J Am Dent Assoc. 2017 Aug 16. pii: S0002-8177(17)30544-5. doi: 10.1016/j.adaj.2017.06.015. [Epub ahead of print]
Abstract
BACKGROUND:
Objectives
were to determine the likelihood that a clinician accepts an impression
for a single-unit crown and document crown remake rates.
METHODS:
The
authors developed a questionnaire that asked dentists about techniques
used to fabricate single-unit crowns. The authors showed dentists
photographs of 4 impressions and asked them to accept or reject each
impression. The authors correlated answers with dentist and practice
characteristics. Other questions pertained to laboratory use and crown
remake rates.
RESULTS:
The
response rate was 83% (1,777 of 2,132 eligible dentists). Of the 4
impressions evaluated, 3 received consistent responses, with 85%
agreement. One impression was more equivocal; 52% accepted the
impression. The likelihood of accepting an impression was associated
significantly with the clinician's sex, race, ethnicity, and practice
busyness. Clinicians produced 18 crowns per month on average, and 9%
used in-office milling. Most dentists (59%) reported a remake rate of
less than 2%, whereas 17% reported a remake rate greater than 4%. Lower
remake rates were associated significantly with more experienced
clinicians, optical impressions, and not using dual-arch trays.
CONCLUSIONS:
Although
dentists were largely consistent in their evaluation of impressions
(> 85%), nonclinical factors were associated with whether an
impression was accepted or rejected. Lower crown remake rates were
associated with more experienced clinicians, optical impressions, and
not using dual-arch trays.
PRACTICAL IMPLICATIONS:
These
results provide a snapshot of clinical care considerations among a
diverse group of dentists. Clinicians can compare their own remake rates
and impression evaluation techniques with those in this sample when
developing best practice protocols.
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