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62例残疾儿童及青少年全身麻醉下牙科治疗的回顾性研究

[Retrospective study of dental treatment under general anesthesia of 62 disabled children and adolescents].

作者信息

Wang N, Zhao Y M

机构信息

Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Apr 18;50(2):293-299.

Abstract

OBJECTIVE

To retrospectively figure out the oral health status, treatment and follow-ups after dental treatment under general anesthesia (DGA) of disabled children or adolescents.

METHODS

Clinical data of disabled children or adolescents and normal children as control received DGA in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from August 2008 to September 2015 were recorded, including: gender, birth date, treatment date, disability type, oral health status before treatment, treatment content and follow-ups (in 1 year). Differences among ages and disabilities were analyzed statistically.

RESULTS

Sixty-two disabled patients and fifty-seven controls were recruited, mean aged (9.38±5.22) years and (3.00±1.41) years. Most patients had 10 to 15 problem teeth with which the mean number of the disabled children and adolescents was (11.79±4.98) while that of the normal controls was (12.40±4.11). Caries, pulpitis, periapical periodontitis, dental trauma and developmental tooth anomalies of the disabled patients accounted for 67.56%, 13.54%, 15.15%, 1.07%, and 2.68%, respectively and the DMFT/dmft index was 11.55±5.56 while in the control group those were at 65.35%,19.09%,14.14%,0,1.41% and 12.23±4.42. The DMFT/dmft index of the disabled patients in the group 6-12 years (8.35±4.69) was significantly less than that of the other three groups (P<0.01) while no differences were found in disabilities (P=0.239). Resin restoration, pit and fissure sealant, preventive resin restoration, pulpotomy, pulpectomy/RCT, extraction and crown of the disabled patients were performed as 52.71%, 7.24%, 8.56%, 0.72%, 17.13%, 10.01% and 3.62% respectively whereas those made up as 56.31%, 1.27%, 0.13%, 2.29%, 19.87%, 7.90% and 12.23% in the control group. Thirty-five (56.45%) disabled patients and forty-three (75.44%) controls recalled. Problem teeth within one year after operation in diabled patients and controls were both nearly twice as much as the number within half a year. Restoration loss/fractured mainly occurred in anterior primary teeth while secondary/ recurrent caries and pulpitis/perapical periodontitis mostly occurred in primary molars.

CONCLUSION

Oral health status in our disabled children and adolescents is poor. Though dental treatment under GA is an effective way to improve the oral health of disabled children and adolescents, periodic follow-ups and family oral health care are equal important for oral health maintenance.

摘要

目的

回顾性分析残疾儿童或青少年在全身麻醉下牙科治疗(DGA)后的口腔健康状况、治疗情况及随访情况。

方法

记录2008年8月至2015年9月在北京大学口腔医学院儿童口腔科接受DGA的残疾儿童或青少年以及作为对照的正常儿童的临床资料,包括:性别、出生日期、治疗日期、残疾类型、治疗前口腔健康状况、治疗内容及随访情况(1年内)。对年龄和残疾情况的差异进行统计学分析。

结果

共纳入62例残疾患者和57例对照,平均年龄分别为(9.38±5.22)岁和(3.00±1.41)岁。大多数患者有10至15颗问题牙,残疾儿童和青少年的平均问题牙数为(11.79±4.98)颗,正常对照为(12.40±4.11)颗。残疾患者的龋病、牙髓炎、根尖周炎、牙外伤和发育性牙异常分别占67.56%、13.54%、15.15%、1.07%和2.68%,DMFT/dmft指数为11.55±5.56,而对照组分别为65.35%、19.09%、14.14%、0、1.41%和12.23±4.42。6至12岁组残疾患者的DMFT/dmft指数(8.35±4.69)显著低于其他三组(P<0.01),而不同残疾情况之间无差异(P=0.239)。残疾患者进行树脂修复、窝沟封闭、预防性树脂修复、牙髓切断术、根管治疗/根管充填、拔牙和冠修复的比例分别为52.71%、7.24%、8.56%、0.72%、17.13%、10.01%和3.62%,而对照组分别为56.31%、1.27%、0.13%、2.29%、19.87%、7.90%和12.23%。35例(56.45%)残疾患者和43例(75.44%)对照进行了随访。残疾患者和对照术后1年内的问题牙数量几乎是半年内的两倍。修复体脱落/折断主要发生在前牙乳牙,而继发/复发性龋和牙髓炎/根尖周炎大多发生在乳磨牙。

结论

我国残疾儿童和青少年的口腔健康状况较差。虽然全身麻醉下的牙科治疗是改善残疾儿童和青少年口腔健康的有效方法,但定期随访和家庭口腔保健对维持口腔健康同样重要。

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