title: An analysis of the decision-making process for single implant treatment in general practice.
abstract: OBJECTIVE
  To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting.
  
  
  METHODS
  One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors.
  
  
  RESULTS
  Ninety-four general dentists (52 men, 42 women; mean age 49; range 24-68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses.
  
  
  CONCLUSIONS
  Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.
authors.affiliation: Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, Ghent, Belgium. jan.cosyn@ugent.be
authors.forename: Jan
authors.initials: J
authors.lastname: Cosyn
authors.forename: Stefanie
authors.initials: S
authors.lastname: Raes
authors.forename: Stefanie
authors.initials: S
authors.lastname: De Meyer
authors.forename: Filiep
authors.initials: F
authors.lastname: Raes
authors.forename: Ronald
authors.initials: R
authors.lastname: Buyl
authors.forename: Danny
authors.initials: D
authors.lastname: Coomans
authors.forename: Hugo
authors.initials: H
authors.lastname: De Bruyn
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D019250:Dental Implants, Single-Tooth / Q000706:statistics & numerical data*; D003793:Dental Restoration, Permanent / Q000379:methods / Q000706:statistics & numerical data; D003829:Denture, Partial / Q000706:statistics & numerical data; D005260:Female; D005792:General Practice, Dental / Q000706:statistics & numerical data*; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D014081:Tooth Extraction; D055815:Young Adult