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门诊、全麻下成年脆弱患者的口腔护理——治疗需求和口腔随访护理的回顾性评估。

Outpatient, dental care of adult vulnerable patients under general anaesthesia-a retrospective evaluation of need for treatment and dental follow-up care.

机构信息

Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.

Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.

出版信息

Clin Oral Investig. 2021 Apr;25(4):2407-2417. doi: 10.1007/s00784-020-03564-2. Epub 2020 Sep 15.

Abstract

OBJECTIVES

To analyse the treatment needs of patients who had received dental treatment under GA and the effectiveness of the treatment provided.

MATERIALS AND METHODS

Retrospective chart analysis of adult at risk and vulnerable patients requiring dental treatment under GA (2007-2017). Outcome variables were indications for GA, DMF/T, and type of treatment, failure rates of treated teeth, emergencies and recall intervals after GA.

RESULTS

Four hundred fourteen subjects (median age 42 years, range 18-93 years) were assigned to four groups (people with disabilities (pwdis), dementias (pwd), dental phobias (pwph), and addictions/psychosocial disorders (pwapd)) and attended the pre-GA assessment. Of these, 247 subjects (median 37 years, range 18-93 years) were treated under GA, mostly pwdis (n = 154, 69.7%). The main indication for treatment under GA was suspicion of pain (n = 178, 72.1%). Pwd had the highest degree of restoration (46.7%), DMF/T value (23.8), and most missing teeth (5.8). Pwapd had the most decayed teeth (12.9). There was a 12-month recall augmented by 2-4 oral hygiene sessions depending on compliance. The failure rate of all treated teeth was 4%. Two dental emergencies were reported for patients who received a GA.

CONCLUSIONS

Dental treatment need was high for adult vulnerable people. The diagnostic groups differed mainly in their subjective reason for need of a GA, their DMF/T, treatment needs and type of treatments performed. Failure and dental emergency rates after GA were low in spite of a recall interval of 12 months.

CLINICAL RELEVANCE

Regular annual recalls could avoid dental emergencies in patients requiring treatment under GA.

摘要

目的

分析接受全身麻醉下牙科治疗的患者的治疗需求以及治疗效果。

材料和方法

对 2007 年至 2017 年间需要全身麻醉下牙科治疗的高危和脆弱成年患者进行回顾性图表分析。主要结局变量为全身麻醉适应证、DMFT/T、治疗类型、治疗后牙齿失败率、全身麻醉后紧急情况和复诊间隔。

结果

411 例患者(平均年龄 42 岁,范围 18-93 岁)分为四组(残疾人士组、痴呆症组、牙科恐惧症组、成瘾/精神障碍组),并接受了全身麻醉前评估。其中 247 例(平均 37 岁,范围 18-93 岁)患者接受了全身麻醉治疗,主要为残疾人士(n = 154,69.7%)。全身麻醉治疗的主要适应证是怀疑疼痛(n = 178,72.1%)。痴呆症患者的修复程度最高(46.7%),DMFT/T 值最高(23.8),缺牙数最多(5.8 颗)。成瘾/精神障碍患者的龋齿数最多(12.9)。根据患者的依从性,每 12 个月增加 2-4 次口腔卫生随访。所有治疗牙齿的失败率为 4%。报告了 2 例接受全身麻醉的患者发生的 2 例牙科急症。

结论

高危脆弱人群的牙科治疗需求较高。诊断组之间的主要区别在于需要全身麻醉的主观原因、DMFT/T、治疗需求和所进行的治疗类型。尽管全身麻醉后的复诊间隔为 12 个月,但全身麻醉后失败和牙科急症的发生率较低。

临床相关性

定期进行年度复查可避免需要全身麻醉治疗的患者发生牙科急症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cf/7966127/ce6c7d324fbd/784_2020_3564_Fig1_HTML.jpg

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