Tahmassebi J F, Achol L T, Fayle S A
Department of Paediatric Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK,
Eur Arch Paediatr Dent. 2014 Oct;15(5):353-60. doi: 10.1007/s40368-014-0123-2. Epub 2014 Mar 28.
This study aimed to analyse the characteristics of comprehensive dental care provided under general anaesthesia (CDGA) and to review the additional treatment required by children over the 6 years subsequent to CDGA.
Information collected from hospital records for the 6-year period following the first CDGA included the types of dental treatment performed at CDGA, the return rates for follow-up appointments, further treatment required subsequent to CDGA and the types of dental treatment performed at repeat DGA.
The study population consisted of 263 children, of whom 129 had a significant medical history, with mean age of 6.7 years. The results revealed that the waiting time for CDGA was significantly shorter in children who had a significant medical history, with 49% being admitted for CDGA within 3 months of pre-GA assessment, as compared to 29% of healthy children. 67% of children had follow-up care recorded, with a slightly higher proportion of children with significant medical history returning for follow-up [70% (90/129)] compared with 65% (87/134) of healthy children. Re-treatment rates were 34% (88/263), the majority of cases being treated under local analgesia (42/88). 34 of 263 children had repeat DGA (12.9%). Of these 71% (24/34) were children with significant medical history. The mean age at repeat DGA was 9 years. In 25 of 34 children (74%), repeat DGA was due to trauma, oral pathology, supernumerary removal, hypomineralized teeth or new caries of previously sound or un-erupted teeth at CDGA. The ratio of extraction over restoration (excluding fissure sealants) performed at repeat DGA was 2.8, compared with the ratio of 1.3 in the initial CDGA.
There was a higher ratio of extraction over restorations at the repeat DGA. This suggests that the prescribed treatments at repeat DGA were more aggressive as compared to the initial CDGA in 1997. The majority of the treatment required at repeat DGA was to treat new disease.
本研究旨在分析全身麻醉下综合牙科护理（CDGA）的特点，并回顾接受CDGA治疗后的6年里儿童所需的额外治疗。
从首次CDGA后6年的医院记录中收集的信息包括在CDGA时进行的牙科治疗类型、随访预约的复诊率、CDGA后所需的进一步治疗以及在重复全身麻醉牙科治疗（DGA）时进行的牙科治疗类型。
研究人群包括263名儿童，其中129名有重大病史，平均年龄6.7岁。结果显示，有重大病史的儿童接受CDGA的等待时间明显更短，49%的儿童在全身麻醉前评估的3个月内接受了CDGA，而健康儿童这一比例为29%。67%的儿童有随访记录，有重大病史的儿童复诊比例略高于健康儿童[70%（90/129）]，健康儿童为65%（87/134）。再治疗率为34%（88/263），大多数病例在局部麻醉下接受治疗（42/88）。263名儿童中有34名接受了重复DGA（12.9%）。其中71%（24/34）是有重大病史的儿童。重复DGA时的平均年龄为9岁。在34名儿童中的25名（74%）中，重复DGA是由于创伤、口腔病变、多生牙拔除、牙齿矿化不全或CDGA时原本完好或未萌出牙齿出现新龋。重复DGA时拔牙与修复（不包括窝沟封闭）的比例为2.8，而初始CDGA时这一比例为1.3。
重复DGA时拔牙与修复的比例更高。这表明与1997年的初始CDGA相比，重复DGA时规定的治疗更积极。重复DGA时所需的大多数治疗是针对新疾病。
