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Minerva Stomatologica 2017 October;66(5):201-11

DOI: 10.23736/S0026-4970.17.04036-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Treatment planning of damaged teeth: to recover or to extract?

Dino RE 1, Francesca CERUTTI 1 , Dario CONSONNI 2, Fabio G. GORNI 3

1 Division of Oral Rehabilitation, Istituto Stomatologico Italiano, University of Milan, Milan, Italy; 2 Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 3 Division of Perioral Aesthetic Dentistry, Vita Salute San Raffaele University, Milan, Italy


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BACKGROUND: Planning the treatment of a compromised tooth is challenging but the choice should refer to evidence-based criteria. The literature proved that patient-related factors influence the treatment plan, but what happens when the patient is a dentist? Aim of the study was to observe whether the dentist goes for the same option suggested to a patient in a hypothetical scenario.
METHODS: One hundred volunteers were interviewed singularly in a quiet ambient. Radiographs of 15 compromised teeth were shown and were identified as belonging to a hypothetical patient with non-contributory medical history asking for the best treatment. For each clinical case, the dentist could decide between: extraction (E), endorestorative recovery (R); referral to a specialist (S) to save the tooth. After a 15-minute wash-out, the same radiographs were shown again with the question: if this was your tooth, what would you do? The alternatives could be E or R. Statistical analysis was performed in order to evaluate the discordance between the choice taken for the patient and for the dentist’s teeth.
RESULTS: A constant increase in recovered teeth was observed in group D with the only exception of case 12. Concordance ranged from scarce to substantial, while symmetry showed that, when changing their mind, the dentists recovered their own teeth.
CONCLUSIONS: The dentists were more conservative on their teeth: this shows the absence of a coherent decision-making pattern and stresses the need for an improvement in the formation of dental practitioners.


KEY WORDS: Decision making - Clinical protocols - Endodontics - Tooth extraction - Surgery

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