Çocuk hastalarda süt molar ve daimi birinci molar dişlere uygulanan paslanmaz çelik kronların klinik başarısının ve memnuniyetin değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Çocuk hastalarda çürükler, süt dişlerinde ve daimi birinci molar dişlerde yaygın olarak rastlanan bir ağız diş sağlığı sorunudur. Bu çürüklerin tedavisinde, geleneksel restorasyon yöntemlerinin yanı sıra diş yüzeylerini tamamen kaplayan paslanmaz çelik kronlar da sıklıkla kullanılmaktadır. Yaygın olarak kullanılan bu kronların klinik performansları ve başarılarını gösteren çalışmalar klinisyenler için yol gösterici olmaktadır. Bu gözlemsel çalışmaya Ege Üniversitesi Diş Hekimliği Fakültesi Pedodonti Anabilim Dalı Kliniği'nde süt ve daimi birinci molar dişlerine prefabrik paslanmaz çelik kron (PÇK) uygulanmış 198 adet çocuk hasta dahil edilmiştir. Bu hastalara geçmişte uygulanmış olan toplam 260 adet paslanmaz çelik kron ve ilgili dişin klinik durumu, belirlenen klinik değerlendirme kriterlerine göre incelenmiştir. PÇK uygulanan dişlerin ve kontrol olarak alınan sağlıklı ve PÇK/dolgu uygulanmamış dişlerin periodontal sağlık durumlarını değerlendirmek üzere Sillness&Löe Plak İndeksi, Löe&Silness Gingival İndeksi kullanılmış, periodontal cep derinlikleri periodontal sond ile ölçülerek kaydedilmiştir. Klinik değerlendirmeler sonucu paslanmaz çelik kronların başarı durumları başarı kriterleri esas alınarak belirlenmiş ve oluşturulan memnuniyet anketine göre çocuk hasta ile ebeveynlerinin memnuniyetlerinin değerlendirilmesi amaçlanmıştır. Klinik değerlendirmeler sonucu elde edilen verilerin istatistiksel analizinde, SPSS 25.0 paket programı kullanılmıştır. Kategorik ölçümler sayı ve yüzde olarak, sürekli ölçümlerse ortalama ve standart sapma, gerekli yerlerde ortanca ve minimum-maksimum olarak belirlenmiştir. Kategorik değişkenlerin karşılaştırılmasında Ki Kare ve Fisher testi kullanılmıştır. Gruplar arasında sürekli ölçümlerin karşılaştırılmasında dağılımlar Kolmogrov Smirnov ve Shapiro Wilks testi ile kontrol edilmiştir; normal dağılım gösteren değişkenler için Bağımsız grup T testi, normal dağılım göstermeyen değişkenler için ise Mann Whitney U ve ikiden fazla grup karşılaştırılmasında Kruskal Wallis testi kullanılmıştır. PÇK uygulanan dişlerin ve kontrol grubu dişlerin periodontal durumlarının karşılaştırılmasında ise Wilcoxon testi kullanılmıştır. Sonuçlar %95 güven aralığı ve 0,05 istatistiksel önem düzeyinde değerlendirilmiştir. Yapılan istatistiksel analizler sonucunda; paslanmaz çelik kronların retansiyonlarının %92,97 oranında, klinik başarılarının ise %93,08 oranında ve oldukça yüksek oldukları tespit edilmiştir. Gingival indeks, plak indeksi ve sondalama derinliği ölçümlerinde PÇK yapılan dişler ile kontrol grubu dişlerin ölçümlerinin sonuçlarına göre, PÇK yapılan dişlerde plak indeksi değerlerinin kontrol diş değerlerine göre daha fazla olduğu fakat aralarındaki ilişkinin anlamlı olmadığı tespit edilmiştir (p>0,05). Paslanmaz çelik kron uygulanan dişlerin gingival indeks ve sondalama derinliklerinin kontrol grubu dişlere göre istatistiksel olarak anlamlı düzeyde yüksek olduğu saptanmıştır (p<0,05). Ebeveyn ve hasta memnuniyet sonuçlarının başarı ile uyumlu olarak yüksek olduğu belirlenmiştir. Paslanmaz çelik kronun estetik memnuniyetinin ise düşük olduğu görülmüştür. Renk açısından ebeveyn memnuniyetlerinin iyi olmadığı; fakat genel ebeveyn memnuniyet puanın ise oldukça yüksek olduğu gözlenmiştir. Sonuç olarak bu çalışmada, çocuk diş hekimliğinde kullanımı oldukça yaygın olan paslanmaz çelik kronların klinik performanslarının oldukça yüksek olduğu tespit edilmiştir. Estetik açıdan memnuniyeti karşılayamamasına karşın, genel memnuniyetin ve klinik başarının oldukça yüksek olması; yaygın kullanımının devam etmesi açısından önem arz etmektedir.
Caries in children is a common oral health problem in primary teeth and permanent first molars. In the treatment of these caries, besides traditional restoration methods, stainless steel crowns that completely cover the surface teeth are also used. The study showing the clinical performance and success of these commonly used crowns is instructive for clinicians. In this observational study, 198 pediatric patients who had prefabricated stainless steel crowns (SSC) applied to their primary and permanent first molar teeth at Ege University Faculty of Dentistry Pedodontics Clinic were included. The clinical condition of a total of 260 stainless steel crowns and related teeth, which were applied to these patients in the past, were examined according to the determined clinical evaluation criteria. Sillness&Löe Plaque Index, Löe&Silness Gingival Index were used to evaluate the periodontal health status of the teeth that underwent SSC and the healthy and unfilled teeth that were taken as control, and periodontal pocket depths were measured with a periodontal probe. As a result of clinical evaluations, the success status of stainless steel crowns was determined on the basis of success criteria and it was aimed to evaluate the satisfaction of the pediatric patient and their parents according to the satisfaction questionnaire created. SPSS 25.0 package program was used in the statistical analysis of the data obtained as a result of clinical evaluations. Categorical measurements were determined as numbers and percentages, continuous measurements as mean and standard deviation, median and minimum-maximum where necessary. Chi-square and Fisher tests were used to compare categorical variables. In comparison of continuous measurements between groups, distributions were checked with the Kolmogrov Smirnov and Shapiro Wilks test; Independent group T test was used for normally distributed variables, Mann Whitney U test was used for non-normally distributed variables, and Kruskal Wallis test was used for comparing more than two groups. The Wilcoxon test was used to compare the periodontal conditions of the SSC applied teeth and the control group teeth. The results were evaluated at 95% confidence interval and 0.05 statistical significance level. As a result of the statistical analysis; It has been determined that the retention of stainless steel crowns is 92.97%, the clinical success rate is 93.08% and they are quite high. In the gingival index, plaque index and probing depth measurements, according to the results of the measurements of the teeth that underwent SSC and the teeth of the control group, it was determined that the plaque index values in the teeth that underwent SSC were higher than the values of the control teeth, but the relationship between them was not significant (p>0.05). It was determined that the gingival index and probing depths of the teeth with stainless steel crowns were statistically significantly higher than the teeth in the control group (p<0.05). It was determined that the results of parent and patient satisfaction were high in line with success. It has been observed that the aesthetic satisfaction of the stainless steel crown is low. Parent satisfaction in terms of color is not good; however, it was observed that the overall parent satisfaction score was quite high. As a result, in this study, it was determined that the clinical performances of stainless steel crowns, which are widely used in pediatric dentistry, are quite high. Although it cannot meet the satisfaction in terms of aesthetics, the general satisfaction and clinical success are quite high; important for its continued widespread use.
Caries in children is a common oral health problem in primary teeth and permanent first molars. In the treatment of these caries, besides traditional restoration methods, stainless steel crowns that completely cover the surface teeth are also used. The study showing the clinical performance and success of these commonly used crowns is instructive for clinicians. In this observational study, 198 pediatric patients who had prefabricated stainless steel crowns (SSC) applied to their primary and permanent first molar teeth at Ege University Faculty of Dentistry Pedodontics Clinic were included. The clinical condition of a total of 260 stainless steel crowns and related teeth, which were applied to these patients in the past, were examined according to the determined clinical evaluation criteria. Sillness&Löe Plaque Index, Löe&Silness Gingival Index were used to evaluate the periodontal health status of the teeth that underwent SSC and the healthy and unfilled teeth that were taken as control, and periodontal pocket depths were measured with a periodontal probe. As a result of clinical evaluations, the success status of stainless steel crowns was determined on the basis of success criteria and it was aimed to evaluate the satisfaction of the pediatric patient and their parents according to the satisfaction questionnaire created. SPSS 25.0 package program was used in the statistical analysis of the data obtained as a result of clinical evaluations. Categorical measurements were determined as numbers and percentages, continuous measurements as mean and standard deviation, median and minimum-maximum where necessary. Chi-square and Fisher tests were used to compare categorical variables. In comparison of continuous measurements between groups, distributions were checked with the Kolmogrov Smirnov and Shapiro Wilks test; Independent group T test was used for normally distributed variables, Mann Whitney U test was used for non-normally distributed variables, and Kruskal Wallis test was used for comparing more than two groups. The Wilcoxon test was used to compare the periodontal conditions of the SSC applied teeth and the control group teeth. The results were evaluated at 95% confidence interval and 0.05 statistical significance level. As a result of the statistical analysis; It has been determined that the retention of stainless steel crowns is 92.97%, the clinical success rate is 93.08% and they are quite high. In the gingival index, plaque index and probing depth measurements, according to the results of the measurements of the teeth that underwent SSC and the teeth of the control group, it was determined that the plaque index values in the teeth that underwent SSC were higher than the values of the control teeth, but the relationship between them was not significant (p>0.05). It was determined that the gingival index and probing depths of the teeth with stainless steel crowns were statistically significantly higher than the teeth in the control group (p<0.05). It was determined that the results of parent and patient satisfaction were high in line with success. It has been observed that the aesthetic satisfaction of the stainless steel crown is low. Parent satisfaction in terms of color is not good; however, it was observed that the overall parent satisfaction score was quite high. As a result, in this study, it was determined that the clinical performances of stainless steel crowns, which are widely used in pediatric dentistry, are quite high. Although it cannot meet the satisfaction in terms of aesthetics, the general satisfaction and clinical success are quite high; important for its continued widespread use.
Açıklama
29.02.2024 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.
Anahtar Kelimeler
Diş Hekimliği, Dentistry
