Impression evaluation and laboratory use for single-unit crowns: Findings from The National Dental Practice-Based Research Network.

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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