SİSTEMİK HASTALIĞI BULUNAN ÇOCUK HASTALARIN DENTAL TEDAVİSİ VE ANESTEZİ PROSEDÜRÜ

Abstract

Bu retrospektif çalışma, diş tedavisi sırasında farmakolojik davranış yönetimi gerektiren çocuklar için anestezi seçimini ve işlem süresini etkileyen faktörleri değerlendirmektedir. Çalışmaya Erciyes Üniversitesi Diş Hekimliği Fakültesi'nde genel anestezi ve sedasyon altında tedavi edilen 209 çocuk hasta dahil edildi. Sağlık durumu, yaşı, anestezi türü, işlem süresi, dolgu sayısı ve kanal tedavi sayısı kaydedildi. Lojistik ve lineer regresyonlar anestezi tipi ve işlem süresinin belirleyicilerini inceledi. Dolgu sayısının arttırılması (OR (%95 GA): 0.857 (0.789-0.931); p<0.001) ve kök kanal tedavilerinin sayısının arttırılması (OR (%95 GA): 0.546 (0.341-0.873); p=0.012) sedasyon olasılığını azalttı. Kombine sistemik hastalık varlığında sedasyon tercih edildi (OR (%95 GA): 45.782 (1.713-1223.446); p=0.023), zeka geriliği varlığında işlem süresi anlamlı olarak arttı (p=0.041). Yaş (p=0.009), dolgu sayısı (p<0.001) ve kanal tedavi sayısı (p<0.001) arttıkça işlem süresi anlamlı derecede arttı. Sedasyon uygulanan hastalarda işlem süresi genel anestezi uygulanan gruba göre anlamlı olarak daha kısaydı (p<0.001). Kombine sistemik hastalık oluştuğunda sedasyon tercih edildi ancak tedavi edilen diş sayısının artması işlem süresini arttırdığı için sedasyon yerine genel anestezi tercih edildi. Çocuk hastalarda dental tedavi sürecinde anestezi seçimini etkileyen birçok faktör vardır; bu çalışma çocuklarda işlem güvenliği ve tedavi sonuçlarını iyileştirmek için hazırlanacak hasta özelliklerine dayalı kanıta dayalı klinik uygulama kılavuzu oluşturulmasına katkıda bulunabilir.

Keywords

• Diş tedavisi
• genel anestezi
• çocuk diş hekimliği
• diş hekimliğinde sedasyon
• özel sağlık bakımı ihtiyacı

DENTAL TREATMENT AND ANESTHESIA PROCEDURE IN PEDIATRIC PATIENTS WITH SYSTEMIC DISEASE*

Abstract

This retrospective study evaluates factors influencing anesthesia selection and procedure duration for children requiring pharmacological behavior management during dental treatment. This retrospective study involved 209 pediatric patients who underwent surgery under general anesthesia and sedation at Erciyes University, Faculty of Dentistry. Health status, age, anesthesia type, procedure time, filling number, and root canal treatment number were recorded. Logistic and linear regressions examined anesthesia type and procedure duration predictors. Increasing the number of fillings (OR (95% CI): 0.857 (0.789-0.931); p<0.001) and the number of root canal treatments (OR (95% CI): 0.546 (0.341-0.873); p=0.012) reduced the likelihood of sedation. In the presence of combined systemic disease, sedation was preferred (OR (95% CI): 45.782 (1.713-1223.446); p=0.023), and the procedure time increased significantly in the presence of mental retardation (p=0.041). Increases in age (p=0.009), number of fillings (p<0.001), and number of root canal treatments (p<0.001) significantly increased the procedure time. The procedure time was significantly shorter in the sedated patients than in the general anesthesia group (p<0.001).Sedation was preferred when combined systemic disease occurred, but general anesthesia was preferred over sedation because the increased number of teeth treated increased the procedure time. The factors affecting the choice of anesthesia and the duration of procedures in pediatric dental treatment are complex; therefore, this study can contribute to create an evidence-based clinical practice guideline based on patient characteristics to improve the safety and treatment outcomes for children.

Keywords

• Dental treatment
• general anesthesia
• pediatric dentistry
• sedation in dentistry
• special health care need

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