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Tooth extraction decision model in periodontitis patients |
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| Authors: | A. Popelut B. Rousval O. Fromentin M. Feghali F. Mora P. Bouchard |
| Affiliation: | 1. Department of Periodontology, Service of Odontology, H?tel‐Dieu Hospital, AP‐HP, Paris 7‐Denis Diderot University, U.F.R. of Odontology, Paris, France;2. Cordeliers Research Centre, INSERM UMRS872, Paris 7‐Denis Diderot University, Paris, France;3. *Contributed equally to this work.;4. Analysis Laboratories for Aiding Decision Systems Modelling (LAMSADE), Paris IX‐Dauphine University, Paris, France;5. Department of Prosthetic Dentistry, Service of Odontology, H?tel‐Dieu Hospital, AP‐HP, Paris 7‐Denis Diderot University, U.F.R. of Odontology, Paris, France |
| Abstract: | 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. To cite this article: Popelut A, Rousval B, Fromentin O, Feghali M, Mora F, Bouchard P. Tooth extraction decision model in periodontitis patients. Clin Oral Impl Res. 21 , 2010; 80–89. |
| Keywords: | decision making dental extraction evidence‐based dentistry fixed partial dentures implant dentistry single crowns supportive periodontal therapy systematic review tooth loss utility |