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有缺陷的直接牙齿修复体的修复与替换:一项荟萃分析的多国横断面研究。

Repair versus replacement of defective direct dental restorations: A multinational cross-sectional study with meta-analysis.

作者信息

Hatipoğlu Ömer, Martins João Filipe Brochado, Karobari Mohmed Isaqali, Taha Nessrin, Aldhelai Thiyezen Abdullah, Ayyad Daoud M, Madfa Ahmed A, Martin-Biedma Benjamin, Fernandez Rafael, Omarova Bakhyt A, Yi Lim Wen, Alfirjani Suha, Lehmann Anna, Sugumaran Surendar, Petridis Xenos, Krmek Silvana Jukić, Wahjuningrum Dian Agustin, Iqbal Azhar, Abidin Imran Zainal, Intriago Martha Gallegos, Elhamouly Yasmine, Palma Paulo Jorge, Hatipoğlu Fatma Pertek

机构信息

Department of Restorative Dentistry, Nigde Omer Halisdemir University, Turkey.

ACTA, Amsterdam, the Netherlands.

出版信息

J Dent. 2024 Sep;148:105096. doi: 10.1016/j.jdent.2024.105096. Epub 2024 May 23.

Abstract

OBJECTIVES

When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process.

METHOD

An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results.

RESULTS

The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95 % CI: 7.40, 27.35, p < 0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95 % CI: 0.12, 0.30, p < 0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used.

CONCLUSION

The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.

CLINICAL SIGNIFICANCE

A significant portion of dental practitioners lack the necessary knowledge and education required for the repair of restorations. Therefore, it is imperative to establish guidelines aimed at enhancing the management of defective restorations, along with protocols for clinical interventions. This includes the incorporation of proper courses in undergraduate, graduate, and continuing education programs.

摘要

目的

当牙科医生遇到有缺陷的修复体时,他们面临着修复还是更换的关键决策。本研究旨在探讨国际上对修复程序的偏好以及修复过程中采取的临床步骤。

方法

通过不同平台向21个国家的牙医发放了一份包含11个问题的调查问卷。该调查包括两个部分:第一部分有五个问题,旨在收集人口统计学信息,而第二部分由六个问题组成,重点关注参与者修复复合树脂或银汞合金修复体的做法。采用荟萃分析来确定修复与更换的合并比值比。使用RevMan 5.3程序进行统计分析,并使用同一程序生成森林图以直观显示结果。

结果

3680名牙科医生完成了该调查。结果表明,对于有缺陷的复合树脂修复体,有强烈的修复倾向(比值比:14.23;95%置信区间:7.40,27.35,p<0.001)。对于银汞合金修复体,有显著的更换倾向(比值比:0.19;95%置信区间:0.12,0.30,p<0.001)。在修复修复体时,无论使用何种修复材料,最常见的方案是用正磷酸酸蚀并制备釉质斜面。

结论

本研究结果表明,牙科医生在修复体修复方面存在知识差距。牙科医生必须接受关于修复体修复的适当教育和培训,以确保使用适当的方案并提高修复体的存留率。

临床意义

很大一部分牙科医生缺乏修复修复体所需的必要知识和教育。因此,必须制定旨在加强对有缺陷修复体管理的指南以及临床干预方案。这包括在本科、研究生和继续教育项目中纳入适当的课程。

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