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职业经验能保住牙齿吗?——一项对修复牙科医生的调查。

Does professional experience save teeth? A survey among prosthodontists.

机构信息

Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany.

Department of Reconstructive Dentistry and Temporomandibular Disorders, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland.

出版信息

Clin Oral Investig. 2018 Mar;22(2):1001-1008. doi: 10.1007/s00784-017-2180-5. Epub 2017 Jul 20.

Abstract

OBJECTIVES

The aim of this study is to investigate the effect of clinical experience and educational background on clinical decision-making of dentists presented with two prosthodontic cases.

METHODS

A questionnaire-based survey was performed among 66 prosthodontists who were divided into two groups. The first group included clinicians from Belgium, Germany, and the Netherlands covering a wide spectrum of dental experience. The second (specialized) group consisted of German dentists performing their last module of a 3-year postgraduate master program in prosthodontics. Two patient scenarios of different complexities were presented to the participants who were asked to make an educated choice among seven therapeutic options.

RESULTS

Sixty-six dentists participated. For case #1, 22 therapeutic suggestions were offered within the international group (variation 54%), while 17 options were chosen in the specialized group (variation 68%). For case #2, five (variation 12%) and four (variation 16%) different therapeutic options were planned in the groups, respectively. Treatment planning in combination with implants was clearly preferred by dentists with an experience of 20 years or less. Conversely, participants with more experience favored more conventional treatments. All differences were statistically significant (p < 0.05).

CONCLUSION

Clinicians' experience and educational background had a clinically relevant influence on decision-making and treatment planning. A clear preference for implant-free therapies was noted for dentists with more than two decades of professional experience.

CLINICAL SIGNIFICANCE

In complex cases, clinicians with more than 20 years of professional experience tend to save questionable teeth rather than to resort to implants. This interindividual variation might less likely occur when more external evidence is taken into account during the decision-making process.

摘要

目的

本研究旨在探讨临床经验和教育背景对两位修复医生临床决策的影响。

方法

对来自比利时、德国和荷兰的一组经验广泛的临床医生和正在进行为期 3 年的口腔修复学研究生课程最后一模块的德国牙医进行了基于问卷的调查。向参与者呈现了两个不同复杂程度的患者病例,并要求他们在七个治疗选择中做出明智的选择。

结果

共有 66 名牙医参与了研究。对于病例 #1,国际组提出了 22 种治疗建议(变化率为 54%),而专科组选择了 17 种治疗建议(变化率为 68%)。对于病例 #2,两组分别计划了五个(变化率为 12%)和四个(变化率为 16%)不同的治疗选择。有 20 年或以上经验的牙医明显更倾向于将种植体结合治疗作为治疗方案。相比之下,经验更丰富的参与者更倾向于更传统的治疗方法。所有差异均具有统计学意义(p < 0.05)。

结论

临床医生的经验和教育背景对决策和治疗计划有临床相关的影响。具有 20 年以上专业经验的牙医明显更倾向于选择无种植体的治疗方法。

临床意义

在复杂病例中,具有 20 年以上专业经验的临床医生倾向于保留有问题的牙齿,而不是选择种植体。当在决策过程中考虑更多外部证据时,这种个体间的差异可能会减少。

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