{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:23:49Z","timestamp":1791926629848,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014688","name":"Region Uppsala","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014688","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the context in which general dental practitioners (GDPs) decide to refrain from further treatment, that is, ortho\u2010 or retrograde retreatment or extraction of a root canal filled tooth with persistent asymptomatic apical periodontitis (PAAP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>Fifteen GDPs were strategically selected for in\u2010depth interviews. The informants were encouraged to describe in their own words and in as much detail as possible, the three most recent patient cases of PAAP of a root canal filled tooth, in which they decided to refrain from further treatment. The interviews were recorded digitally and transcribed <jats:italic>verbatim<\/jats:italic>. The collected material was analysed according to Qualitative Content Analysis with an inductive approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A pattern of varying degrees of uncertainty associated with the decision process was identified. The motives to refrain intervention had great diversity. The result from analysis of the qualitative data was formulated in an overall theme \u2018Between doubt and certainty in a complex clinical context\u2019 covering the latent content. The first main category covering the manifest content was \u2018The continuum of confidence\u2019 with three subcategories \u2018Experienced uncertainty\u2019, \u2018Reluctant approval\u2019 and \u2018At ease with refraining\u2019 illustrating the feelings and attitudes experienced by the informants. The second category was \u2018In support of acceptance\u2019 with three subcategories \u2018Patient's autonomy, risks and cost\u2010benefits\u2019, \u2018Emotional aspects\u2019 and \u2018Relieving measures\u2019 representing the reasons for refraining from intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The decision to refrain from further treatment, that is, ortho\u2010 or retrograde retreatment or extraction of a root canal filled tooth with PAAP was made with some measure of confidence, combined with compensatory strategies to support the decision, taking into account not only values beneficial to the patient and awareness of limited external resources, but also factors related to the informants' personal preferences, convenience, concerns, ambition and emotions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.14158","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T12:29:36Z","timestamp":1729686576000},"page":"225-238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Why do dentists refrain from intervention in cases of persistent asymptomatic apical periodontitis in root canal filled teeth? 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