Evaluation of factors influencing parental treatment preferences for pediatric patients requiring root canal retreatment

Objective: This study aimed to evaluate the factors influencing parental preferences for different treatment options for permanent first molars requiring root canal retreatment in pediatric patients. Materials and Methods: The records of 73 patients, aged 10–17 years, who presented to the Department of Pedodontics Clinic, Faculty of Dentistry, Suleyman Demirel University, with a first permanent molar indicated for root canal retreatment were included in this study. The necessity for treatment was confirmed through clinical and radiographic evaluations. Clinical parameters included spontaneous pain, sensitivity to vertical percussion and palpation, gingival discoloration, mucosal swelling, presence of pus in periodontal pockets, fistula formation, and pathological mobility. Radiographic evaluation included factors such as the Periapical Index (PAI) score, lesion size, level and quality of the root canal filling, status of the coronal restoration, presence of missed or unfilled canals, pathologic or iatrogenic blockages, perforation, instrument fracture, widening of the periodontal ligament space, presence of a lesion in the inter-radicular area, and the root canal retreatment preference score. The caries status of the children was assessed using DMFT, DMFS, and PUFA indices based on data from their intraoral examination records. Treatment options were presented to all parents in a standardized manner, after which sociodemographic data, treatment preferences, and the reasons for these preferences were recorded. Parental dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS), with questions directed to the parents to determine both their anxiety (MDAS-1) and their perceived anxiety for their child (MDAS-2). The obtained data were statistically analyzed. Results: Among the teeth included in the study, 72.6 % were found to have non-ideal root canal fillings and 69.9 % had coronal restoration problems. Clinically, percussion sensitivity was observed in 82.2 % of cases, and widening of the periodontal ligament space was detected in all of them. Furthermore, a significant increase in DMFT and DMFS scores was observed with increasing age, indicating that caries rates increased with age (p=0.021). The findings revealed that as the patient's age increased, parents showed a greater tendency to prefer tooth extraction (p=0.038). The frequency of dental visits also influenced preferences, with parents who sought dental care only for emergencies more frequently opting for extraction or a "wait-and-see" approach. Parents with previous personal experience of root canal treatment (p=0.024) or root canal retreatment (p=0.006) were significantly more likely to choose retreatment over extraction. When dental anxiety scores were analyzed according to treatment choices, no significant differences were found between preferences based on the parent's anxiety (MDAS-1) or their perceived anxiety for their child (MDAS-2) (p>0.05). Conclusion: Parental knowledge levels and personal experiences directly influence their decisions regarding their children's dental treatment. In this context, raising parental awareness can facilitate the adoption of conservative treatment choices, thereby contributing to the preservation of the child's oral and dental health. Keywords: Root Canal Retreatment, Parental Preference, Preference Factors, Clinical Evaluation, Radiographic Evaluation