Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd, Ratchathewi, Bangkok, 10400, Thailand.
Eur Arch Paediatr Dent. 2024 Jun;25(3):349-358. doi: 10.1007/s40368-024-00887-6. Epub 2024 May 24.
The aim of this study was to compare dental-treatment outcomes, oral-hygiene improvement, and patient co-operation during follow-up visits between children treated under general anaesthesia (GA) and non-pharmacological behaviour management (NP).
This retrospective study reviewed the dental chart records of healthy patients less than 71-month-old with severe early childhood caries (S-ECC) from 2008 to 2020 with at least a 6-month follow-up. The demographical data, dental-treatment outcomes, oral-hygiene status, and patient behaviour at the follow-up visits were analysed by the Mann-Whitney U test, Pearson's Chi-square, Fisher's exact test, Friedman test, and Wilcoxon test with a significance level of 0.05.
This study included 210 GA cases and 210 age-matched control NP cases. The GA group had a significantly higher caries experience, lower patient co-operation, poorer oral hygiene, and higher number of complex dental treatment than the NP group at baseline (p < 0.001). The number of children who had incomplete dental treatment under non-pharmacological behaviour management was higher than the GA group. After treatment, the number of new carious teeth in the NP group was significantly higher than in the GA group only at the 6-month follow-up. However, there was no significant difference in treatment failure, oral-hygiene improvement, and patient behaviour between groups.
Although patients in the GA group had higher dental and behaviour problems than the NP group, the overall dental-treatment outcomes, including oral hygiene and behaviour improvement, were not significantly different between groups Therefore, regular follow-up and preventive treatment in the maintenance phase are essential for children with severe early-childhood caries.
本研究旨在比较全麻(GA)和非药物行为管理(NP)下治疗的儿童的治疗效果、口腔卫生改善情况和随访时的患者配合情况。
本回顾性研究分析了 2008 年至 2020 年间至少有 6 个月随访的患有严重婴幼儿龋(S-ECC)且年龄小于 71 个月的健康患者的牙科图表记录。采用 Mann-Whitney U 检验、Pearson Chi-square 检验、Fisher's exact 检验、Friedman 检验和 Wilcoxon 检验对人口统计学数据、牙科治疗效果、口腔卫生状况和随访时的患者行为进行分析,检验水准为 0.05。
本研究纳入了 210 例 GA 组和 210 例年龄匹配的 NP 组对照病例。GA 组的龋齿发生率更高,患者配合度更低,口腔卫生状况更差,需要进行的复杂治疗也更多,基线时各项指标均显著差于 NP 组(p<0.001)。NP 组未完成非药物行为管理下治疗的儿童比例高于 GA 组。治疗后,NP 组在 6 个月随访时新发生龋齿的数量显著高于 GA 组。但两组在治疗失败、口腔卫生改善和患者行为方面无显著差异。
尽管 GA 组患者的口腔和行为问题比 NP 组更为严重,但两组的整体治疗效果,包括口腔卫生和行为改善,并无显著差异。因此,对于患有严重婴幼儿龋的儿童,在维持期进行定期随访和预防性治疗至关重要。