Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network
Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network
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DOI：
10.14219/jada.archive.2012.0238
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发表时间：
2012-06-01
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.;Riley, Joseph L., III;Gilbert, Gregg H.
背景作者的目的是确定牙科实践为基础的研究网络（DPBRN）的牙医是否更有可能修复或更换他们诊断为有缺陷的修复体;量化牙医修复或更换修复体的具体原因;为了验证某个牙医患者和置换相关变量与修复和置换置换之间的决定相关。这项横断面研究采用连续的患者和修复体招募设计。从业者-研究者（P-Is）记录了需要修复或更换的恒牙中连续观察到的牙齿缺失的数据。DPBRN是美国和斯堪的纳维亚半岛的牙科医生和牙科组织的联盟。收集的数据包括修复或替换的主要原因、涉及的牙面、使用的修复材料和患者的人口学信息。P-Is在197个实践中收集了7，502名患者的9，484例复发数据。75%（7，073）的设备被更换，25%（2，411）的设备被修复。继发龋是治疗的主要原因（43%，n = 4，124）。与修复体修复与更换修复体的可能性更大相关的因素（P <0.05）包括最近从牙科学校毕业，在一个大的团体实践中执业，是放置原始修复体的牙医，患者年龄较大，原始修复材料不是汞合金，磨牙修复体和原始修复体涉及的牙面较少。DPBRN牙医更有可能更换而不是修复牙列。继发龋是修复或更换牙本质的最常见原因。某些与牙医、患者和矫正相关的变量与修复或更换的决定相关。为现有修复体选择微创治疗是至关重要的，因为它可能会影响牙齿的寿命。
Background. The authors aimed to determine whether dentists in practices belonging to The Dental Practice-Based Research Network (DPBRN) were more likely to repair or to replace a restoration that they diagnosed as defective; to quantify dentists' specific reasons for repairing or replacing restorations; and to test the hypothesis that certain dentist-, patient- and restoration-related variables are associated with the decision between repairing and replacing restorations.Methods. This cross-sectional study had a consecutive patient and restoration recruitment design. Practitioner-investigators (P-Is) recorded data for consecutively seen restorations in permanent teeth that needed repair or replacement. The DPBRN is a consortium of dental practitioners and dental organizations in the United States and Scandinavia. The collected data included the primary reason for repair or replacement, tooth surface or surfaces involved, restorative materials used and patients' demographic information.Results. P-Is collected data regarding 9,484 restorations from 7,502 patients in 197 practices. Seventy-five percent (7,073) of restorations were replaced and 25 percent (2,411) repaired. Secondary caries was the main reason (43 percent, n = 4,124) for treatment. Factors associated with a greater likelihood of repairing versus replacing restorations (P < .05) included having graduated from dental school more recently, practicing in a large group practice, being the dentist who placed the original restoration, patient's being of an older age, the original restorative material's being something other than amalgam, restoration of a molar and the original restoration's involving fewer tooth surfaces.Conclusions. DPBRN dentists were more likely to replace than to repair restorations. Secondary caries was the most common reason for repairing or replacing restorations. Certain dentist-, patient- and restoration-related variables were associated with the repair-or-replace decision.Clinical Implications. The selection of minimally invasive treatment for an existing restoration is critical, as it may affect the longevity of the tooth.