German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Abstract

Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists’ privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment–decision-correlated factors are recommended for correct treatment planning.

The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany

“…In this survey 732 dentists participated via the online survey link and completed the online questionnaire, displaying a significant sample size and representing German dentists in the investigation. Sociodemographic data of the participants presented an analogous gender distribution compared to the dental population in Germany (60–70% female) and Europe ( Table 1 ) with higher percentages of female dentists [ 23 , 38 ]. The majority of the survey participants were younger than 50 years old and working in dental practices ( Table 1 ).…”

“…First of all, the investigation is restricted by its cross-sectional nature and lacks the follow-up on a longitudinal level. On the other hand, misinterpretations in such investigations are known to be equally dispersed [ 23 ]. In this survey, the observed outcomes of German dentists cannot be accredited exclusively to the analyzed aspects and socio-environmental information.…”

“…Germany is considered the largest member state of the European Union in terms of general population and number of oral healthcare professionals, with about 80.5 million inhabitants and nearly 70,000 dentists [ 22 ]. Under a scheme of statuary or private health insurance, general dental practitioners and dental specialists provide oral healthcare services to their patients in private practices or university clinics [ 23 ]. Although previous studies reported the financial burden affecting dental personnel in Germany during the COVID-19 pandemic [ 24 ], the psychological impact on German dentists, associated with the pandemic and its related factors, still needs to be unveiled.…”

Kobra Surgery Simulator—A Possibility to Improve Digital Teaching? A Case-Control Study

“…This exercise could be done with older students and compared to dentists to show a different effect. The degree of difficulty for an optimal operation is increased in this case, because for a decent apicoectomy, as little bone and dentine or tooth structure as possible, but as much gutta-percha from the orthograde filling and infected tissue as necessary, should be removed [ 37 ], which influences the outcome in the clinic.…”

Oral Health Attitudes among Preclinical and Clinical Dental Students: A Pilot Study and Self-Assessment in an Egyptian State-Funded University

“…One of the disadvantages of cross-sectional studies is the limited evaluation of data aside from the information gathered. However, similar studies have shown that this limitation of cross-sectional surveys has a weak effect on evaluation, as misdiagnoses of gathered data tend to be equally distributed [ 65 ]. In this survey, the detected oral health behaviour and attitudes of preclinical and clinical dental students at Ain Shams University cannot be completely ascribed to the examined aspects and the sociodemographic data.…”