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由一名或多名不同的本科实习医生进行治疗对患者口腔卫生的影响 - 一项随机、对照、临床短期试验。

Influence on the patient's oral hygiene depending on the treatment performed by either one or different pre-graduate practitioners - a randomized, controlled, clinical short-term trial.

机构信息

Department of Conservative Dentistry and Periodontology, University Hospital of Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany.

PHV-Dialysezentrum Waiblingen, Beinsteiner Str. 8/3, 71334, Waiblingen, Germany.

出版信息

Clin Oral Investig. 2022 Aug;26(8):5339-5350. doi: 10.1007/s00784-022-04501-1. Epub 2022 Apr 29.

Abstract

OBJECTIVES

Plaque control by improved domestic oral hygiene is essential in periodontal treatment. However, changing treatment providers may interfere with building a dentist-patient relationship and in turn affect treatment success. The aim of this randomized, controlled, prospective short-term study was to determine the influence of either one or four different pre-graduate practitioners on patients' oral hygiene parameters during active periodontal therapy.

MATERIAL AND METHODS

A total of 55 patients with periodontitis were allocated to two groups. Within the group "continuous treatment" (CT, n = 27), each patient was treated by one individual practitioner over the treatment period. For patients of the group "discontinuous treatment" (DT, n = 28), treatment in each session was performed by a different practitioner. Periodontal parameters (BOP, PBI, and PCR) were assessed at two timepoints: T1 (baseline) and T2 (end of active therapy).

RESULTS

With CT, the PBI improved in 93% of the patients, compared to 71% with DT (p = 0.048). T1-T2 intragroup analysis showed a statistically significant improvement of all observed clinical parameters with no differences in ∆PBI, ∆BOP, and ∆PCR. Spearman's correlation analysis revealed a weak correlation between PCR and BOP of CT only.

CONCLUSIONS

In the present study, improvement of all parameters was comparable between the groups. PBI, as a parameter displaying patient's domestic plaque control compliance, improved in more patients from CT than DT. This is possibly indicating an advantage of continuous treatment by one single practitioner.

CLINICAL RELEVANCE

Treatment by either a single practitioner or by multiple, constantly changing practitioners might influence patients' compliance to modify their behaviour when medically necessary.

摘要

目的

通过改善国内口腔卫生来控制菌斑对于牙周治疗至关重要。然而,改变治疗提供者可能会干扰牙医与患者之间的关系,进而影响治疗效果。本随机、对照、前瞻性短期研究旨在确定一名或四名不同的预毕业实习医生对牙周炎患者在牙周治疗期间口腔卫生参数的影响。

材料与方法

共有 55 名牙周炎患者被分为两组。在“连续治疗”(CT)组(n=27)中,每位患者由一名个体牙医在治疗期间进行治疗。对于“间断治疗”(DT)组(n=28)的患者,每次治疗均由不同的牙医进行。在两个时间点(T1[基线]和 T2[主动治疗结束])评估牙周参数(BOP、PBI 和 PCR)。

结果

与 DT 组相比,CT 组中 93%的患者 PBI 得到改善,而 DT 组中只有 71%的患者 PBI 得到改善(p=0.048)。T1-T2 组内分析显示,所有观察到的临床参数均有统计学显著改善,且 ∆PBI、∆BOP 和 ∆PCR 无差异。Spearman 相关分析显示,仅 CT 组的 PCR 与 BOP 之间存在弱相关。

结论

在本研究中,两组间所有参数的改善情况相当。PBI 作为反映患者家庭菌斑控制依从性的参数,在 CT 组中有更多的患者得到改善。这可能表明由一名单一牙医进行连续治疗具有优势。

临床相关性

由单个牙医或多个不断变化的牙医进行治疗可能会影响患者在必要时改变行为以调整行为的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d18/9381624/10da6c678c29/784_2022_4501_Fig1_HTML.jpg

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