The effect of a training programme on restoration replacement

Objective: To evaluate the effect that a training programme had on the decisions made and time taken to carry out the assessment of plastic dental restorations by a group of dentists. Method: Under standardised simulated clinical conditions 16 dentists assessed 111 plastic restorations in extracted human teeth set into artificial jaws mounted in dental manikins. The dentists had to decide whether, or not, the restorations needed replacing. The dentists' findings were measured against a gold standard decision on replacement need that had been determined previously by two experienced clinicians. A note of the time to complete the examinations and the deliberations of the dentists was made. Half of the sixteen dentists then undertook training in restoration evaluation. The training utilised the USPHS criteria. The trained and untrained groups then evaluated 64 plastic restorations in vivo. The dentists were asked to decide whether, or not, the restorations needed replacing. Comparisons between the test and control groups were made against those of two experienced clinicians who provided the gold standard decision on restoration replacement need. Results: At baseline, there was no statistical difference in the number of restorations scheduled for replacement (39.13 +/- 8.54 compared to 38.88 +/- 4.16, p= 0.94) or the time taken to complete the examinations (34 +/- 7.93 minutes compared to 36.25 +/- 7.78 minutes, p=0.58) between the test and control groups. The in vivo examinations showed statistical differences between the test and the control groups for the number of restorations scheduled for replacement (6 +/- 3.06 compared to 9.71 +/- 3.15, p=0.0439) and the time taken to complete the examinations (27.86 +/- 3.44 minutes compared to 36.71 +/- 3.64 minutes, p=0.001). Conclusions: Within the limitations of this study, training can have significant effects on the time taken to complete clinical evaluations and affect the overall decisions.