Povezanost kliničkih procjena i pacijentovih ocjena estetskog izgleda nadomjestaka na gornjim prednjim zubima

doctoral thesis

• Title (english): Association between clinical assessments and patient evaluations of the esthetic appearance of maxillary anterior restorations
• Author: Ela Kristek Zorić
• Mentor: Dubravka Knezović-Zlatarić (mentor)
• Committee member: Ketij Mehulić (predsjednik povjerenstva)
• Committee member: Silvana Jukić Krmek (član povjerenstva)
• Committee member: Jasmina Stipetić-Ovčariček (član povjerenstva)
• Committee member: Vlatko Pandurić (član povjerenstva)
• Committee member: Vlatka Lajnert (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2014-05-23, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry
• Universal decimal classification (UDC): 616.31 - Stomatology

Abstract

Jedan od razloga zašto je dentalna estetska medicina postala vrlo važna disciplina u dentalnoj medicini je zahtjev pacijenata za visoko estetskim nadomjescima na gornjim prednjim zubima. Stoga doktori dentalne medicine moraju biti spremni odgovoriti estetskim zahtjevima i visokim očekivanjima svojih pacijenata. Međutim, procjena estetskog izgleda nadomjestaka doktora dentalne medicine i pacijenta mogu se međusobno razlikovati.
Svrha ovog istraživanja je bila ispitati i međusobno usporediti procjenu doktora dentalne medicine i pacijentovu ocjenu direktnih i indirektnih estetskih nadomjestaka na gornjim prednjim zubima.
U istraživanju je sudjelovalo 200 pacijenata. Doktor dentalne medicine i pacijent su procjenjivali boju, oblik i površinsku teksturu svakog nadomjeska u području gornjih prednjih zubi uspoređujući ih sa prirodnim zubima te ocjenjujući ih ocjenom dobar, zadovoljavajući ili loš.
Rezultati istraživanja pokazali su da su pacijenti potpunu keramičku krunicu procijenili kao nadomjestak koji se najbolje podudara s ispitivanim prirodnim zubom, a kompozitni ispun najlošijim. Boja nadomjeska bila je karakteristika koju su ispitanici najstrože ocjenjivali. Žene su bile strože u procjeni estetskih nadomjestaka na gornjim prednjim zubima od muškaraca (p<0,05). Stariji pacijenti strože su procjenjivali estetske parametre kompozitnih ispuna, fasetiranih akrilatnih i metalkeramičkih krunica od mlađih (p>0,05). Mlađi pacijenti su općenito bili zadovoljniji svojim nadomjescima od starijih ispitanika (p<0,05). Pacijentov opći dojam o nadomjescima bio je bolji ukoliko je pozitivno procijenjen izgled kompozitnog ispuna (p<0,059). Stomatolozi su strože procjenjivali estetske parametre nadomjestaka na gornjim prednjim zubima od pacijenata (p<0,05).
Estetska procjena nadomjestaka i općenito dojam estetike usne šupljine je kombinacija objektivnih parametara i subjektivnog doživljaja. Ne postoji univerzalna formula za dobivanje savršenog izgleda usne šupljine. Stomatolog se stoga mora voditi nekim općenitim smjernicama i prilagođavati ih željama pacijenta i naravno, u konačnici, svoj estetski rad uklopiti u fizionomiju pacijentovog lica.

Abstract (english)

BACKGROUND: Dental esthetics has become an important discipline in dentistry as patients have started requesting highly esthetic restorations on upper front teeth. Therefore, dentists must be prepared to meet the esthetic demands and high expectations of their patients. Clinical and patient's assessments of quality may differ.
PURPOSE:The purpose of this study is to assess and compare clinical assessment and patient's evaluation of direct and indirect esthetic restorations of upper front teeth.
MATERIALS AND METHODS: Two hundred subjects evaluated color, anatomical shape and surface texture of maxillary anterior teeth restorations (composite fillings, acrylic faceted metal crowns, porcelain-fused-to-metal crowns and all-ceramic crowns) in comparison to adjacent natural teeth ranking the appearance as good, satisfactory or poor. Patients also assessed general impression of their maxillary anterior teeth restorations and rated it as satisfactory or unsatisfactory. Results were compared with clinitian's assessment. The data were expressed in average assessment scores for color, anatomical shape and surface texture as well as overall average assessment scores for every type of restoration and overall average assessment scores for color, anatomical shape and surface texture of all the restorations in general. Logistic regression analysis was used to determine factors that influenced the patient's satisfactory or unsatisfactory overall impression for restorations on the upper front teeth.
RESULTS: All-ceramic crowns were evaluated as best match with the tested natural tooth and the composite fillings as worst. Colour of the restoration is a characteristic where the participants were the stricktest in evaluation. Women were much stricter in assessing esthetic restorations on the upper front teeth (p <0.05). In assessing aesthetic parameters of composite fillings, faceted acrylic and metal-ceramic crowns older patients were strickter than younger respondents(p> 0.05). Younger patients were more satisfied with their restorations than older subjects in general (p <0.05). General impression of restorations was better if the patient positively assessed composite fillings (p <0.059). Dentists's assessment of aesthetic parameters of upper front teeth restorations was always strickter than the patients one (p <0.05).
CONCLUSION: Restoration type can affect patient's satisfaction by its aesthetic and technical characteristics, and not the tested aesthetic parameters. Aesthetic evaluation of restorations and general impression of dental aesthetics is a combination of objective parameters and subjective impression. There is no universal formula for getting a perfect appearance of oral cavity. Therefore a dentist must follow some general guidelines and adapt them to patient's wishes and of course, ultimately, blend his/her aesthetic restoration with patient's facial physiognomy.

• Keywords: dentalna estetika; estetski nadomjesci; potpuno keramičke krunice; pacijentova procjena
• Keywords (english): dental esthetics; estetic restorations; all- ceramic crowns; patients assessment
• Language: croatian
• URN:NBN: urn:nbn:hr:127:668688
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Elektronička verzija rada dostavljena u četiri word dokumenta
• Created on: 2017-03-15 10:47:44