title: Periodontally involved teeth - extract or not?
abstract: METHODS
  Decision analysis modelling.
  
  
  METHODS
  The authors created a scenario in which a patient with a periodontally involved tooth was referred for a decision to be made over whether to extract the tooth or not. Neighbouring teeth were healthy. A decision tree that included no treatment, periodontal treatment, extraction and replacement with fixed partial denture, and extraction with single implant was created. It was populated with 'objective' probability data from systematic reviews and 'subjective' probability data from clinicians. No patient preference data were included. Eligible studies had to have a follow-up of ≥5 years. Four 'senior experts' including three periodontists and one prosthodontist evaluated a quantitative measure of the strength of the preference for an outcome.
  
  
  METHODS
  Expected utility (EU) of each management approach on a scale of 0-100.
  
  
  RESULTS
  The EU could not be calculated for the no treatment option owing to lack of probability data (ie no-one has followed up patients who do not receive periodontal treatment). For the periodontal treatment, FPD and implant groups the respective EU intervals over five years were 79-96, 86-89 and 94-95.
  
  
  CONCLUSIONS
  The EU intervals suggest the implant option is better than the FPD option if the tooth is extracted, but it is unclear whether periodontal treatment or extraction and implant is best.
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Ben
authors.initials: B
authors.lastname: Balevi