Chen Hsiu-Hsien, Lin Po-Yen, Lin Ching-Kai, Hsu Le-Yin, Hung Ming-Hua, Lin Ping-Yi, Chi Lin-Yang
Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Dentistry, National Defense Medical Center, Taipei, Taiwan.
J Dent Sci. 2023 Apr;18(2):761-766. doi: 10.1016/j.jds.2022.12.010. Epub 2023 Jan 3.
BACKGROUND/PURPOSE: Patients with disabilities usually have difficulties in communication and mobility, and the quality of the dental treatments are often inferior. This study uses the Taiwan National Health Insurance Database to analyze the quality of dental treatment for patients with disabilities who receive intravenous sedation (IVS).
This study selected patients with disabilities who received dental treatment under IVS. Their oral cavity was divided into three major sections: anterior teeth, upper posterior teeth, and lower posterior teeth. Self-matching of the same section was conducted to observe whether operative dental treatment (OD) with or without IVS affected the occurrence of dental retreatment. This study observed the occurrence of refilling and the duration from the end of treatment until retreatment to compare treatment differences with or without IVS.
After self-matching, this study found 158 patients who received dental treatment within the same section with and without IVS. During a follow-up period of 17 years, 75.18% of the patients who received OD treatment required refilling, 10.87% required endodontic treatment, and 5.67% required tooth extraction. After OD treatment with IVS, the risks of refilling, endodontic treatment, and tooth extraction were 0.71 (95% CI: 0.58-0.87, < 0.001), 0.77 (95% CI: 0.48-1.23, = 0.28), and 0.64 (95% CI: 0.32-1.27, = 0.20), respectively.
For patients with disabilities, OD treatment with IVS significantly reduces the risk of refilling compared with OD treatment without IVS. IVS can be ideal for people with disabilities who receive dental treatment.
背景/目的:残疾患者通常在沟通和行动方面存在困难,牙科治疗质量往往较差。本研究利用台湾国民健康保险数据库分析接受静脉镇静(IVS)的残疾患者的牙科治疗质量。
本研究选取接受IVS下牙科治疗的残疾患者。他们的口腔分为三个主要部分:前牙、上颌后牙和下颌后牙。对同一部分进行自身匹配,观察有无IVS的手术牙科治疗(OD)是否会影响牙科再治疗的发生。本研究观察了补牙的发生情况以及从治疗结束到再治疗的持续时间,以比较有无IVS的治疗差异。
自身匹配后,本研究发现158例患者在同一部分接受了有无IVS的牙科治疗。在17年的随访期内,接受OD治疗的患者中有75.18%需要补牙,10.87%需要根管治疗,5.67%需要拔牙。在接受IVS的OD治疗后,补牙、根管治疗和拔牙的风险分别为0.71(95%CI:0.58 - 0.87,<0.001)、0.77(95%CI:0.48 - 1.23,=0.28)和0.64(95%CI:0.32 - 1.27,=0.20)。
对于残疾患者,与无IVS的OD治疗相比,有IVS的OD治疗显著降低了补牙风险。IVS对于接受牙科治疗的残疾人士可能是理想的选择。