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国家牙科以患者为导向的研究网络(PBRN)诊所中接受根管治疗的牙齿及患者的特征:牙髓病专科医生与普通牙医诊所的比较

Characteristics of teeth and patients receiving root canal treatment in National Dental PBRN practices: Comparison between Endodontist and general dentist practices.

作者信息

Mungia R, Funkhouser E, Law A S, Nixdorf D R, Rubin R L, Gordan V V, Fellows J L, Gilbert G H

机构信息

Department of Periodontics, School of Dentistry, The University of Texas Health San Antonio, 8403 Floyd Curl Drive; MC 8258; Suite 300.29, San Antonio, TX, 78229.

Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, 611 MT, Birmingham, Alabama, 35294.

出版信息

J Dent. 2025 Jun;157:105723. doi: 10.1016/j.jdent.2025.105723. Epub 2025 Mar 27.

Abstract

PURPOSE

To describe and compare patient and tooth characteristics determined prior to treatment among those receiving root canal treatment (RCT) from general dentists (GD) versus endodontists within the National Dental Practice-Based Research (PBRN) Network.

METHODS

This National Dental PBRN study involved 153 practitioners (104 GDs and 49 endodontists) who used a consecutive enrollment strategy to enroll patients. Practitioners recorded details about pre-operative tooth characteristics. Prior to RCT, patients provided data about their socio-demographic, medication use, temporomandibular disorder (TMD), and psycho-social characteristics. We describe the overall prevalence of these characteristics and compare them by provider type.

RESULTS

1,723 patients were enrolled; 788 by GDs and 935 by endodontists. Endodontists treated higher proportions of female, non-Hispanic white, better-educated patients, patients from the Midwest and Southwest regions, and molar teeth compared to GDs. GDs saw a higher proportion of patients from the Northeast region and whose teeth had a probing depth of 5 mm or more. All of these characteristics were independently and significantly (at p <.05) associated with provider type. Endodontists were more likely than GDs to see patients with TMD symptoms in bivariate comparisons, but their patient groups were similar with regard to treatment outcome expectation, dental fear, depression, and anxiety.

CONCLUSION

Significant differences exist between endodontists and GDs in patient demographics, tooth characteristics, and treatment patterns, with endodontists treating more molars, female, non-Hispanic white, and educated patients, while GDs manage more cases involving antibiotics use and teeth with deep probing depths, highlighting variations in referral patterns and treatment accessibility.

摘要

目的

描述并比较在国家基于牙科实践的研究(PBRN)网络中,从普通牙医(GD)和牙髓病医生处接受根管治疗(RCT)的患者及牙齿特征,这些特征是在治疗前确定的。

方法

这项国家牙科PBRN研究纳入了153名从业者(104名普通牙医和49名牙髓病医生),他们采用连续入组策略招募患者。从业者记录术前牙齿特征的详细信息。在进行根管治疗之前,患者提供有关其社会人口统计学、药物使用、颞下颌关节紊乱病(TMD)和心理社会特征的数据。我们描述这些特征的总体患病率,并按提供者类型进行比较。

结果

共纳入1723名患者;普通牙医纳入788名,牙髓病医生纳入935名。与普通牙医相比,牙髓病医生治疗的女性、非西班牙裔白人、受教育程度较高的患者、来自中西部和西南部地区的患者以及磨牙的比例更高。普通牙医诊治的来自东北地区且牙齿探诊深度为5毫米或更深的患者比例更高。所有这些特征均与提供者类型独立且显著相关(p<0.05)。在双变量比较中,牙髓病医生比普通牙医更有可能诊治有TMD症状的患者,但他们的患者群体在治疗结果期望、牙科恐惧、抑郁和焦虑方面相似。

结论

牙髓病医生和普通牙医在患者人口统计学、牙齿特征和治疗模式方面存在显著差异,牙髓病医生治疗的磨牙、女性、非西班牙裔白人及受教育患者更多,而普通牙医处理更多涉及使用抗生素和探诊深度较深的牙齿的病例,突出了转诊模式和治疗可及性的差异。

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