Doméjean Sophie, Grosgogeat Brigitte
Monogr Oral Sci. 2018;27:137-145. doi: 10.1159/000487840. Epub 2018 May 24.
This chapter aims to discuss the way dental practitioners manage deep carious lesions (DCL) in routine practice and the barriers and incentives/facilitators to changes in accepted practice. In concert with the philosophy of minimal intervention dentistry, the concept of quaternary prevention (actions taken to prevent overtreatment and reduce harm to the patient) emerges in dentistry. This can be applied to carious tissue removal (CTR) in DCL given the risks associated with this procedure (high risk of pulp exposure, pulpal complications, tooth substance loss, and unsuccessful invasive, expensive outcomes). Recently conducted questionnaire surveys show that a gap exists between research findings and professional practices in relation to DCL management. It is, therefore, important to identify the barriers to the implementation of evidence-based dentistry into dental practices for the management of DCL in order to create appropriate corrective interventions to encourage practitioners in the use of selective CTR as a procedure.
本章旨在探讨牙科医生在日常实践中处理深龋病变(DCL)的方式,以及改变公认做法的障碍和激励因素/促进因素。与微创牙科理念相一致,牙科领域出现了四级预防(采取行动防止过度治疗并减少对患者的伤害)的概念。鉴于该操作存在相关风险(牙髓暴露、牙髓并发症、牙体组织丧失以及侵入性、昂贵的治疗结果失败的高风险),这一概念可应用于深龋病变中的龋坏组织去除(CTR)。最近进行的问卷调查显示,在深龋病变管理方面,研究结果与专业实践之间存在差距。因此,识别将循证牙科应用于牙科实践以管理深龋病变的障碍非常重要,以便制定适当的纠正干预措施,鼓励从业者将选择性龋坏组织去除作为一种操作方法。