Treatment preferences related to pulpectomy and prosthetic restorations among Lithuanian general dentists and prosthodontists
DOI:
https://doi.org/10.2340/aos.v85.46336Keywords:
General dentists, prosthodontists, pulpectomy, prosthetic dentistry, restorationsAbstract
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.
Downloads
References
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/
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. DOI: https://doi.org/10.3389/fphar.2019.01068
Duncan HF. Present status and future directions-Vital pulp treatment and pulp preservation strategies. Int Endod J. 2022;55(Suppl 3):497–511. DOI: https://doi.org/10.1111/iej.13688
American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth. The Reference Manual of Pediatric Dentistry. Chicago, L: American Academy of PediatricDentistry; 2025. p. 487–96.
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. DOI: https://doi.org/10.11606/S1518-8787.2018052000042
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. DOI: https://doi.org/10.3109/00016358609004733
Beliay AM, Petrazhyckaya GV. Relevance of the problem of depulping teeth for orthopedic indications. Minsk: Belarusian State Medical University; 2016. p. 6–11.
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. DOI: https://doi.org/10.1186/s12903-018-0500-z
Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: recent trends in management. J Conserv Dent. 2010;13(4):218–24. DOI: https://doi.org/10.4103/0972-0707.73385
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. DOI: https://doi.org/10.1016/j.prosdent.2017.09.013
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. DOI: https://doi.org/10.1177/154405910608500405
Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev. 2001;14(4):727–52, able of contents. DOI: https://doi.org/10.1128/CMR.14.4.727-752.2001
Li L, Chen HJ, Lian Y, Wang T. Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for evere periodontitis. World J Clin Cases. 2021;9(33):10098–105. DOI: https://doi.org/10.12998/wjcc.v9.i33.10098
Bartlett D, Dugmore C. Pathological or physiological erosion – is there a relationship to age? Clin Oral Investig. 2008;12 Suppl 1:S27–31. DOI: https://doi.org/10.1007/s00784-007-0177-1
Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 4th ed. St Louis, MO: Elsevier Health Sciences; 2006.
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. DOI: https://doi.org/10.1590/1807-3107bor-2020.vol34.0103
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.
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. DOI: https://doi.org/10.4103/1305-7456.195170
Haralur SB. Microleakage of porcelain laminate veneers cemented with different bonding techniques. J Clin Exp Dent. 2018;10(2):e166–71.
Linhares LA, Pottmaier LF, Lopes GC. Fracture resistance of veneers in premolars. Eur J Dent. 2018;12(2):191–8. DOI: https://doi.org/10.4103/ejd.ejd_349_17
Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R, et al. European Society of Endodontology position statement: management of deep aries and the exposed pulp. Int Endod J. 2019;52(7):923–34. DOI: https://doi.org/10.1111/iej.13080
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. Erratum n: J Clin Exp Dent. 2019;11(1):e103.
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. DOI: https://doi.org/10.1590/2177-6709.21.3.018-029.oin
Imber JC, Kasaj A. Treatment of gingival recession: when and how? Int Dent J. 2021;71(3):178–87. DOI: https://doi.org/10.1111/idj.12617
Alkaabi AM, AlHumaidan AA, AlQarawi FK, AlShahrani FA. Esthetic smile rehabilitation of enamel hypomineralized teeth with E-max prosthesis: case report. audi Dent J. 2019;31(Suppl):S106–11. DOI: https://doi.org/10.1016/j.sdentj.2019.02.017
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. DOI: https://doi.org/10.1007/978-3-319-31466-2_7
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.
Aspros A. Inlays & onlays clinical experiences and literature review. J Dent Health Oral Disord Ther. 2015;2(1):26–31. DOI: https://doi.org/10.15406/jdhodt.2015.02.00038
Zafar MS. Prosthodontic applications of polymethyl methacrylate (PMMA): an update. Polymers (Basel). 2020;12(10):2299. DOI: https://doi.org/10.3390/polym12102299
Porojan L, Savencu C, Porojan S. Applications of heat-pressed ceramics for single tooth restorations. Rev Chim (Bucharest). 2016;67(1):123–6.
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. DOI: https://doi.org/10.1038/sj.bdj.2019.95
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. DOI: https://doi.org/10.1111/jopr.12279
Fu L, Engqvist H, Xia W. Glass-ceramics in dentistry: a review. Materials (Basel). 2020;13(5):1049. DOI: https://doi.org/10.3390/ma13051049
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. DOI: https://doi.org/10.1155/2020/8846534
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 . 2019;30(5):446–52. DOI: https://doi.org/10.1590/0103-6440201902780
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. DOI: https://doi.org/10.1186/s12903-019-0838-x
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. DOI: https://doi.org/10.1007/s00784-018-2618-4
Dolidze T, Bitarova I. Advantages and disadvantages of E-max and zirconia crowns. Eur Sci J. 2016;67(Special issue):465–8.
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. DOI: https://doi.org/10.1155/2020/8838329
Lawson NC, Sulaiman TA. Diagnosing a failed impression: common errors and how to overcome them. Compend Contin Educ Dent. 2019;40(3):184.
D’Ambrosio F, Giordano F, Sangiovanni G, Di Palo MP, Amato M. Conventional versus digital dental impression techniques: what is the future? An umbrella eview. Prosthesis. 2023;5(3):851–75. DOI: https://doi.org/10.3390/prosthesis5030060
Zarbakhsh A, Jalalian E, Samiei N, Mahgoli MH, Kaseb Ghane H. Accuracy of digital impression taking using intraoral scanner versus the conventional echnique. Front Dent. 2021;18:6. DOI: https://doi.org/10.18502/fid.v18i6.5649
Suese K. Progress in digital dentistry: the practical use of intraoral scanners. Dent Mater J. 2020;39(1):52–6. DOI: https://doi.org/10.4012/dmj.2019-224
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.
Kumar HC, Kumar TP, Hemchand S, Suneelkumar C, Subha A. Accuracy of marginal adaptation of posterior fixed dental prosthesis made from digital mpression technique: a systematic review. J Indian Prosthodont Soc. 2020;20(2):123–30. DOI: https://doi.org/10.4103/jips.jips_382_19
Todorović A, Lisjak D, Lazić V, Spadijer-Gostović A. Possible errors during the optical impression procedure. Stomatol Glas Srb. 2010;57:30–7. DOI: https://doi.org/10.2298/SGS1001030T
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. DOI: https://doi.org/10.4103/jispcd.JISPCD_330_18
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. DOI: https://doi.org/10.4047/jap.2017.9.1.1
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. DOI: https://doi.org/10.1007/s00784-020-03363-9
Kar S, Tripathi A, Singh J, Ramkumar J. Comparison of dimensional accuracy of elastomeric impression materials using 3D laser scanner. Med J Armed orces India. 2022;78(Suppl 1):S55–60. DOI: https://doi.org/10.1016/j.mjafi.2021.05.019
Madanshetty P, Guttal SS, Meshramkar R, Newaskar PS, Anehosur GV. Addition silicone impressions in fixed prosthodontics: clinical standpoints. Cureus. 2023;15(8):e44014. DOI: https://doi.org/10.7759/cureus.44014
Eachempati P, Kumbargere Nagraj S, Kiran Kumar Krishanappa S, George RP, Soe HHK, Karanth L. Management of gag reflex for patients undergoing dental reatment. Cochrane Database Syst Rev. 2019;2019(11):CD011116. DOI: https://doi.org/10.1002/14651858.CD011116.pub3
Hargreaves KM, Cohen S, Berman LH. Cohen’s pathways of the pulp. St Louis, MO: Mosby Elsevier; 2015. p. 13–15.
Pigg M, Nixdorf DR, Nguyen RH, Law AS; National dental practice-based research network collaborative group. validity of preoperative clinical findings to dentify dental pulp status: a national dental practice-based research network study. J Endod. 2016;42(6):935–42. DOI: https://doi.org/10.1016/j.joen.2016.03.016
American Association of Endodontists. AAE white paper – endodontic competency. Chicago, IL: American Association of Endodontists; 2017.
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. DOI: https://doi.org/10.1902/jop.2011.110080
Solanki G. A general overview of periodontal pockets. Int J Biomed Res. 2012;3(3):127–30. DOI: https://doi.org/10.7439/ijbr.v3i3.403
Pindborg JJ. Pathology of the dental hard tissue. Philadelphia, PA: Saunders; 1970. p. 435.
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. DOI: https://doi.org/10.1155/2012/632907
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. DOI: https://doi.org/10.1038/s41598-022-24815-0
d’Incau E, Saulue P. Understanding dental wear. J Dentofacial Anom Orthod. 2012;15:104. DOI: https://doi.org/10.1051/odfen/2011404
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. DOI: https://doi.org/10.4047/jap.2010.2.2.50
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. DOI: https://doi.org/10.4317/jced.50556
Rossi R, Longo E, Cozzani M. Diagnosis and inter-disciplinary treatment of altered passive eruption, the digital evolution. Semin Orthod. 2024;30:190–205. DOI: https://doi.org/10.1053/j.sodo.2023.12.005
aleckiene V, Peciuliene V, Brukiene V, Drukteinis S. Traumatic dental injuries: etiology, prevalence and possible outcomes. Stomatologija. 2014;16(1):7–14.
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.
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. DOI: https://doi.org/10.17533/udea.rfo.v29n1a12
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. DOI: https://doi.org/10.1590/2177-6709.21.6.020-025.oin
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 aser Surg. 2017;35(6):332–7. DOI: https://doi.org/10.1089/pho.2016.4242
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. DOI: https://doi.org/10.1002/cre2.185
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. DOI: https://doi.org/10.3889/oamjms.2018.353
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. DOI: https://doi.org/10.2147/CCIDE.S7837
Heintze SD, Rousson V, Hickel R. Clinical effectiveness of direct anterior restorations – a meta-analysis. Dent Mater. 2015;31:e191–201. DOI: https://doi.org/10.1016/j.dental.2015.01.015
Albuquerque PP, Moreno MBP, Nishida AC, Rodrigues E, Kiyohara C, Francci CE. Prefabricated resin veneer: a case report of a simplified restorative echnique. J Dent Res Dent Clin Dent Prospects. 2018;12(2):140–5. DOI: https://doi.org/10.15171/joddd.2018.022
Shumilovich B, Sushenko AV, Morozov AN. Direct composite veneers for anterior teeth: prevention of aesthetic deformation. Univers J Med Sci. 2016;4:108–20. DOI: https://doi.org/10.13189/ujmsj.2016.040305
Gomes G, Perdigão J. Prefabricated composite veneers: review. J Esthet Restor Dent. 2014;26(5):302–13. DOI: https://doi.org/10.1111/jerd.12114
Veneziani M. Ceramic laminate veneers: clinical procedures with a multidisciplinary approach. Int J Esthet Dent. 2017;12(4):426–48.
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. DOI: https://doi.org/10.1016/j.adaj.2016.06.012
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. DOI: https://doi.org/10.1155/2019/5210162
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.
Makhija SK, Lawson NC, Gilbert GH, Litaker MS, McClelland JA, Louis DR, et al; National Dental PBRN Collaborative Group. Dentist material selection for ingle-unit crowns: findings from the National Dental Practice-Based Research Network. J Dent. 2016;55:40–7. DOI: https://doi.org/10.1016/j.jdent.2016.09.010
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. Erratum in: PLoS One. 2018;13(4):e0196264. DOI: https://doi.org/10.1371/journal.pone.0196264
Ahmed S, Hawsah A, Rustom R, Alamri A, Althomairy S, Alenezi M, et al. Digital impressions versus conventional impressions in prosthodontics: a systematic eview. Cureus. 2024;16(1):e51537.
Additional Files
Published
Issue
Section
License
Copyright (c) 2026 Viktorija Ašmankevičiūtė-Lemisnkė, Gediminas Žekonis
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes high quality original research papers as well as critical reviews relevant on diseases of the oral cavity, their treatment, epidemiology and associated biomaterials and their development.
