修复后前牙美学临床评价与患者满意度关系的初探

目的试分析修复后前牙美学的临床评价与患者满意度之间的关系，为进一步提高患者满意度提供依据。方法选取个别前牙全瓷修复患者90例，修复后由患者本人评价患者满意度。由医师根据修复体的整体轮廓、表面形态质地、整体色调、颜色分布、切端半透明度、表面个体特征与邻牙的相似程度，对修复体进行分级。采用独立样本t检验或方差分析，分析各美学评价指标不同级别间患者满意度的差异。测量修复体与同名天然牙间的色差，分析其与患者满意度的相关关系。结果除整体色调“良”、“中”两个级别问患者满意度的差异无统计学意义外（P=0．553），其他美学评价指标不同级别间患者满意度的差异均有统计学意义（P〈0．05）。修复体与同名牙间的总色差、明度差的绝对值及△a的绝对值与患者满意度相关，Spearman相关系数分别为-0．434、-0．371、-0．406（P〈0．05）。结论修复后前牙各项美学特征的临床评价与患者满意度均相关，其中表面形态质地、颜色分布、表面个体特征与患者满意度的关系更密切。修复体与同名牙的总色差及明度差与患者满意度有一定的相关性。

Relationship between clinical assessment and patient satisfaction in anterior esthetic restorations

OBJECTIVE: To analysis the relationship between esthetic characters and satisfaction degree of patients. METHODS: Ninety patients requiring single anterior tooth restoration were treated in clinic with all-ceramic crowns. A visual analogue scale (VAS) was used to assess the satisfaction degree of patients after treatment. Clinical assessments were made by a prosthodontist in characters of feature, surface texture, hue, color distribution, incisal transparency, and individual characterization of all-ceramic crowns. Color-difference between the crowns and corresponding natural teeth was tested by Vita Easyshade electrical colorimetric instrument. The relationship between the last two items and patients' satisfaction degree was analyzed. RESULTS: There were significance differences in the different degree among all the six esthetic characters (P < 0.05), except good and moderate degrees in the character of hue (P = 0.553). And color distribution, individual characterization, and surface texture of the crowns showed high correlations with the satisfaction degree of patients (r = 0.485, 0.472, 0.467). Total color-differences, absolute value of hue-differences, and Deltaa between restorations and corresponding natural teeth were related to the satisfaction degree of patients, and Spearman correlation coefficient was -0.434, -0.371, and -0.406 (P < 0.05), respectively. CONCLUSIONS: All the esthetic characters assessed in clinic were related to the satisfaction degrees of patients, especially color distribution, individual characterization and surface texture. Total color-differences and hue-differences were correlated with the satisfaction degrees of patients as well.