Prince Philip Dental Hospital, 34 Hospital road, University of Hong Kong, Hong Kong, SAR China.
Prince Philip Dental Hospital, 34 Hospital road, University of Hong Kong, Hong Kong, SAR China.
J Dent. 2023 Sep;136:104640. doi: 10.1016/j.jdent.2023.104640. Epub 2023 Jul 28.
Non-carious cervical lesions (NCCLs) are considered to have a multi-factorial aetiology and their management is affected by a range of variables perhaps most importantly clinical judgement. The aim of this study was to elicit information from practicing dentists, using interviews, to explore their understanding of NCCL aetiology, the decision-making criteria of when to restore, and the restorative techniques used to restore NCCLs. This may help identify gaps or anomalies in our understanding to inform future research and clinical practice for the management of NCCLs.
An interview guide was developed from a literature search which formed 2 domains framed around understanding and management of NCCLs based on: understanding of diagnosis and aetiology, and factors affecting decision making for management. Practicing dentists with more than 10 years of experience were purposively recruited to conduct in-depth, semi-structured interviews. Fifteen interviews were audio recorded and transcribed verbatim. A thematic content analysis was conducted and the results analysed.
From the thematic analysis, 2 domains were identified. In the domain of "diagnosis and aetiology", while participants have similar understanding and methods of diagnosing NCCL, most stated NCCLs in a patient were caused by a "main aetiology" such as "abrasion", "abfraction" while few described the inter-relationship of these aetiological factors. In the domain of "factors affecting decision making". "Patient reported symptoms" and "lesion dimension" were the main factors that affected participants' decision to provide restorative or non-restorative management. However, a "restorative threshold" was not able to be identified.
There was notable variety in participants' understanding of the aetiology, management, and treatment of NCCLs, particularly the restorative threshold of when to treat.
The variability demonstrates the need to have a clearer understanding of the key elements that affect the management of NCCLs and better information to support the decision of when to treat.
非龋性颈部缺损（NCCLs）被认为具有多因素病因，其治疗受到多种因素的影响，也许最重要的是临床判断。本研究的目的是通过访谈从执业牙医那里获取信息，以探讨他们对 NCCL 病因的理解、何时进行修复的决策标准以及用于修复 NCCLs 的修复技术。这有助于确定我们理解中的差距或异常，以告知未来关于 NCCLs 管理的研究和临床实践。
访谈指南是从文献检索中制定的，该检索形成了两个基于以下内容的领域：对 NCCLs 的理解和管理；对诊断和病因的理解；以及影响管理决策的因素。选择具有 10 年以上经验的执业牙医进行深入的半结构化访谈。15 次访谈进行了录音并逐字记录。进行了主题内容分析，对结果进行了分析。
从主题分析中确定了两个领域。在“诊断和病因”领域，尽管参与者对 NCCL 的诊断和方法有相似的理解，但大多数人认为患者的 NCCLs 是由“主要病因”引起的，例如“磨损”、“楔形缺损”，而很少有人描述这些病因因素的相互关系。在“影响决策的因素”领域。“患者报告的症状”和“病变维度”是影响参与者提供修复或非修复管理决策的主要因素。然而，未能确定“修复阈值”。
参与者对 NCCLs 的病因、管理和治疗的理解存在显著差异，特别是何时进行治疗的修复阈值。
这种可变性表明需要更清楚地了解影响 NCCLs 管理的关键因素，并提供更好的信息来支持何时进行治疗的决策。
