Korduner E-K, Collin Bagewitz I, Vult von Steyern P, Wolf E
Department of Prosthetic Dentistry, Public Dental Health Service, Malmö, Sweden.
Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden.
J Oral Rehabil. 2016 Dec;43(12):967-976. doi: 10.1111/joor.12432. Epub 2016 Sep 16.
The aim of this investigation was to study the clinical prosthodontic decision-making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in-depth, semi-structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients' needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision-making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues' or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision-making more than the SDA concept. The conflicting results in the prosthetic decision-making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentist's own clinical practice.
本调查的目的是研究瑞典普通牙科医生(GDPs)针对磨牙受损牙列的临床修复决策过程。我们有目的地挑选了11名瑞典GDPs,他们均同意参与。随后,我们进行了深入的半结构化访谈,内容涵盖了对两个真实患者病例的治疗考量,起初是完整牙弓的情况,之后讨论了基于短牙弓(SDA)的最终治疗方案。这些病例涉及主要位于磨牙区牙齿受损的患者。一名患者患有广泛龋齿,另一名患有严重牙周病。我们采用定性内容分析法对数据进行分析。在系统分析中,确定了两个主要类别:整体方法和功能方法。在接受访谈的GDPs中,重点关注患者的需求、背景病史、治疗动机以及磨牙支持的保留情况。在本研究的局限性范围内,可以得出以下结论:保留带有磨牙的牙弓对瑞典普通牙科医生似乎很重要。SDA概念似乎对磨牙受损牙列的修复决策没有实质性影响。与SDA概念相比,牙医的经验、同事或咨询专家的建议以及病因因素和患者的个体情况对决策的影响更大。修复决策过程中关于年龄相关性和磨牙支持需求的相互矛盾的结果需要进一步调查,例如基于牙医自身临床实践中做出的决策。