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Factors Affecting Aesthetic Treatment Choices in Posterior Teeth

Mary A. Baechle, Charles Janus and Al M. Best

Objectives: New developments of aesthetic restorative materials necessitate dentists choosing between aesthetic or unaesthetic restorations for posterior teeth. This study investigates correlations between dentists? choices of aesthetic or unaesthetic restorations and tooth type, as well as demographic information. The null hypothesis is that no relationship exists between treatment choices and demographic information.

Materials and methods: An online survey was deployed querying participating dentists for treatment recommendations for 15 clinical cases involving posterior restorations with intraoral occlusal views and bitewing images, from a menu of treatment options. Biographical and demographic data were collected about the dentists? practices. Subjects were volunteer subscribers to an online dental magazine with an estimated subscription of over three thousand. Being a cross sectional descriptive study, there are no controls or tests for examiner reliability. Analysis was accomplished using repeated-measures logistic regression.

Results: Respondents (N=300), 16.9% female, 14% foreign. Tooth type (molar or premolar), was significant in the aesthetic restoration decision (p<0.0001). Graduation decade when collapsed to graduates prior to 1980 and all others was significant (p=0.0404). Type of practice was significant when collapsed into educators, military, retired and all other types (p=0.0103). Adjusted odds of a premolar versus a molar being indicated for an aesthetic restoration is 3.67 (95% CI 3.07-4.38), and for other dentists versus educators, military and retired dentists indicating aesthetic restorations is 3.35 (95% CI 2.06-5.42).

Conclusion: Despite continued improvements in aesthetic restorative materials, aesthetic restorations are still chosen for premolars significantly more than molars. Gender, nationality, decade of graduation and practice type were not significant. Practice type collapsed into educators, military and retired dentists was significant, as was graduation decade when collapsed into years prior to 1980 and all others.