Preferences of dental care providers in maintaining compromised teeth in relation to their professional status: implants instead of periodontally involved maxillary molars?
Clinical Oral Implants Research
Article first published online: 29 DEC 2010Nicola U. Zitzmann, Susanne S. Scherrer, Roland Weiger, Niklaus P. Lang, Clemens Walter
Aim: The purpose of this study was to evaluate the dentists' decision making in the maxillary molar region to find out how it is influenced by general practitioners' and specialists' characteristics as well as by the external evidence.
Material and methods: A questionnaire was developed containing clinical cases and statements to assess practitioners' opinions on the treatment of periodontally involved maxillary molars and implant therapy with sinus grafting. Data were analysed with respect to the dentists' age and speciality.
Results: Three hundred and forty questionnaires were evaluated (24% from universities, 76% from educational courses, overall response rate 35.1%). Forty six per cent of all participants indicated they had specialised, 52% placed dental implants, while 33% performed sinus grafting and 64% periodontal surgeries. Forty six per cent were against or were indecisive about having sinus grafting performed on themselves. The treatment proposals given for the clinical cases revealed a preference among older dentists and general practitioners for regenerative treatments even when these were not evidence based in through-and-through furcation involvements. Resective therapies were most often selected by periodontists. Prosthodontists tended to prefer more invasive treatment options with extractions and augmentations. More experienced general practitioners favoured conventional fixed dental prostheses in free-end situations or no treatment rather than the complicated augmentation procedures, which were preferred by younger dentists.
Conclusions: Implant placement seems to be widely accepted by almost all subjects, who may either place implants themselves or refer patients. More information seems to be needed on the indications for regenerative therapies for furcation involved maxillary molars, and guidelines required for decision making in complex clinical situations.