Maryniuk G A, Schweitzer S O, Braun R J
Department of Fixed Prosthodontics, University of North Carolina, Chapel Hill 27599-7450.
Community Dent Oral Epidemiol. 1988 Oct;16(5):263-7. doi: 10.1111/j.1600-0528.1988.tb01770.x.
No formal analyses comparing the treatment alternatives of replacing a failed amalgam with either another amalgam or crown have been done to determine the optimum treatment strategy based on lifetime costs to the patient. Using decision analysis, a computer model was developed of the lifetime restorative needs of an adult's posterior tooth. A cost-effectiveness analysis of large amalgams vs crowns was then done to determine the optimum strategy. According to the analyses, the optimum treatment decision is to attempt to replace the failed first amalgam with another amalgam, instead of with a crown. When this amalgam restoration fails, then the subsequent replacement may be with a crown. Potential lifetime cost savings were between 11% and 24% if the first replacement was an amalgam. This study concludes that the technique of decision analysis provides the dental community with an effective evaluation tool for the study of clinical decision-making, taking into account all levels of clinical uncertainty.
尚未进行正式分析来比较用另一种汞合金或牙冠替换失败汞合金的治疗方案，以根据患者的终身成本确定最佳治疗策略。利用决策分析，开发了一个关于成人后牙终身修复需求的计算机模型。然后对大型汞合金与牙冠进行了成本效益分析，以确定最佳策略。根据分析，最佳治疗决策是尝试用另一种汞合金而非牙冠替换失败的首个汞合金。当这种汞合金修复失败时，随后的替换可以是牙冠。如果首次替换是汞合金，潜在的终身成本节省在11%至24%之间。本研究得出结论，决策分析技术为牙科界提供了一种有效的评估工具，用于研究临床决策，同时考虑到所有层面的临床不确定性。
