ArticleJournal of endodontics2026
Factors Influencing Tooth Preservation Decisions among U.S. General Dentists: A Cross-sectional Vignette Study.
Article in Journal of endodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionThe aims of this study were to evaluate the decision to extract or treat a tooth with initial root canal therapy (RCT) made by general dentists practicing in the United States; and evaluate the effect of clinical and nonclinical factors on decision-making.
methodsAuthors conducted a cross-sectional survey study. Participants read a vignette presenting a questionably restorable tooth for consideration and provided their clinical recommendations. The primary treatment decision was analyzed as a binary variable: tooth extraction or RCT. Other questions about clinical decision-making used the Likert-scale for capturing responses. Clinician-related variables were evaluated as follows: age, gender, years of experience, primary practice setting, and participation with payment systems. Kruskal-Wallis tests were used to compare the treatment decision with Likert-scale responses for clinical decision-making. A logistic regression model investigated the effect of clinician factors on the treatment decision.
resultsOne hundred thirteen eligible dentists completed the survey. For the presented case, a maxillary first molar, 54% of general dentists recommended initial RCT, and 46% recommended extraction. 37.2% of dentists responded that the patient's tooth was somewhat or very likely restorable. None of the evaluated clinician factors were statistically significant in predicting the treatment decision. Borderline significance (P = .05) was noted for general dentists primarily practicing in academic settings; they had 3.57 times the odds of recommending tooth extraction than dentists primarily in private practice (P = .05).
conclusionsThis study found that general dentists' decision to either save a tooth with initial root canal therapy or extract was primarily associated with perceived tooth restorability.
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