全麻下口腔治疗的临床效果及其对儿童龋齿活动度和身体生长的影响:一项 2 年回顾性研究。
Clinical outcomes of dental treatment under general anesthesia and its effects on the caries activity and body growth of children: a 2-year retrospective study.
机构信息
Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, No. 500 Quxi Road, Huangpu District, Shanghai, China.
出版信息
Clin Oral Investig. 2022 May;26(5):4091-4098. doi: 10.1007/s00784-022-04377-1. Epub 2022 Feb 3.
OBJECTIVES
To analyze clinical outcomes of dental treatment under general anesthesia (DGA) and its effects on children's caries activity status and body growth within 2 years after the treatment.
MATERIALS AND METHODS
The case data and 2-year follow-up records of children who underwent DGA from February 2017 to February 2018 were collected and analyzed. The general characteristics of the sample, the success rates of treatment procedures, the caries recurrence rate, the caries activity test scores, and the BMI of all the children were described. The caries activity levels between children with and without caries recurrence at 24 months after DGA were compared before and after DGA to explore the relationship between caries activity level and caries recurrence. The correlation between BMI level and caries recurrence was explored using Cox regression analysis.
RESULTS
A total of 94 children consisting of 46 boys and 48 girls were included in this study. The average dmft score before DGA was 13.90. Within 2 years after the treatment, composite fillings and strip crowns of the anterior teeth achieved similar success rates, around 90%; SSCs showed a similar success rate to composite fillings of posterior teeth (P = 1.000); the clinical success rate of pulpectomy was 90.43%. All the children showed no caries relapse at 1 month after DGA. The number of children with caries relapse at 6-, 12-, and 24-month post-treatment was 24 (25.53%), 35 (37.23%), and 53 (56.38%), respectively. The caries activity scores at each follow-up were significantly lower than those before the treatment (P < 0.0001). Children with caries relapse within 2 years after DGA showed no significantly different caries activity scores than children without caries relapse before and after the treatment. The proportion of children with normal BMI at 12 months after DGA was significantly higher than that before DGA (P = 0.007), and the difference was still very significant at 24 months after DGA (P < 0.0001). Statistical results showed a correlation between BMI level before DGA and caries recurrence (P < 0.001).
CONCLUSIONS
Dental treatment under general anesthesia achieves acceptable clinical outcomes in this study. Children's caries activity scores decrease significantly. Low or high BMI levels before DGA drift towards normal after the treatment.
CLINICAL RELEVANCE
Acceptable outcomes are achieved within 2 years after dental treatment under general anesthesia. However, children with abnormal BMI before the treatment tend to have caries relapse.
目的
分析儿童全麻下牙科治疗(DGA)的临床效果,并探讨其对治疗后 2 年内儿童龋齿活动状态和身体生长的影响。
材料与方法
收集 2017 年 2 月至 2018 年 2 月接受 DGA 的儿童的病例资料和 2 年随访记录。描述样本的一般特征、治疗程序的成功率、龋齿复发率、龋齿活动测试评分和所有儿童的 BMI。比较 DGA 后 24 个月有和无龋齿复发儿童的龋齿活动水平,以探讨龋齿活动水平与龋齿复发的关系。采用 Cox 回归分析探讨 BMI 水平与龋齿复发的相关性。
结果
本研究共纳入 94 例儿童,其中男 46 例,女 48 例。DGA 前平均 dmft 评分为 13.90。治疗后 2 年内,前牙复合树脂充填和带状冠的成功率相近,约为 90%;SSC 后牙复合树脂充填成功率相似(P=1.000);牙髓切除术的临床成功率为 90.43%。所有儿童在 DGA 后 1 个月均无龋齿复发。治疗后 6、12 和 24 个月时,有 24(25.53%)、35(37.23%)和 53(56.38%)例儿童发生龋齿复发。各随访时龋齿活动评分均明显低于治疗前(P<0.0001)。DGA 后 2 年内发生龋齿复发的儿童,其治疗前后的龋齿活动评分无显著差异。DGA 后 12 个月时,BMI 正常的儿童比例明显高于 DGA 前(P=0.007),24 个月时仍非常显著(P<0.0001)。统计结果显示,DGA 前 BMI 水平与龋齿复发有关(P<0.001)。
结论
本研究中,全麻下牙科治疗的临床效果可接受。儿童的龋齿活动评分显著下降。DGA 前低或高 BMI 水平在治疗后向正常水平漂移。
临床意义
全麻下牙科治疗后 2 年内可获得可接受的效果。然而,治疗前 BMI 异常的儿童更容易发生龋齿复发。