Comparación de técnicas convencionales y técnicas alternativas para el manejo de la conducta y el comportamiento en pacientes odontopediátricos: revisión sistemática

Abstract

Objective: To carry out a systematic review comparing conventional and alternative techniques for managing behavior in dental practice with children in the years 2015-2019. Methods: In the first place, the research question was established: What are the conventional and alternative techniques for behavioral management in the pediatric dentistry office reported in the literature between 2015-2019? A preliminary information search was then carried out and the systematic review protocol based on the Cochrane manual was developed. Subsequently, the international prospective registration was carried out in Prospero. A search was then carried out with a PICO question specifying the following terms: patient, intervention, comparison intervention, and outcome. The search was carried out with the terms: Children, Dentistry, For; Dentistry, Children, Behavior; in the following six databases: Cochrane Library (Cochrane Database of Systematic Reviews CDSR, DARE Effects Review Summaries Database, HTA Health Technology Assessment Database); Pubmed, Science Direct; Proquest. Subsequently, the articles obtained were evaluated with the STROBE method and their critical reading was guided by the CASPe guide. Then, the data extraction and its respective tabulation was carried out in Excel. Finally, the information was analyzed. Here the variables and data to be taken from each study were determined. The research instrument was the numerically modified checklist of McEvoy et al. Then, the global analysis was calculated by subgroups with their respective tables and graphs. The PRISMA-P 2015 guide was applied to write the results. Results: 32 articles were included, of which 56% report the use of one or more techniques for the management of pediatric dentistry, where the basic conventional techniques were: say / show / do in 4%, positive reinforcement in 4% , presence / absence 4%, modeling 4%, advanced conventional techniques: pharmacological 4%, sedation 23%, general anesthesia 14%, protective stabilization 4%; and the alternative techniques were: hypnosis 4%, active distraction type virtual reality 18%, other active distraction 4% and passive distraction type audio / music 9%. Additionally, the studies were categorized according to the Mc Evoy instruments and suggestions and recommendations were established for the Children's Clinic of the Antonio Nariño University.