Does professional experience save teeth? A survey among prosthodontists

Bishti, Shaza; Lautensack, Julia; Türp, Jens C.; Wolfart, Stefan

doi:10.1007/s00784-017-2180-5

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…It was revealed that practitioners with more years of experience were associated with greater diagnostic accuracy in comparison to students [ 48 ]. Similar conclusions were drawn regarding extraction in periodontally affected teeth [ 49 , 50 ] and prosthodontic cases [ 51 ], linking greater experience with well-founded and conservative treatment decisions. However, more experience also led to greater variability in treatment recommendations [ 52 ] and did not alter the perceived difficulty [ 36 ].…”

Section: Resultssupporting

confidence: 60%

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

et al. 2023

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Clinical decision-making for diagnosing and treating oral and dental diseases consolidates multiple sources of complex information, yet individual clinical judgements are often made intuitively on limited heuristics to simplify decision making, which may lead to errors harmful to patients. This study aimed at systematically evaluating dental practitioners’ clinical decision-making processes during diagnosis and treatment planning under uncertainty. A scoping review was chosen as the optimal study design due to the heterogeneity and complexity of the topic. Key terms and a search strategy were defined, and the articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) were searched, selected, and analysed in accordance with PRISMA-ScR guidelines. Of the 478 studies returned, 64 relevant articles were included in the qualitative synthesis. Studies that were included were based in 27 countries, with the majority from the UK and USA. Articles were dated from 1991 to 2022, with all being observational studies except four, which were experimental studies. Six major recurring themes were identified: clinical factors, clinical experience, patient preferences and perceptions, heuristics and biases, artificial intelligence and informatics, and existing guidelines. These results suggest that inconsistency in treatment recommendations is a real possibility and despite great advancements in dental science, evidence-based practice is but one of a multitude of complex determinants driving clinical decision making in dentistry. In conclusion, clinical decisions, particularly those made individually by a dental practitioner, are potentially prone to sub-optimal treatment and poorer patient outcomes.

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Section: Resultssupporting

confidence: 60%

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

et al. 2023

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“…The significantly more frequent use of iliac crest transplants by maxillofacial surgeons can be explained by the different training, since maxillofacial surgeons also learn and perform extraoral surgery while oral surgeons mainly learn intraoral procedures during their training. There is evidence in the literature that training and experience can have a significant influence on the therapy decision and its implementation [ 16 – 18 ]. Furthermore, it is remarkable that some surgeons, apparently due to their training, still practice methods such as iliac crest harvesting, although it has been shown that the resorption rate of these grafts is at best comparable but not lower than with alternative methods [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Pre-implantological treatment routines for alveolar ridge atrophy – an investigation among maxillofacial and oral surgeons in southern Germany

Korsch

Walther²,

Robra

et al. 2020

BMC Oral Health

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Background: It is not well-known which pre-implantological procedures are preferred by maxillofacial (MFS) and oral surgeons (OS) for the narrow atrophic alveolar ridge under practice based conditions and, if different training paths in surgery lead to other pre-implantological techniques being preferred. This study aims to identify which procedures are preferred by the respective specialists in which indication. Methods: A questionnaire was sent to a total of 300 MFS and OS in southern Germany. The questionnaire examined pre-implantological procedures (bone block, bone grafting material and/or particulate autogenous bone, titanium mesh, bone split, resection) in the edentulous severely atrophic mandible and in the severely atrophic single-tooth gap. Kendall's Tau-b test was used for statistical analyses. Results: One hundred seventeen participants returned the questionnaire. 68 (58%) were OS and 49 (42%) were MFS. In the edentulous mandible, bone substitute material and resection were most preferred by both specialists. Bone blocks were statistically significantly more frequently associated with MFS and bone substitute materials with OS. Bone split was more frequently used in the atrophic single tooth gap than in the edentulous mandible. OS preferred bone blocks in the single tooth gap more often than in the edentulous mandible. MFS and OS preferred resection in the edentulous mandible significantly more frequently than in the single tooth gap. Conclusions: MFS in general prefer more invasive pre-implantological therapies with the same initial diagnosis than OS, which seems to be attributed to different training paths.

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“…Many studies and surveys are present in the literature regarding the possible therapeutic options available in endodontic, periodontal, prosthetics, and implant therapy (Cosyn & DeBruyn, 2007, Junges et al, 2014, Bishti et al, 2018, Lee et al, 2020). The prognostic evaluation of compromised teeth among different operators with different experience and background also has been investigated extensively (Lang‐Hua et al, 2014; Zitzmann et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Clinical decision‐making and management of stage IV periodontitis: A survey

Merli

Fratini

Sforza³

et al. 2022

Oral Diseases

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ObjectiveTo investigate the clinical management of stage IV periodontitis patients among clinicians within the Italian Society of Periodontology and Implantology.MethodsA cross‐sectional study was designed on a web‐based anonymous survey. Comparison between ordinary members (OMs) versus active and certified members (ACMs) and comparison between members with at least 10 years of experience in periodontology (Ov10) and members with less than 10 years of experience in periodontology (Un10) were performed.ResultsA total of 324 out of 1362 members (response rate of 24%) responded to the questionnaire. ACMs and Ov10 more often reported their teams hold adequate skills to manage cases. Step I and II periodontal therapy took more time in the ACMs and Ov10 groups. ACMs used different strategies to perform step I‐II therapy, and antibiotics were used less frequently than OMs. Unresponsive sites were treated more often with surgery by ACMs compared to OMs. ACMs adopted different treatment sequences compared to OMs. Ov10 group used more often CBCT, lateral cephalogram, and wax‐up while Un10 group tend to avoid orthodontic therapy.ConclusionsMore experienced members spent more time in step I and II of periodontal therapy, used more diagnostic tools, and performed more often surgery and orthodontics in the treatment of stage IV periodontitis patients.

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Does professional experience save teeth? A survey among prosthodontists

Abstract: In complex cases, clinicians with more than 20 years of professional experience tend to save questionable teeth rather than to resort to implants. This interindividual variation might less likely occur when more external evidence is taken into account during the decision-making process.

Cited by 4 publications

References 27 publications

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

Pre-implantological treatment routines for alveolar ridge atrophy – an investigation among maxillofacial and oral surgeons in southern Germany

Clinical decision‐making and management of stage IV periodontitis: A survey

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