Implicaciones bioéticas al decidir entre tratamiento de endodoncia e implantes dentales: estudio cualitativo en especialistas de odontología

Abstract

Objective. When deciding between endodontics and dental implants, it is necessary to take into account multidisciplinary factors that participate in the final choice of the most appropriate treatment for the patient's needs, and factors related to dilemmas involved in the decision. It is essential to investigate the ethical dilemmas which occur when deciding between endodontic treatments versus dental implant treatment. Materials and method. The qualitative research carried out comprises a previous stage in order to identify the categories that have to do with ethical dilemmas and, which arise when deciding between one to another treatment, the documented study of specialized articles was used through Database scan formulas, an inductive process. As a result of this first stage, progress is made deductively, in the preparation of the document of categories described, analyzed and reflected following the model of ethical epistemology, so that criteria are identified that help to guarantee logical coherence, adequacy and thematic continuity. During the second stage of the investigation, based on the previous categories, the sequence of semi-structured interview with professionals is structured, the interview is carried out following the guidelines of confidentiality and informed consent. The information obtained from the specialists, six in total, is processed through the Atlas Ti program, through which nodes, categories and codes are identified. The process of assuming findings is carried out so that the contributions of the professionals emerge as expressed, they are contrasted for the discussion with the references obtained in the previous stages of bioethical foundation from the principialism approach. Results. In relation to the information that the specialist transmits to the patient in order to decide autonomously between endodontic treatment or treatment of integrative dental bone implants, the interviewees stress that said information must be comprehensive, detailed, intelligible and appropriate to each of the stages. of the treatment so that it consists in the informed consent and enables the autonomous decision. Regarding professional suitability, in order to decide on what is most convenient as a treatment, all seek to be correct regarding patient satisfaction, thus it is perceived that in practice professionals have different approaches to practice. Furthermore, the interviewees agree that the consultation with other specialties: periodontics, endodontics, surgery, rehabilitation, related to the decision between endodontics and dental implants, provides clarity and techno-scientific criteria. Regarding the use of biocompatible technologies and materials, it was found that these contribute to the qualification of clinical procedures, making them less invasive, making it possible to optimize care times based on safety and success. Regarding the choice of treatment plan, one of the factors to take into account is that of the patient's expectations, which should correspond to the cost-effective option with the greatest long-term beneficial impact in terms of systemic and whose costs take into account the financial possibilities of the patients. The position assumed by the professionals interviewed is to be ethical when deciding between treatment alternatives, since academic background, professional experience and support in other specialties are essential to ensure the benefit of patients. Conclusions. This research shows how the values are embedded in all the moments of the training, practice and care of the professionals who care for dental patients, also in what it implies to have them or not to take them into account, both for the well-being of the patients, as for the consolidation of social trust, especially when deciding between one or the other treatment.