Gilmour Alan S M, Latif Mudasser, Addy Liam D, Lynch Christopher D
Cardiff University School of Dentistry, Health Park, Cardiff, UK.
Int Dent J. 2009 Jun;59(3):148-54.
To investigate the range of techniques used by U.K. general dental practitioners when placing posterior composites, their attitudes and opinions and problems encountered.
A pre-piloted questionnaire was distributed to 500 UK GDPs selected at random from the U.K. Dentists Register requesting specific information on attitudes, use and problems encountered in relation to posterior composite placement.
254 useable replies were returned (response rate= 51%). Over 95% of respondents would consider placing posterior composites, but only 33% (n=84) would regularly or often place composite in the occlusal surface of a molar tooth. 62% of respondents (n=157) are influenced by articles in peer-reviewed journals when deciding to place a posterior composite, while 95% (n=241) reported that they are not influenced by advertising. Techniques for managing operatively exposed dentine vary, and are related to the depth of the dentine cavity: 79% (n=201) use a 'dentine-bonding' technique (i.e., no base/liner) approach for shallow cavities, while only 9% (n=23) would consider this approach for a deep dentine cavity. Only 10% of respondents (n=25) use a sectional metal matrix system for restoring occlusoproximal cavities, while 29% (n=74) use transparent matrix systems, and 61% (n=155) use a circumferential metal matrix system. More than one-half (52%, n=132) of practitioners reported they experienced problems with food packing in more than one in four posterior composites placed.
Despite having been previously discouraged by financial guidelines and with probable limited exposure to posterior composite instruction at dental school, U.K. GDPs are placing posterior composites with reasonable reference to current best available evidence. Diverse opinions exist on the management of certain clinical scenarios, such as of operatively exposed dentine.
调查英国普通牙科医生在后牙复合树脂充填时所采用的技术范围、他们的态度和观点以及遇到的问题。
一份预先试点的问卷被分发给从英国牙医注册名录中随机选取的500名英国普通牙科医生，询问有关后牙复合树脂充填的态度、使用情况及遇到的问题的具体信息。
共收到254份有效回复（回复率 = 51%）。超过95%的受访者会考虑进行后牙复合树脂充填，但只有33%（n = 84）会经常或频繁地在磨牙的咬合面进行复合树脂充填。62%的受访者（n = 157）在决定进行后牙复合树脂充填时会受到同行评审期刊文章的影响，而95%（n = 241）报告称他们不受广告影响。处理手术暴露牙本质的技术各不相同，且与牙本质洞深度有关：79%（n = 201）对浅洞采用“牙本质粘结”技术（即不使用垫底材料/衬层），而对于深牙本质洞只有9%（n = 23）会考虑这种方法。只有10%的受访者（n = 25）使用分段金属基质系统修复邻面洞，而29%（n = 74）使用透明基质系统，61%（n = 155）使用环形金属基质系统。超过一半（52%，n = 132）的从业者报告称，他们在四分之一以上的后牙复合树脂充填中遇到食物嵌塞问题。
尽管此前受到财务指南的阻碍，且在牙科学校接受后牙复合树脂充填指导的机会可能有限，但英国普通牙科医生在进行后牙复合树脂充填时会合理参考当前可得的最佳证据。对于某些临床情况的处理，如手术暴露牙本质的处理，存在不同观点。
