乳牙深邻面龋损的修复治疗决策

Restorative treatment decisions for deep proximal carious lesions in primary molars.

作者信息

Qudeimat M A, Al-Saiegh F A, Al-Omari Q, Omar R

机构信息

Dept. Developmental and Preventive Sciences, Kuwait University, Kuwait.

出版信息

Eur Arch Paediatr Dent. 2007 Mar;8(1):37-42. doi: 10.1007/BF03262568.

DOI:10.1007/BF03262568

PMID:17394889

Abstract

AIM

To assess clinicians' individual variables that might influence decision-making for the restoration of deep proximal carious lesions in primary molars.

METHODS

A pre-coded questionnaire that sought participants' treatment choices for a deeply carious second mandibular primary molar, as depicted in a simulated periapical radiograph, along with a specific clinical scenario, was distributed among a random sample of 157 dentists and 15 paediatric dentists. Participants were asked to answer questions. After combining the pulpotomy and pulpectomy treatment choices under a 'pulp therapy' category, a binary dependent variable was constructed. Logistic regression of the ratio of the participants who would restore the questioned tooth by a method in question, was run.

RESULTS

A total of 155 dentists (116 males and 39 females) completed the survey, giving a response rate of 90%. Of these 53% of dentists recommended pulpotomy followed by definitive restoration and 39% recommended removal of caries and restoration without pulp therapy. In the logistic regression model, males and graduates of English language undergraduate dental programs had higher probabilities of restoring without prior pulp therapy (p<0.03 and p<0.02, respectively). Compared with graduates of Asian programs, dentists who graduated from Eastern Europe and the Middle East, showed lower likelihoods of restoring the tooth without prior pulp therapy (p<0.01 and p<0.004, respectively). Dentists who treated an average of 6-16 child patients during a week had a lower probability of restoring the tooth without prior pulp therapy than those who were not currently involved in treating children (p<0.01). No other measured variables were associated with participant's treatment choices.

CONCLUSIONS

The lack of agreement among dentists regarding their optimal treatment recommendations for deep proximal carious lesions appears to be due mainly to inter-individual, educational, training and practice characteristic factors.

摘要

目的

评估可能影响乳牙深近中龋损修复决策的临床医生个体变量。

方法

一份预先编码的问卷被分发给157名牙医和15名儿童牙医的随机样本，问卷中询问了参与者对于一张模拟根尖片所示的下颌第二乳磨牙深龋的治疗选择，以及一个特定的临床场景。参与者被要求回答问题。在将牙髓切断术和牙髓摘除术的治疗选择合并到“牙髓治疗”类别下后，构建了一个二元因变量。对采用所讨论方法修复患牙的参与者比例进行逻辑回归分析。

结果

共有155名牙医（116名男性和39名女性）完成了调查，回复率为90%。其中，53%的牙医推荐牙髓切断术然后进行最终修复，39%的牙医推荐去除龋坏组织并在不进行牙髓治疗的情况下进行修复。在逻辑回归模型中，男性和英语本科牙科专业毕业生在不进行牙髓治疗的情况下进行修复的概率更高（分别为p<0.03和p<0.02）。与亚洲项目的毕业生相比，毕业于东欧和中东地区的牙医在不进行牙髓治疗的情况下修复患牙的可能性较低（分别为p<0.01和p<0.004）。每周平均治疗6 - 16名儿童患者的牙医在不进行牙髓治疗的情况下修复患牙的概率低于那些目前不参与儿童治疗的牙医（p<0.01）。没有其他测量变量与参与者的治疗选择相关。