Restorative treatment thresholds for occlusal primary caries among dentists in The Dental Practice-Based Research Network
Restorative treatment thresholds for occlusal primary caries among dentists in The Dental Practice-Based Research Network
复制标题
DOI：
10.14219/jada.archive.2010.0136
复制
发表时间：
2010-02-01
影响因子：
3.9
通讯作者：
Gilbert, Gregg H.
中科院分区：
文献类型：
--
作者：
Gordan, Valeria V.;Bader, James D.;Gilbert, Gregg H.
目标.作者报告了一项旨在量化龋齿病变深度的研究，牙医在不同的龋齿渗透和龋齿风险的情况下进行手术干预。他们还旨在确定与手术干预相关的特征。研究人员调查了参加牙科实践研究网络的牙医，他们报告说至少进行了一些修复性牙科治疗。在调查中，牙医被要求表明他们是否会在一系列涉及牙合手杖的病例中进行手术干预。每个病例介绍包括一张显示龋齿渗透典型特征的咬合面照片和一份处于特定龋齿风险水平的患者书面描述。采用逻辑回归分析，作者分析了外科治疗与牙医和实践的特点和患者的龋齿风险水平之间的关系。共有517名DPBRN的研究人员回答了问卷。63%的受访者（517人中的326人）表示，在患龋风险较低的患者中，他们会通过手术修复内釉质表面病变的牙齿，90%的人会通过手术修复外牙本质表面病变的牙齿。对于高风险的患者，7.7%（517人中的398人）的受访者报告说，他们将手术修复内釉质病变，94%（517人中的486人）报告说，他们将修复位于外牙本质表面的病变。没有评估龋齿风险的牙医比评估风险的牙医更有可能干预牙本质病变（P = .004）。个体诊所或私人诊所中少于4名牙医的从业者-研究者比大群体诊所（4名或更多牙医）中的牙医更有可能对釉质病变进行手术干预（P <0.001）。
Objectives. The authors report on a study aimed at quantifying the carious lesion depths at which dentists intervene surgically for cases of varying caries penetration and caries risk. They also aimed to identify characteristics that are associated with surgical intervention.Methods. The investigators surveyed dentists enrolled in a dental practice-based research network who reported performing at, least some restorative dentistry. In the survey, dentists were asked to indicate whether they would intervene surgically in a series of cases involving occlusal canes. Each case presentation included a photograph of an occlusal surface displaying typical characteristics of caries penetration and a, written description of a patient at a specific level of risk of developing caries. Using logistic regression, the authors analyzed associations between surgical treatment with dentists' and practices' characteristics and patients' caries risk levels.Results. A total of 517 DPBRN practitioner-investigators responded to the questionnaire. Sixty-three percent of the respondents (326 of 517) indicated that in patients at low risk of developing caries, they would surgically restore teeth with lesions located in inner enamel surfaces and 90 percent would surgically restore teeth with lesions located in outer dentin surfaces. Regarding patients with a high risk of developing canes, 7 7 percent (398 of 517) of the respondents reported that they would surgically restore inner enamel lesions, and 94 percent (486 of 517) reported that they would restore lesions located on the outer dentin surface. Dentists who did not assess caries risk were more likely than dentists who did assess risk to intervene with dentinal lesions (P = .004). Practitioner-investigators who were in solo practice or a private practice with fewer than four dentists were significantly more likely to intervene surgically with enamel lesions than were dentists in large group practices (those with four or more dentists) (P < .001).