School of Dentistry, University of Leeds, Leeds, United
School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
Caries Res. 2019;53(1):65-75. doi: 10.1159/000487201. Epub 2018 Jun 25.
Over the last years, conventional restorations for the treatment of active carious lesions (CL) in primary teeth have been challenged and a more biological approach has been suggested. This approach involves less invasive techniques that alter the environment of the CL isolating it from the cariogenic biofilm and substrate.
To investigate the cost-effectiveness and patient acceptance of 2 treatment approaches for the treatment of deep CLs in primary teeth in children.
This was a retrospective/prospective cohort study carried out in 2 UK specialist hospital settings. Data on cost-effectiveness was extracted retrospectively from clinical dental records of 246 patients aged 4-9 years. A prospective study design was used to explore patient acceptance of the 2 treatment approaches. One hundred and ten patients aged 4-9 years and their carers completed 2 questionnaires on treatment acceptance.
In total, 836 primary teeth that had received treatment with either approach were included. More than 2 thirds (75.7%) of the restorations in the conventional approach were of non-selective removal to hard dentine followed by pulpotomy (24.3%). In the biological approach, most of the restorations were stainless steel crowns placed with the Hall Technique (95%) followed by selective removal to firm dentine (5%). The majority of the primary teeth remained asymptomatic after a follow-up period of up to 77 months; 95.3% in the conventional and 95.8% in the biological arm. When the treatment costs were analysed, a statistically significant difference was found between the mean costs of the 2 approaches with a mean difference of GBP 45.20 (Pound Sterling; p < 0.001), in favour of the biological approach. The majority of the children and carers were happy with the conventional or biological restorations.
Although both approaches had similar successful outcomes, the biological approach consisting mainly of Hall Technique was associated with reduced treatment costs. Both approaches were accepted favourably by the children and carers.
在过去的几年中，针对乳牙活跃龋损（CL）的传统修复方法受到了挑战，人们提出了一种更具生物学性的方法。这种方法涉及到侵入性更小的技术，通过改变 CL 的环境将其与致龋生物膜和底物隔离开来。
调查两种治疗方法治疗儿童乳牙深龋的成本效益和患者接受程度。
这是一项在英国两家专科医院进行的回顾性/前瞻性队列研究。从 246 名 4-9 岁儿童的临床牙科记录中回顾性提取成本效益数据。前瞻性研究设计用于探索两种治疗方法的患者接受程度。110 名 4-9 岁的患者及其照顾者完成了两份关于治疗接受度的问卷。
总共纳入了接受过两种治疗方法之一治疗的 836 颗乳牙。在传统方法中，超过三分之二（75.7%）的修复是在硬牙本质上进行非选择性去除，然后进行活髓切断术（24.3%）。在生物学方法中，大多数修复是采用 Hall 技术放置不锈钢冠（95%），其次是选择性去除至硬牙本质（5%）。在长达 77 个月的随访期间，大多数乳牙仍然无症状；传统组为 95.3%，生物学组为 95.8%。当分析治疗成本时，发现两种方法的平均成本之间存在统计学显著差异，生物组的平均差异为 45.20 英镑（英镑；p<0.001），有利于生物学方法。大多数儿童及其照顾者对传统或生物修复均满意。
尽管两种方法的治疗效果相似，但主要采用 Hall 技术的生物学方法与降低治疗成本相关。两种方法都得到了儿童和照顾者的认可。
