4.5 Article

Does professional experience save teeth? A survey among prosthodontists

Journal

CLINICAL ORAL INVESTIGATIONS
Volume 22, Issue 2, Pages 1001-1008

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00784-017-2180-5

Keywords

Evidence-based dentistry; Clinical protocols; Clinical decision-making; Prosthodontics; Dental prosthesis; Dental implants

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The aim of this study is to investigate the effect of clinical experience and educational background on clinical decision-making of dentists presented with two prosthodontic cases. A questionnaire-based survey was performed among 66 prosthodontists who were divided into two groups. The first group included clinicians from Belgium, Germany, and the Netherlands covering a wide spectrum of dental experience. The second (specialized) group consisted of German dentists performing their last module of a 3-year postgraduate master program in prosthodontics. Two patient scenarios of different complexities were presented to the participants who were asked to make an educated choice among seven therapeutic options. Sixty-six dentists participated. For case #1, 22 therapeutic suggestions were offered within the international group (variation 54%), while 17 options were chosen in the specialized group (variation 68%). For case #2, five (variation 12%) and four (variation 16%) different therapeutic options were planned in the groups, respectively. Treatment planning in combination with implants was clearly preferred by dentists with an experience of 20 years or less. Conversely, participants with more experience favored more conventional treatments. All differences were statistically significant (p < 0.05). Clinicians' experience and educational background had a clinically relevant influence on decision-making and treatment planning. A clear preference for implant-free therapies was noted for dentists with more than two decades of professional experience. In complex cases, clinicians with more than 20 years of professional experience tend to save questionable teeth rather than to resort to implants. This interindividual variation might less likely occur when more external evidence is taken into account during the decision-making process.

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