Simplified versus conventional method for the fabrication of complete dentures: procedures adopted by dentists

Introduction:In order to reduce costs and clinical time involved with complete denture treatment, dentists have employed simplified methods based on the reduction or preclusion of certain traditional technical procedures.Purpose:To survey the procedures used by dentists to fabricate complete dentures.Material and method:Data was obtained by an electronic form containing questions about dentists' profile and clinical procedures, in order to quantify traditional and simplified approaches at several moments and to determine them to different professional profiles. Results were evaluated by means of cluster analysis.Result:The majority of respondents were male dentists with clinical practice as their main income source, mainly in private service (n=119). Most participants use to take a pair of impressions from each arch, employ semiadjustable articulators with facebow transfers, shape the occlusal plane with the aid of anatomic references, determine occlusal vertical dimension by metric methods and use mandibular manipulation for centric relation. The dentists performed tooth selection in most cases. Statistical analysis identified two clusters based on demographic characteristics and clinical procedures. General practitioners adopting simplified methods formed the first cluster, whereas prosthodontists used to conventional methods formed the second.Conclusion:General dentists tend to adopt simplified approaches, and prosthodontists tend to work according to traditional academic methods.

引言：为降低全口义齿（complete denture）治疗的成本与临床耗时，牙医已采用基于简化或排除部分传统技术流程的改良诊疗方案。
研究目的：调研牙医制作全口义齿所采用的各类临床操作流程。
材料与方法：本研究通过包含牙医背景信息与临床操作相关问题的电子问卷收集数据，以量化不同诊疗阶段的传统与简化方案，并针对不同职业特征进行分类分析；结果采用聚类分析（cluster analysis）方法进行评估。
结果：本次调研的多数受访者为以临床诊疗为主要收入来源的男性牙医，主要执业于私立诊疗机构（n=119）。绝大多数参与者会为每颌制取一副印模，使用带有面弓转移（facebow transfers）的半可调式牙合架（articulators），借助解剖参考标志确定牙合平面（occlusal plane），通过测量法确定牙合垂直距离（occlusal vertical dimension），并采用下颌手法操作确立正中关系（centric relation）；多数牙医会开展人工牙选型工作。统计分析基于人口统计学特征与临床操作流程识别出两个聚类簇：第一类为采用简化诊疗方案的全科牙医（general practitioners），第二类为采用传统常规方法的口腔修复科医师（prosthodontists）。
结论：全科牙医倾向于采用简化的全口义齿制作流程，而口腔修复科医师则更倾向于遵循传统学术化的诊疗规范。