Kvist Thomas, Heden Gunnar, Reit Claes
Department of Endodontology, Faculty of Odontology, Sahlgrenska Academy, Göteborg University, Gothenburg, Sweden.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Apr;97(4):502-7. doi: 10.1016/j.tripleo.2003.09.006.
Root-filled teeth with persistant periapical radiolucencies are often classified as endodontic failures. Studies have shown that general dental practitioners (GDP) do not consistantly suggest retreatment of "failures." The "Praxis Concept" (PC) theory hypothesizes that dentists conceive periapical health and disease as different states on a continuum. This study examined endodontic retreatment concepts among 157 GDPs from Värmland, Sweden.
In 6 simulated cases the periapical condition, quality of root filling and presence of a root canal-retained post were systematically varied. Five options were offered: no therapy, wait and see, nonsurgical retreatment, surgical retreatment, and extraction.
The investigation showed large interindividual variation in retreatment behavior among the GDPs. Only 9 dentists (6%) where found to repeatedly suggest retreatment of endodontic failures. A majority of GDPs (79%) performed in accordance with PC.
The data indicate that several retreatment decision rules are used by Swedish GDPs, but PC-derived strategies attract the majority.
根尖周持续存在透射影的根管充填牙通常被归类为根管治疗失败。研究表明,普通牙科医生(GDP)并不总是建议对“失败”病例进行再治疗。“实践概念”(PC)理论假设,牙医将根尖周健康和疾病视为连续统一体上的不同状态。本研究调查了瑞典韦姆兰地区157名普通牙科医生的根管再治疗观念。
在6个模拟病例中,根尖周状况、根管充填质量和根管内桩的存在情况被系统地改变。提供了5种选择:不治疗、观察、非手术再治疗、手术再治疗和拔牙。
调查显示,普通牙科医生在再治疗行为上存在很大的个体差异。仅发现9名牙医(6%)反复建议对根管治疗失败病例进行再治疗。大多数普通牙科医生(79%)的行为符合PC理论。
数据表明,瑞典普通牙科医生使用多种再治疗决策规则,但源自PC理论的策略吸引了大多数人。