Fakhruddin Kausar Sadia, Hisham El Batawi, Gorduysus Mehmet Omer
College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Department of Endodontics, Hacettepe University, Faculty of Dentistry, Turkiye.
Eur J Dent. 2015 Oct-Dec;9(4):470-475. doi: 10.4103/1305-7456.172637.
The aim of this study is to assess the effectiveness of audiovisual distraction technique with video eyewear and computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in phobic pediatric patients undergoing pulp therapy of primary molars.
This randomized, crossover clinical study includes 60 children, aged between 4 and 7-year-old (31 boys and 29 girls). Children were randomly distributed equally into two groups as A and B. This study involved two treatment sessions of pulp therapy, 1-week apart. During treatment session I, group A had an audiovisual distraction with video eyewear, whereas group B had audiovisual distraction using projector display only without video eyewear. During treatment session II, group A had undergone pulp therapy without video eyewear distraction, whereas group B had the pulp treatment using video eyewear distraction. Each session involved the pulp therapy of equivalent teeth in the opposite sides of the mouth. At each visit scores on the Modified Child Dental Anxiety Scale (MCDAS) (f) were used to evaluate the level of anxiety before treatment. After the procedure, children were instructed to rate their pain during treatment on the Wong Bakers' faces pain scale. Changes in pulse oximeter and heart rate were recorded in every 10 min.
From preoperative treatment session I (with video eyewear) to preoperative treatment session II (without video eyewear) for the MCDAS (f), a significant (P > 0.03) change in the mean anxiety score was observed for group A. Self-reported mean pain score decreases dramatically after treatment sessions' with video eyewear for both groups.
The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.
本研究旨在评估在对患有恐惧症的乳牙牙髓治疗的儿科患者进行局部麻醉时，使用视频眼镜和计算机化给药系统-龈沟内给药（CDS-IS）的视听分心技术的有效性。
这项随机交叉临床研究纳入了60名4至7岁的儿童（31名男孩和29名女孩）。儿童被随机平均分为A组和B组。本研究包括两个牙髓治疗疗程，间隔1周。在治疗疗程I期间，A组使用视频眼镜进行视听分心，而B组仅使用投影仪显示屏进行视听分心，不使用视频眼镜。在治疗疗程II期间，A组在无视频眼镜分心的情况下进行牙髓治疗，而B组使用视频眼镜分心进行牙髓治疗。每个疗程都涉及口腔对侧相应牙齿的牙髓治疗。每次就诊时，使用改良儿童牙科焦虑量表（MCDAS）（f）评分来评估治疗前的焦虑程度。治疗后，指导儿童在面部表情疼痛量表上对治疗期间的疼痛进行评分。每10分钟记录一次脉搏血氧饱和度和心率的变化。
对于MCDAS（f），从术前治疗疗程I（使用视频眼镜）到术前治疗疗程II（不使用视频眼镜），A组的平均焦虑评分出现了显著变化（P>0.03）。两组在使用视频眼镜进行治疗疗程后，自我报告的平均疼痛评分均显著降低。
事实证明，与常规心理干预相比，使用视频眼镜进行视听分心以及使用CDS-IS系统进行麻醉给药在提高儿童合作度方面是有效的，因此，强烈推荐将其作为一种有效的行为管理技术，用于幼儿牙髓治疗的长时间侵入性操作。
