Gordan Valeria V, Riley Joseph, Geraldeli Saulo, Williams O Dale, Spoto Joseph C, Gilbert Gregg H
Tex Dent J. 2015 Jul;132(7):448-58.
To evaluate how restoration characteristics are associated with the decision to repair or replace an existing restoration. The following hypotheses were studied: dentists who placed the original restoration are more likely to repair instead of replace restorations (H1) that are in molar teeth; (H2) that are in the upper arch; (H3) that have amalgam restorative material; (H4) if a fracture is not the primary reason for the defect; and (H5) when the restoration comprises more than one surface.
This cross-sectional study used a consecutive patient/restoration recruitment design. 194 dentists members of a dental practice-based research network recorded data on restorations in permanent teeth that needed repair or replacement.
For 6,623 of the 8,770 defective restorations in 6,643 patients, the treatment was provided by the dentist who had not placed the original restoration (75%). The 2-way interaction revealed that dentists who had placed the original restoration often chose to repair when the defective restoration was in a molar, relative to premolar or anterior teeth (OR = 2.2, p <.001); and chose to replace when the restoration had amalgam (OR = 0.5, p < .001), and when it was a fracture compared to another reason (OR = 0.8, p = 001).
Most dentists are not conservative when they revisit a restoration that they originally placed regardless of type of failure, number of surfaces or material used. However, dentists who had placed the original restoration were significantly more likely to repair it when the defective restoration was in a molar tooth.
Most dentists who placed the original restoration were prone to replace it, however if the defective restoration was located in a molar tooth they would consider repairing it.
评估修复体特征与修复或替换现有修复体决策之间的关联。研究了以下假设：放置原始修复体的牙医更有可能修复而非替换磨牙中的修复体（假设1）；上颌牙中的修复体（假设2）；使用汞合金修复材料的修复体（假设3）；如果骨折不是缺损的主要原因（假设4）；以及修复体包含多个表面时（假设5）。
这项横断面研究采用连续患者/修复体招募设计。一个基于牙科实践的研究网络的194名牙医成员记录了恒牙中需要修复或替换的修复体数据。
在6643名患者的8770个有缺陷的修复体中，6623个修复体（75%）由未放置原始修复体的牙医进行治疗。双向交互分析显示，放置原始修复体的牙医在缺损修复体位于磨牙时，相对于前磨牙或前牙，通常更倾向于修复（优势比=2.2，p<.001）；当修复体使用汞合金时（优势比=0.5，p<.001），以及当缺损原因是骨折而非其他原因时（优势比=0.8，p = 001），则更倾向于替换。
大多数牙医在重新审视他们最初放置的修复体时并不保守，无论失败类型、表面数量或使用的材料如何。然而，放置原始修复体的牙医在缺损修复体位于磨牙时，显著更有可能修复它。
大多数放置原始修复体的牙医倾向于替换它，然而，如果缺损修复体位于磨牙，他们会考虑修复。
