Dentists and Dental Intern’s Preferences of Root Canal Treatment with Restoration Versus Extraction then Implant-Supported Crown Treatment Plan

Abstract

Objectives: The intent of this study was to evaluate and compare the preferences and treatment choices between dentists and dental interns with regard to the following different treatment modalities: Root Canal Treatment (RCT) with restoration versus extraction with Implant-Supported Crown (ISC) or surgical treatment in relation to the given case scenarios. Methods: The questionnaire was presented as an online survey with a case scenario. The total number of the respondents were 165. The four clinical case scenarios included an anterior and posterior tooth having apical periodontitis, with and without previous RCT. The treatment options were as follows: RCT with restoration, extraction then implant, and surgical treatment. Results: A total of 165 dentists and dental interns were included in this study. A hundred and three 62.4% respondents were dentists, 60; 36.3% were males and 105; 63.7% were females. Most of the respondents graduated from the College of Dentistry, Jazan University (93.9%). The highest percentages and numbers for Anterior Teeth (AT) were selected in related to the RCT and restorations in the four scenarios among gender, dentists, and interns, with no considerable differences. A high percentage of RCT and restoration option was recorded for Posterior Teeth (PT) with no previous restoration and around 50% for the same treatment modality to posterior teeth with previous restorations. For Future Planning Postgraduate Studies (FPPS), it was obvious that most of the selected specialties agreed with the RCT and restorations choice. Conclusion: All dentists and interns in both genders preferred RCT with restorations over extraction, and then ISC in the AT with and without previous RCTs. In the PT with no previous RCT, the participants agreed that RCT with restorations is superior to other choices. Among the FPPS, the respondents demonstrated an absolute agreement to RCT and restorations as a treatment of choice for different scenarios. Clinical Significance: Dentists should preserve the natural teeth by RCT with restoration as the first treatment choice followed by other choices. The nonsurgical approach should always be adopted as a routine measure in PA lesions of endodontic origin. Conservative orthograde endodontic therapy demonstrates favorable outcomes with a regular periodic review and assessment of the healing process of PA lesions.

Virtual Approach to the Comparative Analysis of Biomaterials Used in Endodontic Treatment

“…Keeping the tooth functional when it is no longer possible to keep it alive is the basis of the conventional approach that prescribes endodontic treatment, which is the subject of this paper. Of course, an alternative could be extracting a diseased tooth, but dentists prefer endodontic treatment for pragmatic and ethical reasons [103,104]. The paradigm shift of this approach leads to revascularization and regenerative endodontic procedures.…”

“…but dentists prefer endodontic treatment for pragmatic and ethical reasons [103,104]. The paradigm shift of this approach leads to revascularization and regenerative endodontic procedures.…”

“…The treatment is based on caries, as the most common infectious disease in the world, affecting 3-5 billion people [1], causing many systemic diseases [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], as well as personality changes leading to dementia [29][30][31][32][33][34][35], and if necessary the necessity to extract teeth, causing toothlessness, which may also cause many systemic complications [8][9][10][11][12][13]. However, it should be emphasized that dentists treat tooth extraction as a necessity in the event of failure to continue endodontic treatment [103,104], performed carefully to avoid complications due to iatrogenic causes [53][54][55][56][57][58]. The endodontic treatment results in sealing the previously infected and then developed root canals, preventing the spread of bacteria and their toxins to the root tip [110][111][112], including saliva [113].…”

Development Strategy of Endodontic Filling Materials Based on Engineering and Medical Approaches

“…On the evidence, especially in the early stages, this cycle covers the basic cyclical steps of 5D Caries Management Cycle Rules 5D (CMCRs) (Figure 7d According to ICDAS [78,79] and the patient's pain symptoms, endodontic treatment may be undertaken as an alternative to dental extraction in the case of at least the third stage of caries advancement. For health and aesthetic reasons, dentists prefer endodontic treatment to extraction [85,86]. Clinically, there are reversible pulpopathies and pulp necrosis among pulp diseases and irreversible pulpopathies that can be treated endodontically [87,88].…”

Is Gutta-Percha Still the “Gold Standard” among Filling Materials in Endodontic Treatment?

“…It successfully acts as a natural dental implant, also providing cosmetic qualities. Dentists prefer endodontic treatment to extraction for health reasons and to respect the aesthetic expectations of patients [72,73]. The decision on such treatment is made based on determining the severity of caries [74,75] under the so-called "caries continuum" [76] and the classification contained in the International Caries Detection and Assessment System (ICDAS) [14,[77][78][79].…”