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Periodontally involved teeth - extract or not?
1Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Evidence-Based Dentistry
|December 24, 2011
Summary
Dental decision analysis suggests implants offer better outcomes than fixed partial dentures after tooth extraction. However, the best treatment for periodontally involved teeth remains unclear, needing further research.
Area of Science:
- Decision analysis modelling in periodontology.
- Quantitative evaluation of dental treatment outcomes.
Background:
- A decision tree model was developed to compare treatment options for a periodontally involved tooth.
- Options included no treatment, periodontal treatment, extraction with fixed partial denture (FPD), and extraction with single implant.
Discussion:
- The study utilized both objective (systematic reviews) and subjective (clinician) probability data.
- Patient preferences were not included in the analysis.
- Expert evaluation of treatment outcome strength was incorporated.
Key Insights:
- Expected utility (EU) intervals for periodontal treatment, FPD, and implant over five years were 79-96, 86-89, and 94-95, respectively.
- The implant option showed a higher EU than the FPD option post-extraction.
- The EU for the 'no treatment' option could not be calculated due to data limitations.
Outlook:
- Further research is needed to definitively determine the optimal treatment strategy between periodontal treatment and extraction with single implant.
- The findings highlight the utility of decision analysis in complex dental treatment planning.
- Incorporating patient-specific data could refine future decision models.
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