Factors influencing treatment decision-making for maintaining or extracting compromised teeth

Clin Oral Implants Res. 2014 Jan;25(1):59-66. doi: 10.1111/clr.12142. Epub 2013 Mar 21.


Aims: To evaluate treatment decision-making with respect to maintaining periodontally compromised teeth among dentists with or without postgraduate qualifications in implant dentistry.

Material and methods: A series of patient scenarios with varying degrees of periodontal disease levels was presented to dental practitioners. Practitioners' decision-making outcome was determined, and intention to retain the compromised teeth was analyzed in bivariate and regression analyses (accounting for postgraduate implant training, gender, years in dental practice, and implant placement experience).

Results: This study involved 30 dental practitioners with postgraduate implant qualifications (GDPP), 33 dental practitioners without postgraduate implant qualifications (GDP), and 27 practitioners undergoing training for postgraduate implant qualifications (GDPT). Variations in treatment decision-making were evident between the three groups. Differences in treatment approaches to retaining compromised teeth were apparent. Furthermore, variations in rehabilitation of extracted scenarios existed in terms of use of implant and number of implants need for rehabilitation. Accounting for dentist and practice factors in regression analyses, GDPP/GDPT were three times as likely to retain periodontally compromised upper molar, with or without pain, compared to GDP (without pain OR 3.10, 95%CI 1.04, 10.62 P = 0.04; with pain OR 3.08, 95%CI 1.09, 8.14 P = 0.03).

Conclusion: Variations in treatment decision-making with respect to retaining periodontally compromised teeth exist between dental practitioners with and those without postgraduate training in implant dentistry. Furthermore differences in management approaches in how they would retain the teeth or rehabilitate the dental arch were apparent.

Keywords: compromised teeth; decision-making; dental education; extraction; implant dentistry; public health; treatment planning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Decision Making*
  • Dental Implantation / education*
  • Educational Status
  • Female
  • Hong Kong
  • Humans
  • Male
  • Pain Measurement
  • Patient Care Planning
  • Periodontal Diseases / diagnosis*
  • Periodontal Diseases / surgery*
  • Tooth Extraction*