Dahlström L, Molander A, Reit C
Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg and Public Dental Service, Region Västra Götaland, Sweden.
Eur J Dent Educ. 2015 Feb;19(1):23-30. doi: 10.1111/eje.12097. Epub 2014 Mar 20.
The aim of the study was to test the hypothesis that a further education programme relating to nickel-titanium rotary instrumentation (NTRI), with the concurrent activation of social/professional networks amongst all general dental practitioners (GDPs) in a public dental service in Sweden, would increase the adoption rate and improve root-filling quality.
To activate the networks, the GDPs at the 25 clinics elected training coaches from amongst themselves. The coaches were educated by a specialist and were then free to organise and conduct the training of the local GDPs. However, collective hands-on training and discussions were mandatory. Lectures were held by an endodontist. The rate of adoption and root-filling quality was evaluated just before and 6 months after the education. Statistical tests were performed with chi-square using a 95% confidence interval.
Nickel-titanium rotary instrumentation was adopted by 88%. Excellent root fillings (score 1) increased from 45% to 59% (P = 0.003). The rate of poor-quality root fillings (score 4 and score 5) was not affected. The quality ratio (score 1/score 5) increased from 5.36 (118/22) to 9.5 (133/14). Eleven dentists (17%) at nine different clinics produced 49% of the poor-quality root fillings (score 4 and score 5). Seventy-three per cent of these dentists stated that they had adopted NTRI.
The introduction of NTRI will increase the adoption rate and the frequency of good-quality root fillings. However, it will not overcome the problems associated with dentists producing a low-quality level, even if a local professional network is activated.
本研究的目的是检验以下假设：在瑞典公共牙科服务机构中，开展一项与镍钛旋转器械（NTRI）相关的继续教育项目，并同时激活所有普通牙科医生（GDPs）之间的社会/专业网络，这将提高采用率并改善根管充填质量。
为激活网络，25家诊所的GDPs从他们自己当中选出培训教练。这些教练由一位专家进行培训，然后可以自由组织并对当地的GDPs进行培训。然而，集体实践培训和讨论是强制性的。由一位牙髓病医生进行讲座。在教育前和教育后6个月评估采用率和根管充填质量。使用卡方检验进行统计分析，置信区间为95%。
镍钛旋转器械的采用率为88%。优秀根管充填（评分为1）从45%增加到59%（P = 0.003）。质量差的根管充填（评分为4和5）的比例未受影响。质量比（评分1/评分5）从5.36（118/22）增加到9.5（133/14）。9家不同诊所的11名牙医（17%）产生了49%的质量差的根管充填（评分为4和5）。这些牙医中有73%表示他们采用了NTRI。
引入NTRI将提高采用率和高质量根管充填的频率。然而，即使激活了当地的专业网络，它也无法克服与低质量水平牙医相关的问题。
