Treatment recommendations for single-unit crowns

Findings from The National Dental Practice-Based Research Network

Michael Scott McCracken, David R. Louis, Mark S. Litaker, Helena M. Minyé, Rahma Mungia, Valeria V. Gordan, Don G. Marshall, Gregg H. Gilbert

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background The objectives of this study were to quantify practitioner variation in likelihood to recommend a crown and test whether certain dentist, practice, and clinical factors are associated significantly with this likelihood. Methods Dentists in The National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In 4 clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. The authors used these responses to calculate a dentist-specific crown factor (range, 0-12). A higher score implied a higher likelihood of recommending a crown. The authors tested certain characteristics for statistically significant associations with the crown factor. Results A total of 1,777 of 2,132 eligible dentists (83%) responded. Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, or endodontically treated or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, practitioners in the Southwest, and practitioners with a balanced workload were more likely to recommend crowns, as were practitioners who used optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. Although consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied according to type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture—whether from endodontic treatment, fractured teeth, or large restorations—prompted many clinicians to recommend crowns.

Original languageEnglish (US)
Pages (from-to)882-890
Number of pages9
JournalJournal of the American Dental Association
Volume147
Issue number11
DOIs
StatePublished - Nov 1 2016

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Crowns
Tooth
Research
Dentists
Tooth Crown
Therapeutics
Endodontics
Nonvital Tooth
Insurance Coverage
Workload

Keywords

  • Dentistry
  • crowns
  • prosthodontics

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

McCracken, M. S., Louis, D. R., Litaker, M. S., Minyé, H. M., Mungia, R., Gordan, V. V., ... Gilbert, G. H. (2016). Treatment recommendations for single-unit crowns: Findings from The National Dental Practice-Based Research Network. Journal of the American Dental Association, 147(11), 882-890. https://doi.org/10.1016/j.adaj.2016.06.012

Treatment recommendations for single-unit crowns : Findings from The National Dental Practice-Based Research Network. / McCracken, Michael Scott; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

In: Journal of the American Dental Association, Vol. 147, No. 11, 01.11.2016, p. 882-890.

Research output: Contribution to journalArticle

McCracken, MS, Louis, DR, Litaker, MS, Minyé, HM, Mungia, R, Gordan, VV, Marshall, DG & Gilbert, GH 2016, 'Treatment recommendations for single-unit crowns: Findings from The National Dental Practice-Based Research Network', Journal of the American Dental Association, vol. 147, no. 11, pp. 882-890. https://doi.org/10.1016/j.adaj.2016.06.012
McCracken, Michael Scott ; Louis, David R. ; Litaker, Mark S. ; Minyé, Helena M. ; Mungia, Rahma ; Gordan, Valeria V. ; Marshall, Don G. ; Gilbert, Gregg H. / Treatment recommendations for single-unit crowns : Findings from The National Dental Practice-Based Research Network. In: Journal of the American Dental Association. 2016 ; Vol. 147, No. 11. pp. 882-890.
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abstract = "Background The objectives of this study were to quantify practitioner variation in likelihood to recommend a crown and test whether certain dentist, practice, and clinical factors are associated significantly with this likelihood. Methods Dentists in The National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In 4 clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. The authors used these responses to calculate a dentist-specific crown factor (range, 0-12). A higher score implied a higher likelihood of recommending a crown. The authors tested certain characteristics for statistically significant associations with the crown factor. Results A total of 1,777 of 2,132 eligible dentists (83{\%}) responded. Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, or endodontically treated or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94{\%}). Practice owners, practitioners in the Southwest, and practitioners with a balanced workload were more likely to recommend crowns, as were practitioners who used optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. Although consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied according to type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture—whether from endodontic treatment, fractured teeth, or large restorations—prompted many clinicians to recommend crowns.",
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