Factors influencing treatment decision-making for maintaining or extracting compromised teeth

• Published in: Clinical oral implants research 2014-01, Vol.25 (1), p.59-66
• Main Authors: Lang-Hua, Bich Hue, McGrath, Colman P. J., Lo, Edward C. M., Lang, Niklaus P.
• Format: Article
• Language: English
• Subjects: Adult; Clinical Competence; compromised teeth; Decision Making; dental education; Dental Implantation - education; Dentistry; Educational Status; extraction; Female; Hong Kong; Humans; implant dentistry; Male; Pain Measurement; Patient Care Planning; Periodontal Diseases - diagnosis; Periodontal Diseases - surgery; public health; Tooth Extraction; treatment planning
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/clr.12142

Aims To evaluate treatment decision‐making with respect to maintaining periodontally compromised teeth among dentists with or without postgraduate qualifications in implant dentistry. Material and methods A series of patient scenarios with varying degrees of periodontal disease levels was presented to dental practitioners. Practitioners' decision‐making outcome was determined, and intention to retain the compromised teeth was analyzed in bivariate and regression analyses (accounting for postgraduate implant training, gender, years in dental practice, and implant placement experience). Results This study involved 30 dental practitioners with postgraduate implant qualifications (GDPP), 33 dental practitioners without postgraduate implant qualifications (GDP), and 27 practitioners undergoing training for postgraduate implant qualifications (GDPT). Variations in treatment decision‐making were evident between the three groups. Differences in treatment approaches to retaining compromised teeth were apparent. Furthermore, variations in rehabilitation of extracted scenarios existed in terms of use of implant and number of implants need for rehabilitation. Accounting for dentist and practice factors in regression analyses, GDPP/GDPT were three times as likely to retain periodontally compromised upper molar, with or without pain, compared to GDP (without pain OR 3.10, 95%CI 1.04, 10.62 P = 0.04; with pain OR 3.08, 95%CI 1.09, 8.14 P = 0.03). Conclusion Variations in treatment decision‐making with respect to retaining periodontally compromised teeth exist between dental practitioners with and those without postgraduate training in implant dentistry. Furthermore differences in management approaches in how they would retain the teeth or rehabilitate the dental arch were apparent.