Shared Decision-Making for Periodontally Compromised Teeth: Study Protocol for an Ongoing Prospective Multicenter...

Area of Science:

• Dental Medicine
• Periodontology
• Health Services Research

Background:

• Treatment decisions for teeth with poor periodontal prognosis require balancing clinical evidence and patient values.
• Shared decision-making (SDM) aligns clinical judgment with patient preferences but faces limited implementation in dental settings.
• Structured SDM protocols are needed to manage severe periodontitis and hopeless-prognosis teeth.

Purpose of the Study:

• To evaluate the effectiveness of a structured SDM protocol versus usual care for patients with severe periodontitis and hopeless-prognosis teeth.
• To assess the impact of SDM on tooth preservation decisions, patient experience, and clinical outcomes.
• To provide evidence for integrating structured SDM into dental practice for personalized care.

Main Methods:

• A multicenter, before-and-after clinical trial across 12 dental centers in South Korea.
• Intervention involved a three-step SDM protocol (team talk, option talk with decision aids, decision talk) for patients with stage III/IV periodontitis.
• Data collected via Research Electronic Data Capture, with primary outcome as tooth preservation decisions.

Main Results:

• The structured SDM protocol is expected to increase tooth preservation decisions compared to usual care.
• Secondary outcomes will assess improvements in SDM measures, patient experience (satisfaction, regret), and treatment adherence.
• Clinical outcomes, including periodontal condition and treatment costs, will also be evaluated.

Conclusions:

• The study anticipates providing evidence supporting the integration of structured SDM protocols in dental practice.
• Findings are expected to advance personalized and participatory approaches in managing severe periodontitis.
• The research aims to improve patient-centered and clinical outcomes in periodontitis management.