Tratamientos bajo "Anestesia no convencional" en pacientes discapacitados del programa de atención bucodental infantil (PADI) de la Comunidad Autónoma de Murciaestudio retrospectivo de 10 años

Abstract

Since 2003, the Children's Dental Care Program (PADI) of the Region of Murcia has collected the need to provide oral treatment to disabled patients who are not likely to receive conventional odontostomatological treatment but who can benefit from special therapeutic techniques. We have proceeded to review the medical records of 143 patients with disabilities treated under general anesthesia, and aged between 6 to 14 years old by the Department of Special Patients of the Dental Clinic of the University of Murcia from 2004 to 2013, being the main objective to assess the needs for oral treatment and the results obtained in the therapy carried out in this population group during the first decade of its establishment. The parameters under study have been: gender, age, associated medical pathologies, number and types of oral treatments performed and affected teeth, average time of delay between the request, granting and performance of the intervention, average duration of the intervention, and know the possible post- treatment complications, as well as the needs for reoperation. As results, we can observe that in terms of gender, there is a predominance of males treated with a more significant number of interventions in the age range of 6-7 years, with an increase in patients assisted as the implementation of the oral health program progressed. The most frequently associated medical pathologies have been psychomotor retardation, encephalopathies and epilepsy, with the confluence of 2 or more clinical entities per patient being common. A total of 1528 treatments have been carried out under non-conventional anesthesia. Fillings, followed by pulpotomies with pediatric dental crowns and extractions, constitute more than 90% of procedures in primary dentition. In permanent dentition, most treatments have been restorative (90.9%), followed by extractions (6.93%). Temporary second molars and permanent first molars have been the teeth with the greatest need for treatment. The average delay when carrying out the therapeutic procedure, from its request to its execution, has been 2 months, and only 13.2% exceed 4 months of waiting, while the average duration time used in the interventions has been 107 ± 32 minutes, with a range of 35 to 256 minutes. We have not recorded post-treatment complications during hospitalization or in the weekly check-up visits; and less than 10% of the patients have required reintervention. We can conclude that, with an adequate selection criteria for patients with special needs, treatment under general anesthesia is safe and improves their quality of life and oral health, but in all cases requires regular check-ups and correct maintenance of oral hygiene.