A survival analysis of primary second molars in children treated under general anesthesia.
Early childhood caries
general anesthesia
primary second molar
stainless steel crown
survival analysis
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
23
12
2019
revised:
10
03
2020
accepted:
03
04
2020
entrez:
29
7
2020
pubmed:
29
7
2020
medline:
14
8
2020
Statut:
ppublish
Résumé
The authors examined time to need new treatment of primary second molars in very young children treated under general anesthesia (GA). During this retrospective chart review, the authors examined patients aged 2 through 4 years with severe early childhood caries (ECC) who received dental treatment under GA. Primary second molars were tracked in periodic recall visits after GA for 6 through 89 months. Using a random-effects Cox proportional hazards model, the authors compared hazards of teeth requiring new treatment based on treatments received at GA. Of 3,166 primary second molars included in the study, 367 (12%) were not erupted, 77 (2%) received topical fluoride only, 873 (28%) received a pit and fissure sealant, 242 (8%) received a composite restoration, and 1,607 (50%) received a stainless steel crown (SSC) at GA. SSCs had a survival probability of 98% by 84 months after GA, significantly higher than all other groups (P < .0001). The second molars that were not erupted at GA had the highest hazard, especially within the first 24 months after GA. Teeth that received sealant had longer time to need new treatment than nonsealed teeth; however, at 84 months after GA, only 33% of the sealed teeth did not require additional treatment. Preventive or restorative treatments other than SSCs resulted in need for new treatment in a substantial number of teeth. SSCs had the highest success in this population with severe ECC treated under GA and should be chosen over other restorative options to reduce risk of undergoing repeat dental treatment. Aggressive treatment with SCC should be considered for young children with severe ECC especially those who are treated under GA at a young age.
Sections du résumé
BACKGROUND
The authors examined time to need new treatment of primary second molars in very young children treated under general anesthesia (GA).
METHODS
During this retrospective chart review, the authors examined patients aged 2 through 4 years with severe early childhood caries (ECC) who received dental treatment under GA. Primary second molars were tracked in periodic recall visits after GA for 6 through 89 months. Using a random-effects Cox proportional hazards model, the authors compared hazards of teeth requiring new treatment based on treatments received at GA.
RESULTS
Of 3,166 primary second molars included in the study, 367 (12%) were not erupted, 77 (2%) received topical fluoride only, 873 (28%) received a pit and fissure sealant, 242 (8%) received a composite restoration, and 1,607 (50%) received a stainless steel crown (SSC) at GA. SSCs had a survival probability of 98% by 84 months after GA, significantly higher than all other groups (P < .0001). The second molars that were not erupted at GA had the highest hazard, especially within the first 24 months after GA. Teeth that received sealant had longer time to need new treatment than nonsealed teeth; however, at 84 months after GA, only 33% of the sealed teeth did not require additional treatment.
CONCLUSIONS
Preventive or restorative treatments other than SSCs resulted in need for new treatment in a substantial number of teeth. SSCs had the highest success in this population with severe ECC treated under GA and should be chosen over other restorative options to reduce risk of undergoing repeat dental treatment.
PRACTICAL IMPLICATIONS
Aggressive treatment with SCC should be considered for young children with severe ECC especially those who are treated under GA at a young age.
Identifiants
pubmed: 32718486
pii: S0002-8177(20)30288-9
doi: 10.1016/j.adaj.2020.04.015
pii:
doi:
Substances chimiques
Pit and Fissure Sealants
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
568-575Informations de copyright
Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved.