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Dentists' clinical decision-making about teeth with apical periodontitis using a variable-controlled survey model in South Korea

 Junghoon Lee  ;  Sumi Kang  ;  Hoi-In Jung  ;  Sunil Kim  ;  Bekir Karabucak  ;  Euiseong Kim 
 BMC ORAL HEALTH, Vol.20(1) : 23, 2020 
Journal Title
Issue Date
Apical periodontitis ; Decision-making ; Dentists ; Endodontists ; Root canal treatment ; Survey

This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making.


A questionnaire with 36 questions about identical patient information, clinical signs, and symptoms was filled out by participants. Each question referred to a radiograph that had been manipulated using computer software in order to control tooth-related factors. Participants were instructed to record their demographic information and choose the ideal treatment option related to each radiograph. Simple and multivariable logistic regression analyses (p < .05) were used to investigate factors related to the decision to extract the tooth. We divided factors into dentist-related factors (gender, years of experience, and professional registration) and tooth-related factors (tooth position, coronal status, root canal filling status, and size of the periapical radiolucency). Dentists were categorized into three groups, based on professional registration: general dental practitioners (GDPs), endodontists, and other specialists. Simple logistic regression analysis (p < .05) was used to evaluate the tooth-related factors influencing extraction, depending on the dentists' specialty.


Participants mostly preferred saving the teeth over extraction. This preference was highest among the endodontists, followed by other specialists and GDPs. Extractions were significantly preferred for molars, teeth with previous root canal fillings, and those with apical lesions greater than 5 mm.


This study suggests that dentists' decision-making regarding teeth with apical periodontitis was associated with their work experience and specialty and influenced by tooth position, root canal filling status, and size of the apical lesion.


This survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists' specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion.
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Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Dental Education (치의학교육학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Conservative Dentistry (보존과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Preventive Dentistry and Public Oral Health (예방치과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sumi(강수미) ORCID logo https://orcid.org/0000-0002-4682-6540
Kim, Sun Il(김선일) ORCID logo https://orcid.org/0000-0002-8889-9844
Kim, Eui Seong(김의성) ORCID logo https://orcid.org/0000-0003-2126-4761
Jung, Hoi In(정회인) ORCID logo https://orcid.org/0000-0002-1978-6926
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