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Replacement of plastic restorations in clinical dental practice and the effect that a simple training programme can have on the decision making process

McAndrew, Robert 2008. Replacement of plastic restorations in clinical dental practice and the effect that a simple training programme can have on the decision making process. PhD Thesis, Cardiff University.

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AIM: To investigate how a simple training programme affected restoration replacement decision making by a group of sixteen dentists. METHOD: This project had two distinct phases, one involving a simulated clinical examination of 111 restorations and the other a clinical examination of 66 restorations. On both occasions, two experienced clinicians using the United States Public Health Service (USPHS) criteria determined the restorative status of the restorations these evaluations determined the gold standard status with respect to restoration integrity for the restorations. All evaluations were completed under strictly controlled clinical conditions with standard equipment and lighting provided. After completing the simulated clinical phase half of the sixteen dentists were randomly assigned to undertake restoration evaluation training (test group). The results of the simulated clinical and clinical examinations between the test and the non-trained group (control group) were compared by the non-parametric statistical analysis of a number of parameters i.e. the number of restorations scheduled for replacement, the time taken to complete examinations, sensitivity, specificity, positive predictive value, negative predictive value, Dice's coincidence index and Cohen's Kappa statistic. RESULTS: There were no statistical differences between the groups at baseline with test and control groups scheduling a similar number of restorations for replacement (36.25 7.78 and 34.75 7.93). After training the test group took longer to complete a repeat simulated clinical examination 59.2515.06 minutes, when this was compared with that of the initial examination, 39.1318.54 minutes. However, there were no other statistically significant differences when baseline measurements were compared. The clinical phase highlighted a number of statistically significant results when the test and the control group were compared the number of restorations scheduled for replacement (6.00 3.01 and 9.7113.15), examination time (27.8613.45 and 36.7113.74) and agreement with the gold standard for restoration replacement (0.8510.27 and 0.79 0.06). CONCLUSION: Within the limits of this study, it was concluded that examiner training can have a significant effect on plastic restoration replacement decision making by dentists.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Dentistry
Subjects: R Medicine > RK Dentistry
ISBN: 9781303186400
Date of First Compliant Deposit: 30 March 2016
Last Modified: 03 Dec 2014 16:53

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