AÇIK APEKSLİ DEVİTAL DİŞLERDE VAKA SEÇİMİ VE KLİNİK PROTOKOL AÇISINDAN DİŞ HEKİMLERİ, ENDODONTİSTLER VE PEDODONTİSTLERİN TEDAVİ YAKLAŞIMLARI

Abstract

KARAYEL, P., Evaluation of Treatment Approaches of General Dentists, Endodontists, and Pediatric Dentists Regarding Case Selection and Clinical Protocols for Non-vital Immature Teeth with Open Apices, Hacettepe University, Faculty of Dentistry, Department of Endodontics, Specialty Thesis, Ankara, 2026. This study aimed to evaluate and compare the knowledge levels, information sources, treatment-planning approaches, regenerative endodontic treatment (RET) protocols, success criteria, follow-up strategies, complications encountered, and treatment preferences among general dentists, endodontists, and pediatric dentists regarding the management of non-vital immature permanent teeth with open apices. This cross-sectional, questionnaire-based study included 230 dentists practicing in Türkiye, comprising general, endodontic, and pediatric dentists. A structured questionnaire was used to collect data on sociodemographic characteristics, self-reported knowledge level, information sources, factors influencing treatment planning, RET protocols, success criteria, follow-up approaches, complications, and responses to two clinical case scenarios. Statistical analyses were performed using appropriate statistical methods, and a p-value of <0.05 was considered statistically significant. Endodontists and pediatric dentists reported significantly higher levels of knowledge regarding RET than general dentists. These specialists also relied more frequently on current scientific literature and the clinical guidelines of the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE). Root development stage, patient age, infection control, and apical diameter were considered important treatment-planning factors by all participants, whereas significant intergroup differences were observed only in the evaluation of periapical lesion size. Significant differences among specialties were also identified regarding irrigation solutions, intracanal medicaments, irrigation activation techniques, and coronal barrier materials. In the first clinical case scenario, which represents an ideal indication for RET, Endodontists and pediatric dentists more frequently preferred RET than general dentists. In contrast, MTA apexification was more commonly preferred in the second case scenario, which involved uncontrolled type 1 diabetes mellitus. Furthermore, specialists showed greater agreement with contemporary international guidelines on treatment success criteria and follow-up protocols. Clinical decision-making regarding regenerative endodontic treatment is influenced not only by professional specialty but also by knowledge level, use of evidence-based guidelines, professional experience, and case-specific characteristics. Clinicians with greater access to current scientific evidence and international guidelines were more likely to adopt biologically based treatment approaches. These findings underscore the importance of continuing professional education and broader dissemination of evidence-based clinical guidelines to promote standardized, contemporary, and predictable regenerative endodontic practice.