伢典Ⅲ凝胶微创去腐治疗乳牙龋齿对患儿心理影响
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摘要
目的伢典(Carisolv)微创技术是牙科恐惧者治疗龋齿的辅助手段。文章采用4种心理指标评估伢典Ⅲ凝胶微创去腐与机械去腐法对患者心理影响的差异。方法纳入南京市儿童医院收治的60名患儿共计120枚乳磨牙龋,每名患儿口腔内2枚乳磨牙龋分别采用CarisolvⅢ凝胶去腐(凝胶组)和机械去腐(机械组)。分别使用视觉模拟量表(Visual AnalogueScale,VAS)、Frank1依从性量表、Kuttner量表和Houpt行为量表评估2组患儿诊疗过程中对龋齿治疗的疼痛程度、合作程度、耐受程度和舒适度。记录并比较每种方法的去腐时间及6个月后充填效果。结果与机械组相比,凝胶组治疗前VAS值、Frank1值、Kuttner值和Houpt值差异均无统计学意义(P>0.05)。治疗中和治疗后,凝胶组VAS值和Kuttner值均低于机械组,Frank1值和Houpt值均高于机械组,差异均有统计学意义(P<0.05)。凝胶组治疗前、中、后相比,VAS值、Frank1值、Kuttner值和Houpt值差异均无统计学意义(P>0.05)。机械组治疗前与治疗中、治疗后相比,VAS值、Frank1值、Kuttner值和Houpt值差异有统计学意义(P<0.05)。凝胶组平均去腐时间为(6.23±1.91)min,显著短于机械组去腐时间(12.47±3.68)min,差异有统计学意义(t=3.197,P=0.001)。6个月后复查结果显示,2组成功率比较差异无统计学意义(P=0.082)。结论 CarisolvⅢ凝胶去腐技术能有效规避疼痛,提高舒适度,降低患儿的畏惧率,适合临床推广应用。
Objective Mini-invasive Carisolv is an aid to treat dental caries for patients with dental phobia. The article was to investigate the level of pain in caries removal using mini-invasive Carisolv Ⅲ gel and mechanical methods with four psychological indi?cators.Methods We collected 120 primary molar tooth caries of 60 children treated in our hospital. Two primary molar tooth caries of each child were respectively treated with Carisolv Ⅲ gel(Group A)and mechanical method(Group B)for caries removal. Psycho?logical indicators including the visual analog scale(VAS),the Frank1 behavior rating scale(Frank1),the Kuttner law(Kuttner),and the Houpt behavior rating scale(Houpt)were used to assess the level of pain,degree of cooperation,pain tolerance and comfort.The clinical efficiency after six months and treatment time were compared between the two groups.Results There was no statistical?ly significant difference before treatment between the two groups using the four psychological indicators(P>0.05),while significant differences were found during and after the treatment between the two groups(P<0.05). Then,Carisolv Ⅲ gel and mechanical groups for careis removal were compared before,during and after treatment themselves. In the Carisolv Ⅲ gel group,there was no statistically significant difference using the four psychological indicators(P>0.05). In the mechanical group,there were statistically significant differences before and during treatment or before and after treatment using the four psychological indicators(P<0.05). The treatment time in Carisolv Ⅲ gel group was longer than in mechanical group(P=0.001). There was no statistical difference between the two groups in filling examination after six months(P=0.082).Conclusion Carisolv Ⅲ gel for caries removal can effectively avoid pain,improve comfort and decrease fear in children,which can be promoted in clinical application.
Objective Mini-invasive Carisolv is an aid to treat dental caries for patients with dental phobia. The article was to investigate the level of pain in caries removal using mini-invasive Carisolv Ⅲ gel and mechanical methods with four psychological indi?cators.Methods We collected 120 primary molar tooth caries of 60 children treated in our hospital. Two primary molar tooth caries of each child were respectively treated with Carisolv Ⅲ gel(Group A)and mechanical method(Group B)for caries removal. Psycho?logical indicators including the visual analog scale(VAS),the Frank1 behavior rating scale(Frank1),the Kuttner law(Kuttner),and the Houpt behavior rating scale(Houpt)were used to assess the level of pain,degree of cooperation,pain tolerance and comfort.The clinical efficiency after six months and treatment time were compared between the two groups.Results There was no statistical?ly significant difference before treatment between the two groups using the four psychological indicators(P>0.05),while significant differences were found during and after the treatment between the two groups(P<0.05). Then,Carisolv Ⅲ gel and mechanical groups for careis removal were compared before,during and after treatment themselves. In the Carisolv Ⅲ gel group,there was no statistically significant difference using the four psychological indicators(P>0.05). In the mechanical group,there were statistically significant differences before and during treatment or before and after treatment using the four psychological indicators(P<0.05). The treatment time in Carisolv Ⅲ gel group was longer than in mechanical group(P=0.001). There was no statistical difference between the two groups in filling examination after six months(P=0.082).Conclusion Carisolv Ⅲ gel for caries removal can effectively avoid pain,improve comfort and decrease fear in children,which can be promoted in clinical application.
引文
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[2]吴偲,刘映伶,邹静,等.乳牙深龋的间接牙髓治疗[J].华西口腔医学杂志,2018,36(4):435-440.
[3]Keenan AV,Congiusta MA.Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth[J].Evid Based Dent.2016,17(2):44-5.
[4]蒋琪霞,王桂玲,翁志强.压疮愈合计分量表评价不同类型伤口的治疗效果[J].医学研究生学报,2017,30(4):436-439.
[5]Hegde S,Kakti A,Bolar DR,Bhaskar SA.Clinical Efficiency of Three Caries Removal Systems:Rotary Excavation,Carisolv,and Papacarie[J].J Dent Child(Chic),2016,83(1):22-28.
[6]杨霞,侯锐,尚磊,等.STA无痛麻醉仪在老年牙周病患者牙拔除术中的应用[J].中华老年口腔医学杂志,2015,13(2):88-91.
[7]Feng L,Wang H,Lin M.Effect of painless STA on tooth extraction of elderly patients with periodontal diseases[J].Exp Ther Med.2018,15(3):2956-60.
[8]Keiko T,Yoshihiro M,Satoshi S,et al.Infant feeding practices and risk of dental caries in Japan:the Osaka Maternal And Child Health Study[J].Pediatr Dent,2013,35(3):267-71.
[9]Tickotsky N,Petel R,Araki R,et al.Caries Progression Rate in Primary Teeth:A Retrospective Study[J].J Clin Pediatr Dent.2017,41(5):358-361.
[10]Martignon S,Cortes A,Gómez SI,et al.How Long does it Take to Examine Young Children with the Caries ICDAS System and how do they Respond?[J]Braz Dent J.2018,29(4):374-380.
[11]Jaikaria A,Thakur S,Singhal P,et al.A Comparison of Oral Midazolam-ketamine,Dexmedetomidine-fentanyl,and Dexmedetomidine-ketamine Combinations as Sedative Agents in Pediatric Dentistry:A Triple-Blinded Randomized Controlled Trial[J].Contemp Clin Dent.2018,9(Suppl 2):S197-S203.
[12]Cohen LA,Snyder TL,La Belle AD.Correlates of dental anxiety in a university population[J].J Public Health Dent,1982,42(3):228-235.
[13]Keenan AV,Congiusta MA.Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth[J].Evid Based Dent,2016,17(2):44-5.
[14]葛风华,唐世洁,钟婉金,等.伢典三代凝胶微创治疗乳磨牙深龋的疗效观察[J].口腔医学,2018,38(8):720-723.
[15]Hamama H,Yiu C,Burrow MF.Effect of chemomechanical caries removal on bonding of resin-modified glass ionomer cement adhesives to caries-affected dentine[J].Aust Dent J,2015 Jun,60(2):190-199.
[16]华志祥,蔡传宝.龋齿治疗中微创去腐技术的临床观察[J].口腔医学研究,2016,32(6):652-653.
[2]吴偲,刘映伶,邹静,等.乳牙深龋的间接牙髓治疗[J].华西口腔医学杂志,2018,36(4):435-440.
[3]Keenan AV,Congiusta MA.Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth[J].Evid Based Dent.2016,17(2):44-5.
[4]蒋琪霞,王桂玲,翁志强.压疮愈合计分量表评价不同类型伤口的治疗效果[J].医学研究生学报,2017,30(4):436-439.
[5]Hegde S,Kakti A,Bolar DR,Bhaskar SA.Clinical Efficiency of Three Caries Removal Systems:Rotary Excavation,Carisolv,and Papacarie[J].J Dent Child(Chic),2016,83(1):22-28.
[6]杨霞,侯锐,尚磊,等.STA无痛麻醉仪在老年牙周病患者牙拔除术中的应用[J].中华老年口腔医学杂志,2015,13(2):88-91.
[7]Feng L,Wang H,Lin M.Effect of painless STA on tooth extraction of elderly patients with periodontal diseases[J].Exp Ther Med.2018,15(3):2956-60.
[8]Keiko T,Yoshihiro M,Satoshi S,et al.Infant feeding practices and risk of dental caries in Japan:the Osaka Maternal And Child Health Study[J].Pediatr Dent,2013,35(3):267-71.
[9]Tickotsky N,Petel R,Araki R,et al.Caries Progression Rate in Primary Teeth:A Retrospective Study[J].J Clin Pediatr Dent.2017,41(5):358-361.
[10]Martignon S,Cortes A,Gómez SI,et al.How Long does it Take to Examine Young Children with the Caries ICDAS System and how do they Respond?[J]Braz Dent J.2018,29(4):374-380.
[11]Jaikaria A,Thakur S,Singhal P,et al.A Comparison of Oral Midazolam-ketamine,Dexmedetomidine-fentanyl,and Dexmedetomidine-ketamine Combinations as Sedative Agents in Pediatric Dentistry:A Triple-Blinded Randomized Controlled Trial[J].Contemp Clin Dent.2018,9(Suppl 2):S197-S203.
[12]Cohen LA,Snyder TL,La Belle AD.Correlates of dental anxiety in a university population[J].J Public Health Dent,1982,42(3):228-235.
[13]Keenan AV,Congiusta MA.Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth[J].Evid Based Dent,2016,17(2):44-5.
[14]葛风华,唐世洁,钟婉金,等.伢典三代凝胶微创治疗乳磨牙深龋的疗效观察[J].口腔医学,2018,38(8):720-723.
[15]Hamama H,Yiu C,Burrow MF.Effect of chemomechanical caries removal on bonding of resin-modified glass ionomer cement adhesives to caries-affected dentine[J].Aust Dent J,2015 Jun,60(2):190-199.
[16]华志祥,蔡传宝.龋齿治疗中微创去腐技术的临床观察[J].口腔医学研究,2016,32(6):652-653.