Balhaddad Abdulrahman A, AlGhamdi Nawaf, Alqahtani Mohammed, Alsulaiman Osama A, Alshammari Ali, Farraj Malik J, Alsulaiman Ahmed A
Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia.
Internship Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Saudi Dent J. 2024 Apr;36(4):638-644. doi: 10.1016/j.sdentj.2023.12.017. Epub 2023 Dec 27.
To identify the potential factors that induce procedural errors during posterior proximal resin composite restorations placed by dental students.
This retrospective study evaluated 803 bitewing radiographs of posterior proximal resin composite restorations placed by dental students at Imam Abdulrahman bin Faisal University. Atypical radiographic signs of failure were screened, and different patient-, operator-, and clinical-related factors were recorded. Chi-square test was used to examine the relationship between procedural errors and recorded factors. Stepwise adjusted logistic regression model was performed to identify predictors of procedural errors.
The most observed errors were internal gaps at the bonding interface and internal voids. Molars had 0.39 the risk of internal voids (odds ratio [OR] = 0.39; confidence interval [CI] = 0.250.60; = <0.0001), 0.41 the risk of sharp angle (OR = 0.41; CI = 0.240.68; = <0.001), and 0.57 the risk of open contact (OR = 0.57; CI = 0.340.97; = 0.04) compared to premolars. Those who were >40 years of age had 1.79 the risk of overhang compared to younger patients (OR = 1.79; CI = 1.043.11; = <0.04). First molars and premolars had 0.64 the risk of overhang compared to second molars and premolars (OR = 0.64; CI = 0.411.00; = 0.04). Junior students had 1.97 the risk of internal gap compared to their senior counterparts (OR = 1.97; CI = 1.203.21; = 0.008). Mesial restorations had 0.38 the risk of external gap compared to mesio-occluso-distal (MOD) restorations (OR = 0.38; CI = 0.190.78; = 0.003). Restorations with a margin coronal to the cemento-enamel junction (CEJ) had 0.44 the risk of external gap compared to those restorations with a margin apical to the CEJ (OR = 0.44; CI = 0.290.66; = <0.0001).
Our findings suggested a higher incidence of procedural errors in restoring premolars and MOD cavity preparations. Therefore, it is crucial to enhance the comprehensiveness of laboratory training and expose students to diverse clinical scenarios and various techniques.
确定牙科学生在后牙近中树脂复合体修复过程中导致操作失误的潜在因素。
这项回顾性研究评估了伊玛目阿卜杜勒拉赫曼·本·费萨尔大学牙科学生所做的803张后牙近中树脂复合体修复的咬合翼片。筛查失败的非典型影像学征象，并记录不同的患者、操作者和临床相关因素。采用卡方检验来检验操作失误与记录因素之间的关系。进行逐步调整的逻辑回归模型以确定操作失误的预测因素。
最常观察到的失误是粘结界面处的内部间隙和内部空洞。与前磨牙相比，磨牙出现内部空洞的风险为0.39（比值比[OR]=0.39；置信区间[CI]=0.25 - 0.60；P<0.0001），出现锐角的风险为0.41（OR = 0.41；CI = 0.24 - 0.68；P<0.001），出现开放接触的风险为0.57（OR = 0.57；CI = 0.34 - 0.97；P = 0.04）。与年轻患者相比，年龄>40岁的患者出现悬突的风险为1.79（OR = 1.79；CI = 1.04 - 3.11；P<0.04）。与第二磨牙和前磨牙相比，第一磨牙和前磨牙出现悬突的风险为0.64（OR = 0.64；CI = 0.41 - 1.00；P = 0.04）。与高年级学生相比，低年级学生出现内部间隙的风险为1.97（OR = 1.97；CI = 1.20 - 3.21；P = 0.008）。与近中 - 咬合 - 远中（MOD）修复相比，近中修复出现外部间隙的风险为0.38（OR = 0.38；CI = 0.19 - 0.78；P = 0.003）。与边缘位于牙骨质 - 釉质界（CEJ）根尖侧的修复相比，边缘位于CEJ冠侧的修复出现外部间隙的风险为0.44（OR = 0.44；CI = 0.29 - 0.66；P<0.0001）。
我们的研究结果表明，在前磨牙修复和MOD洞形制备中操作失误的发生率较高。因此，加强实验室培训的全面性并让学生接触不同的临床场景和各种技术至关重要。
