生理测试法评估3种去龋方法对儿童牙科畏惧的影响

目的：用生理测试法评估不同去龋方法对儿童牙科畏惧的影响.方法：选取90例有乳磨牙中龋的儿童,随机分为化学机械去龋组（第1组）、非创伤性充填组（第2组）及传统车针去龋组（第3组）.分别于治疗前、治疗后5、10、15min及治疗结束时测量患儿血压和脉搏值,记为T0、T1、T2、T3和TE.通过观察患儿血压和脉搏的变化,评估不同去龋方法对儿童牙科畏惧的影响.实验资料用SPSS11.5统计软件包进行单因素方差分析,并用Student-Newman-Keuls法对不同治疗方法和时间的血压、脉搏值进行两两比较.结果：在时间点T1,第3组各指标与第1组差异无显著性（P＞0.05）,与第2组差异有显著性（P＜0.05）,第1组与第2组各指标间差异无显著性（P＞0.05）;在时间点T2,第3组收缩压与第1组、第2组差异有显著性（P＜0.05）,而第2组与第1组间差异无显著性（P＞0.05）,其他指标3组间差异无显著性（P＞0.05）;以后各时间点各指标间差异均无显著性（P＞0.05）.结论：化学机械去龋及非创伤性充填较传统车针去龋,能有效缓解儿童牙科畏惧.

Effects of three caries removal methods on children's dental fear evaluated by physiological measure

PURPOSE: To evaluate the effects of three caries removal methods on children' s dental fear by physiological measure. METHODS: 90 children with caries lesions into dentin in primary molars were divided into three groups randomly: Chemomechanical carious removal group, atraumatic restorative treatment (ART) groups and traditional rotary instrument group. The baseline of blood pressure, pulse was recorded before the treatment. Then the blood pressure and the pulse of each subjects were measured 5, 10 and 15 minutes and at the end of the treatment respectively. The dental fear was evaluated by observing the trend of blood pressure and pulse in the process of the treatment, and the results were analyzed by SPSS11.5 software package, using one-way ANOVA and Student-Newman-Keuls methods to determine the effects of different caries removal methods on children' s dental fear. RESULTS: The degree of dental fear in traditional drilling group was significantly higher than that in chemo-mechanical group and ART group. The difference of each index between rotary instrument group and ART group was significant at the first time-point from the beginning of the treatment (P<0.05), but not significantly between rotary group and chemo-mechanical group (P>0.05), and between ART and chemo-mechanical group. (P>0.05). At the second time-point, the difference of systolic blood pressure was significant between rotary group and chemomechanical group(P<0.05), and the same between rotary group and ART group (P<0.05), but not between ART and chemo-mechanical group (P>0.05), while the difference of the other index among the three groups was not significant (P>0.05). There was no significantly difference of each index among the three groups at the time-point afterwards (P>0.05). CONCLUSION: Compared to traditional caries removal method, chemomechanical technique and ART may decrease children' s dental fear effectively.