Dr. Azadani is an assistant professor, The Ohio State University College of Dentistry, and attending pediatric dentist, Nationwide Children's Hospital, Columbus, Ohio, USA;, Email:
Dr. Casamassimo is professor Emeritus, The Ohio State University College of Dentistry, and attending pediatric dentist, Nationwide Children's Hospital, Columbus, Ohio, USA.
Pediatr Dent. 2021 Sep 15;43(5):380-386.
The purpose of this study was to investigate an association between treatments on the primary second molars (PSMs) under general anesthesia (GA) and odds of repeat GA. This was a retrospective study of children who received dental treatment under GA between the ages of 24 to 48 months. Descriptive statistics and logistic regression models (P<0.05) were used to test the association between the treatment of PSMs at the first dental GA visit (GA1) and the odds of receiving GA a second time (GA2) within the next 55 months post-GA1. A total of 819 children (53 percent male) with a mean (±SD) age of 36 (±seven SD) months and 3,276 PSMs were included. Only three percent of children with all PSMs covered at GA1 received GA2. The odds of GA2 significantly increased for children with any uncovered PSMs. Among children with four uncovered PSMs, 19 percent (odds ratio [OR] equals 13; 95 percent confidence interval [95% CI] equals 5.8 to 33.5; P<0.001) and among those with unerupted PSMs at GA1, 51 percent received GA2 (OR equals 62.9; 95% CI equals 23.5 to 189.2; P<0.001). In the group that received GA2, 79.1 percent of uncovered PSMs at GA1 eventually received a stainless steel crown at GA2. Restorative treatments other than stainless steel crowns were associated with higher odds of repeat general anesthesia. These findings support the preferential use of full-coverage restorations for the treatment of carious primary molars in young children undergoing GA to minimize the risk of the need for repeat GA.
本研究旨在探讨全身麻醉（GA）下第一磨牙（PSM）治疗与再次 GA 可能性之间的关联。这是一项回顾性研究，纳入了年龄在 24 至 48 个月之间接受 GA 下牙科治疗的儿童。采用描述性统计和逻辑回归模型（P<0.05）来检验 GA1 时 PSM 治疗与 GA1 后 55 个月内再次接受 GA（GA2）的可能性之间的关联。共纳入 819 名（53%为男性）儿童，平均（±标准差）年龄为 36（±7 标准差）个月，共有 3276 颗 PSM。仅 3%的 GA1 时所有 PSM 均被覆盖的儿童接受了 GA2。任何未覆盖的 PSM 的儿童 GA2 的可能性显著增加。在四颗未覆盖的 PSM 的儿童中，19%（比值比[OR]等于 13；95%置信区间[95%CI]等于 5.8 至 33.5；P<0.001），在 GA1 时未萌出 PSM 的儿童中，51%接受了 GA2（OR 等于 62.9；95%CI 等于 23.5 至 189.2；P<0.001）。在接受 GA2 的组中，79.1%的 GA1 时未覆盖的 PSM 最终在 GA2 时被不锈钢冠覆盖。GA2 时除不锈钢冠外的其他修复治疗与再次 GA 的可能性更高相关。这些发现支持在对接受 GA 的幼儿进行 PSM 龋齿治疗时，优先采用全冠修复，以最小化再次 GA 的风险。
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