Method: A questionnaire and clinical record were mailed to all educationally-certified periodontists in 3 U.S. states (N=297). The clinical record provided medical information, probing depths, attachment levels, furcation involvements, clinical photographs, and radiographs of a patient with mild to moderate chronic periodontitis. Participants were asked to indicate their most likely and second most likely treatment choices from a list of treatment options. Data were tabulated, reviewed for possible errors, and analyzed statistically. The OSU-IRB reviewed and approved the study.
Result: 93 periodontists (31.3%) returned the questionnaire, responding to all questions. The sample was not different statistically (P=0.284) from the population regarding gender distribution. However, very experienced periodontists (>20 years) were over represented among responders (P=0.007). 49 periodontists (52.7%) agreed on osseous surgery (OsS) as the preferred treatment, and 13 (14%) opted for osseous regeneration (OsR). SRP or open flap plus debridement (OFD) received 8 votes each (8.6%). The most frequent secondary choices were OFD, OsR, and OsS with 29, 23, and 22 votes, respectively. Statistically, experience level did not affect the primary nor secondary treatment choice.
Conclusion: Periodontists showed substantial variation in primary and secondary choices for treatment of a standardized case scenario. These decisions in dental-care provision may have important implications in the current climate of cost containment and suggests that periodontal practice may have failed keeping pace with the evolving science of periodontal care to ensure evidence-based practice.