Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN.
Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN.
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DOI：
10.1016/j.jdent.2010.09.003
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发表时间：
2010-12
影响因子：
4.4
通讯作者：
DPBRN Collaborative Group
中科院分区：
文献类型：
--
作者：
Rindal DB;Gordan VV;Litaker MS;Bader JD;Fellows JL;Qvist V;Wallace-Dawson MC;Anderson ML;Gilbert GH;DPBRN Collaborative Group
(1)量化牙科实践研究网络（DPBRN）牙医在决定手术治疗原发性龋齿病变之前使用的诊断技术；(2)检查某些牙医、实践和患者特征是否与这些技术的使用有关。共有228名DPBRN牙医记录了3,751名患者因原发性龋齿病变而连续插入5,676个修复体的信息。医师-研究者平均放置24.9个（SD=12.4）个修复体。病变分为后近端、前近端、后咬合、后平滑或前平滑。用于诊断病变的技术分为临床评估、x线片和/或光学。统计分析利用广义混合模型方差分析来解释数据的层次结构。根据病变类别，最常用的诊断技术组合是临床评估加x线片后近端（47%）、临床评估前近端（51%）、临床评估后咬合（46%）、临床评估后平滑（77%）和临床评估前平滑（80%）。在调整牙医的聚类后，诊断技术与病变类别显著相关（p<0.0001）。这些结果是在实际的临床程序中获得的，而不是基于问卷的假设情景，量化了常规恢复性护理实际提供过程中最常用的诊断技术。诊断技术因病变种类而异，有一定的实践和患者特点。
To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. A total of 228 DPBRN dentists recorded information on 5,676 consecutive restorations inserted due to primary caries lesions on 3,751 patients. Practitioner-investigators placed a mean of 24.9 (SD=12.4) restorations. Lesions were categorized as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorized as clinical assessment, radiographs, and/or optical. Statistical analysis utilized generalized mixed-model ANOVA to account for the hierarchical structure of the data. By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p<0.0001). These results — obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios — quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics.
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