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全麻下尽量减少拔牙可改善口腔健康:一种全面的方法。

A Comprehensive Approach Limiting Extractions under General Anesthesia Could Improve Oral Health.

机构信息

Université Clermont Auvergne, Centre de Recherche en Odontologie Clinique (CROC), F-63000 Clermont-Ferrand, France.

CHU Clermont-Ferrand, Service d'Odontologie, F-63003 Clermont-Ferrand, France.

出版信息

Int J Environ Res Public Health. 2020 Oct 8;17(19):7336. doi: 10.3390/ijerph17197336.

Abstract

Access to dental treatment could be difficult for some patients due to dental phobia or anxiety, cognitive or sensorial disabilities, systemic disorders, or social difficulties. General anesthesia (GA) was often indicated for dental surgery, and there is almost no available data on adapted procedures and materials that can be applied during GA for maintaining functional teeth on the arches and limiting oral dysfunctions. This study evaluates changes in oral health-related quality of life and mastication in a cohort of uncooperative patients treated under GA according to a comprehensive and conservative dental treatment approach. Dental status, oral health-related quality of life, chewed bolus granulometry, kinematic parameters of mastication, and food refusals were evaluated one month preoperatively (T0), and then one month (T1) and six months post-operatively (T2). One hundred and two adult patients (mean age ± SD: 32.2 ± 9.9 years; range: 18-57.7) participated in the preoperative evaluation, 87 were treated under GA of which 36 participated in the evaluation at T1 and 15 were evaluated at T2. Preoperative and postoperative data comparisons demonstrated that oral rehabilitation under GA helped increase chewing activity and oral health-related quality of life. The conditions for providing dental treatment under GA could be arranged to limit dental extractions in uncooperative patients.

摘要

由于牙科恐惧症或焦虑、认知或感觉障碍、全身疾病或社会困难,一些患者可能难以获得牙科治疗。全麻(GA)通常用于牙科手术,但几乎没有关于在 GA 期间可应用于保持弓上功能性牙齿和限制口腔功能障碍的适应性程序和材料的可用数据。本研究评估了根据综合保守牙科治疗方法在全麻下治疗的不合作患者的口腔健康相关生活质量和咀嚼变化。在术前一个月(T0)、术后一个月(T1)和术后六个月(T2)评估了牙齿状况、口腔健康相关生活质量、咀嚼团粒粒度、咀嚼运动学参数和食物拒绝情况。102 名成年患者(平均年龄 ± 标准差:32.2 ± 9.9 岁;范围:18-57.7)参加了术前评估,87 名患者接受了 GA 治疗,其中 36 名患者在 T1 时接受了评估,15 名患者在 T2 时接受了评估。术前和术后数据比较表明,GA 下的口腔康复有助于增加咀嚼活动和口腔健康相关生活质量。可以安排在 GA 下提供牙科治疗的条件,以限制不合作患者的拔牙。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3824/7579293/9c7a40718888/ijerph-17-07336-g001.jpg

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