Table 1.

Included studies

Study	Method	Country, year	Sample	Scenario	Treatment decisions	Reasons, barriers, facilitators
Oen [9]	Quest	USA, 2006	PEARL research network, response 92 %, final 85	Deep dentin lesion in permanent molar with vital (sensible) pulp (pain lasts <3 s) and different risk of exposure	No risk of exposure: 58/85 CR, 19/85 SE, 8/85 endodontic treatment Risk of exposure: 51/85 CR, 15/85 SE, 17/85 endodontic treatment	Age and general caries risk/experience of patient influenced decisions (more invasive in older and high-risk patients); dentists knew risk of failure of direct capping. Authors discuss peer pressure and educational background.
Seale and Glickman [29]	Real-time poll	USA, 2007	Conference, 376 dentists (102 endodontists, 252 pedodontists, 22 others), unclear response	Young permanent teeth with open apex	Pedodontists: 179/252 SW, endodontists: 222/376 SW	Reasons against SW: second visit needed—compliance problems, MTA pulpotomy better evidence, SE better evidence, reimbursement. Reasons for SW: option to recall symptoms/vitality, root maturation, low costs, re-assess dentin, payment for second appointment.
Weber [8]	Quest	Brazil, 2009	Dentists from one southern city 44 % response, final 54	Deep carious lesion in permanent molar with vital pulp and no spontaneous pain, but pain when chewing or cold	42/53 CR, 7/53 SW, 4/53 SE. We excluded the third case as the pulp and peri-apical status were unclear.	SE/SW: female OR 0.6 (0.2–1.2), younger (graduation >2000): OR 5.5 (1.5–19.7), possible reasons: SW requires second appointment, patients, do not return, younger dentists use evidence-base better.
Chisini [34]	Quest	Brazil, 2009	Single city, all dentists, 68 % response, final 187	Deep lesion in proximity of pulp, unclear pulp status and dentition (assumed permanent)	65/171 CR, 106/171 SE	Dentists with more recent graduation or postgraduate training chose SE more often. Authors evaluated experience and setting (public versus private practice versus university).
McBride [35]	Quest	USA, 2009/2010	National, practice based research networks, 66–82 % response, final 950	Lower molar with visible cavitated lesion, deeper than anticipated, may involve pulp (pulpal status not stated)	372/812 CR 285/812 SE 155/812 ET	Age was found a factor, with dentists practicing 5–15 years performing ET more often, while those <5 years performed SE more often; full network participant also more likely to perform SE.
Stangvaltaite [7]	Quest	Norway, 2011	Northern Norway, all dentists, 56 % response, final 222	Deep carious lesion in permanent mature teeth without symptoms and exposure (further scenarios: with symptoms and exposure)	Without symptoms and exposure: 104/212 CR, 95/212 SW, 13/212 SE	CR versus SE: male OR 1.5 (0.8–2.8), from Norway: 0.5 (0.2–0.9), public practice: 0.6 (0.3–1.3), experienced (5+ years): 1.3 (0.7–2.6), urban: 2.2 (1.2–4.1), main reasons for choosing a strategy were good results, easy, restoration longevity, patients’ health; SW recommended in guidelines.
Katz [27]	Quest	Brazil, 2012	Northeastern Brazil, participants of a regional dentistry congress, final 123	Unclear scenario	59/108 CR, 49/108 SE	Majority of dentists considers caries to be treated only restoratively. Attitudes towards minimally invasive dentistry procedures significantly associated with SE (professionals considering minimal invasive as permanent recommended SE); Lack of belief in SE rather than knowledge or specialist status drove decision-making.
Schwendicke [28]	Quest	Germany, 2012	Northern Germany, all practitioners, 35 % response, final 821	Young female patient with deep lesion in vital asymptomatic tooth, risk of pulp exposure	400/799 CR, 160/799 SE, 239/799 both	Dentists aware of risks and success rates; dentists who accepted bacteria to remain and possible restorative risks were more likely to SE, those who strived for restorative longevity and feared bacteria to remain performed CR and accepted ET. Demographics not a factor; generally more or less invasive dentist types.
Schwendicke [6]	Quest	Germany, France, Norway 2015	National, all practitioners, 28–50 % response, final 1481	Deep lesion in permanent tooth with a vital painless pulp with risk of exposure in young patient	France: 340/661 CR, 62/661 SE, 259/661 SW, Germany: 201/622 CR, 122/622 SE, 299/622 SW, Norway: 3/199 CR, 29/199 SE, 167/199 SW	Male dentists chose SE more often (OR: 1.73 [1.26/2.45]), dentists in private setting performed fewer SW (0.60 [0.39/0.93]), those who believed bacteria needed removal to avoid progression chose SE less often (0.48 [0.33/0.71]), as did those who feared bacteria to harm the pulp (0.42 [0.28/0.62]) and vice versa for those who thought sealed lesions to arrest (2.84 [1.86/4.36]) or who strived to avoid exposure (2.18 [1.40/3.29]). Satisfaction with a treatment, familiarity and its evidence-base were main reasons, only few stated financial issues or peers as problems, knowledge also minor factor. Authors discuss education, caries philosophy as further reasons.

The proportion of dentists performing selective (SE), stepwise (SW), “complete” removal (CR), or immediate endodontic treatment (ET) for different scenarios of deep lesions were assessed. In addition, reasons (barriers, facilitators) for the decisions were recorded