Table 4.
Comparison of change between baseline and follow-up, by baseline level of invasiveness, after stratifying by DPBRN participation level
| Full DPBRN participants | Partial DPBRN participants | |||||
|---|---|---|---|---|---|---|
| Baseline response to treatment scenario | Response at follow-up was … | Response at follow-up was … | ||||
| … more-invasive | … the same | … less-invasive | … more-invasive | … the same | … less-invasive | |
| 1. Defective composite restoration with cementum-dentin marginsa | ||||||
| No treatment/preventive only | 50% (n=18) | 50% (n=18) | np | 67% (n=8) | 33% (n=4) | np |
| Polish, re-surface, repair | 25% (n=17) | 66% (n=45) | 9% (n=6) | 36% (n=12) | 55% (n=18) | 9% (n=3) |
| Replace entire restoration | np | 47% (n=55) | 53% (n=61) | np | 73% (n=96) | 27% (n=36) |
| 2. Defective composite restoration with enamel marginsa | ||||||
| No treatment/preventive only | 59% (n=19) | 41% (n=13) | np | 87% (n=13) | 13% (n=2) | np |
| Polish, re-surface, repair | 15% (n=18) | 70% (n=87) | 15% (n=19) | 23% (n=20) | 67% (n=58) | 10% (n=9) |
| Replace entire restoration | np | 44% (n=26) | 56% (n=33) | np | 65% (n=46) | 35% (n=25) |
| 3. Defective amalgam restorationa | ||||||
| No treatment/preventive only | 16% (n=16) | 84% (n=87) | np | 33% (n=29) | 67% (n=59) | np |
| Polish, re-surface, repair | 10% (n=4) | 44% (n=18) | 46% (n=19) | 29% (n=4) | 7% (n=1) | 64% (n=9) |
| Replace entire restoration | np | 53% (n=36) | 47% (n=32) | np | 56% (n=38) | 44% (n=30) |
| 4. Occlusal caries scenario 1b | ||||||
| No treatment/preventive only | 18% (n=17) | 82% (n=75) | np | 19% (n=8) | 81% (n=35) | np |
| Minimal intervention | 8% (n=8) | 37% (n=39) | 56% (n=59) | 14% (n=14) | 40% (n=39) | 45% (n=44) |
| Place complete restoration | np | 13% (n=2) | 88% (n=14) | np | 61% (n=14) | 39% (n=9) |
| 5. Occlusal caries scenario 2b | ||||||
| No treatment/preventive only | 17% (n=4) | 83% (n=20) | np | 14% (n=1) | 86% (n=6) | np |
| Minimal intervention | 20% (n=22) | 56% (n=63) | 24% (n=27) | 27% (n=20) | 52% (n=39) | 21% (n=16) |
| Place complete restoration | np | 41% (n=27) | 59% (n=39) | np | 60% (n=47) | 40% (n=31) |
| 6. Proximal caries scenarioc | ||||||
| Outer ½ of enamel | np | 67% (n=2) | 33% (n=1) | np | 50% (n=2) | 50% (n=2) |
| Inner ½ of enamel | 6% (n=4) | 57% (n=37) | 37% (n=24) | 1% (n=1) | 76% (n=60) | 23% (n=18) |
| Outer 1/3 of dentin | 10% (n=12) | 80% (n=94) | 10% (n=12) | 27% (n=23) | 69% (n=58) | 4% (n=3) |
| Middle 1/3 of dentin | 38% (n=10) | 62% (n=16) | 0% (n=0) | 100% (n=3) | 0% (n=0) | 0% (n=0) |
| Inner 1/3 of dentin | 0% (n=0) | 0% (n=0) | np | 100% (n=1) | 0% (n=0) | np |
As in Table 3, This table shows results for each of the six clinical scenarios separately. This is necessary because the percentages of change vary for each scenario. The left column shows what the practitioner’s response for that scenario was at baseline. The three right-most columns show what that practitioner’s response for that same scenario was at follow-up, describing whether or not the follow-up response was more-invasive, less-invasive, or the same. This table shows results in Table 3, but after stratifying into two strata: full participants and partial participants. Percentages in some rows do not add to 100% due to rounding.
Response categories were: (1) no treatment or preventive treatment only; (2) polish, re-surface, or repair the restoration; and (3) replace the entire restoration. A “less-invasive” response meant moving to a category 1 response after having provided at baseline a response of category 2 or 3; or to a category 2 response after having provided at baseline a response of category 3. A “more-invasive” response meant moving to a category 3 response after having provided at baseline a response of category 1 or 2; or to a category 2 response after having provided at baseline a response of category 1.
Response categories were: (1) no treatment or preventive treatment only; (2) minimal intervention; and (3) complete restoration. A “less-invasive” response meant moving to a category 1 response after having provided at baseline a response of category 2 or 3; or to a category 2 response after having provided at baseline a response of category 3. A “more-invasive” response meant moving to a category 3 response after having provided at baseline a response of category 1 or 2; or to a category 2 response after having provided at baseline a response of category 1.
Response categories were to intervene surgically (i.e., restore the tooth) at this caries lesion depth: (1) outer half of enamel; (2) inner half of enamel; (3) outer one-third of dentin; (4) middle one-third of dentin; (5) inner one-third of dentin. A “less-invasive” response meant moving to a category with a lower number after having provided at baseline a category with a higher number. A “more-invasive” response meant moving to a category with a higher number after having provided at baseline a category with a lower number.
np: not possible because of the scale’s floor or ceiling effects
A multivariable regression of change score was done for each of the six scenarios; baseline response and participation level were the only covariates in each regression. The baseline response variable was statistically significant in each regression (p<0.001). Participation level was statistically significant in scenario 1 (p < 0.001), scenario 2 (p = 0.001), scenario 4 (p = 0.014), scenario 5 (p = 0.041), and scenario 6 (p=0.001). It was not significant for scenario 3 (p = 0.053).