Sheller Barbara, Williams Bryan J, Hays Katrina, Mancl Lloyd
Children's Hospital and Regional Medical Center, Seattle, Wash, USA.
Pediatr Dent. 2003 Nov-Dec;25(6):546-52.
This study investigated reasons a healthy child may need repeat dental treatment under general anesthesia (GA).
Experimental subjects were 23 healthy children who received dental treatment under GA twice; controls were 23 healthy children requiring a single dental treatment session under GA. Records review determined demographics, intraoperative information, diagnosis, and treatment provided. Parents of 11 subjects and 9 controls competed a questionnaire and were interviewed.
Many factors differed between subject and control children. Common characteristics of children requiring repeat care under GA (subjects) were: (1) 100% percent caries involvement of maxillary central incisors at time of initial treatment; (2) majority of central incisors were nonrestorable; (3) still using nursing bottle at the time of GA; (4) child responsible for brushing own teeth; (5) poor cooperation in the medical and dental setting; (6) difficult personality as described by parent; (7) dysfunctional social situation; and (8) lack of follow-up dental care. Stainless steel crowns were the most successful restoration placed.
A number of predictors were found to help identify high-risk children. Best outcomes following dental rehabilitation under GA may result from aggressive treatment of caries, active follow-up, and education of parents.
本研究调查了健康儿童可能需要在全身麻醉(GA)下接受重复牙科治疗的原因。
实验对象为23名接受了两次GA下牙科治疗的健康儿童;对照组为23名需要在GA下进行单次牙科治疗的健康儿童。通过记录审查确定人口统计学信息、术中信息、诊断和所提供的治疗。11名实验对象和9名对照组儿童的家长完成了一份问卷并接受了访谈。
实验对象儿童和对照儿童之间存在许多差异因素。需要在GA下接受重复治疗的儿童(实验对象)的共同特征为:(1)初次治疗时上颌中切牙100%患龋;(2)大多数中切牙无法修复;(3)在GA时仍使用奶瓶;(4)孩子自己负责刷牙;(5)在医疗和牙科环境中合作性差;(6)家长描述其性格倔强;(7)社会情况不良;(8)缺乏后续牙科护理。不锈钢冠是最成功的修复方式。
发现了一些有助于识别高危儿童的预测因素。GA下牙科康复后的最佳效果可能源于积极的龋齿治疗、积极的随访以及对家长的教育。