LONG-TERM RESULTS OF DENTAL TREATMENT IN CHILDREN UNDER GENERAL ANESTHESIA

Abstract

The high prevalence of caries in children may be related to the lack of implementation of statesupported prevention programs in Ukraine, the lack of sanitation at various levels (individual, population, state), and reduced somatic health of the child. The problem of quality full mouth debridement is related to many factors and first of all to the psycho-emotional state of the child. Aim: to analyze of the results of full mouth debridement in children under general anesthesia for 3 years in children from 2 to 9 years. Object and methods. In the period from 2014 to 2018, in the conditions of the Dental Medical Center of the O.O. Bogomolets National Medical University, 346 different aged children underwent complete mouth debridement by general anesthesia. Results. Among 346 children, 187 were children aged 2 to 5 years, 109 were aged 5 to 9 years, the remaining 56 were children over 9 years of age. Thus, the largest percentage (54%) was made up of children aged 2 to 5 years with unstable psycho-emotional state, 31.5% – children aged 5 to 9 years. In 89% of children from all surveyed, the indications for the general anesthesia in treatment were psycho-emotional state, and in 11% – these are diseases that affect the central nervous system (autism, cerebral palsy). A significant percentage of complicated caries (52%) were diagnosed with dental lesions. In total, 2,768 teeth were treated, including 2331 temporary teeth and 437 permanent teeth. Among 2331 temporary teeth, 1121 were diagnosed with acute and chronic middle or deep caries (48%), 908 had chronic fibrous pulpitis, the rest were chronic or exacerbation of chronic granulating periodontitis (302 teeth). Analysis of the temporary teeth lesions shows that first of all caries was diagnosed in the neck area of 52, 51, 61, 62 teeth, which made up the largest percentage (68%) of all temporary examined teeth. Complicated caries (chronic fibrous pulpitis (57%) and chronic or exacerbation of chronic granulating periodontitis (13%). 21% are the first molars, among which were diagnosed 59% of teeth with caries the other teeth were with chronic fibrous pulpitis (31%) and chronic or exacerbation of chronic periodontitis (10%). Among all children with temporary bite who were treated, it was found that the frequency of the fallout of fillings in the treatment of caries was 7% after 6 months, 12% after a year, and 18% of all treated teeth after 2 years. Most often, the fallout of the fillings occurred in the teeth, which affected 2 or more surfaces. In the treatment of pulpitis in temporary teeth, the percentage of the fallout fillings after 6 months was 9%, and after 1 year significantly increased – 15%. It should be noted that after treatment of pulpitis of temporary teeth the percentage of complications after 6 months was 4%, and after 1-2 years – about 13%. Most parents (85%) did not accept the recommendations regarding the need for a regular visit to the dentist for preventive measures and overcoming stomatophobia, did not control the hygiene of the oral cavity, which often led to the need for re-treatment of children under general anesthesia (15%) after 1.5-2 years. In children who did not visit a dentist for preventive purposes, the occurrence of new carious lesions was 69% after 1 year, and after 1.5-2 years to 80%. The increase in caries after 1 year in children whose parents visited a dentist for preventive purposes was about 12%, and after 1.5-2 years – up to 18%. Conclusion. After treatment wıth general anesthesia, dynamic monitoring of children is required at least once every 3-4 months for the purpose of preventive measures and overcoming stomatophobia in the child. When choosing filling materials, it is necessary to give priority to standard crowns (in case of destruction of 2 or more surfaces), composite materials of light curing (especially in case of damage to more than 3 surfaces of the tooth), glass-ıonomer cements can be used – in case of damage no more than one tooth surface (chewing).

Keywords

• dental caries in children
• treatment of teeth under sedation.