Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Özel Muayenehanelerde Çalışan Genel Diş Hekimlerinin Periodontal Tanı, Tedavi ve Yönlendirme Yaklaşımları: Pilot Çalışma
Periodontal Diagnosis, Treatment and Referral Approaches of General Dentists in Private Practice: a Pilot Study
İbrahim Çağrı ÖZÇELEBİa, Elif ÜNSALa
aAnkara Üniversitesi Diş Hekimliği Fakültesi, Periodontoloji ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(3):417-25
doi: 10.5336/dentalsci.2019-71313
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızın amacı, serbest çalışan genel diş hekimlerinin periodontal tedaviye karşı algı ve davranışlarının değerlendirilmesi ve hekimlerin hastalarını hangi durumlarda periodontoloğa yönlendirdiklerinin belirlenmesidir. Gereç ve Yöntemler: Bu çalışmaya, Ankara merkez (n=121) ve perifer (n=50) ilçelerinde çalışan toplam 171 diş hekimi dâhil edildi. Hekimlere demografi, periodontal muayene, faz 1 yönlendirme, oral hijyen, periodontal cerrahi tedavi uygulaması ve yönlendirmesi ile idame tedavilerini içeren 10 soruluk anket yüz yüze uygulandı. Bulgular: Hekimlerin %74,85'inin ilk ağız muayenesinde, periodontal muayene yaptığı fakat periodontal kayıt ve indeks almadıkları gözlendi. İlk muayenede en sık alınan kaydın, cep derinliği olduğu ve en sık panoramik radyograflardan yararlanıldığı belirlendi. Hekimlerin %65,5'i faz 1 tedavi için hastalarını periodontoloğa yönlendirmezken, en sık agresif periodontitis ve nekrotizan ülseratif gingivitis [necrotizing ulcerative gingivitis (NUG)] hastalarının yönlendirildiği görüldü. Hekimlerin %97,7'sinin hastalarına oral hijyen eğitimi verdiği görüldü. Hekimlerin %80,7'si periodontal cerrahi tedavi için hastalarını periodontoloğa yönlendirirken, merkez ilçelerde çalışan hekimlerin, perifer ilçelerde çalışan hekimlere göre daha fazla yönlendirdiği gözlendi. Hastaların en sık mukogingival problemler, gingival büyüme ve periodontal apse varlığında yönlendirildiği, yönlendirilen hastalarda ise sıklıkla flep cerrahisi, kemik greftleme ve kök kapatma işlemleri uygulandığı tespit edildi. Hekimlerin, kliniklerinde en sık uyguladıkları işlemlerin gingivektomi ve kron boyu uzatma olduğu gözlendi. Hekimlerin periodontal tedavi sonrasında, diş etinde kanamanın durması ve dişlerin ağızda kalış süresinin uzamasını bekledikleri görüldü. Hekimlerin, tedaviyi takiben sıklıkla 3 ay sonra idame tedavisi için hastalarını geri çağırdıkları gözlendi. Sonuç: Çalışmamızın sınırları kapsamında; diş hekimleri periodontal cerrahi tedavi için daha fazla yönlendirme yaparken, faz 1 tedaviyi kendileri uygulamayı tercih etmektedir.

Anahtar Kelimeler: Anket; periodontal tedavi; özel muayenehane; yönlendirme
ABSTRACT
 Objective: The aim of our study is to evaluate the perceptions and behaviors of general dentists towards periodontal treatment and to determine the referral conditions to periodontists. Material and Methods: A total of 171 dentists from central (n=121), and peripheral (n=50) districts of Ankara were included. A questionnaire consisting of 10 questions was given to physicians in the study. The questionnaire includes demographics, examination, phase 1 periodontal therapy and referral, oral hygiene, periodontal surgical therapy and referral and maintenance therapy. Results: Most of the dentists did not take any periodontal indices while performing periodontal examination in the first visit (74.85%). Most frequently, pocket depth measurements were recorded and panoramic radiographs were taken. It was observed that the dentists performed phase 1 treatment themselves (65.5%) where they referred the patients with aggressive periodontitis and necrotizing ulcerative gingivitis (NUG) to a periodontist. Dentists in the center districts provide more frequent referral for periodontal surgery then periphery. It was observed that %80,7 of the dentists referred their patients for periodontal surgical treatment to periodontists. Mucogingival problems, gingival overgrowth and periodontal abscess were frequently seen in the patients referred, and flap surgery, bone grafting and root closure procedures were carried out by periodontists. Dentists performed easy surgical procedures such as gingivectomy and crown lengthening in their clinics. Dentists expected an increase in survival of the effected teeth and no bleeding on probing following the periodontal treatment. The majority of dentists call their patients in every 3 months for maintenance. Conclusion: Within the limitations of this study it was concluded that the dentists prefer to refer their patients generally for periodontal surgical treatment while applying phase 1 treatment themselves.

Keywords: Survey; periodontal therapy; private practice; referral
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