Mejàre I, Sundberg H, Espelid I, Tveit B
Eastman Dental Institute, Stockholm County Council, Sweden.
Acta Odontol Scand. 1999 Jun;57(3):149-54. doi: 10.1080/000163599428887.
The aim was to study any variability in approximal and occlusal caries diagnoses and restorative treatment decisions among Swedish dentists. The material consisted of a pre-coded questionnaire sent to a random sample of 923 dentists with 4 items concerning approximal and occlusal caries diagnosis and restorative treatment decisions. Responses were received from 651 (70.5%) dentists. In an adolescent with low caries activity and good oral hygiene, more than 90% of the dentists stated that they would not automatically restore a primary approximal caries lesion if its radiographic appearance did not show obvious progression in the outer 1/3 to 1/2 of the dentin. Moreover, 67% of the dentists would only consider immediate restorative treatment of an occlusal surface if obvious cavitation and/or radiographic signs of dentin caries could be observed. When diagnosing questionable occlusal caries, the dentists largely relied on the radiographic appearance. Concerning both approximal and occlusal caries, the threshold for restorative treatment differed between the metropolitan regions in Sweden, and younger more often than older dentists would postpone restorative treatment of approximal caries until the lesion had reached a relatively advanced stage of progression. The responses also showed that dentists in private practice would restore approximal caries at an earlier stage of progression than the dentists in the Public Dental Health Service.
目的是研究瑞典牙医在邻面和咬合面龋病诊断以及修复治疗决策方面的差异。研究材料是一份预编码问卷，随机发送给923名牙医，问卷包含4个与邻面和咬合面龋病诊断及修复治疗决策相关的问题。共收到651名（70.5%）牙医的回复。对于龋病活动度低且口腔卫生良好的青少年，如果邻面龋损的X线片显示牙本质外层1/3至1/2没有明显进展，超过90%的牙医表示不会自动对原发性邻面龋损进行修复。此外，只有在能观察到明显的龋洞形成和/或牙本质龋的X线征象时，67%的牙医才会考虑对咬合面进行即刻修复治疗。在诊断可疑的咬合面龋时，牙医很大程度上依赖于X线片表现。关于邻面龋和咬合面龋，瑞典各都市地区的修复治疗阈值存在差异，而且年轻牙医比年长牙医更常将邻面龋的修复治疗推迟到龋损发展到相对较晚期阶段。回复还表明，私人执业牙医会比公共牙科保健服务机构的牙医在龋损进展的更早阶段对邻面龋进行修复。
