Endodontic retreatment decisions: no consensus

• Published in: International endodontic journal 2000-05, Vol.33 (3), p.208-218
• Main Authors: Aryanpour, S., Van Nieuwenhuysen, J. -P., D'Hoore, W.
• Format: Article
• Language: English
• Subjects: Analysis of Variance; behavioural science; Belgium; Decision Making; Dental Restoration Failure; Dentistry; endodontic retreatment; Endodontics - education; Female; France; Humans; Male; Middle Aged; Practice Patterns, Dentists; Regression Analysis; Retreatment; Root Canal Therapy; Schools, Dental; Statistics, Nonparametric; Students, Dental; Surveys and Questionnaires
• ISSN: 0143-2885; 1365-2591
• DOI: 10.1046/j.1365-2591.1999.00297.x

Aim  The objectives of the present study were to: (i) evaluate the consensus, if any, amongst dental schools, students and their instructors managing the same clinical cases, all of which involved endodontically treated teeth; and (ii) determine the predominant proposed treatment option. Methodology  Final year students, endodontic staff members and instructors of 10 European dental schools were surveyed as decision makers. Fourteen different radiographic cases of root canal treated teeth accompanied by a short clinical history were presented to them in a uniform format. For each case the decision makers were requested to: (i) choose only one out of nine treatment alternatives proposed, from ‘no treatment’ to ‘extraction’ via ‘retreatment’ and ‘surgery’ (ii) assess on two 5‐point scales: the difficulty of making a decision, and the technical complexity of the retreatment procedure. Results  The results indicate wide inter‐ and also intra‐school disagreements in the clinical management of root canal treated teeth. Analysis of variance showed that the main source of variation was the ‘school effect’, explaining 1.8% (NS) to 18.6% (P< 0.0001) of the treatment variations. No other factor explained as much variance. Decision difficulty was moderately correlated to technical complexity (Pearsons' r ranging from 0.19 to 0.35, P< 0.0001). Conclusions  No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the ‘school effect’.