Endodontic retreatment decision‐making: The influence of the framing effect

Kvist, Thomas; Henelius, Daniela; Smakiqi, Agnesa

doi:10.1002/cre2.715

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…This ndings are consistent with those of earlier researches [26,27]. In our study, there were large inter-and intra-observer discrepancies during the interpretation of PR images by the general practitioners; this may be attributed to the diversity in decision-making in many cases due to a lack of knowledge and the buildup of experience that is needed to accurately diagnose endodontic cases [28,29]. In contrast, our results documented a high degree of inter-and intra-observer agreement with the use of CBCT images; this may be explained by Patel et a [30] who demonstrated that examiner expertise had no effect on the interpretation of CBCT images.…”

Section: Discussionsupporting

confidence: 93%

Accuracy of Cone-Beam Computed Tomography in Detection of Root Perforations Using Different Voxel Sizes in Comparison to Digital Periapical Radiograph, An in vitro study

Abada,

gemaie,

Shreif

et al. 2023

Preprint

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Objectives: The aim of this study is to quantitatively compare the diagnostic accuracy of CBCT with 0.2 and 0.4 mm3 voxel sizes and a digital PR for the detection of strip perforation for mesial root of the mandibular first molar with and without root canal obturation when evaluated by different observer specialty. Materials and Methods: 48 intact mandibular first molars were selected for this study, the teeth were divided to the following groups: (i) no strip perforation and no obturation, (ii) no strip perforation and obturation, (iii) strip perforation and no obturation, (iv) strip perforation and obturation. Each tooth was inserted in a dry mandible to obtain intraoral digital, CBCT images were obtained using two voxel sizes 0.2 and 0.4 mm3. Two general practitioners, two endodontists, and two dentomaxillofacial radiologists were asked to evaluate all images for detection of strip root perforation individually and together. The sensitivity and specificity of all images modalities to diagnose perforations were calculated. Results: There was no statistically significant difference between the accuracy of the PR images observed by the two general practitioners and two radiologists, while they showed a statistically low significant difference compared to the images observed by the two endodontists. CBCT images accuracy showed a higher significant difference than PR images observed by general practitioners and radiologists. Conclusions: CBCT was associated with significantly greater accuracy for detection of strip root perforation than PR. When two endodontist specialists observed the PR together, they showed a higher significance difference in the detection of root perforation compared to general practitioners and radiologists, and they showed no significant difference compared CBCT images. There was no significant difference between 0.2 and 0.4 mm3 voxel sizes of CBCT images. Clinical Relevance: The accuracy of PR in the detection of root perforation is equal to that of CBCT when observed by two endodontists, and it is higher than the accuracy of PR images observed by general practitioners and radiologists.

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Section: Discussionsupporting

confidence: 93%

Accuracy of Cone-Beam Computed Tomography in Detection of Root Perforations Using Different Voxel Sizes in Comparison to Digital Periapical Radiograph, An in vitro study

Abada,

gemaie,

Shreif

et al. 2023

Preprint

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“…how information about the situation is conveyed) can be a decisive factor in itself. Certain words or phrases, which implicitly contain values, even if intended to provide neutral information, can demonstrably have a large impact on decision‐makers' choices (Kvist et al., 2023; Tversky & Kahneman, 1981). Our results showed that the decision aid was able to exert a positive educational and psychological effect on our patients, despite them choosing the same treatment decision after watching the video.…”

Section: Discussionmentioning

confidence: 99%

A video‐based decision aid improved knowledge and decreased decisional conflict for asymptomatic persistent endodontic lesions

Wei,

Tan,

et al. 2024

Int Endodontic J

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AimThis prospective cohort study aimed to (i) evaluate patients' treatment decisions, decisional conflict and knowledge levels before and after use of a video‐based decision aid (DA) on asymptomatic persistent endodontic lesions (APEL) and to (ii) elicit important decision factors for patients in the decision‐making process.MethodologyA video DA modelled after the International Patient Decision Aids Standards (IPDAS) was designed. The video was pilot‐tested, revised and used on 50 patients referred to the graduate endodontic clinic and presenting with an incidental finding of APEL detected on radiographs, with informed consent (DSRB 2020/00133). Recruitment was conducted from June 2020 to November 2021. Patients' treatment decisions and decision‐making process were studied. Patients also completed a questionnaire on knowledge gain, decisional conflict and confidence levels.ResultsForty‐three patients (48 teeth) out of 50 patients chose long‐term monitoring of APEL while 7 patients (7 teeth) decided on endodontic intervention. Median knowledge scores increased from 58.3 (IQR: 41.7, 75.0) to 87.5 (IQR: 75.0, 100.0) (p < .001); median decisional conflict scale (DCS) scores decreased from 25.0 (IQR: 12.5, 34.4) to 3.1 (IQR: 0, 23.8) (p < .001), and 44 (88%) patients were confident or very confident with their treatment decisions. Statistical analyses showed that asymptomatic condition of tooth was the sole decision factor with statistical significance while socioeconomic factors (age, gender, race, education and income levels) showed no significant trend.ConclusionsThe majority of patients presenting with APEL in this study chose long‐term monitoring over immediate intervention. Using the video‐based DA in the decision‐making process significantly improved patients' knowledge and decreased their decisional conflict levels.

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“…According to the prevailing academic paradigm, a root filled tooth with apical periodontitis is defined as an "endodontic failure" and thus implies a clinical decision and action (41,42). The repeatedly demonstrated variation in clinical decisions and in particular the reluctance among practitioners to institute retreatment has bothered scholars in endodontology since the 1980's (43).…”

Section: Decision Making Of a Root Filled Tooth With Apical Periodont...mentioning

confidence: 99%

Uncertainties and decision making in endodontics

Kvist¹,

Hofmann²,

Brodén³

et al. 2023

Tidende

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Headline This paper is concerned with uncertainties and decision making in endodontics. Uncertainties are of different kinds; risk, fundamental uncertainty, ignorance and indeterminacy. The various types of uncertainties that are involved in the process of clinical making decisions are briefly reviewed in case of an injured vital pulp, a necrotic pulp with apical periodontitis and finally a root-filled tooth with a persistent apical lesion.

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Endodontic retreatment decision‐making: The influence of the framing effect

Cited by 10 publications

References 33 publications

Accuracy of Cone-Beam Computed Tomography in Detection of Root Perforations Using Different Voxel Sizes in Comparison to Digital Periapical Radiograph, An in vitro study

Accuracy of Cone-Beam Computed Tomography in Detection of Root Perforations Using Different Voxel Sizes in Comparison to Digital Periapical Radiograph, An in vitro study

A video‐based decision aid improved knowledge and decreased decisional conflict for asymptomatic persistent endodontic lesions

Uncertainties and decision making in endodontics

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