う蝕充填治療中の歯科恐怖症予防における2つの方法のコスト最小化分析

[Cost-minimization analysis of two methods during the prevention of dental fear during caries filling treatments].

抄録

目的:

う蝕充填治療時の歯科恐怖症（DF）予防について、術前教育法または局所麻酔法による経済効果を明らかにすること。

OBJECTIVE: To determine the economic effects on the prevention of dental fear (DF) by pre-operation-education or local anesthesia method during the process of tooth filling.

方法:

本研究では、下顎第一大臼歯の咬合う蝕に罹患している7～12歳の学童150名を対象とした。男児25名、女児25名を3群に分けた。A群（術前教育）では、う蝕に関するビデオテープを見せ、歯科用椅子や器具などの診療環境に慣れさせ、B群（局所麻酔）では、治療の約15分前に2％リドカイン1.8mlを注射して局所麻酔を行い、C群（ブランク）では、DFの介入を行わなかった。その後、すべての被験者が同じ充填治療を受けた。その過程で、各DF症例は、不安と協力に関するVenhamの臨床的評価に基づいて盲検的に評価された。その後、費用最小化分析が検討された。

METHODS: One hundred and fifty school children of age 7 to 12, participating in this study, suffered from occlusal caries on their mandibular first molars. They were divided into 3 groups, with 25 boys and 25 girls each. Group A (pre-operation-education) was showed video tape on caries to, familiarized with clinic environment, including dental chairs and instruments; Group B (local anesthesia) received injection of 1.8 ml of 2% lidocaine for local anesthesia about 15 minutes before treatment; Group C (blank) received no intervention for DF. Thereafter, all subjects received same filling treatment. During that process, each DF case was evaluated blindly based on Venham's clinical ratings of anxiety and cooperation. Cost-minimization analysis was then studied.

結果:

DF率には群間に有意差が認められたが、A群とB群の間には有意差は認められなかった（5/50、9/50、21/50、χ(2) = 15.503 1、P = 0.000 4）。3群における各症例の費用は、それぞれ83.99元、87.09元、87.76元であった。

RESULTS: Significant difference was found between groups, but not between group A and B in DF rate (5/50, 9/50 and 21/50, chi(2) = 15.503 1, P = 0.000 4). The costs of each case in 3 groups were 83.99 Yuan, 87.09 Yuan and 87.76 Yuan respectively.

結論:

術前教育法と局所麻酔法では、前者の方がDF予防の臨床効果が高く、費用も安いため、普及させる価値があった。

CONCLUSION: Between pre-operation-education and local anesthesia methods, the former was worth promoted for it's better clinical effect in DF prevention with lower cost.