Vinckier F, Gizani S, Declerck D
Paediatric and Preventive Dentistry, Department of Operative Dentistry, School for Dentistry, Faculty of Medicine, Catholic University Leuven, Belgium.
Int J Paediatr Dent. 2001 Jan;11(1):25-32. doi: 10.1046/j.1365-263x.2001.00204.x.
Critical reflection on treatment strategy for dental rehabilitation of young children with rampant caries using day-stay general anaesthesia at a university dental clinic.
Cross-sectional analysis of 98 cases.
The study was undertaken at the university paediatric dental clinic of Leuven, Belgium.
The sample consisted of 98 healthy patients referred for dental treatment under general anaesthesia with a mean age of 4.8 (+/- 1.1) years and mean dmft-score of 9.3 (+/- 3.0). Data were obtained by history taking, clinical examination, questionnaires (filled in by parents) and standardized data records (filled in by dentists and nurses in the recovery area and day-stay clinic).
Most patients were referred by their private dentist (74.5%) because of a need for extensive dental treatment in an uncooperative child. Induction of anaesthesia was upsetting in a significant number of cases (68% of children). The mean duration of the whole procedure was 80.9 (+/- 24.7) minutes. A mean number of 7.2 (+/- 2.9) primary teeth were filled and 1.8 (+/- 2.0) extracted per patient. Post-operative problems (nausea/vomiting, temperature rise) were seen in only 8.2% of the patients.
The technique used at this centre allows for extensive dental treatment of young children with a high level of acceptability and minimal morbidity, using day-stay general anaesthesia. Based on this review, it became clear that less upsetting methods for the induction of anaesthesia need to be explored. Criteria for the administration of antibiotics need to be defined more clearly and the use of stainless steel crowns should be envisaged for restorations on primary molars. The global outcome of this treatment provision in children at high caries risk should be evaluated over a longer period, including an evaluation of oral health status, restorative treatment (conservation vs. extraction) and behavioural aspects.
对一所大学牙科诊所采用日间住院全身麻醉为重度龋齿幼儿进行牙齿修复的治疗策略进行批判性反思。
对98例病例进行横断面分析。
该研究在比利时鲁汶大学儿科牙科诊所进行。
样本包括98例因全身麻醉下接受牙科治疗而转诊的健康患者，平均年龄4.8（±1.1）岁，平均乳牙龋失补牙面数（dmft）为9.3（±3.0）。数据通过病史采集、临床检查、问卷（由家长填写）以及标准化数据记录（由恢复区和日间住院诊所的牙医和护士填写）获得。
大多数患者（74.5%）由其私人牙医转诊，原因是不合作儿童需要进行广泛的牙科治疗。相当数量的病例（68%的儿童）在麻醉诱导时感到不适。整个手术的平均时长为80.9（±24.7）分钟。每位患者平均填充7.2（±2.9）颗乳牙，拔除1.8（±2.0）颗乳牙。仅8.2%的患者出现术后问题（恶心/呕吐、体温升高）。
该中心所采用的技术通过日间住院全身麻醉，能够对幼儿进行广泛的牙科治疗，且具有较高的可接受性和最低的发病率。基于此次综述，显然需要探索对麻醉诱导干扰较小的方法。抗生素使用标准需要更明确地界定，并且应考虑在乳牙磨牙修复中使用不锈钢冠。对于高龋风险儿童的这种治疗的整体效果应在更长时期内进行评估，包括口腔健康状况、修复治疗（保存与拔除）以及行为方面的评估。
