# A Cross-Sectional Survey Assessing the Factors Influencing Dentists’ Decisions on Post-Endodontic Prosthetic Crown Restoration

## TL;DR

This study explores how dentists in Romania make decisions about placing crowns after root canals, highlighting the need for standardized guidelines to improve patient care.

## Contribution

The study identifies practice disparities among dental specialists in post-endodontic crown placement and advocates for standardized protocols.

## Key findings

- Endodontists are significantly less likely to choose invasive treatments compared to other specialists.
- Over 70% of dentists prefer delaying crown placement until radiographic healing of periapical lesions.
- There is substantial variability in diagnostic imaging preferences, with high confidence in CBCT's precision.

## Abstract

Interdisciplinary decision-making significantly influences both the therapeutic potential and clinical outcomes, shaping clinical attitudes and management strategies. As the integration between endodontic and restorative-prosthetic considerations becomes increasingly prevalent, it is essential to understand how different dental specialists, particularly general dental practitioners, prosthodontists and endodontists, approach clinical decision-making and collaborate to optimize patient care. Objectives: This study aims to identify practice disparities in post-endodontic crown placement to inform national policy reforms, including standardised timing protocols and interdisciplinary referral criteria. Methods: A structured questionnaire was distributed to dentists practicing in Romania, yielding 238 collected responses. Results: Substantial variability was found in clinical approaches: diagnostic imaging preferences indicated frequent use of periapical radiography (83.49%) and CBCT (53.67%). Over 70% expressed high confidence in CBCT’s diagnostic precision, significantly higher than periapical radiography (Wilcoxon Signed-Rank test, p < 0.00001). A statistically significant majority (69.3%, binomial test, p < 0.001) preferred delaying definitive crown placement until radiographic healing of periapical lesions. Logistic regression analysis showed endodontists were significantly less likely to choose invasive treatments compared to other specialists (p = 0.027). Although clinicians widely recognize the significance of prosthetic planning, its early integration into the overall treatment strategy has been inconsistent. Conclusions: This study points out the necessity for standardised guidelines that clearly integrate prosthetic planning into endodontic decision-making, enhancing predictability and tooth preservation.