Gordan Valeria V, Garvan Cynthia W, Heft Marc W, Fellows Jeffrey L, Qvist Vibeke, Rindal D Brad, Gilbert Gregg H
College of Dentistry, Department of Operative Dentistry, University of Florida, Gainesville, FL, USA.
Gen Dent. 2009 Nov-Dec;57(6):654-63; quiz 664-6, 595, 680.
This study sought to quantify the depths of proximal caries lesions that lead dentists in regular clinical practice to intervene restoratively, based on hypothetical scenarios that present radiographic images and patient background information, and to identify characteristics associated with restorative intervention in lesions that have penetrated only the enamel surface. This study surveyed dentists from the Dental Practice-Based Research Network (DPBRN) who had reported doing at least some restorative dentistry (n = 901). Dentists were asked to indicate the depth at which they would restore a lesion, based on a series of radiographic images depicting interproximal caries at increasing lesion depths in a mandibular premolar; in addition, the dentists were questioned regarding two caries risk scenarios: one involving a patient with low caries risk and another involving a patient at higher risk. Logistic regression was used to analyze associations between the decision to intervene restoratively and specific dentist, practice, and patient characteristics. Of the 901 DPBRN practitioner-investigators, 500 (56%) completed the survey. For a high caries risk patient, 66% of respondents indicated that they would restore a proximal enamel lesion, while 24% would do so once the lesion had reached into the outer third of the dentin. For a low caries risk patient, 39% of respondents reported that they would restore an enamel lesion, and 54% would do so once the lesion had reached into the outer third of the dentin. In multivariate analyses that accounted for dentist and practice characteristics, dentists in large group practices were less likely to intervene surgically for enamel caries, regardless of patient's caries risk.
本研究旨在根据呈现放射影像和患者背景信息的假设情景，量化在常规临床实践中促使牙医进行修复干预的邻面龋损深度，并确定仅累及釉质表面的龋损中与修复干预相关的特征。本研究对来自基于牙科实践的研究网络（DPBRN）且报告至少从事一些修复牙科工作的牙医进行了调查（n = 901）。要求牙医根据一系列描绘下颌前磨牙邻面龋损深度不断增加的放射影像，指出他们会对龋损进行修复的深度；此外，还就两种龋病风险情景对牙医进行了询问：一种涉及龋病风险低的患者，另一种涉及龋病风险高的患者。采用逻辑回归分析修复干预决策与特定牙医、诊所及患者特征之间的关联。在901名DPBRN从业者 - 研究者中，500名（56%）完成了调查。对于龋病风险高的患者，66%的受访者表示他们会修复邻面釉质龋损，而24%的受访者表示一旦龋损累及牙本质外三分之一就会进行修复。对于龋病风险低的患者，39%的受访者报告他们会修复釉质龋损，54%的受访者表示一旦龋损累及牙本质外三分之一就会进行修复。在考虑了牙医和诊所特征的多变量分析中，大型团体诊所的牙医无论患者的龋病风险如何，对釉质龋进行手术干预的可能性都较小。
