Professor/Consultant in Restorative Dentistry, University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland.
Research Fellow, Warwick Medical School, Warwick University, Coventry.
Br Dent J. 2018 Aug 10;225(3):229-234. doi: 10.1038/sj.bdj.2018.541.
The aim of this study was to investigate the reasons for placement and replacement of crowns in general dental practice.
Forty general dental practitioners recorded the principal reason for the provision of new (initial) and replacement crowns for a maximum of up to 20 patients over a 20-week period.
A total of 664 patients received 783 crowns during the period of this study. Of these, 69% (n = 542) were new (initial) placements and 31% (n = 241) were replacements. Overall, tooth fracture (45%, n = 241) was the most frequently reported reason for new/ initial crown placements. Aesthetics (21%, n = 53) and secondary/recurrent caries (20%; n = 47) were the most frequent reasons for crown replacement. Maxillary premolars (27%, n = 145) and mandibular molars (25%, n = 137) were the teeth that received most initial crown placements. In contrast, maxillary incisors (50%, n = 115) were the most common teeth to receive a replacement crown. Dentists were more likely to replace a crown if they had not placed the original crown: 74% of replacement crowns (n = 178) were placed by a different dentist. Most patients had only one crown placed or replaced per course of treatment (n = 611; 90%).
The results of this study reveal the prescribing habits of dentists in relation to provision of initial and replacement crowns. The vast majority of patients had only one crown provided per course of treatment, which is probably a reflection of funding schemes and changing patterns of oral health. This sample reported fewer replacement crowns than previous studies. In keeping with existing literature, crowns were more frequently replaced when the treating dentist had not placed the initial crown. However, against this, more replacements were provided for more long-standing patients (5+ years attendance) compared to those with shorter attendance history (<5 years). In an area where high quality evidence is lacking, further consensus on the need for placement and replacement crowns is needed. Such information would assist dentists to provide high-quality care and commissioners in developing an evidence-based service.
本研究旨在探讨一般牙科实践中牙冠修复和更换的原因。
40 名普通牙科医生在 20 周内为最多 20 名患者记录新（初始）牙冠和更换牙冠的主要原因。
在本研究期间，共有 664 名患者接受了 783 个牙冠。其中，69%（n=542）为新（初始）放置，31%（n=241）为更换。总体而言，牙折（45%，n=241）是新/初始牙冠放置最常报告的原因。美观（21%，n=53）和继发/复发性龋（20%；n=47）是更换牙冠的最常见原因。上颌前磨牙（27%，n=145）和下颌磨牙（25%，n=137）是接受初始牙冠放置最多的牙齿。相比之下，上颌切牙（50%，n=115）是最常见的更换牙冠的牙齿。如果牙医没有放置原始牙冠，他们更有可能更换牙冠：74%的更换牙冠（n=178）由不同的牙医放置。大多数患者在一次治疗过程中只放置或更换一个牙冠（n=611；90%）。
本研究结果揭示了牙医在提供初始和更换牙冠方面的处方习惯。绝大多数患者每次治疗只接受一个牙冠，这可能反映了资金计划和口腔健康模式的变化。与以前的研究相比，本样本报告的更换牙冠数量较少。与现有文献一致，当治疗牙医未放置初始牙冠时，牙冠更频繁地被更换。然而，与此相反，与就诊时间较短（<5 年）的患者相比，就诊时间较长（>5 年）的患者更换牙冠的比例更高。在缺乏高质量证据的地区，需要进一步就牙冠的放置和更换达成共识。这些信息将有助于牙医提供高质量的护理，也有助于决策者制定基于证据的服务。
