摘要
目的:对比全部冠髓切断术(full pulpotomy,FP)和根管治疗术(root canal therapy,RCT)联合心理干预在中度牙科畏惧症(dental fear,DF)患儿乳磨牙深龋露髓治疗中的临床疗效。方法:纳入2021年1月~2023年6月间连续就诊于我院口腔科,且通过儿童畏惧调查表(children's fear survey schedule-dental subscale,CFSS-DS)评估为中度DF的68名患儿(4~8岁),共103颗深龋露髓乳磨牙。采用数字表法随机分为FP治疗组和RCT治疗组,治疗前均进行心理干预及行为诱导。记录两组患儿术前、术中及术后心率值,采用Venham临床焦虑与合作行为级别评定量表评估两组患儿术中临床合作情况。对比分析两组术后1、3、7 d视觉疼痛模拟评分(visual analog scale,VAS),术后1、6、12、24个月治疗成功率。结果:两组患儿治疗中心率及治疗中与治疗前心率差值,均具有统计学差异(P<0.05);治疗中FP组和RCT组临床2级以上合作率分别为88.2%和64.7%,FP组合作程度优于RCT组(P<0.05)。FP组术后1 d、3 d VAS评分均低于RCT组(P<0.05);术后7 d两组疼痛缓解情况相当(P>0.05)。术后1个月、6个月两组成功率差异无统计学意义(P>0.05);术后12个月和24个月,FP组成功率分别为100%、98%,高于RCT组(92.3%、86.5%)(P<0.05)。结论:对于中度DF患儿乳磨牙深龋露髓的治疗,冠髓切断术并辅以心理干预,不仅能有效缓解患儿术中焦虑情绪,还能显著提升治疗依从性;与传统根管治疗相比,该治疗方案可减少术后疼痛发生,提高治疗成功率与家属满意度。
Objective:To compare the clinical efficacy of full pulpot omy(FP)versus root canal therapy(RCT),both combined with psychological intervention,for treating deep carious pulp-exposed primary molars in children with moderate dental fear(DF).Methods:A total of 68 children(aged 4~8 years)with 103 deep carious pulp-exposed primary molars,who were recruited between January 2021 and June 2023,were included.All children were diagnosed with moderate DF using the children's fear survey schedule-dental subscale(CFSS-DS).They were randomly allocated to either the FP group or the RCT group using random number table method.All children received psychological intervention and behavior guidance prior to treatment.Heart rate was measured and recorded preoperatively,intraoperatively and postoperatively.Intraoperative coopera-tion was assessed using the Venham clinical anxiety and cooperative behavior scale.Postoperative pain was evaluated using visual analog scale(VAS)at 1,3,and 7 days.Treatment success rates were assessed at 1,6,12,and 24 months postoperative-ly.Results:Significant differences were observed between the FP and RCT groups in both intraoperative heart rate and the change in heart rate from pre-to intra-operative measurements(P<0.05).According to the Venham scale,the rate of level 2 or better cooperation intraoperatively was 88.2%in the FP group and 64.7%in the RCT group,with the FP group showing better cooperation(P<0.05).The FP group also exhibited significantly lower VAS scores at 1 and 3 days postoperatively(P<0.05),by day 7 postoperatively,pain had subsided to similar levels in both groups(P>0.05).The success rates of the FP group at 1 month and 6 months were higher than in the RCT group,but the differences were not statistically significant(P>0.05).At 12 months and 24 months after the operation,the success rates of the FP group were 100%and 98%,respectively,significantly higher than the 92.3%and 86.5%in the RCT group(P<0.05).Conclusion:For managing deep carious pulpexposed primary molars in children with moderate DF,FP combined with psychological intervention is superior to RCT.It not only better alleviates intraoperative anxiety and improves cooperation but also results in less postoperative pain and significantly higher long-term success rates and parental satisfaction.
作者
熊文秀
董青山
陈晓建
冯源
XIONG Wen-xiu;DONG Qing-shan;CHEN Xiao-jian;FENG Yuan(General Hospital of Central Theater Command,Hubei Wuhan 430070,China)
出处
《临床口腔医学杂志》
2025年第11期662-667,共6页
Journal of Clinical Stomatology
关键词
牙科畏惧症
冠髓切断术
根管治疗术
心理干预
龋病
Dental fear
Full pulpotomy
Root canal therapy
Psychological intervention
Dental caries
