Decision-Making in Endodontics Prior to the Surgical Removal of Large Cysts Involving Vital Teeth

TL;DR

This study explores how dental professionals decide on treating teeth affected by large cysts, highlighting differences in opinions and awareness of guidelines.

Contribution

The study identifies variations in clinical decision-making and awareness of AAE guidelines among dental specialists regarding large cystic lesions.

Findings

There are dissimilarities between dental groups in decision-making for managing teeth in large cystic lesions.

Endodontists and general dentists showed higher awareness of AAE guidelines compared to other specialists.

The study highlights the need for randomized clinical trials to better understand treatment outcomes for these cases.

Abstract

Introduction

Maintaining pulp vitality is crucial; however, treatment options for large lesions may hinder the vitality of the teeth involved within the lesion. Some clinicians are not updated about the diagnostic terminology of the American Association of Endodontists (AAE) which may affect their decision-making. In the literature, there was no absolute treatment to manage such cases. The purpose of this study is to explore different opinions, identify the evidence of practice and treatment options to help in decision-making and assess if clinicians are acknowledged by the AAE guidelines.

Materials and methods

This cross-sectional study was conducted through a qualitative survey designed to interview randomly selected endodontists, oral maxillofacial surgeons, oral medicine specialists, oral pathologists, and general partitioners to record their decisions and management about a structured case scenario. A total of 120 participants were included in the study. The interviews were conducted by a single investigator, and the answers were recorded by another investigator. Finally, the responses of the interviewees were collected using Google Forms (Google, Mountain View, California).

Results

We found that there are dissimilarities between the different groups in decision-making concerning the management of teeth involved in large cystic lesions. Regarding the AEE guidelines, almost all the endodontics and general dentists were aware of the guidelines when compared with the other groups.

Conclusion

The management of teeth involved in large cystic lesions is controversial. Furthermore, the AEE guidelines are not a common language between the different disciplines. Randomized clinical trials are needed to investigate the prognosis and management of teeth associated with large cystic lesions.

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