Factors Influencing Decision-making for Maintaining or Extracting Compromised Teeth

Abstract

Objectives: to evaluate treatment decision-making with respect to maintaining compromised teeth among dentist who provide implant therapy. Methods: A series of patient scenarios with varying degrees of periodontal disease levels was presented to practitioners with and without postgraduate implant experience. Practitioners’ decision-making outcome was determined, and intention to retain compromised teeth was analysed in bivariate and regression analyses among the case and control group (accounting for postgraduate implant training, gender, years in dental practice and number of implant patients managed).

Results: This study involved 30 dental practitioners with postgraduate implant qualifications, 33 practitioners without postgraduate implant qualifications and 27 practitioners undergoing training for postgraduate implant qualifications. Variations in treatment decision-making were found between the three groups. Across most scenario, differences in treatment decision was observed with respect to postgraduate implant qualifications/training. Those without postgraduate qualifications tended to opt for extraction of periodontally compromised teeth and opted to replace these with implants. In regression analyses postgraduate training emerged as the key factors associated with treatment decision-making. Those with postgraduate training were approximately three times as likely to retain an upper first molar tooth with compromised periodontal status with or without pain (OR 3.3, 95%CI 1.1-10.6, P<0.05; OR=3.0 95%CI 1.1-8.1, P<0.05).

Conclusions: Variations in treatment decision making with respect to retaining periodontally compromised teeth exist. Postgraduate experience in implant dentistry is associated with increased likelihood of retaining teeth conservatively rather than replacing comprised teeth with dental implants.

Student Presenter This abstract is based on research that was funded entirely or partially by an outside source: Clinical Research Foundation (CRF) for the Promotion of Oral Health, Brienz, Switzerland