Li Jin-Yi, He Shu-Yang, Wang Pan-Xi, Dai Shan-Shan, Zhang Shu-Qi, Li Zheng-Yang, Guo Qing-Yu, Liu Fei
Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Pediatr. 2023 Jul 27;11:1163368. doi: 10.3389/fped.2023.1163368. eCollection 2023.
This study aimed to retrospectively describe the unplanned retreatment of dental general anesthesia (DGA) in children with severe early childhood caries (S-ECC) and explore potential factors that may influence the outcome of DGA treatment.
Medical records of children with S-ECC who received DGA treatment were screened, and necessary data were extracted. The Kaplan-Meier method and Cox proportional hazards model were used to estimate the DGA survival rate and explore the potential factors affecting the success rate of DGA treatment.
Medical records of 852 children were included; 509 (59.7%) children with 1,212 (10.7%) teeth underwent unplanned retreatment. Restoration failure (30.12%) and new caries (29.46%) accounted for the most significant proportion of all failures. The median survival times were 510 and 1,911 days at the child and tooth levels, respectively. Unplanned retreatment risk was associated with the age of S-ECC children, frequency of follow-up, and fluoride application (hazard ratio = 0.97, 0.78, 0.69, < 0.001).
The treatment outcome of DGA administered to children with S-ECC was satisfactory at the tooth level from the perspective of the incidence of unplanned retreatment. Restoration failure was the main reason for the high unplanned retreatment rate. Strategies for a better outcome of DGA include improving the professional knowledge and skills of pediatric dentists and enhancing compliance of parents/patients. Health education and regular topical fluoride application may improve the success rate of DGA treatment.
本研究旨在回顾性描述重度幼儿龋(S-ECC)患儿牙科全身麻醉(DGA)的非计划性再治疗情况,并探讨可能影响DGA治疗效果的潜在因素。
筛选接受DGA治疗的S-ECC患儿的病历,并提取必要数据。采用Kaplan-Meier法和Cox比例风险模型来估计DGA生存率,并探讨影响DGA治疗成功率的潜在因素。
纳入852例患儿的病历;509例(59.7%)患儿的1212颗牙齿(10.7%)接受了非计划性再治疗。修复失败(30.12%)和新发龋(29.46%)在所有失败原因中占比最高。在患儿和牙齿层面,中位生存时间分别为510天和1911天。非计划性再治疗风险与S-ECC患儿的年龄、随访频率和氟化物应用有关(风险比分别为0.97、0.78、0.69,P<0.001)。
从非计划性再治疗发生率来看,S-ECC患儿接受DGA治疗在牙齿层面的治疗效果令人满意。修复失败是高非计划性再治疗率的主要原因。提高DGA治疗效果的策略包括提高儿童牙医的专业知识和技能,以及增强家长/患者的依从性。健康教育和定期局部应用氟化物可能会提高DGA治疗的成功率。