操作性の悪い健康な患者と特別な医療を必要とする患者に全身麻酔下で行った歯科治療のレトロスペクティブな比較

A Retrospective Comparison of Dental Treatment under General Anesthesia Provided for Uncooperative Healthy Patients and Patients with Special Health Care Needs.

• Volkan Ciftci
• İffet Yazicioglu

抄録

このレトロスペクティブ比較分析では、非協力的な健常者と特別医療ニーズのある患者に対して行われた歯科治療のパターンを年齢区分別に評価している。 本研究では、2016年1月から2018年12月までの間に、ククロバ大学医学部の手術室で全身麻酔下で包括的な歯科治療を受けた、治療時の年齢が1歳から12歳までの342人の患者（男性205人、女性137人）のデータをレビューした。患者のカルテは、患者の病状や精神状態に応じて2つのグループに分けた。少なくとも1種類の精神的、医学的、身体的障害を有するSHCN患者（272名）をS群に、非協力的な健常者（70名）をH群に割り付けた。 歯列の萌出段階（6年未満と6～12年）に関して、修復処置、抜歯数、歯髄療法、その他の歯科処置の治療様式をこれらの群間で比較した。抜歯した歯の平均本数はS群の方が有意に多く、修復処置を行った歯の平均本数はH群4.40本、S群4.40本であり、有意差は認められなかった。 手術室で包括的な歯科治療を受けたことのある患者を2つの異なるグループに分けて比較したところ、SHCN患者の方が抜歯数が有意に多いことがわかった。以上の結果から、医学的・精神的条件が歯科治療の方法に影響を与えると結論づけられた。SHCN患者には特に予防的な治療戦略が必要であり、患者とその保護者に在宅歯科治療の重要性を啓発することが重要であると考えられる。

This retrospective comparative analysis evaluates the patterns of dental treatment undertaken on uncooperative healthy and special health care needs patients with respect to different age categories. This study reviewed the data from 342 patients (205 male and 137 female), between the ages of 1 and 12 at the time of the treatment, who had received comprehensive dental treatment under general anesthesia in the operating rooms of the Faculty of Medicine, Cukurova University from January 2016 through December 2018. Patient records were divided into two groups according to the patient's medical and mental conditions. SHCN patients (272 patients) with at least one type of mental, medical or physical disability were assigned to Group S and uncooperative healthy patients (70 patients) were assigned to Group H. Treatment modalities of restorative procedures, number of extracted teeth, pulp therapy, and other dental procedures were compared between these groups with respect to eruptional stages in the dentition (<6 years and 6-12 years) There was no significant difference between groups H and S in terms of the mean duration of dental treatment among age categories in both groups. The mean number of extracted teeth was significantly greater in Group S. The mean number of teeth treated by restorative procedures in groups H and S were 4.40 and 4.40, respectively, showing no significant difference. Comparison of two different groups, with patients who have received comprehensive dental treatment in an operating room, revealed that the number of teeth extracted was significantly higher for the SHCN patients. On the basis of our results, it was concluded that medical and mental conditions affect dental treatment modalities. Preventive treatment strategies are particularly required for patients with SHCN and it is important to educate patients and their parents/caregivers on the importance of home dental care.