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Tooth extraction decision model in periodontitis patients

Popelut, A.; Rousval, Benjamin; Fromentin, O.; Feghali, M.; Mora, F.; Bouchard, P. (2010), Tooth extraction decision model in periodontitis patients, Clinical Oral Implants Research, 21, 1, p. 80-89. http://dx.doi.org/10.1111/j.1600-0501.2009.01850.x

Type
Article accepté pour publication ou publié
Date
2010
Journal name
Clinical Oral Implants Research
Volume
21
Number
1
Publisher
Wiley
Pages
80-89
Publication identifier
http://dx.doi.org/10.1111/j.1600-0501.2009.01850.x
Metadata
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Author(s)
Popelut, A.
Rousval, Benjamin
Fromentin, O.
Feghali, M.
Mora, F. cc
Bouchard, P.
Abstract (EN)
Objective: The purpose of this study was to build, around several types of input data, a decision analysis model for dental extraction strategy in periodontitis patients. Materials and methods: The decision analysis was based on the following scenario: a fictitious adult chronic periodontitis patient with no chief complaint, being referred to make a decision of extraction on one single tooth presenting a periodontal defect that may affect the decision-making process. A decision tree was used to identify the treatment options within the next 5 years. Scientific evidences were based on probabilities given by a literature analysis using a systematic approach. Clinical expertize was based on subjective utilities (SUs) assigned by an experts' panel. Expected utilities (EUs) were used to rank the following options: no treatment (EU1) or periodontal treatment (EU2); extraction followed by a tooth-supported fixed partial denture – FPD – (EU3) or an implant-supported single crown – ISC – (EU4). Results: The robustness analysis calculation indicates that the probability of tooth survival needed to be equal to 0.78 in order that the passive option becomes optimal. However, EU1 was impossible to calculate due to the lack of available probabilities. The EU intervals were 79–96, 86–89 and 94–95 for EU2, EU3 and EU4, respectively. Consequently, the FPD option is dominated by the ISC option, and it is not possible to conclude to a difference between the periodontal and the ISC therapy. Conclusions: Within the limits of this model, tooth extraction followed by FPD is the worst strategy compared with ISC or periodontal therapies.
Subjects / Keywords
decision making; dental extraction; evidence-based dentistry; fixed partial dentures; implant dentistry; single crowns; supportive periodontal therapy; systematic review; tooth loss; utility

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