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在巴西低收入地区,单次就诊根管治疗是否可行?

Single-session Endodontic Treatment is a Reality in Low-income Areas in Brazil?

作者信息

Nagata Juliana Y, Fagundes Fernanda B, Münchow Eliseu A, Albuquerque Maria Tp

机构信息

Dentistry Department, Endodontics, Federal University of Sergipe, Lagarto, Sergipe, Brazil, e-mail:

Department of Clinical Dentistry, Endodontics, Federal University of Bahia, Salvador, Bahia, Brazil.

出版信息

J Contemp Dent Pract. 2020 Jun 1;21(6):657-665.

Abstract

AIM

The present study aimed to investigate the total number of visits required to conclude root canal treatments (RCTs) as well as the motivations associated to the choice of dentists practicing in low-income areas of Brazil.

MATERIALS AND METHODS

A total of 3,103 questionnaires were electronically and individually delivered to professionals of Salvador, Sergipe, and Alagoas (Brazil). The questionnaire encompassed sociodemographic data and questions regarding the number of sessions required to conclude RCT. Also, postoperative pain, professional qualification, the use of technological resources, and time for one-visit treatment were evaluated. Data were analyzed using Chi-square and Poisson regression analyses ( < 0.05).

RESULTS

A total of 326 responses were obtained with higher prevalence of specialists in the field of endodontics (36.8%). Dentists reported greater preference for rotary instrumentation (Alagoas 54.6%, Aracaju 62.1%, and Salvador 83.5%), and most of the participants reported multiple visits to treat root canals with the necrotic pulp tissue associated or not to periapical radiolucency, excluding Salvador (53.8%). Dentists who graduated in public dental schools were less likely to perform RCT of necrotic teeth with periapical lesion in one clinical appointment ( = 0.034). The single-session therapy was positively associated to continuing education attendance ( = 0.004) and to the occurrence of clinical complications ( < 0.001). Dentists who graduated in programs were more likely to conclude RCT in less than 60 minutes ( < 0.001), although the occurrence of postoperative pain was more likely observed upon this scenario ( < 0.001).

CONCLUSION

Despite the social inequalities in the analyzed area, professionals have been seeking for knowledge by means of continuing education programs and the implementation of technological resources in their clinical routine, although this fact has poorly influenced the acceleration of RCT. Clinical significances: The total number of visits to conclude endodontic treatment may be influenced by both professional and biological parameters such as the attendance to postgraduation programs and the use of technology as well as to the biological condition of the pulp and the occurrence of postoperative complications.

摘要

目的

本研究旨在调查完成根管治疗(RCT)所需的就诊总次数,以及与在巴西低收入地区执业的牙医选择相关的动机。

材料与方法

通过电子方式向巴西塞尔希培州、阿拉戈斯州和巴伊亚州萨尔瓦多市的专业人员共发放3103份问卷。问卷包括社会人口统计学数据以及关于完成RCT所需疗程数的问题。此外,还评估了术后疼痛、专业资格、技术资源的使用以及一次性治疗所需时间。采用卡方检验和泊松回归分析对数据进行分析(P<0.05)。

结果

共获得326份回复,牙髓病学领域的专家占比更高(36.8%)。牙医表示更倾向于使用旋转器械(阿拉戈斯州54.6%、阿拉卡茹62.1%、萨尔瓦多83.5%),并且大多数参与者报告对伴有或不伴有根尖周透射区的坏死牙髓组织进行根管治疗需要多次就诊,但萨尔瓦多除外(53.8%)。毕业于公立牙科学校的牙医在一次临床就诊中对伴有根尖周病变的坏死牙齿进行RCT的可能性较小(P=0.034)。单次治疗与参加继续教育(P=0.004)和临床并发症的发生呈正相关(P<0.001)。毕业于特定项目的牙医在不到60分钟内完成RCT的可能性更大(P<0.001),尽管在这种情况下术后疼痛的发生率更高(P<0.001)。

结论

尽管所分析地区存在社会不平等,但专业人员一直在通过继续教育项目寻求知识,并在临床常规中采用技术资源,尽管这一事实对加速RCT的影响不大。临床意义:完成牙髓治疗的就诊总次数可能受到专业和生物学参数的影响,如参加研究生课程、技术的使用以及牙髓的生物学状况和术后并发症的发生。

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