摘要：Aims: To determine the frequency with which dental materials are used for direct coronal restorations and to evaluate the quality of the result. Method: We performed a cross-sectional survey involving 31 dental-surgeon advisors (chirurgiens-dentistesconseils) of the three mandatory health insurance funds of the Rhône-Alpes region based on a sample of 7,500 dental coronal restorations reimbursed in September 1998. The restorations were selected from a continuous series and appraised by using G. Ryge’s quality criteria, a guideline approved by the International Dental Federation. Results: We studied 7,164 dental coronal restorations in 3,796 patients which were performed by over 2,000 dental surgeons (more than half the total number of all dental surgeons working in the Rhône-Alpes region). The average time between treatment and examination by a dental surgeon advisor was 6.1 months (± 3.3 months). Amalgam was used in 52.2 % of the cases while 47.8 % of the patients had received composite resins. Large posterior dental restorations on both maxillaries were treated with an amalgam. Qualitatively, composite resin restorations demonstrated a better marginal adaptation and anatomic morphology than amalgam, but the chromatic tone was not always appropriate. Dental coronal restorations were clinically acceptable in 63.4 %, showed anomalies requiring clinical follow up in 19 % and 17.6 % presented significant defects requiring direct repair. Decay recurrence with amalgam was 8.6 % and 9.4 % with composite resins. Each year, the health insurance funds of the Rhône-Alpes region of France reimburse at least 10.7 million euros for defective dental coronal restorations (out of a total of 82.3 million euros reimbursed for all dental coronal restorations). Conclusion: We instituted a campaign to increase practitioner awareness to this problem and in two years, the Rhône-Alpes Regional Union of Local Health Care Offices (URCAM) will conduct an impact study.
