Effect of different design preparations on the flexural and fracture strength of fiber-reinforced composite fixed partial dentures: an in vitro study.

PURPOSE: To determine and compare the flexural and fracture strength of three-unit fiber-reinforced composite (FRC) fixed partial dentures (FPDs) using three abutment design preparations. MATERIAL AND METHODS: The flexural and fracture strength of three-unit FRC FPDs were evaluated using three design preparations of the abutments (conventional full crown [group A], box-shaped [group B], and tub-shaped [group C]). Thirty three-unit FRC FPDs were fabricated (10 specimens per group) for the replacement of missing mandibular first molars and were adhesively luted to extracted human teeth. The flexural and fracture strength were determined using a universal testing machine with a steel loading pin of 20 mm diameter with a 3-mm-diameter hardened circular tip. Each specimen was evaluated under SEM to determine mode of failure. RESULTS: Mean fracture strength for group A was 820.00 ± 56.51 N, group B was 536.94 ± 65.62 N, and group C was 501.24 ± 66.71 N. The highest mean flexural strength was found in group A (68.33 ± 4.71 MPa), followed by group B (44.74 ± 5.46 MPa) and lowest in group C (41.77 ± 5.56 MPa). The SEM evaluation showed partial or complete debonding of veneering composite from fiber framework, leaving intact fiber frameworks in all the specimens. CONCLUSION: Full-coverage design had significantly higher flexural and fracture strengths than box and tub-shaped designs. Since both values were noted to be in the order of masticatory stresses, the full coverage design is a good alternative for the replacement of missing molar teeth; however, the framework veneering composite interface was the weakest phase of FRC FPDs, thus indicating that further improvement in veneering composite or fiber framework is needed to improve the compatibility of veneering composite with that of fiber framework for long-term clinical implications.

Structural, magnetic and dielectric properties of Ni(1_x)Zn(x)Fe2O4 (x = 0,0.5 and 1) nanoparticles synthesized by chemical co-precipitation method.

Ni(1-x)Zn(x)Fe2O4 (x = 0, 0.5 and 1) ferrite nanoparticles were synthesized by chemical co-precipitation method. X-ray diffraction technique and Rietveld refinement were used to investigate the structural characteristics and determination of the particle size which was found to decrease from 4.9 to 4.1 nm as a function of increasing Zn from 0 to 1.0. Vibrating sample magnetometer was used to study magnetic properties of nickel zinc ferrite nanoparticles. Field-dependent magnetization measurements (M-H curve) at 300 K revealed that Zn substitutions on inverse spinel nickel ferrites enhance the magnetic properties. Magnetization as a function of temperature showed the superparamagnetic behavior of Ni(1-x)Zn(x)Fe2O4 (x = 0,0.5 and 1) nanoparticles. Dielectric permittivity and a.c. conductivity were measured as a function of frequency from 100 kHz to 1 MHz at certain temperatures. The observed response in a.c. conductivity as a function of log of frequency of these nickel zinc ferrite systems was believed to be due to the presence of Maxwell-Wagner type interfacial polarization and hopping of electron by means of quantum mechanical tunneling.

An evaluation of Vitamin E and Pycnogenol in children suffering from oral mucositis during cancer chemotherapy.

OBJECTIVE: The purpose of the present study was to evaluate and compare the effectiveness of Vitamin E (E) and Pycnogenol (P) in treatment of Chemotherapy-Related Oral Mucositis (ChROM) in children. MATERIALS AND METHODS: A total of 72 children, aged between 6 and 15 years, with ChROM were selected and randomly divided into three groups after assessment of oral mucositis (OM) by WHO grading system. Glycerine (control), E, and P were topically applied in group I, II, and III, respectively, and the prognosis of OM was assessed by functional, objective, and subjective parameters. RESULTS: Patients of group II and III showed significant improvement when ChROM was analyzed through scoring systems - WHO grading, Oral Mucositis Assessment Scale (OMAS), and Children's International Mucositis Evaluation Scale (ChIMES) as compared to group I (P < 0.001); however, there was no significant difference between groups II and III. CONCLUSION: Both the drugs E and P per se are effective for treatment of OM with P being not effective for the treatment of severe mucositis (grade 4). Combination of E and P and additional agents may be tried for better results.

Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin: a case report.

AIM: To discuss the clinical and radiological outcome of a revascularization procedure in an immature tooth with a necrotic pulp using platelet-rich fibrin (PRF), a second-generation platelet concentrate. SUMMARY: A 7-year-old male reported with pain in the maxillary anterior region as a result of the injury to his immature right maxillary central incisor tooth. After preparation of the access cavity, the necrotic pulp was removed and the canal irrigated using 5.25% sodium hypochlorite solution. The canal was then dried and packed with triantibiotic paste for 3 weeks. After removal of the antibiotic paste, a 5 mL sample of whole venous blood was drawn from the patient's forearm to prepare PRF. The freshly prepared PRF was condensed in the canal until the cementoenamel junction. Three millimetres of white MTA was placed directly over the PRF clot. Three days later, the tooth was restored using a permanent restoration. At 7-, 12- and 15-month recall, the tooth was asymptomatic with no sensitivity to percussion or palpation. At 12- and 15-month follow-up, the tooth responded positively to cold and an electric pulp test, and similarly to adjacent lateral incisor and canine teeth. Radiographic examination demonstrated continued thickening of root canal walls, root lengthening and apical closure. KEY LEARNING POINT: Platelet-rich fibrin might serve as a potentially ideal scaffold in revascularization of immature permanent teeth with necrotic pulps as it is rich in growth factors, enhances cellular proliferation and differentiation, and acts as a matrix for tissue ingrowth.

Investigation of liver-targeted peripheral focused ultrasound stimulation (pFUS) and its effect on glucose homeostasis and insulin resistance in type 2 diabetes mellitus: a proof of concept, phase 1 trial.

BACKGROUND: Mechanical waves produced by ultrasound pulses have been shown to activate mechanosensitive ion channels and modulate peripheral nerves. However, while peripheral ultrasound neuromodulation has been demonstrated in vitro and in pre-clinical models, there have been few reports of clinical tests. AIM: We modified a diagnostic imaging system for ultrasound neuromodulation in human subjects. We report the first safety and feasibility outcomes in subjects with type 2 diabetes (T2D) mellitus and discuss these outcomes in relation to previous pre-clinical results. DESIGN: The study was performed as an open label feasibility study to assess the effects of hepatic ultrasound (targeted to the porta hepatis) on glucometabolic parameters in subjects with T2D. Stimulation (peripheral focused ultrasound stimulation treatment) was performed for 3 days (i.e. 15 min per day), preceded by a baseline examination and followed by a 2-week observation period. METHODS: Multiple metabolic assays were employed including measures of fasting glucose and insulin, insulin resistance and glucose metabolism. The safety and tolerability were also assessed by monitoring adverse events, changes in vital signs, electrocardiogram parameters and clinical laboratory measures. RESULTS AND CONCLUSION: We report post-pFUS trends in several outcomes that were consistent with previous pre-clinical findings. Fasting insulin was lowered, resulting in a reduction of HOMA-IR scores (P-value 0.01; corrected Wilcoxon signed-rank test). Additional safety and exploratory markers demonstrated no device-related adverse impact of pFUS. Our findings demonstrate that pFUS represents a promising new treatment modality that could be used as a non-pharmaceutical adjunct or even alternative to current drug treatments in diabetes.

Timely sown maize hybrids improve the post-anthesis dry matter accumulation, nutrient acquisition and crop productivity.

Delayed sowing of maize hybrids could exacerbate the capability of maximizing the yield potential through poor crop stand, root proliferation, nutrient uptake, and dry matter accumulation coupled with the inadequate partitioning of the assimilates. This study appraised the performance of five recent maize hybrids viz., PMH-1, PJHM-1, AH-4158, AH-4271, and AH-8181 under timely and late sown conditions of the irrigated semi-arid ecologies. Timely sowing had the grain and stover yields advantage of 16-19% and 12-25%, respectively over the late sown maize hybrids. The advanced hybrids AH-4271 and AH-4158 had higher grain yields than the others. During the post-anthesis period, a greater dry matter accumulation and contribution to the grain yield to the tune of 16% and 10.2%, respectively, was observed under timely sown conditions. Furthermore, the nutrient acquisition and use efficiencies also improved under the timely sown. The nutrient and dry matter remobilization varied among the hybrids with AH-4271 and PMH-1 registering greater values. The grain yield stability index (0.85) was highest with AH-4158 apart from the least yield reduction (15.2%) and stress susceptibility index (0.81), while the maximum geometric mean productivity was recorded with the AH-4271 (5.46 Mg ha-1). The hybrids AH-4271 and PJHM-1 exhibited improved root morphological traits, such as root length, biomass, root length density, root volume at the V5 stage (20 days after sowing, DAS) and 50% flowering (53 DAS). It is thus evident that the timely sowing and appropriate hybrids based on stress tolerance indices resulted in greater yields and better utilization of resources.

Novel mutations in calcium/calmodulin-dependent protein kinase IV (CAMK4) gene in infertile men.

Calcium/calmodulin-dependent protein kinase IV (CAMK4) is a multifunctional serine/threonine protein kinase, which plays an important role in the spermatogenesis by phosphorylating protamines. It has been shown to be involved in the regulation of human sperm motility. Moreover, the Camk4 knockout mice were infertile because of severely reduced sperm count and morphological abnormalities. As no study is available on the association of this gene with male infertility, we analysed all the exons of CAMK4 gene in ethnically matched 283 infertile and 268 fertile Indian men. We identified twenty nucleotide substitutions, of which twelve were novel. Of these novel variants, eight were exclusively detected in infertile men. Moreover, two infertile men-specific mutations were non-synonymous replacing amino acids at the highly conserved region. In silico analysis predicted both of these mutations as 'deleterious'. In addition to nucleotide substitutions, we identified five novel insertion-deletion mutations; of these, g.150264_66delGCG was exclusively found in two oligoasthenoteratozoospermic men. In silico analysis of infertile men exclusive mutations predicted that they can alter/diminish the potential binding sites of splicing factors, which may affect the mRNA splicing and protein translation. Our study suggests that the mutations in CAMK4 may lead to abnormal semen parameters.

Steroidal feedback on photoperiodic induction of testicular growth and development in two bird species.

Present study was performed to demonstrate the effect of exogenous administration of testosterone propionate on photoperiodic induction of testicular growth and development in brahminy myna (Sturnus pagodarum) and baya weaver (Ploceus philippinus). Two groups of brahminy myna and baya weaver (n=5 each) were exposed to 15L:9D (group-I) and 9L:15D (group-II), and received 30 microg of TP bird(-1) for 15 days. Then, the photoperiod was reversed; the one receiving 15L was exposed to 9L and vice versa. Observations on body mass and testis volume were taken at the beginning and at 15 days interval. In brahminy myna, a significant change in body mass occurred under 9L:15D, transfer to 15L:9D, but not under 15L:9D group, transfer to 9L:15D. Also, testes were stimulated under 15L:9D transferred to 9L:15D, but not under 9L:15D transferred to 15L:9D. In baya weaver, body mass increased under 15L:9D and 9L:15D for first 15 days and was maintained until the end of the experiment. Testes enlarged gradually in both groups (15L:9D and 9L:15D transfer to vice versa), but it regressed in 15L:9D group, transferred to 9L:15D after 45 days. Taken together it appears that body mass response indicates the photoperiodic effect and gonadal response indicates the hormonal effect. Finally results conclude that the photoperiod and circulating testosterone levels feedback on to hypothalamus regulates reproductive cycle in these birds.

Photodynamic therapy augments the efficacy of oncolytic vaccinia virus against primary and metastatic tumours in mice.

BACKGROUND: Therapies targeted towards the tumour vasculature can be exploited for the purpose of improving the systemic delivery of oncolytic viruses to tumours. Photodynamic therapy (PDT) is a clinically approved treatment for cancer that is known to induce potent effects on tumour vasculature. In this study, we examined the activity of PDT in combination with oncolytic vaccinia virus (OVV) against primary and metastatic tumours in mice. METHODS: The effect of 2-[1-hexyloxyethyl-]-2-devinyl pyropheophorbide-a (HPPH)-sensitised-PDT on the efficacy of oncolytic virotherapy was investigated against subcutaneously implanted syngeneic murine NXS2 neuroblastoma and human FaDu head and neck squamous cell carcinoma xenografts in nude mice. Treatment efficacy was evaluated by monitoring tumour growth and survival. The effects of combination treatment on vascular function were examined using magnetic resonance imaging (MRI) and immunohistochemistry, whereas viral replication in tumour cells was analysed by a standard plaque assay. Normal tissue phototoxicity following PDT-OV treatment was studied using the mouse foot response assay. RESULTS: Combination of PDT with OVV resulted in inhibition of primary and metastatic tumour growth compared with either monotherapy. PDT-induced vascular disruption resulted in higher intratumoural viral titres compared with the untreated tumours. Five days after delivery of OVV, there was a loss of blood flow to the interior of tumour that was associated with infiltration of neutrophils. Administration of OVV did not result in any additional photodynamic damage to normal mouse foot tissue. CONCLUSION: These results provide evidence into the usefulness of PDT as a means of enhancing intratumoural replication and therapeutic efficacy of OV.

Oral & maxillofacial manifestations in pediatric esthesioneuroblastoma-report of a case and review of literature.

Esthesioneuroblastoma (ENB) is a rare, malignant neoplasm arising from the olfactory epithelial cells, with only approximately 100 pediatric cases being reported in the literature since its original description in 1924. As a result of its origin high in the nasal cavity, most patients have non-specific symptoms, precluding early diagnosis and leading to the development of locally advanced disease that usually has been found to involve the orbital cavity, paranasal sinuses, and anterior cranial fossa in children. The purpose of this paper was to report a rare case of pediatric esthesioneuroblastoma diagnosed following the patient's dental complaints, wherein local invasion of the tumor into the maxillofacial region was noticed before its extension into other vital structures.

Bilateral fusion in primary mandibular teeth: a report of two cases.

The rare anomaly of fusion in primary dentition has very little documentation in Indian population. Two rare cases of bilateral fusion between primary mandibular lateral incisors and canines and primary mandibular central incisors and lateral incisors have been presented in this report. A minimal intervention approach, preventive procedures, and a long-term follow-up have been discussed.

A comparative evaluation of intranasal midazolam, ketamine and their combination for sedation of young uncooperative pediatric dental patients: a triple blind randomized crossover trial.

OBJECTIVE: The purpose of this study was to evaluate and compare the efficacy and safety of intranasal (IN) administration of midazolam (M), ketamine (K) and their combination (MK) to produce moderate sedation in young, uncooperative pediatric dental patients. STUDY DESIGN: In this three stage crossover trial forty five uncooperative ASA type-1 children, who required dental treatment, were randomly assigned to receive one of the three drugs/combination by IN route during three subsequent visits. The efficacy and safety of the agents were assessed by overall success rate and by monitoring of vital signs, respectively. RESULTS: The onset of sedation was rapid with K as compared to M and MK. The difference was statistically significant (P < 0.01) between K and M. The overall success rate was 89% with K, MK was 84% and 69% with M. The difference between the overall success rates of K and M was statistically significant (P < 0.01). Vital signs were within physiological limits and there were no significant adverse effects with any medication. CONCLUSIONS: M, K and MK are safe and effective by IN route to produce moderate sedation for providing dental care to pediatric dental patients who have been otherwise indicated for treatment under general anesthesia.

A comparative evaluation of drops versus atomized administration of intranasal ketamine for the procedural sedation of young uncooperative pediatric dental patients: a prospective crossover trial.

OBJECTIVE: The objective of this study was to compare and evaluate the efficacy and safety of drops and atomized administration of intranasal ketamine (INK) in terms of behavioral response for agent acceptance during administration and for agent efficacy and safety for the sedation of young uncooperative pediatric dental patients. STUDY DESIGN: Thirty-four uncooperative ASA grade-1 children, requiring dental treatment were randomly assigned to receive INK as drops and atomized spray in one of the subsequent visit. This was a two stage cross-over trial and each child received INK by both modes of administration. The vital signs were monitored continuously during each visit. RESULTS: A statistically significant difference in patients acceptance (P < 0.0001) was observed in the atomized administration when compared to drops administration for the procedural event of drug administration. Moreover there were also significant differences (P < 0.05) between onset of sedation and recovery time between two groups. All the vital signs were within normal physiological limits and there were no significant adverse effects in either group. CONCLUSIONS: INK is safe and effective by either mode of intranasal (IN) drug administration for moderate sedation in facilitating dental care for anxious and uncooperative pediatric dental patients. Moreover, INK when administered with the mucosal atomization device, the acceptance of the drug was associated with less aversive reaction, rapid onset and recovery of sedation, as compared to the drop administration of the same agent.

Reliability and factor analysis of children's fear survey schedule-dental subscale in Indian subjects.

CONTEXT: Fear to visit a dentist is a common observation even in adults; however, among children it becomes one of the most important issues for a dentist. Psychographic analysis of the factors that add to fear level of the children can be accessed through Children fear survey schedule-dental subscale (CFSS-DS); however, its varied applicability in different environmental situations has been tested through this paper. AIMS: The aim of present study is to evaluate the reliability and factor structure of the Indian version of the CFSS-DS. MATERIALS AND METHODS: The routine patients attending Outpatient Department of Pedodontics with Preventive Dentistry, Faculty of Dental Sciences, Lucknow, India (n=197, aged 7-12 years old) were evaluated for children's fear survey schedule-dental subscale which was filled by parents on behalf of the child. STATISTICAL ANALYSIS: Reliability analysis (alpha) was performed to assess the internal consistency of the Indian translation of the scale. Factor analysis (principle components, varimax rotation) was employed to assess the factor structure. RESULTS: Children fear survey scale-dental subscale was found to be equally reliable (Cronbach alpha = 0.92) and applicable among Indian subjects. However, factorization revealed emergence of 1) hospital, injections and hospital personnel, 2) drilling and interaction with unknown, 3) dental care personnel and practices. CONCLUSION: The present study extended the universal applicability of children fear survey schedule -dental subscale, while at the same time it was able to highlight different facets of problem in different environments.

Midazolam-fentanyl analgo-sedation in pediatric dental patients--a pilot study.

OBJECTIVE: The objective of this study was to comparatively evaluate the effectiveness ofsubmucosalfentanyl when administered in conjunction with oral midazolam during pediatric procedural sedations. STUDY DESIGN: Twenty three uncooperative ASA type I children who met the selection criteria were randomly assigned to receive either submucosal fentanyl (3 microg/kg) or placebo, along with oral midazolam (0.5 mg/kg). A triple blind, 2-stage cross-over design was adopted so that each child received both the regimens. RESULTS: Transient oxygen desaturation was observed in 4 children who were sedated with the combination of oral midazolam and submucosalfentanyl. The overall success was 73.91% with oral midazolam and submucosal fentanyl regimen and 47.83% for oral midazolam and submucosal placebo regimen. The chances of 'satisfactorily'completing a 45 minute dental procedure in an uncooperative pediatric patient was 2.8 times more, when submucosalfentanyl was used along with oral midazolam. CONCLUSION: Submucosal fentanyl appears to improve the short working time associated with oral midazolam. But the oxygen desaturation associated with this regimen necessitates further studies to evaluate the efficacy of this combination at relatively lower doses before being used routinely for pediatric procedural sedation and analgesia.

Estrogen receptor beta gene mutations in Indian infertile men.

Recent studies suggest that estrogens play an important role in male fertility. Estrogen signaling is mediated by Estrogen Receptors (ERalpha and ERbeta). Association of ERbeta with male infertility has not been analyzed to date except for genotyping of known polymorphisms in two different studies, which yielded controversial interpretation. Hence, we performed sequencing of all the exons and untranslated regions of ERbeta gene in 300 infertile and 255 fertile control Indian men. We identified eight novel mutations and four known single nucleotide polymorphisms (SNPs). Of the eight novel mutations, four were non-synonymous, of which one was detected only in infertile men, whereas the other three mutations were detected only in fertile men. Using different bioinformatics tools, we predicted that non-synonymous mutations were benign and they neither altered the structure nor the function of the protein. Among synonymous novel mutations, one was detected in both fertile and infertile men, two were exclusive to infertile men and one was exclusive to fertile men. None of the known SNPs or novel mutations showed statistically significant difference between infertile and fertile men. Moreover, infertile men having ERbeta mutations had normal reproductive tract and serum hormone levels. Our results suggest that the SNPs and mutations in ERbeta gene are not a common cause of spermatogenesis failure in Indian men, although mutations specifically found in infertile men can affect transcription, translation or have synergic effect with other variants in causing infertility.

CA repeat and RsaI polymorphisms in ERbeta gene are not associated with infertility in Indian men.

Oestrogen Receptor beta (ERbeta) gene plays an important role in the regulation of fertility in both males and females. Polymorphism in CA repeat located in the flanking region of ERbeta has been shown to be associated with several diseases, but its association with male infertility has not been analysed so far. However, RsaI polymorphism (rs1256049) in exon 5 of ERbeta has been shown to be associated with male infertility in Caucasian patients. Hence, we have analysed 695 Indian men, including 443 infertile and 252 fertile men to evaluate the association of CA repeat length and RsaI polymorphisms in male infertility. Our results revealed no significant difference in the distribution of CA repeat length between infertile (mean +/- SD 23.24 +/- 2.06, median 24) and fertile men (mean +/- SD 23.16 +/- 2.27, median 24). The analysis of dosage effect by classifying samples into SS (short/short), SL (short/long) and LL (long/long) groups also did not show any significant difference between infertile and fertile men. Similarly, RsaI polymorphism also did not show any significant difference between infertile and fertile men. Furthermore, the combined analysis of CA repeat and RsaI polymorphisms by haplotyping showed that the distribution of haplotypes was not significantly different between fertile and infertile men. Our results suggest that CA repeat length and RsaI polymorphisms in ERbeta are not associated with infertility in Indian men.

Structural and optical investigation of semiconductor CdSe/CdS core-shell quantum dot thin films.

Highly luminescent CdSe/CdS core-shell nanocrystals have been assembled on indium tin oxide (ITO) coated glass substrates using a wet synthesis route. The physical properties of the quantum dots (QD) have been investigated using X-ray diffraction, transmission electron microscopy and optical absorption spectroscopy techniques. These quantum dots showed a strong enhancement in the near band edge absorption. The in situ luminescence behavior has been interpreted in the light of the quantum confinement effect and induced strain in the core-shell structure.

A comparison of enameloplasty sealant technique with conventional sealant technique: a scanning electron microscope study.

CONTEXT: An accurate diagnosis of occlusal surface of permanent posterior teeth for the presence of caries is a challenge to the clinician, when using traditional explorer. This dilemma of hidden caries has led to invasively opening of the fissure before sealant placement. Enameloplasty is one such invasive procedure that has been implicated in the successful application of pit and fissure sealants. AIMS: The present study aims at evaluating the fissure micromorphology and sealant penetration under scanning electron microscope both with conventional sealant technique and enameloplasty sealant technique. SETTINGS AND DESIGN: The study comprised of extracted human posterior teeth subjected to enameloplasty of the fissures in the study groups as compared to unprepared fissures in the control groups. MATERIALS AND METHODS: The enameloplasty was performed with the help of specially designed Fissurotomy bur. The sealant used was Clinpro from 3M. All the samples were prepared for examination under scanning electron microscope. STATISTICAL ANALYSIS: A student 't' test was performed to compare the study and the control groups. RESULTS: (i) The surface area available for sealant placement on the occlusal surface was significantly increased following enameloplasty. (ii) Fissure width following enameloplasty was significantly increased. (iii) Extent of sealant penetration was significantly greater with enameloplasty sealant technique as compared to conventional sealant. CONCLUSION: Enameloplasty sealant technique can be preferred to conventional sealant technique for improving adhesion, adaptation and penetration of the sealant within the fissure system.

A comparative evaluation of agents producing analgo-sedation in pediatric dental patients.

OBJECTIVE: Procedural sedation and analgesia (PSA) has reduced the need for general anesthesia (GA) for many surgical procedures in pediatric patients. The objective of this study was to evaluate the efficacy of four analgo-sedative combinations- midazolam plus ketamine (MK), midazolam plus tramadol (MT), promethazine plus tramadol (PT) and promethazine plus ketamine (PK) in facilitating dental treatment of uncooperative children. STUDY DESIGN: Thirty six uncooperative ASA type I children who required extensive dental treatment were randomly assigned to receive one of the four analgo-sedative combinations during each visit. A 4-stage cross-over design was adopted so that each child received all the four combinations. Safety was monitored through vital signs and side effects. RESULTS: The overall success was 81% with MK, 69% for PK, 67% for MT and 42% for PT and the difference between the success rates of these agents was statistically significant (p < 0.001). The required dental treatment could be successfully completed at least during 3 sessions in 23 children (62.2%). CONCLUSIONS: Segmental dental treatment under analgo-sedation can be considered as a viable alternative before considering patients for dental management under GA. MK and MT were found to be safe and effective for sedating pediatric dental patients.