上颌中切牙全瓷冠牙体预备学习曲线的预测、分析与应用

Prediction,analysis and application of learning curve of tooth preparation for all ceramic crowns of maxillary central incisors

目的:运用改良Wright学习曲线模型预测参加口腔住院医师规范化培训的研究生在仿真头颅模型上进行上颌中切牙全瓷冠牙体预备的学习曲线,分析其特点,并用于评价牙体预备的效果。方法:选取12名参加口腔住院医师规范化培训的研究生在仿真头颅模型上进行4次右上中切牙树脂牙的全瓷冠牙体预备,预备体由3名具有10年以上口腔修复经验的专家按照预备量、外形轮廓、聚合度、肩台、边缘线角及位置、邻牙损伤和预备时长等方面进行评价。根据4次牙体预备分数计算牙体预备的学习率,用改良Wright学习曲线函数预测牙体预备的学习曲线。参考北京市住院医师规范化培训技能考核要求,以80分作为合格的考核标准,推算牙体预备技能达到考核标准(80分)所需的最少训练次数,分析学习曲线的特点,评价牙体预备的效果。结果:4次牙体预备的分数分别为(64.03±7.80)分、(71.40±6.13)分、(74.33±5.96)分、(75.98±4.52)分,学习率为(106±4)%,学习曲线呈上升趋势。第5~13次牙体预备预测分数与考核标准的差异无统计学意义(P>0.05),第14次的牙体预备预测分数高于考核标准(P<0.05)。结论:参加口腔住院医师规范化培训的研究生在仿真头颅模型上进行上颌中切牙全瓷冠牙体预备的学习曲线呈上升趋势,学习曲线预测14次是牙体预备分数高于考核标准所需的最少训练次数。

Objective:To predict the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training based on the modified Wright learning curve model,then to analyze and applicate the learning curve.Methods:Twelve graduate students participating in standardized dental resident training were selected to prepare the resin maxillary central incisors on phantom head simulators for all ceramic crowns 4 times.The results of preparation were evaluated by 3 prosthetic experts with at least 10 years’experience focusing on the reduction,contour,taper,shoulder,finish line,margin placement,adjacent tooth injury,and preparation time for tooth preparation.The learning rate of tooth preparation was calculated by scores of tooth preparation of 4 times.The learning curve of tooth preparation was predicted based on the modified Wright learning curve model.According to the criteria of standardized training skill examinations for dental residents in Beijing,80 was taken as the qualified standard score.The minimum training times for tooth preparation to satisfy the qualified standard score(80)was calculated,to analyze the characteristics of learning curve and evaluate the effectiveness of tooth preparation.Results:The scores of 4 tooth preparation were 64.03±7.80,71.40±6.13,74.33±5.96,and 75.98±4.52,respectively.The learning rate was(106±4)%,which showed the learning curve an upward trend.There were no significant differences between the qualified standard score and the predicted scores of tooth preparation from the 5thpreparation to the 13thpreparation(P>0.05).The predicted score of the 14thpreparation was higher than the qualified standard score(P<0.05).Conclusion:The trend of the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training is upward,which predicts the minimum training times higher than the qualified standard score is 14 times.