Çocuk hastalarda Er:YAG lazer ile çürük uzaklaştırılmasında ağrı algısının değerlendirilmesi: bölünmüş-ağız çalışması
Öz
Amaç: Çocuk hastaların dental tedavilerinde korku ve anksiyete önemli bir
problem olarak karşımıza çıkmaktadır. Çürük temizleme aletlerinin kullanımı
esnasında oluşan ağrı, çoğu çocuk ve yetişkinde dental korku ve anksiyeteyi
tetikleyebilmektedir. Bu çalışmanın amacı; Er:YAG lazer ve geleneksel döner
aletler kullanılarak çürük temizleme işlemi uygulanan çocuklardaki ağrı
algılarını değerlendirmek ve karşılaştırmaktır.
Gereç ve Yöntem: Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi
Pedodonti Kliniğine başvuran 120 çocuk hastanın daimi molar dişlerindeki
okluzal çürükler, Er:YAG lazer ve konvansiyonel çürük temizleme yöntemi olan
yüksek ve düşük hızlı döner aletler kullanılarak uzaklaştırıldı. Tüm restoratif
işlemler tek klinisyen tarafından gerçekleştirildi. Tedavi sonrası tüm
çocuklardan Wong-Baker skalasındaki değer veya görsellerden bir tanesini
seçmeleri istendi. Elde edilen verilerin değerlendirilmesinde Wilcoxon testi
kullanıldı (α=0.05).
Bulgular: Çalışma grupları arasında istatistiksel fark gözlendi
(p<0.05). Er:YAG lazer grubunda ‘canım acımıyor’ seçeneği %20.83 oranında
seçilirken; konvansiyonel yöntem grubunda %6.66 bulundu. ‘Canım çok fazla
acıyor’ seçeneği hiçbir grupta seçilmedi.
Sonuç: Çalışmadan elde edilen sonuçlara göre; Er:YAG
lazerlerin çürük temizleme amacıyla kullanılmasının geleneksel döner aletlere
kıyasla daha az ağrıya sebep olduğu ve çocuk hastalar için daha konforlu ve
kabul edilebilir bir yöntem olduğu düşünülebilir.
Anahtar Kelimeler
Kaynakça
- Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent 2016;8:35-50.
- Porritt J, Buchanan H, Hall M, Gilchrist F, Marshman Z. Assessing children’s dental anxiety: a systematic review of current measures. Community Dent Oral Epidemiol 2013;41:130-42.
- Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J 2013;58:390-407.
- Oosterink FM, de Jongh A, Aartman IH. What are people afraid of during dental treatment? Anxiety-provoking capacity of 67 stimuli characteristic of the dental setting. Eur J Oral Sci 2008;116:44-51.
- Montedori A, Abraha J, Orso M, D’Errico PG, Pagano S, Lombardo G. Lasers for caries removal in deciduous and permanent teeth. Cochrane Database Syst Rev 2016;9:CD010229.
- Cozean C, Arcoria CJ, Pelagalli J, Powell GL. Dentistry for the 21st Century? Erbium:YAG laser for teeth. J Am Dent Assoc 1997;128:1080-7.
- Sarmadi R, Hedman E, Gabre P. Laser in caries treatment – patients’ experiences and opinions. Int J Dent Hyg 2014;12:67-73.
- Wong-Baker FACES Foundation [Internet]. Oklahoma City: Wong-Baker FACES® Pain Rating Scale. Originally published in Whaley & Wong’s Nursing Care of Infants and Children [cited 2016]. © Elsevier Inc. Retrieved [02.03.2017] with permission from: http://www.WongBakerFACES.org
- Klinberg G, Raadal M, Arnrup K. Dental fear and behavior management problems. Koch G, Poulsen S, editors. Pediatric dentistry: a clinical approach. 2nd edn. London: John Wiley & Sons; 2009. p. 32-4.
- Garra G, Singer AJ, Taira BR, Chauhan J, Cardoz H, Chisena E, Thode HC Jr. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med 2010;17:50-4.
- Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8:1153-7.
- Güngör Ö, Yıldız E, Köylüoğlu Z, Hanımeli S, Küçükçetin İ, Öztürk O, et al. Çocuklardaki Dental Kaygının Psikometrik, Projektif ve Fizyolojik Testlerle Karşılaştırmalı Olarak Değerlendirilmesi. Turkiye Klinikleri J Pediatr Dent-Special Topics 2015;1:29-36.
- Bulloch B, Tenenbein M. Validation of 2 Pain Scales for Use in the Pediatric Emergency Department. Pediatrics 2002;110:e33.
- Bailey B, Trottier ED. Managing Pediatric Pain in the Emergency Department. Pediatr Drugs 2016;18:287-301.
- Piaget J. The Early Growth of Logic in the Child. London: Routledge and Kegan Paul Ltd; 1964.
- Shields BJ, Cohen DM, Harbeck-Weber C, Powers JD, Smith GA. Pediatric pain measurement using a visual analogue scale: a comparison of two teaching methods. Clin Pediatr 2003;42:227-34.
- Chomyszyn-Gajewska M, Kwapinska H, Zarzecka J. Pain perception in children during caries removal with the Vector system: a pilot study. Eur Arch Paediatr Dent 2006;7:38-41.
- Topaloglu-Ak A, Eden E, Frencken JE. Perceived dental anxiety among schoolchildren treated through three caries removal approaches. J Appl Oral Sci 2007;15:235-40.
- Anegundi RT, Patil SB, Tegginmani V, Shetty SD. A comparative microbiological study to assess caries excavation by conventional rotary method and a chemo-mechanical method. Contemp Clin Dent 2012;3:388-92.
- Kumar K, Prasad G, Sandeep R, Reddy S, Divya D, Pratyusha K. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community-based setting: A comparative in vivo study. Eur J Dent 2016;10:386-91.
- Dommisch H, Peus K, Kneist S, Krause F, Braun A, Hedderich J, et al. Fluorescence-controlled Er: YAG laser for caries removal in permanent teeth: a randomized clinical trial. Eur J Oral Sci 2008;116:170-6.
- Eren F, Altinok B, Ertugral F, Tanboga I. The Effect of Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet (Er,Cr:YSGG) Laser Therapy on Pain During Cavity Preparation in Paediatric Dental Patients: A Pilot Study. Oral Health Dent Manag 2013;12:80-4.
- Hjertton PM, Bagesund M. Er:YAG Laser or High-Speed Bur for Cavity Preparation in Adolescents. Acta Odontol Scand 2013;71:610-5.
Evaluation of Er:YAG lasers on pain perception in pediatric patients during caries removal: a split-mouth study
Öz
Objective: Fear and anxiety is a major problem in the
treatment of pediatric patients. The pain that occurs during the use of caries
removal instruments has a strong potential of triggering dental anxiety and
fear in most children and adults. This study aimed to evaluate and compare the
pain perceptions of children who underwent caries removal via an Er:YAG laser
and traditional rotary instruments.
Materials and Method: Occlusal caries was removed from the permanent
molar teeth of 120 pediatric patients who referred to the Department of
Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan
University, using an
Er:YAG laser and high- and low-speed rotary instruments. All restorative
procedures were performed by one clinician. The participant children were asked
to choose a value or figure from the Wong-Baker FACES Pain Rating Scale, and
the data were analyzed using the Wilcoxon test (α=0.05).
Results: A statistically significant difference was found
between the groups (p<0.05). In the Er:YAG laser group, 20.83% of the
participants, and in the conventional group, 6.66% of the participants selected
the option ‘no hurt’. The option ‘hurts worst’ was selected in neither of the
groups.
Conclusion: The use of Er:YAG laser for caries removal causes
less or no pain during the operations, compared to traditional rotary
instruments. Therefore, it can be argued that Er:YAG laser is a more comfortable
and acceptable alternative for pediatric patients.
Anahtar Kelimeler
pain perception pedodontics Dental caries Er-YAG lasers pedodontics
Kaynakça
- Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent 2016;8:35-50.
- Porritt J, Buchanan H, Hall M, Gilchrist F, Marshman Z. Assessing children’s dental anxiety: a systematic review of current measures. Community Dent Oral Epidemiol 2013;41:130-42.
- Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J 2013;58:390-407.
- Oosterink FM, de Jongh A, Aartman IH. What are people afraid of during dental treatment? Anxiety-provoking capacity of 67 stimuli characteristic of the dental setting. Eur J Oral Sci 2008;116:44-51.
- Montedori A, Abraha J, Orso M, D’Errico PG, Pagano S, Lombardo G. Lasers for caries removal in deciduous and permanent teeth. Cochrane Database Syst Rev 2016;9:CD010229.
- Cozean C, Arcoria CJ, Pelagalli J, Powell GL. Dentistry for the 21st Century? Erbium:YAG laser for teeth. J Am Dent Assoc 1997;128:1080-7.
- Sarmadi R, Hedman E, Gabre P. Laser in caries treatment – patients’ experiences and opinions. Int J Dent Hyg 2014;12:67-73.
- Wong-Baker FACES Foundation [Internet]. Oklahoma City: Wong-Baker FACES® Pain Rating Scale. Originally published in Whaley & Wong’s Nursing Care of Infants and Children [cited 2016]. © Elsevier Inc. Retrieved [02.03.2017] with permission from: http://www.WongBakerFACES.org
- Klinberg G, Raadal M, Arnrup K. Dental fear and behavior management problems. Koch G, Poulsen S, editors. Pediatric dentistry: a clinical approach. 2nd edn. London: John Wiley & Sons; 2009. p. 32-4.
- Garra G, Singer AJ, Taira BR, Chauhan J, Cardoz H, Chisena E, Thode HC Jr. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med 2010;17:50-4.
- Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8:1153-7.
- Güngör Ö, Yıldız E, Köylüoğlu Z, Hanımeli S, Küçükçetin İ, Öztürk O, et al. Çocuklardaki Dental Kaygının Psikometrik, Projektif ve Fizyolojik Testlerle Karşılaştırmalı Olarak Değerlendirilmesi. Turkiye Klinikleri J Pediatr Dent-Special Topics 2015;1:29-36.
- Bulloch B, Tenenbein M. Validation of 2 Pain Scales for Use in the Pediatric Emergency Department. Pediatrics 2002;110:e33.
- Bailey B, Trottier ED. Managing Pediatric Pain in the Emergency Department. Pediatr Drugs 2016;18:287-301.
- Piaget J. The Early Growth of Logic in the Child. London: Routledge and Kegan Paul Ltd; 1964.
- Shields BJ, Cohen DM, Harbeck-Weber C, Powers JD, Smith GA. Pediatric pain measurement using a visual analogue scale: a comparison of two teaching methods. Clin Pediatr 2003;42:227-34.
- Chomyszyn-Gajewska M, Kwapinska H, Zarzecka J. Pain perception in children during caries removal with the Vector system: a pilot study. Eur Arch Paediatr Dent 2006;7:38-41.
- Topaloglu-Ak A, Eden E, Frencken JE. Perceived dental anxiety among schoolchildren treated through three caries removal approaches. J Appl Oral Sci 2007;15:235-40.
- Anegundi RT, Patil SB, Tegginmani V, Shetty SD. A comparative microbiological study to assess caries excavation by conventional rotary method and a chemo-mechanical method. Contemp Clin Dent 2012;3:388-92.
- Kumar K, Prasad G, Sandeep R, Reddy S, Divya D, Pratyusha K. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community-based setting: A comparative in vivo study. Eur J Dent 2016;10:386-91.
- Dommisch H, Peus K, Kneist S, Krause F, Braun A, Hedderich J, et al. Fluorescence-controlled Er: YAG laser for caries removal in permanent teeth: a randomized clinical trial. Eur J Oral Sci 2008;116:170-6.
- Eren F, Altinok B, Ertugral F, Tanboga I. The Effect of Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet (Er,Cr:YSGG) Laser Therapy on Pain During Cavity Preparation in Paediatric Dental Patients: A Pilot Study. Oral Health Dent Manag 2013;12:80-4.
- Hjertton PM, Bagesund M. Er:YAG Laser or High-Speed Bur for Cavity Preparation in Adolescents. Acta Odontol Scand 2013;71:610-5.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Özgün Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Ağustos 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 35 Sayı: 3 |