Recurrent Caries at Crown Margin: Re-treatment Decision-Making

Methods: A random sample of 158 dentists participated in the study. Four variations were used: small root caries away from crown margin, small carious lesion at crown margin, root caries reaching the crown margin and large carious lesion at the margin. Each of the variations had the possibility of the tooth being vital or non-vital, giving a total of 8 cases. Crown removal tendency (CRT) was computed after dichotomization of the responses for the different cases for each participant. Logistic regression analysis was used to test the association between CRT and educational and work related factors. Paired sample t-test was used to compare cases with and without root canal treatment.

Results: Mean CRT for the group was 0.69 (SD 0.18). Except for cases of root caries away from the crown margin, participants tended to remove the crown before they treat the recurrent caries. Participants more than 50 years of age had less CRT. Participants who had their undergraduate training in East Europe or Middle East had more CRT. The participants' CRT increased with increasing size of the lesion. Participants had more CRT when the tooth is vital.

Conclusion: The lack of agreement among dentists regarding their management of recurrent caries around crown margin appears to be due mainly to educational training and experience factors.