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英国牙体修复科顾问关于接受牙种植患者后续护理情况的调查

Survey of consultants in restorative dentistry in the UK regarding ongoing care of patients provided with dental implants.

作者信息

Beddis H P, Durey K A, Chan M F W Y

机构信息

Leeds Dental Institute, Department of Restorative Dentistry, Worsley Building, Clarendon Way, Leeds, LS2 9LU.

出版信息

Br Dent J. 2017 Aug 25;223(4):255-260. doi: 10.1038/sj.bdj.2017.711.

Abstract

Background Funding for implant-based treatment within secondary care is limited, and acceptance criteria are determined locally according to funding agreements with NHS England. Indefinite review of all patients in secondary care is unlikely to be feasible due to limitations on departmental capacity. The increasing number of patients provided with implant-based treatment in secondary care has resulted in a growing maintenance burden, raising the question of who should provide this care. Management of some complications within primary care would facilitate patients' access to treatment, although no specific provision for maintenance of implant-retained prostheses is made within the NHS Dental Charges Regulations.Materials and methods An online survey was carried out to review services provided within restorative dentistry departments across the UK, investigating departmental protocols for review and maintenance of patients provided with dental implants.Results There was no consensus view on review protocols, discharge or provision of maintenance following implant placement. Fifty-seven percent would indefinitely carry out remake of implant-retained overdentures when clinically indicated, replace worn inserts, housings or abutments. Sixty-one percent would manage loose/lost screw- or cement-retained restorations and 68% would manage fractured restorations. Re-referral for peri-implant disease would be accepted by 64% of respondents. The lack of clear NHS funding for the management of complications was of concern to respondents in this survey.

摘要

背景

二级医疗保健中基于种植体治疗的资金有限,接受标准根据与英国国民医疗服务体系(NHS)英格兰地区的资金协议在当地确定。由于部门能力的限制,对二级医疗保健中的所有患者进行无限期复查不太可行。二级医疗保健中接受基于种植体治疗的患者数量不断增加,导致维护负担日益加重,这就引发了应由谁来提供这种护理的问题。在初级医疗保健中处理一些并发症将有助于患者获得治疗,尽管NHS牙科收费规定中没有对种植体固位义齿的维护做出具体规定。

材料与方法

开展了一项在线调查,以评估英国各地修复牙科部门提供的服务,调查对接受牙种植体治疗患者的复查和维护部门协议。

结果

在种植体植入后的复查方案、出院或维护提供方面没有达成共识。57%的人会在临床指征明确时无限期地对种植体固位覆盖义齿进行重制,更换磨损的嵌体、基托或基台。61%的人会处理松动/丢失的螺丝固位或粘结固位修复体,68%的人会处理修复体折断问题。64%的受访者会接受因种植体周围疾病而再次转诊。本调查中的受访者担心NHS缺乏用于处理并发症的明确资金。

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