基于实践的口腔研究网络中牙医对咬合面原发性龋齿的修复治疗阈值。
Restorative treatment thresholds for occlusal primary caries among dentists in the dental practice-based research network.
机构信息
Department of Operative Dentistry, College of Dentistry, Health Science Center, University of Florida, PO Box 100415, Gainesville, Fla. 32610-0415, USA.
出版信息
J Am Dent Assoc. 2010 Feb;141(2):171-84. doi: 10.14219/jada.archive.2010.0136.
UNLABELLED
OBJECTIVES. The authors report on a study aimed at quantifying the carious lesion depths at which dentists intervene surgically for cases of varying caries penetration and caries risk. They also aimed to identify characteristics that are associated with surgical intervention.
METHODS
The investigators surveyed dentists enrolled in a dental practice-based research network who reported performing at least some restorative dentistry. In the survey, dentists were asked to indicate whether they would intervene surgically in a series of cases involving occlusal caries. Each case presentation included a photograph of an occlusal surface displaying typical characteristics of caries penetration and a written description of a patient at a specific level of risk of developing caries. Using logistic regression, the authors analyzed associations between surgical treatment with dentists' and practices' characteristics and patients' caries risk levels.
RESULTS
A total of 517 DPBRN practitioner-investigators responded to the questionnaire. Sixty-three percent of the respondents (326 of 517) indicated that in patients at low risk of developing caries, they would surgically restore teeth with lesions located in inner enamel surfaces and 90 percent would surgically restore teeth with lesions located in outer dentin surfaces. Regarding patients with a high risk of developing caries, 77 percent (398 of 517) of the respondents reported that they would surgically restore inner enamel lesions, and 94 percent (486 of 517) reported that they would restore lesions located on the outer dentin surface. Dentists who did not assess caries risk were more likely than dentists who did assess risk to intervene with dentinal lesions (P = .004). Practitioner-investigators who were in solo practice or a private practice with fewer than four dentists were significantly more likely to intervene surgically with enamel lesions than were dentists in large group practices (those with four or more dentists) (P < .001).
目的
作者报告了一项研究，旨在量化在不同龋穿透和龋风险水平下牙医进行手术干预的龋齿病变深度。他们还旨在确定与手术干预相关的特征。
方法
研究人员调查了参加基于牙科实践的研究网络的牙医，这些牙医报告至少进行了一些修复性牙科治疗。在调查中，牙医被要求指出他们是否会对一系列涉及咬合面龋的病例进行手术干预。每个病例介绍都包括一张显示龋穿透典型特征的咬合面照片和一份描述特定龋风险水平患者的书面描述。研究人员使用逻辑回归分析了手术治疗与牙医和实践特征以及患者龋风险水平之间的关联。
结果
共有 517 名 DPBRN 从业者调查员对问卷做出了回应。63%的受访者（517 名中的 326 名）表示，在患龋风险低的患者中，他们会对位于内釉质表面的病变进行手术修复，90%的患者会对位于外牙本质表面的病变进行手术修复。对于患龋风险高的患者，77%（517 名中的 398 名）的受访者表示他们会对位于内釉质的病变进行手术修复，94%（517 名中的 486 名）表示他们会对位于外牙本质表面的病变进行手术修复。不评估龋风险的牙医比评估风险的牙医更有可能对牙本质病变进行干预（P=.004）。单独执业或牙医人数少于 4 人的私人执业从业者比在拥有 4 名或更多牙医的大型团体实践中的牙医更有可能对釉质病变进行手术干预（P<.001）。
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