Diş Hekimliğinde Genel Anestezi Altında Tedavi Gören Hastaların Demografik Değerlendirmesi

Öz

Giriş: Bu çalışmada diş hekimliğinde genel anestezi altında tedavi edilen hastaların demografik özellikleri ve genel anesteziye yatış nedenleri değerlendirilmesi amaçlanmıştır. Yöntemler: 20 Mayıs 2013 ile 1 Nisan 2023 tarihleri ​​arasında Eskişehir Osmangazi Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalı'nda genel anestezi altında tedavi edilen hastalar analiz edilmiştir. Dahil etme kriterlerini karşılayanlar için yaş, cinsiyet, sistemik hastalıklar, genel anestezi nedenleri ve genel anestezi altında diş tedavisi parametreleri arasındaki ilişkiler değerlendirilmiştir. Sonuçlar: Genel anestezi altında tedavi edilen 550 hastanın verileri analiz edilmiştir. Hastaların yaşları 1 ile 79 arasında değişmekte olup, ortalama yaş 16,41'dir. En sık uygulanan tedaviler diş çekimi ve restoratif işlemlerdir. Cinsiyet ile genel anestezi nedeni arasında anlamlı bir ilişki bulunamamıştır (p=0,064). Ancak sistemik durumlar ile genel anestezi nedenleri arasında güçlü bir ilişki bulunmuştur (p<0,001). Mental retardasyonu olan hastalarda diş fobisi daha yaygındı. Genel anestezinin nedenlerinde yaş grupları arasında anlamlı farklılıklar gözlendi (p<0,001). Sonuç: Genel anestezi altında en sık uygulanan tedaviler diş çekimi ve restoratif prosedürlerdi. Genel anesteziye girmenin birincil nedenleri anestezi gereksinimleri, diş fobisi ve öğürme refleksiydi. Genel anestezi altında uygulanan diş tedavileri hastaların demografik özelliklerine göre değişmekte olup bu faktörler arasında anlamlı ilişkiler bulunmuştur. Bu bulguları desteklemek ve genel anestezi uygulamalarının nedenini daha iyi anlamak için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Demografi
• Diş Hekimliği
• Genel Anestezi

Demographic Evaluation of Patients Treated Under General Anesthesia in Dentistry

Öz

Aim: This study aims to evaluate the demographic characteristics of patients treated under general anesthesia in dentistry and the reasons for their admission to general anesthesia. Material and Method: Patients treated under general anesthesia at Eskişehir Osmangazi University Faculty of Dentistry Department of Oral and Maxillofacial Surgery between May 20, 2013, and April 1, 2023, were analyzed. The relationships between age, gender, systemic diseases, reasons for general anesthesia, and dental treatment parameters under general anesthesia were evaluated for those who met the inclusion criteria. Descriptive statistics, including standard deviation, mean, minimum and maximum values, percentages, cross tables, and frequencies, were used. The chi-square test was used to evaluate relationships between groups. Post-hoc analyses were performed using the chi-square distribution's right-tailed probability to identify significant differences between groups. A significance level of p<0.05 was used to determine statistical significance. Results: The data of 550 patients treated under general anesthesia were analyzed. The patients' ages ranged from 1 to 79 years, with a mean age of 16.41. The most common treatments were tooth extraction and restorative procedures. No significant relationship was found between gender and the reason for general anesthesia (p>0.05). However, there was a strong relationship between systemic conditions and reasons for general anesthesia (p<0.05). Dental phobia was more common among patients with mental retardation. Significant differences were observed in the reasons for general anesthesia across age groups (p<0.05). Conclusion: The most frequent treatments under general anesthesia were tooth extraction and restorative procedures. The primary reasons for undergoing general anesthesia were anesthesia requirements, dental phobia, and gag reflex. Demographic factors such as age and systemic health significantly influence the causes and outcomes of treatments. These findings highlight the need for specific strategies to improve the effectiveness and accessibility of dental care under general anesthesia.

Anahtar Kelimeler

• General anesthesia
• demographic
• dentistry
• dental phobia

Kaynakça

1. Kepekçi AH, Kepekçi AB. Surgery and the Operating Room From Past to Present. Journal of Medical Sciences. 2023;4:15-20.
2. Breen P, Park KW. General anesthesia versus regional anesthesia. Int Anesthesiol Clin. 2002;40:61-71.
3. Balaji S, Balaji PP. Textbook of Oral and Maxillofacial Surgery- E-Book. 4th edition . Elsevier Health Sciences. 2023;199-227.
4. Savanheimo N, Sundberg SA, Virtanen JI, Vehkalahti MM. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service. BMC Oral Health. 2012;12:45.
5. Andreeva R. Indications for dental treatment under general anesthesia. Scripta Scientifica Medica. 2018;50:15-8.
6. Arbağ H, Uyar Y, Öztürk K, Ülkü ÇH. The evaluation of the le fort I osteotomy approach. KBB-Forum. 2004;3:110-4.
7. Wang YC, Lin IH, Huang CH, Fan SZ. Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50:122-5.
8. Hulland S, Sigal MJ. Hospital-based dental care for persons with disabilities: a study of patient selection criteria. Spec Care Dentist. 2000;20:131-8.

9. Silvestre-Rangil J, Silvestre FJ, Espín-Gálvez F. Hospital dental practice in special patients. Med Oral Patol Oral Cir Bucal. 2014;19:163-9.
10. Sacoor S. Anaesthesia and sedation for the autistic patient. SAAD Dig. 2017;33:40-3.
11. Mallineni SK, Yiu CK. Dental treatment under general anesthesia for special-needs patients: analysis of the literature. J Investig Clin Dent. 2016;7:325-31.
12. Özkan AS, Erdoğan MA, Şanlı M, et al. Retrospective evaluation of dental treatment under general anaesthesia. Turk J Anaesthesiol Reanim. 2015;43:332-6.
13. van der Walt JH, Moran C. An audit of perioperative management of autistic children. Paediatr Anaesth. 2001;11:401-8.
14. Chang J, Kim HY. Does caries risk assessment predict the incidence of caries for special needs patients requiring general anesthesia?. Acta Odontol Scand. 2014;72:721-8.
15. Rada RE. Treatment needs and adverse events related to dental treatment under general anesthesia for individuals with autism. Intellect Dev Disabil. 2013;51:246-52.
16. Miyawaki T, Kohjitani A, Maeda S, et al. Intravenous sedation for dental patients with intellectual disability. J Intellect Disabil Res. 2004;48:764-8.
17. Kuban KC, Leviton A. Cerebral palsy. N Engl J Med. 1994;330:188-95.
18. Stanková M, Buček A, Dostálová T, et al. Patients with special needs within treatment under general anesthesia - meta-analysis. Prague Med Rep. 2011;112:216-25.
19. Morgan JP, Minihan PM, Stark PC, et al. The oral health status of 4,732 adults with intellectual and developmental disabilities. J Am Dent Assoc. 2012;143:838-46.
20. Schnabl D, Guarda A, Guarda M, et al. Dental treatment under general anesthesia in adults with special needs at the University Hospital of Dental Prosthetics and Restorative Dentistry of Innsbruck, Austria: a retrospective study of 12 years. Clin Oral Investig. 2019;23:4157-62.
21. Jockusch J, Hopfenmüller W, Ettinger R, Nitschke I. Outpatient, dental care of adult vulnerable patients under general anaesthesia-a retrospective evaluation of need for treatment and dental follow-up care. Clin Oral Investig. 2021;25:2407-17.
22. Fernández-Feijoo J, Carro B, Branco A. The effect of dentist experience on the treatment of individuals with disability under general anesthesia. Spec Care Dentist. 2019;39:281-6.
23. Shin B, Yoo S, Kim J, et al. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic. J Dent Anesth Pain Med. 2016;16:203-8.
24. Choi J, Doh RM. Dental treatment under general anesthesia for patients with severe disabilities. J Dent Anesth Pain Med. 2021;21:87-98.
25. Mastilovic G, Petrovic B, Peric T, et al. Dental treatment and oral rehabilitation for adults with intellectual disability under general anesthesia. Journal of Policy and Practice in Intellectual Disabilities. 2021;18:306-12.
26. Marinho MA, Ramos FCT, Cardoso AL, et al. Dental treatment under general anesthesia in patients with special needs provided by private and public healthcare services-a retrospective, comparative study. Healthcare (Basel). 2022;10:1147.
27. Kasemkhun P, Smutkeeree A, Jirarattanasopha V. A retrospective comparison of dental treatment under general anesthesia versus non-pharmacological approach in patient with special health care needs. J Dent Sci. 2022;17:1238-43.
28. Karaduran B, Kumas Solak S, Koruyucu M. Dental treatments under general anesthesia. Yeditepe J Dent. 2024;20:60-4.