診断から経過観察まで：サウジアラビアの歯科医におけるバイタルパルプ療法の診療におけるばらつきとエビデンスに基づくギャップ

Vital pulp therapy (VPT) is a minimally invasive approach aimed at preserving pulp vitality in cases of caries or trauma. Despite advancements in diagnostic tools and bioactive materials, clinical practices vary significantly. This study explored the preoperative, intraoperative, and postoperative practices of dental professionals in Saudi Arabia regarding VPT, with a focus on diagnostic tools, rubber dam isolation, and material selection. The aim was to identify practice variability and evidence-based gaps and propose strategies to standardise care.

A cross-sectional study was conducted among 302 dental professionals using a validated online questionnaire. Data collection spanned December 2024 to early March 2025. Descriptive statistics, non-parametric tests, including the Mann-Whitney U and Kruskal-Wallis tests, were employed to compare practices across groups, while binary logistic regression identified predictors of good knowledge (≥70%). A P value 0.05 was considered statistically significant.

Preoperative practices highlighted frequent use of pulp sensibility testing (79.1%) and periapical radiographs (50%), with cold testing as the preferred method (52.6%). However, advanced tools like CBCT were underutilised. Intraoperatively, 67.2% consistently used rubber dam isolation, while calcium hydroxide (22.5%) was the most commonly used pulp capping material, despite increasing adoption of mineral trioxide aggregate (MTA) and biodentine. Postoperatively, 46% adhered to a 3-6 month follow-up interval, relying on cold testing and percussion for assessment. Logistic regression revealed postgraduate education, specialisation, and frequency of VPT procedures as significant predictors of evidence-based practices.

The findings highlight significant variability in VPT practices among dental professionals in Saudi Arabia, emphasising the need for targeted training programmes and standardised guidelines to bridge evidence-based gaps, improve clinical consistency, and optimise patient outcomes.