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牙医对其治疗牙脱位和牙根折断损伤能力的自我评估。

Dentists' self-estimation of their competence to treat avulsion and root fracture injuries.

作者信息

Skaare Anne B, Pawlowski Andrzej Adam, Maseng Aas Anne-Lise, Espelid Ivar

机构信息

Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.

Public Dental Health Service, Rogaland, Norway.

出版信息

Dent Traumatol. 2015 Oct;31(5):368-73. doi: 10.1111/edt.12186. Epub 2015 Jun 7.

Abstract

AIM

The purpose of this study was to evaluate the knowledge of Norwegian dentists on avulsion and root fracture injuries.

METHOD

An electronic questionnaire (QuestBack) was sent in 2012 to all dentists (n = 255) employed in the Public Dental Service (PDS) in three counties of Norway. The dentists were asked to state whether they felt they had sufficient competence to treat avulsion and root fractures immediately and long term. Based on international guidelines, the authors achieved a consensus for ideal treatment. Based on two cases, the clinicians were to assess their own competence. They were classified into either a 'sufficient competence' (SC) group or an 'insufficient competence' (ISC) group. The data were evaluated by descriptive statistics and chi-square bivariate analysis.

RESULTS

The response rate was 64%, 95 dentists (62%) in the SC group and 58 (38%) in the ISC group. Significantly more young dentists responded (P < 0.001). Correct treatment (reposition and splint) for a one-day-old fracture in the middle third of the root with luxation of the coronal fragment was chosen more often by the SC group compared with the ISC group (P = 0.03), but estimating the long-term prognosis, there was no difference (P = 0.14). In a case with a previous avulsion injury and obvious signs of pulp necrosis and external infection-related root resorption, the majority (n = 97, 63%) would choose root canal treatment with a Ca(OH)₂ dressing which was considered correct treatment, but fewer than half of the clinicians (40%) diagnosed the external infection related to root resorption which was visible on a radiograph. There was no difference between the groups (P = 0.81).

CONCLUSION

The study shows that overall knowledge among Norwegian dentists is good, but more knowledge on detecting and diagnosing external root resorption is needed. Self-estimation of own competence does not reflect level of knowledge.

摘要

目的

本研究旨在评估挪威牙医对牙脱位和牙根折断损伤的了解情况。

方法

2012年向挪威三个郡公共牙科服务机构(PDS)雇佣的所有牙医(n = 255)发送了一份电子问卷(QuestBack)。询问牙医他们是否觉得自己有足够的能力立即和长期治疗牙脱位和牙根折断。基于国际指南,作者达成了理想治疗的共识。基于两个病例,临床医生要评估自己的能力。他们被分为“足够能力”(SC)组或“能力不足”(ISC)组。数据通过描述性统计和卡方双变量分析进行评估。

结果

回复率为64%,SC组有95名牙医(62%),ISC组有58名(38%)。年轻牙医的回复明显更多(P < 0.001)。与ISC组相比,SC组更常选择对牙根中三分之一处一日龄骨折伴冠部碎片脱位进行正确治疗(复位和夹板固定)(P = 0.03),但在估计长期预后方面,两组没有差异(P = 0.14)。在一个有既往牙脱位损伤且有明显牙髓坏死和与外部感染相关的牙根吸收迹象的病例中,大多数(n = 97,63%)会选择用氢氧化钙敷料进行根管治疗,这被认为是正确的治疗方法,但不到一半的临床医生(40%)诊断出了在X线片上可见的与牙根吸收相关的外部感染。两组之间没有差异(P = 0.81)。

结论

该研究表明挪威牙医的总体知识水平良好,但在检测和诊断外部牙根吸收方面需要更多知识。对自身能力的自我评估并不能反映知识水平。

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