背景:外部根尖吸收(EARR)是在接受固定矫治器治疗的患者中经常观察到的不良事件。在治疗期间评估患者的风险很重要,因为某些因素被认为与发生的可能性增加有关。然而,它们的预测价值仍然有限,使基于证据的临床决策对正畸医生具有挑战性。为了解决这个问题,荷兰正畸医师协会(NvVO)于2018年根据AGREEII工具(评估研究和评估指南II)制定了EARR临床实践指南(CPG).这项研究的目的是了解正畸医生对指南的实际利用和实际实施情况。要检验的假设是,在引入之后,EARR的临床实践已转向CPG中的建议。
目的:调查2018年EARR临床实践指南在口腔正畸医师中的使用情况。
方法:针对指南中描述的EARR的四个领域,开发了使用7点Likert量表的问卷。问卷是试行的,定稿,然后在荷兰的正畸医生中以数字方式分发。REDCap用于数据收集,从2021年6月的邀请电子邮件开始,然后是两个提醒。效果由曼-惠特尼U检验检验,并分析了人口统计学变量的影响。
结果:向所有275人发送了问卷,并由133人完成(回应率48%);包括N=59名女性和N=73名男性;81%的人在荷兰接受过培训,89%有≥6年的工作经验,89%的人在私人正畸诊所工作。一百三十名正畸医生(98.5%)报告了临床实践的变化。如果在治疗期间诊断出EARR,则有关EARR的临床行为发生了最大的积极变化。性,临床经验,专业培训国家,受访者的工作环境并不影响EARR的临床实践。
结论:这份问卷表明,指南出台3年后,正畸医生改进了他们自我报告的临床实践,以更标准化地管理牙根吸收。没有一个人口统计学预测因子对结果有显著影响。
BACKGROUND: External apical root resorption (EARR) is a frequently observed adverse event in patients undergoing fixed appliance therapy. Assessing the patients\' risk during treatment is important, as certain factors are assumed to be associated with an increased likelihood of occurrence. However, their predictive value remains limited, making evidence-based clinical decision-making challenging for orthodontists. To address this issue, the Dutch Association of Orthodontists (NvVO) developed a clinical practice
guideline (CPG) for EARR in accordance with the AGREE II instrument (Appraisal of
Guidelines for Research and Evaluation II) in 2018. The aim of this study is to get insight into the actual utilization and the practical implementation of the
guideline among orthodontists. The hypothesis to be tested was that after its introduction, clinical practice for EARR has changed towards the recommendations in the CPG.
OBJECTIVE: To investigate the use of the 2018 clinical practice
guidelines for EARR among orthodontists 3 years after its introduction.
METHODS: A questionnaire using a 7-point Likert scale was developed concerning four domains of EARR described in the guideline. The questionnaire was piloted, finalised, and then distributed digitally among Dutch orthodontists. REDCap was used for data collection, starting with an invitation email in June 2021, followed by two reminders. Effect was tested by the Mann-Whitney U test, and the influence of demographic variables was analysed.
RESULTS: Questionnaires were sent out to all 275 and completed by 133 (response rate 48%); N = 59 females and N = 73 males were included; 81% had their training in the Netherlands, 89% had ≥ 6 years of work experience, and 89% worked in private orthodontic practice. One hundred thirty orthodontists (98.5%) reported changes in clinical practice. The biggest positive change in clinical behaviour regarding EARR occurred if EARR was diagnosed during treatment. Sex, clinical experience, country of specialist training, and working environment of the respondents did not affect clinical practices regarding EARR.
CONCLUSIONS: This questionnaire demonstrated that, 3 years after introduction of the
guideline, orthodontists improved their self-reported clinical practices to a more standardised management of root resorption. None of the demographic predictors had a significant effect on the results.