Abstract
BackgroundThis study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making.MethodsA questionnaire with 36 questions about identical patient information, clinical signs, and symptoms was filled out by participants. Each question referred to a radiograph that had been manipulated using computer software in order to control tooth-related factors. Participants were instructed to record their demographic information and choose the ideal treatment option related to each radiograph. Simple and multivariable logistic regression analyses (p < .05) were used to investigate factors related to the decision to extract the tooth. We divided factors into dentist-related factors (gender, years of experience, and professional registration) and tooth-related factors (tooth position, coronal status, root canal filling status, and size of the periapical radiolucency). Dentists were categorized into three groups, based on professional registration: general dental practitioners (GDPs), endodontists, and other specialists. Simple logistic regression analysis (p < .05) was used to evaluate the tooth-related factors influencing extraction, depending on the dentists’ specialty.ResultsParticipants mostly preferred saving the teeth over extraction. This preference was highest among the endodontists, followed by other specialists and GDPs. Extractions were significantly preferred for molars, teeth with previous root canal fillings, and those with apical lesions greater than 5 mm.ConclusionsThis study suggests that dentists’ decision-making regarding teeth with apical periodontitis was associated with their work experience and specialty and influenced by tooth position, root canal filling status, and size of the apical lesion.Clinical relevanceThis survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists’ specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion.
Highlights
This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making
Clinical relevance: This survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists’ specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion
The survey was completed by 380 dentists including 13,566 answers; 114 missing or inappropriate responses were excluded from the data
Summary
This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making. An inflammatory lesion around the root apex, is one of the main reasons for tooth extraction [1]. It has a prevalence of one in every three people [2], up to 62% being over 60 years of age [3]. Apical periodontitis is usually managed by root canal treatment. If the tooth is difficult to retain because of clinical or other reasons, the clinician may consider extraction. Patients may prefer preserving teeth affected by apical periodontitis, and this should be dentists’ priority [8]
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