Lewis D W, Kay E J, Main P A, Pharoah M G, Csima A
Faculty of Dentistry, University of Toronto, Ontario, Canada.
J Public Health Dent. 1996 Summer;56(4):176-81. doi: 10.1111/j.1752-7325.1996.tb02433.x.
This study examines the relationships between stated restorative treatment thresholds of 16 dentists and both their restorative decisions and caries depth determinations for approximal tooth surfaces based on bitewing radiographs.
Sixteen dentists independently examined 15 pairs of experimental bitewing radiographs. They separately recorded restorative and dental caries depth decisions for 4,864 unrestored approximal tooth surfaces, 304 identical surfaces per dentist. In addition to caries depth and restorative decision data, these dentists provided their restorative thresholds using a five-point scale.
Three dentists stated it would be appropriate to restore enamel lesions, nine would wait until caries had reached the dentinoenamel junction, and four would wait until caries extended into the dentine. Although dentists stating an enamel restorative threshold intended definitely or probably to restore relatively more surfaces and recorded relatively more surfaces with dentinal caries, ANOVA analyses revealed that the differences among the restorative and the depth means according to the restorative thresholds were not significant. Considerable variation existed in both the restorative and depth decisions among the dentists in each threshold group.
Although interesting trends occurred in the restorative and depth decisions relative to the stated thresholds, this study suggests, like others in Europe, that these thresholds cannot be taken at face value to explain restorative decisions.
本研究探讨了16位牙医声明的修复治疗阈值与他们基于咬合翼片对邻面牙齿表面的修复决策和龋损深度判断之间的关系。
16位牙医独立检查15对实验性咬合翼片。他们分别记录了4864个未修复邻面牙齿表面的修复和龋齿深度判断结果,每位牙医检查304个相同的表面。除了龋损深度和修复决策数据外,这些牙医还使用五点量表提供了他们的修复阈值。
三位牙医表示修复釉质病变是合适的,九位会等到龋损到达牙釉质牙本质界,四位会等到龋损扩展到牙本质。尽管声明釉质修复阈值的牙医明确或可能打算修复相对更多的表面,并且记录了相对更多有牙本质龋的表面,但方差分析显示,根据修复阈值,修复和深度平均值之间的差异并不显著。每个阈值组内的牙医在修复和深度决策方面都存在相当大的差异。
尽管相对于声明的阈值,修复和深度决策中出现了有趣的趋势,但本研究表明,与欧洲的其他研究一样,这些阈值不能被表面看待以解释修复决策。