Determination of indications for the treatment of temporary teeth in conditions of general anesthesia in preschool children by equipping the study of indicators of oxygen saturation of the brain using the method of cerebral oximetry

Abstract

Annotation. A common problem at the dental appointment with different treatment methods (without general anesthesia and general anesthesia) is the risk of cognitive dysfunctions against the background of hypoxic brain damage in children: in the first case, against the background of stress, in the other, against the background of general anesthesia. The purpose of the study — to determine indications for the treatment of temporary teeth at the stages of growth and stabilization in conditions of general anesthesia in preschool children based on the study of oxygen saturation indicators of the brain using the cerebral oximetry method. Dental examination and dental procedures of varying severity were performed for 100 children under the age 3–7 years (545 teeth were treated) at the Dental Medical Center at the Bogomolets National Medical University. The method of cerebral oximetry was applied (the permissible reduction of cerebral oximetry was not more than 20%). The results of treatment of medium and deep caries showed a reliably low percentage of complications at different stages of tooth development that occur during rehabilitation of the oral cavity under general anesthesia (12.83% and 15%, respectively) than during rehabilitation of the oral cavity on an outpatient basis (23.5 % and 28.87%, respectively) (p≤0.01)). The results of the treatment of chronic fibrous pulpitis showed a reliably low percentage of complications that occur during oral rehabilitation in conditions of general anesthesia (15%) than during oral rehabilitation in outpatient settings (28.87%) (p<0.01). In the treatment of chronic forms of periodontitis at the stage of root stabilization on an outpatient basis, 59% have complications that cause tooth extraction. Of these, 38% have complications in the form of an exacerbation of the process with a violation of the cortical plate, the rudiment of permanent teeth, 62% — pathological resorption of the roots of temporary teeth. In the treatment of chronic forms of periodontitis at the stage of root resorption on an outpatient basis, 73% have complications, including local enamel hypoplasia of permanent teeth. The treatment of this diagnosis involves several visits, which is technically impossible to perform under general anesthesia. Therefore, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the aggravation stage were subject to lengthening, at the stage of remission, at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodine paste (according to indications, removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Dentistry with such a diagnosis involves several visits, which is technically impossible to perform under general anesthesia. The poem, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the exacerbation stage were subject to extension, at the stage of remission — at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodoform paste (according to indications - removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Thus, in children aged 3–7 years: the choice of the method of dental treatment depends on the temperament and type of phobias, which determine the nature of the behavior at the dental appointment. Dispensary supervision of children ensures their habituation to the dental chair and, as a consequence, prevents the development of cryptogenic phobias in them.