulpectomy. Although such defects may be associated with dentin hypersensitivity, structural compromise, or restorative complexity [21–24], contemporary evidence generally supports conservative management unless irreversible pulpal pathology is present [10, 11]. These findings may reflect differences in the interpretation of borderline clinical situations and varying restorative philosophies between practitioner groups.
In the present study, GDs associated extensive coronal destruction and deep carious lesions with the need for pulpectomy more frequently than Ps did. This may reflect a more precautionary approach toward avoiding future endodontic complications after prosthetic rehabilitation. Previous studies have similarly reported concerns regarding overtreatment and variability in endodontic treatment recommendations among clinicians [6, 21].
External root resorption was more frequently considered an indication for pulpectomy by Ps. However, current evidence suggests that endodontic treatment is not always necessary in cases of external root resorption unless pulpal involvement or infection is present [25, 26]. This finding further highlights variability in the interpretation of pathological findings among clinicians.
Overall, the findings of the present study suggest that although both practitioner groups generally support preservation of tooth vitality, differences remain in the management of clinically ambiguous or borderline conditions. These differences may be associated with variations in specialist training, clinical experience, and prosthetic treatment philosophy.
The present study demonstrated significant differences in restoration selection between GDs and Ps. Ps reported greater preference for indirect restorations such as lithium disilicate ceramic inlays and onlays, PFM crowns, pressed ceramic crowns, and PMMA restorations.
The greater use of indirect restorations among Ps may reflect increased familiarity with laboratory-fabricated restorations, greater involvement in complex prosthetic rehabilitation, and more advanced prosthetic training. Previous studies have similarly shown that clinicians with specialist prosthodontic training are more likely to utilize indirect restorative techniques and advanced restorative materials [27–29].
Lithium disilicate ceramic inlays and onlays were more frequently selected by Ps in the present study. These restorations are often associated with more conservative preparation designs and preservation of healthy tooth structure compared to full-coverage crowns [30, 31]. Their increased use among prosthodontists may therefore reflect greater adoption of minimally invasive restorative concepts.
Significant differences were also observed in the use of PFM crowns and pressed ceramic crowns. Ps reported greater preference for these restorations, which may be related to broader experience with material selection, laboratory communication, and long-term prosthetic treatment planning. Although all-ceramic systems and zirconia restorations have gained popularity because of favorable aesthetic and mechanical properties [32–35], PFM crowns continue to demonstrate reliable long-term clinical performance [36, 37].
PMMA restorations were also used substantially more frequently by Ps. This finding may reflect more frequent use of provisional restorations during complex prosthetic rehabilitation procedures. PMMA materials remain widely used because of their favorable mechanical properties, ease of fabrication, and acceptable temporary aesthetic performance [38, 39].
Overall, these findings suggest that specialization and extensive prosthetic training may influence restorative preferences, particularly regarding indirect restorations.
The present study demonstrated statistically significant differences in impression-taking methods between GDs and Ps. GDs predominantly reported using conventional analog impression techniques, whereas Ps more frequently used digital or mixed workflows.
These findings may reflect differences in specialist training, access to digital technologies, frequency of complex prosthetic procedures, and integration of laboratory-based workflows into daily clinical practice. Previous studies have similarly demonstrated greater adoption of digital impression systems among prosthodontic specialists and clinicians performing advanced prosthetic rehabilitation [40–48].
Conventional elastomeric impressions remain widely used because of clinician familiarity, lower equipment costs, and broad accessibility [49–52]. However, digital impression systems offer several potential advantages, including improved patient comfort, simplified communication with dental laboratories, immediate visualization of preparations, and reduction of certain technical errors [40–42].
The greater use of digital workflows among Ps observed in the present study may also indicate increased engagement with contemporary digital prosthodontic concepts and CAD/CAM technologies. Nevertheless, adoption of digital systems may remain influenced by financial considerations, operator experience, and availability of digital infrastructure.
The present study provides insight into self-reported prosthetic treatment preferences among Lithuanian GDs and Ps within the same healthcare and educational environment. Although differences between these groups are expected because of differences in training and scope of practice, the findings identify specific areas where reported preferences differ, particularly in selected pulpectomy indications, indirect restoration use, and impression-taking methods. These results may help identify topics for continuing education and may support future development of more standardized guidance for borderline prosthetic situations. However, because the study was based on self-reported questionnaire responses rather than standardized clinical scenarios, the findings should be interpreted as reported preferences rather than direct evidence of clinical behavior.
It is important to note the limitations of this study. The study was based on self-reported questionnaire responses rather than direct observation of clinical behavior, which may introduce response bias. In addition, convenience-based online recruitment may have resulted in self-selection bias and limited representativeness of the sample, as dentists with a greater interest in prosthodontics or continuing education may have been more likely to participate. Gender and other demographic variables were not collected, which limited further analysis of respondent characteristics. Because the survey was distributed through multiple online channels, the response rate could not be calculated. Furthermore, the questionnaire was not externally validated, which may limit the generalizability and methodological robustness of the findings.
The findings suggest that continuing education may be particularly useful in areas where reported preferences differed between GDs and Ps, including pulpectomy indications in borderline cases, selection of indirect restorations, and adoption of digital impression workflows. Future studies using standardized clinical vignettes are needed to determine whether these self-reported preferences correspond to actual clinical decision-making.
Within the limitations of this cross-sectional survey, GDs and Ps demonstrated similar overall approaches toward preservation of tooth vitality during prosthetic treatment. However, statistically significant differences were observed in reported preferences regarding selected pulpectomy indications, restoration types, and impression-taking methods. Ps reported greater use of indirect restorations and digital workflows. These findings may reflect differences in specialist training and clinical experience.
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
This study was conducted in Lithuania.
[1] Lithuanian Higher Education Associations for Organizing Joint Admission. Residency (specialty training) [Internet]. Kaunas: LAMA BPO; [cited 2026 May 24]. Available from: https://lamabpo.lt/en/residency-specialty-training/
[2] Schuh CMAP, Benso B, Aguayo S. Potential novel strategies for the treatment of dental pulp-derived pain: pharmacological approaches and beyond. Front Pharmacol. 2019;10:1068. https://doi.org/10.3389/fphar.2019.01068
[3] Duncan HF. Present status and future directions-Vital pulp treatment and pulp preservation strategies. Int Endod J. 2022;55(Suppl 3):497–511. https://doi.org/10.1111/iej.13688
[4] American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of PediatricDentistry; 2025. p. 487–96.
[5] Bulgareli JV, Faria ET, Cortellazzi KL, Guerra LM, Meneghim MC, Ambrosano GMB, et al. Factors influencing the impact of oral health on the daily activities of adolescents, adults and older adults. Rev Saude Publica. 2018;52:44. https://doi.org/10.11606/s1518-8787.2018052000042
[6] Randow K, Kjell R, Glantz PO. On cantilever loading of vital and non-vital teeth: an experimental clinical study. Acta Odontol Scand. 1986;44:271–7. https://doi.org/10.3109/00016358609004733
[7] Beliay AM, Petrazhyckaya GV. Relevance of the problem of depulping teeth for orthopedic indications. Minsk: Belarusian State Medical University; 2016. p. 6–11.
[8] Tikhonova S, Booij L, D’Souza V, Crosara KTB, Siqueira WL, Emami E. Investigating the association between stress, saliva and dental caries: a scoping review. BMC Oral Health. 2018;18(1):41. https://doi.org/10.1186/s12903-018-0500-z
[9] Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: recent trends in management. J Conserv Dent. 2010;13(4):218–24. https://doi.org/10.4103/0972-0707.73385
[10] Sheets CG, Wu JC, Earthman JC. Quantitative percussion diagnostics as an indicator of the level of the structural pathology of teeth: retrospective follow-up investigation of high-risk sites that remained pathological after restorative treatment. J Prosthet Dent. 2018;119(6):928–34. https://doi.org/10.1016/j.prosdent.2017.09.013
[11] Bartlett DW, Shah P. A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion. J Dent Res. 2006;85(4):306–12. https://doi.org/10.1177/154405910608500405
[12] Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev. 2001;14(4):727–52, table of contents. https://doi.org/10.1128/CMR.14.4.727-752.2001
[13] Li L, Chen HJ, Lian Y, Wang T. Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis. World J Clin Cases. 2021;9(33):10098–105. https://doi.org/10.12998/wjcc.v9.i33.10098
[14] Bartlett D, Dugmore C. Pathological or physiological erosion – is there a relationship to age? Clin Oral Investig. 2008;12 Suppl 1:S27–31. https://doi.org/10.1007/s00784-007-0177-1.
[15] Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 4th ed. St Louis, MO: Elsevier Health Sciences; 2006.
[16] Moccelini BS, Alencar NA, Magno MB, Bolan M, Maia LC, Cardoso M. Is there an association between crown discoloration and pulp necrosis in traumatized permanent teeth? A meta-analysis. Braz Oral Res. 2020;34:e103. https://doi.org/10.1590/1807-3107bor-2020.vol34.0103
[17] Beier US, Kapferer I, Burtscher D, Dumfahrt H. Clinical performance of porcelain laminate veneers for up to 20 years. Int J Prosthodont. 2012;25(1):79–85.
[18] Baloch H, Sheikh Z, Misbahuddin S, Kazmi SMR, Qureshi S, Uddin MZ. Advancements in all-ceramics for dental restorations and their effect on the wear of opposing dentition. Eur J Dent. 2016;10:583–9. https://doi.org/10.4103/1305-7456.195170
[19] Haralur SB. Microleakage of porcelain laminate veneers cemented with different bonding techniques. J Clin Exp Dent. 2018;10(2):e166–71. https://doi.org/10.4317/jced.53954
[20] Linhares LA, Pottmaier LF, Lopes GC. Fracture resistance of veneers in premolars. Eur J Dent. 2018;12(2):191–8. https://doi.org/10.4103/ejd.ejd_349_17
[21] Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R, et al. European Society of Endodontology position statement: management of deep caries and the exposed pulp. Int Endod J. 2019;52(7):923–34. https://doi.org/10.1111/iej.13080
[22] Crespo-Gallardo I, Hay-Levytska O, Martín-González J, Jiménez-Sánchez MC, Sánchez-Domínguez B, Segura-Egea JJ. Criteria and treatment decisions in the management of deep caries lesions: is there endodontic overtreatment? J Clin Exp Dent. 2018;10(8):e751–60. https://doi.org/10.4317/jced.55050. Erratum in: J Clin Exp Dent. 2019;11(1):e103. https://doi.org/10.4317/jced.532742
[23] Jati AS, Furquim LZ, Consolaro A. Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press J Orthod. 2016;21(3):18–29. https://doi.org/10.1590/2177-6709.21.3.018-029.oin
[24] Imber JC, Kasaj A. Treatment of gingival recession: when and how? Int Dent J. 2021;71(3):178–87. https://doi.org/10.1111/idj.12617
[25] Alkaabi AM, AlHumaidan AA, AlQarawi FK, AlShahrani FA. Esthetic smile rehabilitation of enamel hypomineralized teeth with E-max prosthesis: case report. Saudi Dent J. 2019;31(Suppl):S106–11. https://doi.org/10.1016/j.sdentj.2019.02.017
[26] Levin M, Jong G. The use of CBCT in the diagnosis and management of root resorption. In: S Patel, editor. Cone beam computed tomography in endodontics. Cham: Springer; 2016. p. 99–114.
[27] Fiorin L, Theodoro GT, Moris ICM, Rodrigues RCS, Ribeiro RF, Faria ACL. Fracture toughness of three heat-pressed ceramic systems. Braz J Oral Sci. 2018;17:e18017.
[28] Aspros A. Inlays & onlays clinical experiences and literature review. J Dent Health Oral Disord Ther. 2015;2(1):26–31. https://doi.org/10.15406/jdhodt.2015.02.00038
[29] Zafar MS. Prosthodontic applications of polymethyl methacrylate (PMMA): an update. Polymers (Basel). 2020;12(10):2299. https://doi.org/10.3390/polym12102299
[30] Porojan L, Savencu C, Porojan S. Applications of heat-pressed ceramics for single tooth restorations. Rev Chim (Bucharest). 2016;67(1):123–6.
[31] Jum’ah AA, Creanor S, Wilson NHF, Burke FJT, Brunton PA. Dental practice in the UK in 2015/2016. Part 3: aspects of indirect restorations and fixed prosthodontics. Br Dent J. 2019;226(3):192–6. https://doi.org/10.1038/sj.bdj.2019.95
[32] Homsy F, Eid R, El Ghoul W, Chidiac JJ. Considerations for altering preparation designs of porcelain inlay/onlay restorations for nonvital teeth. J Prosthodont. 2015;24(6):457–62. https://doi.org/10.1111/jopr.12279
[33] Fu L, Engqvist H, Xia W. Glass-ceramics in dentistry: a review. Materials (Basel). 2020;13(5):1049. https://doi.org/10.3390/ma13051049
[34] Soleimani F, Jalali H, Mostafavi AS, Zeighami S, Memarian M. Retention and clinical performance of zirconia crowns: a comprehensive review. Int J Dent. 2020;2020:8846534. https://doi.org/10.1155/2020/8846534
[35] Felberg RV, Bassani R, Pereira GKR, Bacchi A, Silva-Sousa YTC, Gomes EA, et al. Restorative possibilities using zirconia ceramics for single crowns. Braz Dent J. 2019;30(5):446–52. https://doi.org/10.1590/0103-6440201902780
[36] Zarone F, Di Mauro MI, Ausiello P, Ruggiero G, Sorrentino R. Current status on lithium disilicate and zirconia: a narrative review. BMC Oral Health. 2019;19:134. https://doi.org/10.1186/s12903-019-0838-x
[37] Reitemeier B, Hänsel K, Range U, Walter MH. Prospective study on metal ceramic crowns in private practice settings: 20-year results. Clin Oral Investig. 2019;23(4):1823–8. https://doi.org/10.1007/s00784-018-2618-4
[38] Dolidze T, Bitarova I. Advantages and disadvantages of E-max and zirconia crowns. Eur Sci J. 2016;67(Special issue):465–8.
[39] Lipski M, Woźniak K, Szyszka-Sommerfeld L, Borawski M, Droździk A, Nowicka A. In vitro infrared thermographic assessment of temperature change in the pulp chamber during provisionalization: effect of remaining dentin thickness. J Healthc Eng. 2020;2020:8838329. https://doi.org/10.1155/2020/8838329
[40] Lawson NC, Sulaiman TA. Diagnosing a failed impression: common errors and how to overcome them. Compend Contin Educ Dent. 2019;40(3):184.
[41] D’Ambrosio F, Giordano F, Sangiovanni G, Di Palo MP, Amato M. Conventional versus digital dental impression techniques: what is the future? An umbrella review. Prosthesis. 2023;5(3):851–75. https://doi.org/10.3390/prosthesis5030060
[42] Zarbakhsh A, Jalalian E, Samiei N, Mahgoli MH, Kaseb Ghane H. Accuracy of digital impression taking using intraoral scanner versus the conventional technique. Front Dent. 2021;18:6. https://doi.org/10.18502/fid.v18i6.5649
[43] Suese K. Progress in digital dentistry: the practical use of intraoral scanners. Dent Mater J. 2020;39(1):52–6. https://doi.org/10.4012/dmj.2019-224
[44] Müller P, Ender A, Joda T, Katsoulis J. Impact of digital intraoral scan strategies on the impression accuracy using the TRIOS Pod scanner. Quintessence Int. 2016;47(4):343–9. https://doi.org/10.3290/j.qi.a35524
[45] Kumar HC, Kumar TP, Hemchand S, Suneelkumar C, Subha A. Accuracy of marginal adaptation of posterior fixed dental prosthesis made from digital impression technique: a systematic review. J Indian Prosthodont Soc. 2020;20(2):123–30. https://doi.org/10.4103/jips.jips_382_19
[46] Todorović A, Lisjak D, Lazić V, Spadijer-Gostović A. Possible errors during the optical impression procedure. Stomatol Glas Srb. 2010;57:30–7. https://doi.org/10.2298/SGS1001030T
[47] Bilir H, Ayguzen C. Comparison of digital and conventional impression methods by preclinical students: efficiency and future expectations. J Int Soc Prev Community Dent. 2020;10(4):402–9. https://doi.org/10.4103/jispcd.JISPCD_330_18
[48] Yun MJ, Jeon YC, Jeong CM, Huh JB. Comparison of the fit of cast gold crowns fabricated from the digital and the conventional impression techniques. J Adv Prosthodont. 2017;9(1):1–13. https://doi.org/10.4047/jap.2017.9.1.1
[49] Rauch A, Schrock A, Schierz O, Hahnel S. Material selection for tooth-supported single crowns-a survey among dentists in Germany. Clin Oral Investig. 2021;25(1):283–93. https://doi.org/10.1007/s00784-020-03363-9
[50] Kar S, Tripathi A, Singh J, Ramkumar J. Comparison of dimensional accuracy of elastomeric impression materials using 3D laser scanner. Med J Armed Forces India. 2022;78(Suppl 1):S55–60. https://doi.org/10.1016/j.mjafi.2021.05.019
[51] Madanshetty P, Guttal SS, Meshramkar R, Newaskar PS, Anehosur GV. Addition silicone impressions in fixed prosthodontics: clinical standpoints. Cureus. 2023;15(8):e44014.
[52] Eachempati P, Kumbargere Nagraj S, Kiran Kumar Krishanappa S, George RP, Soe HHK, Karanth L. Management of gag reflex for patients undergoing dental treatment. Cochrane Database Syst Rev. 2019;2019(11):CD011116. https://doi.org/10.1002/14651858.CD011116.pub3
[53] Hargreaves KM, Cohen S, Berman LH. Cohen’s pathways of the pulp. St Louis, MO: Mosby Elsevier; 2015. p. 13–15.
[54] Pigg M, Nixdorf DR, Nguyen RH, Law AS; National dental practice-based research network collaborative group. validity of preoperative clinical findings to identify dental pulp status: a national dental practice-based research network study. J Endod. 2016;42(6):935–42. https://doi.org/10.1016/j.joen.2016.03.016
[55] American Association of Endodontists. AAE white paper – endodontic competency. Chicago, IL: American Association of Endodontists; 2017.
[56] Zucchelli G, Gori G, Mele M, Stefanini M, Mazzotti C, Marzadori M, et al. Non-carious cervical lesions associated with gingival recessions: a decision-making process. J Periodontol. 2011;82(12):1713–24. https://doi.org/10.1902/jop.2011.110080
[57] Solanki G. A general overview of periodontal pockets. Int J Biomed Res. 2012;3(3):127–30.
[58] Pindborg JJ. Pathology of the dental hard tissue. Philadelphia, PA: Saunders; 1970. p. 435.
[59] Johansson AK, Omar R, Carlsson GE, Johansson A. Dental erosion and its growing importance in clinical practice: from past to present. Int J Dent. 2012;2012:632907. https://doi.org/10.1155/2012/632907
[60] Zhang M, Xiong Y, Wang X, Wang Y, Cai Y, Xu J, et al. Factors affecting the outcome of full pulpotomy in permanent posterior teeth diagnosed with reversible or irreversible pulpitis. Sci Rep. 2022;12(1):20280. https://doi.org/10.1038/s41598-022-24815-0
[61] d’Incau E, Saulue P. Understanding dental wear. J Dentofacial Anom Orthod. 2012;15:104. https://doi.org/10.1051/odfen/2011404
[62] Seol HW, Koak JY, Kim SK, Heo SJ. Full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: a case report. J Adv Prosthodont. 2010;2(2):50–3. https://doi.org/10.4047/jap.2010.2.2.50
[63] Sharma A, Rahul GR, Poduval ST, Shetty K. Short clinical crowns (SCC) – treatment considerations and techniques. J Clin Exp Dent. 2012;4(4):e230–6. https://doi.org/10.4317/jced.50556
[64] Rossi R, Longo E, Cozzani M. Diagnosis and inter-disciplinary treatment of altered passive eruption, the digital evolution. Semin Orthod. 2024;30:190–205.
[65] Zaleckiene V, Peciuliene V, Brukiene V, Drukteinis S. Traumatic dental injuries: etiology, prevalence and possible outcomes. Stomatologija. 2014;16(1):7–14.
[66] Gbadebo SO, Ajayi DM. Self-reported tooth discolorations among patients seen at dental center university college hospital Ibadan. J West Afr Coll Surg. 2015;5(3):66–77.
[67] Martínez-Galeano G, Pacheco-Muñoz LF, López-Palomar LC. Selection of dental ceramics in an esthetic area: a case report. Rev Fac Odontol Univ Antioq. 2017;29(1):222–40. https://doi.org/10.17533/udea.rfo.v29n1a12
[68] Consolaro A, Bittencourt G. Why not to treat the tooth canal to solve external root resorptions? Here are the principles! Dental Press J Orthod. 2016;21(6):20–5. https://doi.org/10.1590/2177-6709.21.6.020-025.oin
[69] Yuan F, Zheng J, Sun Y, Wang Y, Lyu P. Regulation and measurement of the heat generated by automatic tooth preparation in a confined space. Photomed Laser Surg. 2017;35(6):332–7. https://doi.org/10.1089/pho.2016.4242
[70] Abu-Awwad M. Dentists’ decisions regarding the need for cuspal coverage for endodontically treated and vital posterior teeth. Clin Exp Dent Res. 2019;5(4):326–35. https://doi.org/10.1002/cre2.185
[71] Alothman Y, Bamasoud MS. The success of dental veneers according to preparation design and material type. Open Access Maced J Med Sci. 2018;6(12):2402–8. https://doi.org/10.3889/oamjms.2018.353
[72] Pini NP, Aguiar FH, Lima DA, Lovadino JR, Terada RS, Pascotto RC. Advances in dental veneers: materials, applications, and techniques. Clin Cosmet Investig Dent. 2012;4:9–16. https://doi.org/10.2147/CCIDEN.S7837
[73] Heintze SD, Rousson V, Hickel R. Clinical effectiveness of direct anterior restorations – a meta-analysis. Dent Mater. 2015;31:e191–201. https://doi.org/10.1016/j.dental.2015.01.015
[74] Albuquerque PP, Moreno MBP, Nishida AC, Rodrigues E, Kiyohara C, Francci CE. Prefabricated resin veneer: a case report of a simplified restorative technique. J Dent Res Dent Clin Dent Prospects. 2018;12(2):140–5. https://doi.org/10.15171/joddd.2018.022
[75] Shumilovich B, Sushenko AV, Morozov AN. Direct composite veneers for anterior teeth: prevention of aesthetic deformation. Univers J Med Sci. 2016;4:108–20. https://doi.org/10.13189/ujmsj.2016.040305
[76] Gomes G, Perdigão J. Prefabricated composite veneers: review. J Esthet Restor Dent. 2014;26(5):302–13. https://doi.org/10.1111/jerd.12114
[77] Veneziani M. Ceramic laminate veneers: clinical procedures with a multidisciplinary approach. Int J Esthet Dent. 2017;12(4):426–48.
[78] McCracken MS, Louis DR, Litaker MS, Minyé HM, Mungia R, Gordan VV, et al. Treatment recommendations for single-unit crowns: findings from The National Dental Practice-Based Research Network. J Am Dent Assoc. 2016;147(11):882–90. https://doi.org/10.1016/j.adaj.2016.06.012
[79] Brunton PA, Ratnayake J, Loch C, Veerasamy A, Cathro P, Lee R. Indirect restorations and fixed prosthodontics: materials and techniques used by general dentists of New Zealand. Int J Dentistry. 2019;2019:5210162. https://doi.org/10.1155/2019/5210162
[80] Almotairy M, Almaghrabi F, Alharthy A, Alrashaid H, Diab H, Shibatalhamad Y. Effect of full ceramic crown versus ceramic fused to metal crown on periodontal tissues health. EC Dent Sci. 2018;17(7):1041–6.
[81] Makhija SK, Lawson NC, Gilbert GH, Litaker MS, McClelland JA, Louis DR, et al; National Dental PBRN Collaborative Group. Dentist material selection for single-unit crowns: findings from the National Dental Practice-Based Research Network. J Dent. 2016;55:40–7. https://doi.org/10.1016/j.jdent.2016.09.010
[82] Astudillo-Rubio D, Delgado-Gaete A, Bellot-Arcís C, Montiel-Company JM, Pascual-Moscardó A, Almerich-Silla JM. Mechanical properties of provisional dental materials: a systematic review and meta-analysis. PLoS One. 2018;13(2):e0193162. https://doi.org/10.1371/journal.pone.0193162. Erratum in: PLoS One. 2018;13(4):e0196264. https://doi.org/10.1371/journal.pone.0196264
[83] Ahmed S, Hawsah A, Rustom R, Alamri A, Althomairy S, Alenezi M, et al. Digital impressions versus conventional impressions in prosthodontics: a systematic review. Cureus. 2024;16(1):e51537. https://doi.org/10.7759/cureus.51537