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Tooth extraction decision model in periodontitis patients.

A Popelut¹, B Rousval, O Fromentin

¹Department of Periodontology, Service of Odontology, Hôtel-Dieu Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France.

Clinical Oral Implants Research

|January 15, 2010

Summary

This study developed a decision model for periodontitis patients, finding that tooth extraction followed by a fixed partial denture is the least effective strategy compared to implant-supported crowns or periodontal therapy.

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Area of Science:

Dentistry
Periodontology
Decision Analysis

Background:

Periodontitis often necessitates complex treatment decisions.
Evaluating extraction strategies requires robust analytical models.

Purpose of the Study:

To construct a decision analysis model for guiding dental extraction strategies in periodontitis patients.
To compare the expected utilities of various treatment options.

Main Methods:

A decision tree model was employed for a hypothetical adult chronic periodontitis patient.
Systematic literature review determined scientific probabilities.
Expert panels assigned subjective utilities for treatment options.
Expected utilities (EUs) ranked: no treatment, periodontal treatment, tooth-supported fixed partial denture (FPD), and implant-supported single crown (ISC).

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Main Results:

Tooth survival probability of 0.78 was needed for the 'no treatment' option to be optimal.
Expected utility intervals: Periodontal treatment (79-96), FPD (86-89), ISC (94-95).
The FPD option was dominated by the ISC option; no significant difference was found between periodontal therapy and ISC.

Conclusions:

Within the model's limitations, tooth extraction followed by FPD is the least favorable strategy.
Implant-supported single crowns and periodontal therapies present comparable, favorable outcomes.