Different Treatment Choices Regarding Extensive Molar Restorations

Method: A questionnaire was distributed to teachers (n=131) (53 Bergen/ 78 Oslo) affiliated to Departments of Cariology and Prosthodontics and students (n=200) (70 Bergen /130 Oslo). The questionnaire comprised information about different operator-related factors as well as questions related to a well documented clinical case (tooth number 36 with extensive amalgam restorations). The participants were asked to rank the treatment alternatives, to indicate presumed longevity, complication and main reason for their first treatment alternative. Groups were compared using Chi Square analyses. 

Result: The response rates were 32% and 51 % among teachers and 39% and 24 % among students, in Bergen and Oslo, respectively. Both schools regarded metal-ceramic crown as the first treatment alternative 53% (47 and 60, Bergen and Oslo), followed by composite restoration 19%, full-metal gold crown 12%, gold onlay 8% and ceramic crown/onlay 4%. There was a statistical significant difference (P=0.036) when comparing these treatment choices between the two schools. Ranking the treatment choices according to preserve tooth-substance, the statistical significant difference between the schools was stronger (P=0.011). The treatment decisions were not associated to operator-related factors such as age, gender, clinical experience or being a student vs. teacher.

Conclusion: This study shows variation in treatment decisions among teachers and students in dental schools in relation to tooth preservation. Clinical decision making may be related to different treatment philosophies taught in the two dental schools rather than operator-related factors.