An evaluation of dental treatment strategies after the diagnosis of irreversible pulpitis and/or apical periodontitis and influences on the decisionmaking process

Peters, S.T.W. (2016) An evaluation of dental treatment strategies after the diagnosis of irreversible pulpitis and/or apical periodontitis and influences on the decisionmaking process. thesis, Dentistry.

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Abstract

Introduction: What dentists’ and their patients’ preferences are regarding treatment of Irreversible Pulpitis (IP) and/or Apical Periodontitis (AP), have only been researched separately and retrospectively. Additionally, the vast majority of the literature only covers decisions made under ideal circumstances with no limits regarding money, time, practitioners’ expertise and other (patient) factors. Delivering adequate dental care requires an understanding of the possible factors that influence dentists’ and patients’ decision-making. For these reasons, the present study will be prospective and include and identify all of the influential factors combined. Methodology: Having thoroughly studied the literature, a list of possible interactions on the treatment decisions was compiled. Using a prospective study design, data was recorded directly when patients were diagnosed. The population consists of 96 adult patients who attended the Emergency Services of a US Dental School during two consecutive months. Added to which they were diagnosed with IP and/or AP. As they all had 1 diagnosed tooth, the sample size consists of 96 cases. Finally, using a stepwise logistic regression approach, models were constructed to find possible interactions on the treatment decisions of both the dentist and the patient (P≤0,05). Results: Regarding dentists’ preference, the following variables were found to be influential: endo specialist supervisor, regular checkup, adjacent teeth problems, pocket depth, bone level 2/3, and tooth mobility. Regarding patients’ preference, endo specialist supervisor and bone level 2/3, proved to be influential. Tooth retention was preferred the most and most of them were chosen to be treated with an additional crown. Yet when extraction was chosen, only few of the teeth would be replaced. The main reasons for removal were financial and having been deemed non-restorable. Conclusion: With respect to dentists’ preference, it seems that the periodontal status and restorability of a tooth are more important than any endo-specific reasons in the decision-making process. In addition, endo specialty training increased the probability of a tooth being preferred to save though RCT (Root Canal Treatment). Finally, it appears that the majority of patients more often prefer to save their teeth and that finances is a major reason for teeth that are being extracted.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Peters, Prof. dr. O.A. and Faculty Supervisor: and Sluis, Dr. L.W.M. Van Der
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:39
Last Modified:	25 Jun 2020 10:39
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/75

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