Coronal dentinal tubules of non-erupted deciduous incisors.

The diameter and density of coronal dentinal tubules were assessed in non-erupted human deciduous incisors. Using liquid nitrogen, frozen samples were fractured in longitudinal and oblique directions and observed by means of a Jeol JSM-6100 scanning electron microscope. It was observed that the diameter of dentinal tubules ranged from 0.50 to 1.94 micrometers and increased significantly from the outer to the inner layers. However, comparing the incisal, middle and cervical thirds, no statistically significant differences were observed. The number of tubules per square millimeter varied from 3,281 to 32,313 and also increased from the external dentinal surface to the dentinal surface of the pulp chamber.

A randomized, controlled, crossover trial of oral midazolam and hydroxyzine for pediatric dental sedation.

The effectiveness of oral midazolam in pediatric dentistry is controversial. This randomized, controlled, crossover, double blind clinical trial was conducted in order to study the effect of midazolam, used either alone or in association with hydroxyzine, during child dental treatment. Thirty seven dental sedation sessions were carried out on 11 ASA I uncooperative children less than five years-old. In each appointment children were randomly assigned to groups: P - placebo, M - midazolam (1.0 mg/kg), or MH - midazolam (0.75 mg/kg) plus hydroxyzine (2.0 mg/kg). Vital signs (blood pressure, breathing rate, pulse and oxygen saturation) and behavior parameters (consciousness, crying, movement, overall behavior) were evaluated every 15 minutes. Friedman and Wilcoxon statistical tests were used to compare groups and different moments in the same group. Normal values of vital signs were usually registered. Heart rate increased in groups P and M as the session went on. Group M presented less crying and movement at the first 15 minutes of treatment. Group MH caused more drowsiness at the beginning of the session. Overall behavior was better in group M than in groups P or MH. Group M produced effective sedation in 77% of the cases, and group MH did so in 30.8%. It was concluded that midazolam was effective and safe, and its association with hydroxyzine did not lead to additional advantages in pediatric dental sedation.

In vitro antimicrobial activity of endodontic pastes with propolis extracts and calcium hydroxide: a preliminary study.

The purpose of this study was to evaluate the antimicrobial activity of two experimental pastes containing propolis extract associated with calcium hydroxide against polymicrobial cultures collected from 16 necrotic and fistulae root canals in primary molars of 4-8-year-old children of both sexes. The agar-well diffusion technique was used to determine the antimicrobial activity of the following pastes: 11.0% ethanolic extract of propolis (EEP) + calcium hydroxide; and 11.0% extract of propolis without ethanol (EP) + calcium hydroxide. EEP, EP and the association of calcium hydroxide and propylene glycol (CHP) was used as the positive control groups, and propylene glycol was used as a negative control group. Friedman and Wilcoxon tests were used to compare the data from the microbial growth inhibition zones (p<0.05). Paste 1 and Paste 2 showed larger growth inhibition zones against microorganisms from root canal samples than CHP (p=0.021 and 0.003, respectively). Paste 2 tended to have larger growth inhibition zones than Paste 1 (p=0.053). The association between propolis and calcium hydroxide was effective in controlling dental infections in vitro.

A randomized double-blinded trial of chloral hydrate with or without hydroxyzine versus placebo for pediatric dental sedation.

Chloral hydrate and hydroxyzine are a drug combination frequently used by practitioners to sedate pediatric dental patients, but their effectiveness has not been compared to a negative control group in humans. The aim of this crossover, double-blinded study was to evaluate the effect of these drugs compared to a placebo, administered to young children for dental treatment. Thirty-five dental sedation sessions were carried out on 12 uncooperative ASA I children aged less than 5 years old. In each session patients were randomly assigned to groups P (placebo), CH (chloral hydrate 75 mg/kg) and CHH (chloral hydrate 50 mg/kg plus hydroxyzine 2.0 mg/kg). Vital signs and behavioral variables were evaluated every 15 min. Comparisons were statistically analyzed using Friedman and Wilcoxon tests. P, CH and CHH had no differences concerning vital signs, except for breathing rate. All vital signs were in the normal range. CH and CHH promoted more sleep in the first 30 min of treatment. Overall behavior was better in CH and CHH than in P. CH, CHH and P were effective in 62.5%, 61.5% and 11.1% of the cases, respectively. Chloral hydrate was safe and relatively effective, causing more satisfactory behavioral and physiological outcomes than a placebo.