RESUMEN
BACKGROUND: Studies have been conducted to evaluate changes in hemodynamics, postoperative bleeding, and pain in pediatric dental patients receiving general anesthesia (GA). However, a limited number of studies have evaluated the effects of local anesthetics (LA) on tooth extraction procedures during GA. There is no consensus in the literature regarding LA application in the perioperative period for dental treatments performed within the scope of GA. AIM: This study aimed to determine the retrospective physiologic effects of fluctuations in vital signs and postoperative bleeding in children who did or did not receive LA for tooth extraction under GA. METHODS: A retrospective evaluation of 77 patients aged 5.16 ± 1.85 years who had the extraction of primary posterior teeth with or without LA under GA were reviewed in the post-anaesthesia care unit (PACU) for postoperative bleeding and the effects of intraoperative LA on fluctuations in postoperative parameters such as mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO2), respiratory rate (RR), and the end-tidal carbon dioxide (EtCO2). These were compiled from the patient records of the procedures. RESULTS: Significant differences between the baseline and peak MAP (P < 0.001), HR (P = 0.011), and EtCO2 (P = 0.002) were noted in children without LA compared to those who had LA. In addition, substantial variations were observed between the baseline and peak values for MAP (P < 0.001) and HR (P = 0.037) in children who had tooth extraction in the mandibular region. Statistically significant differences were noted between the baseline and peak values for patients who did not receive LA before the extraction of the first primary molar in terms of MAP (P < 0.02) and EtCO2 (P = 0.032). Similarly, significant differences in MAP (P < 0.02) and EtCO2 (P = 0.034) were noted in the extraction of the second primary molar. In addition, there was a significant difference in bleeding based on the number of tooth extractions in those who did not receive LA (P = 0.020). CONCLUSION: This study showed that in children who underwent tooth extraction under GA, additional LA application minimized changes in HR, MAP, and EtCO2, whereas a lack of LA application produced significant fluctuations from baseline to peak values of HR, MAP, and EtCO2. In addition, LA application reduced postoperative bleeding.
Asunto(s)
Anestesia General , Anestesia Local , Hemorragia Posoperatoria , Extracción Dental , Humanos , Extracción Dental/efectos adversos , Extracción Dental/métodos , Estudios Retrospectivos , Femenino , Masculino , Anestesia General/métodos , Niño , Preescolar , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Frecuencia Cardíaca/efectos de los fármacosRESUMEN
AIM: Plaque removal from first permanent molar teeth was evaluated when conventional and a new silicone tooth and gum brush was used. Also, the effectiveness of parents' brushing was compared with childrens'. MATERIALS AND METHODS: Study design: This crossover clinical study was conducted with 9 children aged 5 to 7 years, with 18 mandibular first permanent molar teeth which were partially erupted. Four appointments were planned at one-week intervals and at every appointment, dental plaque on teeth was disclosed first. At their first appointment, the children were given a conventional toothbrush, and at their second appointment they were given a silicone tooth andgum brush . Then, at the third appointment, parents performed brushing with a conventional toothbrush, and then brushed with a silicone tooth & gum brush at the fourth appointment. Before and after brushing, photographs were taken for baseline and final plaque scores to determine Occlusal Plaque Index with Image Analysis Software Program. STATISTICS: Anova was used for comparison of groups with p<0.05 considered to be significant. RESULTS: There was statistically significant difference between baseline and final plaque scores among all of the groups (p<0.05) but, there was not statistically significant difference between the groups (p>0.05). CONCLUSIONS: Children under the age of nine are usually believed to lack the developmental skills needed to brush their own teeth, and as a result, the silicone tooth & gum brush might be recommended instead of brushing with parents.