Clinical outcomes for early childhood caries: influence of aggressive dental surgery.
Clinical outcomes for early childhood caries: influence of aggressive dental surgery.
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发表时间：
2004-05
影响因子：
0.8
通讯作者：
C. E. Graves;Robert J. Berkowitz;H. Proskin;I. Chase;P. Weinstein;Ronald J. Billings
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作者：
C. E. Graves;Robert J. Berkowitz;H. Proskin;I. Chase;P. Weinstein;Ronald J. Billings
目的研究儿童早期龋病(ECC)患者植入不锈钢冠(SSCs)的数量、术后表面危险性(SAR)与复发风险之间的关系。方法研究人群包括57名在全身麻醉下接受ECC治疗的儿童，年龄从入院时的2.3岁到7.3岁不等。牙科外科采用了一种积极的方法：拔除有牙髓坏死或不可修复的牙齿；拔除不能通过剥离治疗的腐烂的下颌乳门牙；拔除有3个或3个以上龋面的乳磨牙；用冠内银汞合金修复不损害尖牙完整性的乳磨牙的单面病变；用冠内复合材料修复表面光滑的上颌、门牙和尖牙；用SSCs修复需要活髓治疗的乳磨牙和尖牙；用SSCs修复有2个或2个以上表面的龋损(包括光滑表面、白斑病变)的乳磨牙；有3个或3个以上龋面的原始尖牙用不锈钢全冠修复；在所有修复治疗完成后，局部应用氟化物。在牙科手术后6个月对队列进行新的龋损检查。根据Radike的定义，复发定义为出现新的光滑表面的龋损。用t检验和Wilcoxon检验比较复发(R)组和非复发(NR)组之间放置的SSCs的数量和SAR的数量。在所有的统计检验中采用了0.05的显著性水平。结果57例患者中21例(37%)复发。R组(SSCs：平均值=4.57，中位数=4+/-2.18；SAR：平均值=39.76，中位数=40+/-13.62)与NR组(SSCs：平均值=5.44，中位数=5.5+/-2.62；SAR：平均值=39.98，中位数=39.5+/-15.19)比较，差异无统计学意义。结论在接受ECC治疗的儿童中，复发的风险与放置的SSCs的数量或SAR无关；积极的牙科手术治疗ECC不会产生可接受的临床结果。
PURPOSE The objective of this study was to assess the relationship between the number of stainless steel crowns (SSCs) placed, number of surfaces at risk (SAR) post dental surgery, and the risk for relapse in patients treated for Early Childhood Caries (ECC). METHODS The study population consisted of 57 children treated for ECC under general anesthesia, ranging in age from 2.3 to 7.3 years old at the time of entry. Dental surgery utilized an aggressive approach: teeth that had necrotic pulps or were nonrestorable were extracted; decayed primary mandibular incisors that could not be treated by stripping were extracted; primary maxillary incisors with 3 or more carious surfaces were extracted; single-surface lesions of primary molars that did not compromise cusp integrity were restored with intracoronal amalgam restorations; primary maxillary, incisors and canines with smooth-surface lesions affecting 2 or less surfaces were treated with intracoronal composites; primary molars and canines requiring vital pulp therapy were restored with SSCs; primary molars with caries lesions affecting 2 or more surfaces (including smooth-surface, white-spot lesions) were restored with SSCs; primary canines with caries affecting 3 or more surfaces were restored with stainless steel crowns; topical fluoride was applied after all restorative therapy was completed. The cohort was examined for new caries lesions 6 months post dental surgery. Relapse was defined as the presence of new smooth-surface caries lesions as defined by Radike. Comparisons between relapse (R) and nonrelapse (NR) groups, with respect to the number of SSCs placed and the number of SAR, were performed using t tests and Wilcoxon tests. A 0.05 level of significance was employed in all statistical tests. RESULTS Twenty-one of the 57 (37%) patients relapsed. No statistically significant difference for the number of SSCs placed or SAR existed between the R group (SSCs: mean = 4.57, median = 4 +/- 2.18; SAR: mean = 39.76, median = 40 +/- 13.62) and NR group (SSCs: mean=5.44, median = 5.5 +/- 2.62; SAR: mean = 39.98, median = 39.5 +/- 15.19). CONCLUSIONS The risk for relapse in children treated for ECC is not associated with the number of SSCs placed or SAR; aggressive dental surgery for ECC does not result in acceptable clinical outcomes.