Pediatric Dentist, private practice, Nashville, Tennessee, USA.
Assistant Professor, Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Eur J Paediatr Dent. 2017 Dec;18(4):313-318. doi: 10.23804/ejpd.2017.18.04.09.
The purpose of this chart review study was to investigate the common factors that exist in paediatric patients requiring a repeat dental treatment under general anaesthesia (GA2) within four years after the initial dental treatment under general anaesthesia (GA1).
The Electronic Health Records of one to 12 year-old children who received dental treatment under general anaesthesia (GA) between April 2004 and October 2009 were identified and analysed by a single examiner. Children who had GA2, within a four year period following GA1 were categorised as cases. Children who had only one dental treatment under GA were considered the control pool. Each case was matched to three controls based on sex and age range at GA1 of ± 6 months. Other recorded variables included: date of birth, date of GAs (GA1 and GA2 for cases; GA1 for controls), type of payment, dmfs before GA1, dental treatments provided under GA, return of 1-week post-GA1 follow-up, frequency of recare/recall visits following one-year post-GA1 visit and the type and frequency of post GA1 emergency visits.
Out of 581 subjects, 29 (4.99%) cases were matched to 87 controls. Medically compromised patients had four times the risk of GA2. At GA1, cases received statistically significant less sealants (p=0.026), less extractions (p<0.0001), and more composite restorations (p=0.0002) compared to controls.
Medically compromised children and children treated with more composites and fewer sealants and extractions at their initial dental treatment under general anaesthesia were more likely to have a repeat dental treatment under general anaesthesia within 4 years.
本图表回顾性研究旨在调查在初次全身麻醉(GA1)下接受牙科治疗后四年内再次需要全身麻醉(GA2)的儿科患者中存在的共同因素。
通过一名检查人员对 2004 年 4 月至 2009 年 10 月期间接受全身麻醉(GA)牙科治疗的 1 至 12 岁儿童的电子健康记录进行了识别和分析。在 GA1 后四年内接受 GA2 的儿童被归类为病例。仅接受一次 GA 下牙科治疗的儿童被视为对照组。每个病例根据性别和 GA1 时的年龄范围(± 6 个月)与三个对照组相匹配。其他记录变量包括:出生日期、GA 日期(病例为 GA1 和 GA2;对照组为 GA1)、付款类型、GA1 前 dmfs、GA 下提供的牙科治疗、GA1 后 1 周随访的返回情况、GA1 后 1 年随访后再次就诊/召回的频率以及 GA1 后急诊就诊的类型和频率。
在 581 名患者中,29 例(4.99%)病例与 87 例对照组相匹配。患有医学合并症的患者发生 GA2 的风险增加了四倍。在 GA1 时,病例组接受的窝沟封闭剂数量明显减少(p=0.026),拔牙数量明显减少(p<0.0001),复合树脂修复数量明显增多(p=0.0002),与对照组相比。
在初次全身麻醉下接受牙科治疗时患有医学合并症的儿童以及接受更多复合树脂治疗、更少窝沟封闭剂和拔牙的儿童,在 4 年内再次接受全身麻醉下牙科治疗的可能性更大。