Supplementary Material for: Assessing the Acceptability of Less Invasive Caries Removal Techniques for treating Deep Carious Lesions: A Conjoint Survey among Dentists Practicing in a Midwestern American State”

Background: This study identified factors that influence dentists’ decisions regarding less invasive caries removal techniques such as stepwise removal (SW) and selective removal (SE) using a marketing research technique, conjoint analysis. Methods: A survey was sent to 1,434 dentists practicing in Iowa. Dentists were randomly assigned to receive a questionnaire to rate the likelihood they would use either SW/SE in hypothetical clinical scenarios. The scenarios were carefully created by conjoint design and included three relevant attributes: depth of lesion, hardness of carious dentin and patient age. Descriptive and conjoint analysis were performed to assess trade-offs between these attributes, using SPSS Results: The study revealed that depth of lesion was the most important factor in dentists’ decisions (49 importance value) when choosing a SW to treat a deep carious lesion (DCL), followed by hardness of carious dentin and patient age (21 importance value). For the SE-group, depth of the lesion was also the predominant factor when selecting a treatment. The study also identified that a high proportion of dentists (24.9%) indicated they would never consider using SW or SE under any circumstances. Conclusions: Our survey showed that depth of lesion was the most important reason to select a less invasive caries removal method. The high proportion of dentists indicating they would never consider selective caries removal techniques suggests that these less invasive options are underutilized.

背景：本研究采用市场调研技术——联合分析（conjoint analysis），识别影响牙科医生选择微创龋病去腐技术（如逐步去腐法（stepwise removal, SW）与选择性去腐法（selective removal, SE））的决策因素。方法：本研究向执业于爱荷华州的1434名牙科医生发放了调查问卷。研究采用随机分组方式向受试者发放问卷，要求其对在假想临床场景中使用SW/SE的可能性进行评分。本次研究的假想场景通过联合分析设计精心构建，涵盖三项核心属性：龋损深度、龋损牙本质硬度与患者年龄。本研究采用SPSS软件开展描述性统计与联合分析，以评估上述属性间的权衡关系。结果：研究显示，牙科医生选择逐步去腐法治疗深龋损（deep carious lesion, DCL）时，龋损深度是最重要的决策影响因素（重要性占比49%），其次为龋损牙本质硬度与患者年龄（重要性占比21%）。针对选择性去腐法组，龋损深度同样是治疗选择中的主导因素。本研究同时发现，高达24.9%的牙科医生表示，在任何场景下均不会考虑使用SW或SE。结论：本次调查结果表明，龋损深度是牙科医生选择微创龋病去腐术式的最核心考量因素。占比颇高的牙科医生（24.9%）表示绝不会采用选择性去腐技术，这提示此类微创治疗方案的临床应用仍未得到充分推广。