Vora Khevna M, Shah Preetam P, Patil Krishna V, Kunte Sanket S, Jagtap Chetana M, Davalbhakta Rucha N
Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
Int J Clin Pediatr Dent. 2024 May;17(5):585-590. doi: 10.5005/jp-journals-10005-2853.
Routine dental procedures frequently involve invasive treatment, multiple injections, and the use of sharp, high-speed cutting instruments, and treatment is often extended over several visits, which are said to be stress-provoking events. Salivary chromogranin A (CgA) is a biomarker that can help clinicians evaluate and quantify the stress experienced by a child during these procedures.
To quantify the changes in salivary CgA levels in children before, during, and after routine dental procedures for multiple appointments.
Eight children, aged 6-8 years, visiting a clinic for the first time and requiring one class I restorative treatment and another treatment involving the use of local anesthesia were included in the study. Unstimulated salivary samples were collected from them during three visits-outpatient department (OPD), before, during, and after restorative treatment at the second visit, and before, during, and after treatment using local anesthesia in the third visit. The salivary samples were centrifuged, stored, and analyzed for CgA.
Salivary CgA levels showed a nonsignificant increase from 2.56 to 3.21 pmol/mg protein during the restorative treatment, followed by a nonsignificant reduction after cessation of the treatment. Whereas, salivary CgA levels before the use of local anesthesia were 1.88 pmol/mg protein, which showed a nonsignificant increase to 2.24 pmol/mg protein after its administration and progressed further to 3.27 pmol/mg protein even after the cessation of the treatment.
The use of an airotor can cause an increase in stress levels in children, and local anesthesia administration is a more stress-provoking stimulus than an airotor. Multiple visits allow desensitization, which reduces stress and anxiety. Also, salivary CgA can be used as a reliable stress indicator in children.
Vora KM, Shah PP, Patil KV, Quantification of Salivary Chromogranin A Levels during Routine Dental Procedures in Children: An Study. Int J Clin Pediatr Dent 2024;17(5):585-590.
常规牙科手术常常涉及侵入性治疗、多次注射以及使用锋利的高速切割器械，而且治疗通常需要分多次就诊进行，这些都被认为是会引发压力的事件。唾液嗜铬粒蛋白A（CgA）是一种生物标志物，可帮助临床医生评估和量化儿童在这些手术过程中所经历的压力。
量化多次预约的常规牙科手术前、手术期间及手术后儿童唾液CgA水平的变化。
研究纳入了8名年龄在6至8岁之间、首次到诊所就诊且需要进行一次I类修复治疗以及另一项需要使用局部麻醉的治疗的儿童。在三次就诊期间采集他们的非刺激性唾液样本——门诊就诊时、第二次就诊修复治疗前、治疗期间及治疗后，以及第三次就诊局部麻醉治疗前、治疗期间及治疗后。对唾液样本进行离心、储存并分析CgA。
在修复治疗期间，唾液CgA水平从2.56皮摩尔/毫克蛋白无显著升高至3.21皮摩尔/毫克蛋白，治疗结束后无显著降低。而在使用局部麻醉前，唾液CgA水平为1.88皮摩尔/毫克蛋白，给药后无显著升高至2.24皮摩尔/毫克蛋白，甚至在治疗结束后进一步升至3.27皮摩尔/毫克蛋白。
使用高速涡轮牙钻会导致儿童压力水平升高，且局部麻醉给药比高速涡轮牙钻更能引发压力刺激。多次就诊可实现脱敏，从而减轻压力和焦虑。此外，唾液CgA可作为儿童可靠的压力指标。
Vora KM, Shah PP, Patil KV, 儿童常规牙科手术期间唾液嗜铬粒蛋白A水平的量化研究。《国际临床儿科牙科学杂志》2024；17(5):585 - 590。
