Al-Ali K, Marghalani H, Al-Yahya A, Omar R
Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Int Endod J. 2005 Jul;38(7):470-6. doi: 10.1111/j.1365-2591.2005.00973.x.
To test the applicability of Praxis Concept (PC) theory in endodontic re-treatment decision-making amongst dental students of similar backgrounds, but from two dental schools.
A total of 172 students from two dental schools (n = 97 and n = 75) were asked to select their management choices (from five possible options) for each of six variations on quality (by way of adequacy of root filling) and complexity (by way of absence or presence of a post) of a simulated radiograph of an anterior tooth. The six variations each had five possible levels of periapical condition, giving a total of 30 cases for which management choices were sought. Individual re-treatment preference scores (RPS) were obtained, from which school and gender differences were compared by t-test. The association between students' stated re-treatment propensities and the different cases was expressed as odds ratios using unconditional logistic regression analysis.
There were large inter-individual variations in RPS within the cases at both schools. Mean RPS for the group was 0.62 (SD 0.14), and did not differ between the schools (P = 0.44), but was significantly lower for males than females (P = 0.01). For all participants and a given case, if re-treatment was proposed for a particular size of lesion, then all larger lesions for that case were also marked for re-treatment. Presence of a defective root filling or overfilling reflected a greater propensity for re-treatment than when the root filling was adequate, whilst the absence/presence of a post had no clear effect on re-treatment choices.
The findings support the explanatory potential of PC theory in endodontic re-treatment decision-making in the group investigated, and suggest that factors besides disease status alone, may contribute to the choices that clinicians make.
测试实践概念（PC）理论在背景相似但来自两所牙科学院的牙科学生进行根管再治疗决策中的适用性。
来自两所牙科学院（n = 97和n = 75）的172名学生被要求针对一颗前牙模拟X光片在质量（通过根充的充分性）和复杂性（通过有无桩）方面的六种变化，从五个可能的选项中选择各自的处理方案。这六种变化每种都有五种可能的根尖周状况水平，总共30个病例需要做出处理选择。获得了个体再治疗偏好分数（RPS），通过t检验比较学校和性别差异。使用无条件逻辑回归分析将学生陈述的再治疗倾向与不同病例之间的关联表示为比值比。
两所学校的病例中，个体间RPS存在很大差异。该组的平均RPS为0.62（标准差0.14），两所学校之间无差异（P = 0.44），但男性显著低于女性（P = 0.01）。对于所有参与者和给定病例，如果针对特定大小的病变提出再治疗，那么该病例中所有更大的病变也会被标记为再治疗。存在根充缺陷或超充比根充适当时反映出更高的再治疗倾向，而有无桩对再治疗选择没有明显影响。
研究结果支持PC理论在本研究群体根管再治疗决策中的解释潜力，并表明除疾病状态外，其他因素可能影响临床医生的选择。
