title: A survey of dentists' preferences for the treatment of teeth with apical periodontitis.
abstract: BACKGROUND
  This study surveyed the preferences of Ontario, Canada dentists for teeth with apical periodontitis when selecting between retention via root canal treatment (RCT) and extraction without replacement, or replacement with implant-supported crowns (ISC), fixed, or removable partial prostheses.
  
  
  METHODS
  A mail-out survey (census of Ontario endodontists, periodontists, prosthodontists, and oral and maxillofacial surgeons; n = 498, 40% response rate) and a Web-based survey (sample of Ontario general dentists; n = 1983, 15% response rate) were conducted. Participants ranked their treatment preferences for 4 clinical scenarios: an anterior or posterior tooth, without or with previous RCT. Associations between treatment preferences and covariates were explored by using bivariate and logistic regression analyses (P ≤ .05).
  
  
  RESULTS
  For all 4 scenarios, the majority of participants preferred either RCT or ISC, whereas other treatment options were preferred by ≤ 3.1% of the participants in any professional registration category. A pattern of declining preference for RCT and increasing preference for ISC was noted across the scenarios, with significantly lower preference for RCT and higher preference for ISC associated with teeth needing repeated RCT compared with initial RCT (odds ratio [OR] = 3.3; confidence interval [CI], 2.5-4.4). Preferences were significantly lower for RCT and higher for ISC among general dentists (OR = 6.4; CI, 2.3-17.6), prosthodontists (OR = 9.1; CI, 3.0-28.3), periodontists (OR = 18.3; CI, 6.4-51.6), and surgeons (OR = 30.1; CI, 10.8-86.6) when compared with endodontists.
  
  
  CONCLUSIONS
  More surveyed dentists preferred RCT than ISC for teeth with apical periodontitis requiring initial RCT than repeated RCT. The dentists' preferences were associated with their professional registration but not with other characteristics.
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Ontario, Canada; Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada. Electronic address: amir.azarpazhooh@dentistry.utoronto.ca.
authors.forename: Amir
authors.initials: A
authors.lastname: Azarpazhooh
authors.forename: Thuan
authors.initials: T
authors.lastname: Dao
authors.forename: Rafael
authors.initials: R
authors.lastname: Figueiredo
authors.forename: Murray
authors.initials: M
authors.lastname: Krahn
authors.forename: Shimon
authors.initials: S
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003442:Crowns / Q000523:psychology; D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology; D003815:Dentists / Q000523:psychology*; D003830:Denture, Partial, Fixed / Q000523:psychology; D003832:Denture, Partial, Removable / Q000523:psychology; D004708:Endodontics; D005260:Female; D005792:General Practice, Dental; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010485:Periapical Periodontitis / Q000628:therapy*; D010517:Periodontics; D019239:Practice Patterns, Dentists'; D011365:Professional Practice Location; D011476:Prosthodontics; D012390:Root Canal Therapy / Q000523:psychology; D012737:Sex Factors; D013515:Surgery, Oral; D014081:Tooth Extraction / Q000523:psychology; D019553:Tooth, Nonvital / Q000628:therapy
keywords: Apical periodontitis; decision-making; delivery of health care; dental implant; dentists; root canal treatment