363 The Use of Printed Radiographs to Document Dental Extractions for Alveolar Bone Graft Patients

Abstract

Abstract Aim Recent cases of additional operations had to be offered prior to an alveolar bone graft (ABG) to complete dental extractions. Appropriate planning is important to avoid multiple GAs or the potential extraction of a wrong tooth. This quality improvement project was performed to assess and improve our practice. Method As a gold-standard, all dental extractions should be correctly identified and documented on printed orthopantograms (OPG) or upper standard occlusal (UOS) radiographs at the time of ABG planning. Documentation should include their timing (pre- vs intra-operative), a cross tooth marking on the radiograph, signed by two consultants, and filed with the consent form. In the first audit cycle we completed retrospective data collection of the above parameters for all ABG clinic patients between June and August 2021. After discussion with the stakeholders and implementation of changes, prospective data was collected for the second cycle, from October to December 2021. Results The documentation of the date of the OPG and UOS improved from 26.6% (4/15) to 100% (11/11). For 1 of the patients in the 2nd cycle, no OPG was done, as the patient's dental development didn't justify it. For the preoperative extraction cases, the presence of printed OPG in file increased from 53.8% (7/13) to 100%, marking of teeth improved from 57.1% (4/7) to 83.3% (5/6), and filing of the consent forms remained stable around 70%. Conclusions Adherence to the gold-standard was improved in most aspects as a result of this quality improvement project. Further changes will be introduced to achieve 100% compliance rate.