The effect of mouth prop on endotracheal tube intracuff pressure in children during dental rehabilitation under general anaesthesia.

Although the endotracheal tube (ETT) cuff may be associated with tracheal morbidity, cuffed tubes may reduce the aspiration risk in oral procedures. Dentists must use a mouth prop to facilitate oral visualization and to protect the oral soft tissues during dental rehabilitation under general anaesthesia (DRGA). The aim of this study was to evaluate the effect of mouth prop on endotracheal tube intracuff pressure in children during DRGA. Two-hundred and three ASA I-II patients, <18 years of age (mean: 5.3 ± 2.4 years) were included in the prospective observational study whose comprehensive dental treatment was performed under general anaesthesia. Following the induction of general anaesthesia, placement of a cuffed endotracheal tube which was an appropriate size for children was fixed. The intracuff pressure was measured intermittently after the intubation (baseline) (T0), immediately after the mouth prop (T1), 30 min after the mouth prop (T2), after taking out the mouth prop (T3) and just before extubation (T4). The mean intracuff pressure was 28.3 ± 2.01 cm H2O at T0. The mean intracuff pressure significantly increased at T1 (30.8 ± 2.7) and T2 (29.6 ± 3.7) compared to T0 (P < 0.001). No significant differences were observed between the duration of the procedure and intracuff pressure or postoperative complications (P > 0.05). Cough, sore throat and nausea were observed in 4, 1 and 5 patients, respectively. Because a mouth prop may increase the intracuff pressure of ETT, strict measurement and readjustment of cuff pressures should be employed when used in children during DRGA.

Intravenous ketamine, propofol and propofol-ketamine combination used for pediatric dental sedation: A randomized clinical study.

BACKGROUND AND OBJECTIVE: Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments. METHODS: Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0.5 mg/kg propofol plus 0.5 mg/kg ketamine intravenously for anesthesia induction. RESULTS: Recovery time was significantly lower in Group P than Group KP. No significant differences were found between groups regarding HR, before and after the induction, at tenth minute. Fifth minute's HR was higher in Group K than Group KP. Mean arterial pressure (MAP) values were similar at baseline, before and after the induction, and at tenth minute, whereas significantly lower values were found in Group P and Group KP than in Group K at fifth minute. CONCLUSIONS: Although ketamine, propofol and ketamine-propofol combination are effective for sedation in tooth extraction in pediatric patients, propofol may be an excellent alternative, with the shortest recovery, no nausea and vomiting, and reasonable surgical satisfaction.

Evaluation of effectiveness of the using a pillow in children for dental rehabilitation under general anesthesia in term for facilitate intubation.

BACKGROUND AND OBJECTIVE: Airway safety may be provided with endotracheal intubation especially for oral procedures because of some potential risks such as aspiration of secretion or foreign bodies. In this study, we aimed to determine whether placing a pillow under the occiput may facilitate endotracheal intubation in non-cooperative children whose extensive dental treatments were planned to take place under general anesthesia. METHODS: The study was performed in Erciyes University, Faculty of Dentistry between March-July 2014. A total 150 ASA I-II children, between 3-9 years were included in this study. Pillow was folded under the occiput in Group 1 (n=75), patients lay on a flat surface in Group 2 (n=75) during the anesthesia induction and intubation period. RESULTS: There were no statistically significant differences between groups regarding the demographic data (age, weight, gender) (p>0.05). Operation times were similar in both groups (p=0.329). The number of intubation attempts was smilar in both groups (p=0.412). The intubation time was longer in group one than in group two (p= 0.025). CONCLUSION: We concluded that, placing a pillow under the patients occiput provided longer intubation time without changing the number of attempts in the normal airway in non-cooperative children whose extensive dental treatments were planned to take place under general anesthesia.

Microshear bond strength of preheated silorane- and methacrylate-based composite resins to dentin.

The aim of this study was to investigate the effect of preheating on microshear bond strength (MSBS) of silorane and methacrylate-based composite resins to human dentin. The teeth were randomly divided into three main groups: (1) composite resins were heated upto 68 °C; (2) cooled to 4 °C; and (3) control [room temperature (RT)]. Each group was then randomly subdivided into four subgroups according to adhesive system used [Solobond M (Voco), All Bond SE (Bisco), Clearfil SE Bond (CSE) (Kuraray), Silorane adhesive system (SAS) (3M ESPE)]. Resin composite cylinders were formed (0.9 mm diameter × 0.7 mm length) and MSBS of each specimen was tested. The preheated groups exhibited the highest MSBS (p < 0.001) and the groups cooled to 4 °C exhibited the lowest MSBS (p < 0.001). The CSE showed higher MSBS than the other adhesives (p < 0.001). This study concludes that preheating of composite resins may be an alternative way to increase the MSBS of composites on dentin.

Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature.

OBJECTIVE: Knowledge of primary tooth morphology is essential for clinical dentistry, especially for root canal treatment and dental traumatology. However, this has not been well documented to date with a large sample. This study was carried out to investigate the variation in number and morphology of the root canals of the primary molars, to study the applicability of cone beam computerized tomography (CBCT) in assessing the same and to provide a comprehensive review of the literature. MATERIALS AND METHODS: A total of 343 primary molars, without any root resorption, were divided into four main groups including the maxillary first molars, maxillary second molars, mandibular first molars and mandibular second molars. All of them were analysed in CBCT images in the axial, sagittal and coronal planes. Various parameters such as the number of roots, number of canals, the root canal type, diameter of root and root canal and root canal curvature were studied. RESULTS: Primary molars in all four groups showed variability in the number of roots and root canals. As far as length of the roots was concerned, the palatal root of the maxillary molar was found to be longest, while the distobuccal root was shortest. In mandibular molars, the mesial root was longer than the distal root. The length of distobuccal root canal of the maxillary molars and the distolingual canal of the mandibular molars was found to be shortest. The number of roots and root canals varied from two to four and three to four, respectively. The maxillary molars exhibited more one-canal than two-canal roots. CONCLUSION: The present study provides comprehensive information to the existing literature concerning the variation in root canal morphology of the maxillary and mandibular primary molar teeth. These data may help clinicians in the root canal treatment of these teeth.

Evaluation of the bond strength of different adhesive agents to a resin-modified calcium silicate material (TheraCal LC).

This study evaluated the bond strength of different adhesive agents to TheraCal LC and mineral trioxide aggregate (MTA) and examined the morphologic changes of these materials with different surface treatments. A total of 120 specimens, 60 of MTA Angelus (AMTA), and 60 of TheraCal LC, were prepared and divided into six subgroups according to the adhesive agent used; these agents included Scotchbond Multipurpose, Clearfil SE Bond, Clearfil Protect Bond, Clearfil S3 Bond, OptiBond All-in-One, and G-aenial Bond. After application of adhesive agents, Filtek Z250 composite resin was placed onto the specimens. Shear bond strengths were measured using a universal testing machine, followed by examination of the fractured surfaces. The surface changes of the specimens were observed using scanning electron microscopy. Data were compared by two-way analysis of variance. Although no significant differences were found among the bond strengths of different adhesives to AMTA (p = 0.69), a significant difference was found in terms of bond strengths of different adhesives to the TheraCal LC surface (p < 0.001). The total-etch adhesive system more strongly bonded to TheraCal LC compared to the bond with other adhesives. TheraCal LC bonded significantly more strongly than AMTA regardless of the adhesive agents tested. Resin-modified calcium silicate showed higher bond strength than AMTA in terms of the composite bond to these materials with different bonding systems. On the other hand, the highest shear bond-strength values were found for composite bonds with the combination of TheraCal LC and the total-etch adhesive system. SCANNING 38:403-411, 2016. © 2015 Wiley Periodicals, Inc.

Presence and distribution of dental enamel defects, recurrent aphthous lesions and dental caries in children with celiac disease.

OBJECTIVE: To determine presence and distribution of enamel defects, recurrent oral aphthous lesions (RAS) and dental caries in children with Celiac Disease (CD) and compare the results with a healthy control group. METHODS: Twenty- five CD patients age between 4- 16 years with no other systemic disease, were examined in Pediatric Gastroenterology Clinic of Erciyes University, Faculty of Medicine (Kayseri, Turkey) and then referred to Department of Pediatric Dentistry, Faculty of Dentistry for dental examination and treatment. The control group (25 patients) consisted healthy patients referred to the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University for restorative treatment. Both the CD group and control group was examined by the same investigator for the following; (1) enamel defects, (2) recurrent aphthous stomatitis, (3) dental caries. RESULTS: The mean dmft values for the CD group and control group were 3.25±3.25 and 4.56±2.87 respectively. The difference was not statistically significant.(P>0.05). The mean DMFT values for the CD and the control group were 3.75±2.62 and 1.83±1.7, respectively. There was a significant difference between the two groups (P<0.01). The prevalence of enamel defects and recurrent apthous stomatitis (RAS) was greater in celiac patients than in the control group. Enamel defects (in at least one permanent tooth) were observed in 12 out of 25 (48%) children in the CD group and four out of 25 children (16%).(P =0.01). Recurrent apthous stomatitis was found in 11/25 (44%) CD group, while no RAS was detected in the control group. CONCLUSION: Celiac Disease (CD) has adverse effects on oral health in term of enamel defect, recurrent aphthous stomatitis and caries score. Pediatricians and dentists especially pediatric dentists should be knowledgeable about oral symptoms of CD. Increased awareness can provide an early diagnosis and prevent long- term complications of this disease. On the other hand, further comprehensive investigations of CD patients can add to our understanding of the efficacy of CD on oral health in children.

The evaluation of developmental enamel defects and dental treatment conditions in a group of Turkish children with congenital heart disease.

OBJECTIVE: The aim of this study was to determine developmental enamel defects and dental treatment conditions in children with congenital heart disease by comparing them with a control group of healthy children. METHODS: Children included in the study were referred to a paediatric dentistry for dental examination and treatment after undergoing routine examination in a paediatric clinic. RESULTS: The congenital heart disease group included 72 children and the control group included 56 healthy children. Children in the age group of 3-14 years were included in this study. The mean age of the congenital heart disease group and control group was 6.24±2.85 and 6.73±3.01, respectively. The mean values of the decayed, missing, and filled indices for primary and permanent teeth in the congenital heart disease group were 2.80±3.77 and 0.81±1.63, respectively. In the control group, the values were 1.87±3.31 and 0.72±1.46, respectively. The care score for primary teeth was 3.6% in the congenital heart disease group and 13.3% in the control group. The enamel defect was detected in at least one permanent tooth in seven out of 72 children (9.7%) in the congenital heart disease group and in three out of 56 children (5.3%) in the control group. CONCLUSION: Although there was no significant difference in the development of dental caries or the prevalence of enamel defects between children with congenital heart disease and healthy children, the care score was low in children with congenital heart disease. In addition, children with congenital heart disease had a higher rate of pulled primary teeth and delayed treatment of decayed teeth.

Cone beam computed tomographic analysis of neurovascular anatomical variations other than the nasopalatine canal in the anterior maxilla in a pediatric population.

PURPOSE: This study aimed to analyze and assess the presence of accessory foramina and canals other than the nasopalatine canal (NPC) in the anterior palate region in a pediatric population, through cone beam computed tomography (CBCT) images, describing their location, direction, and diameter. STUDY DESIGN: Reformatted sagittal, coronal and axial slices of 368 individual CBCT images were analyzed. Any bone canal with a minimum diameter of 1.00 mm other than the nasopalatine canal was analyzed regarding size, location, and course, as well as patient gender and age. RESULTS: Eighty-two patients (22.3 %); presented additional foramina in the anterior palate (AFP) and in total 131 additional foramina were registered. A higher frequency of accessory canals was observed in girls (29.5 %) than in boys (15.7 %) (p = 0.012). The average diameter of AFP was 1.2 mm. Their location was variable, with most of the cases occurring in the alveolar process near the incisors or canines. Gender and age did not significantly influence the diameter. CONCLUSIONS: The study confirms the presence of bone channels within the anterior maxilla other than the NPC in a pediatric population. Over 22 % of the population studied had additional foramina other than the NPC in the anterior palate, between 1 and 1.7 mm wide, with variable locations.

Pulp chamber temperature increase from curing light units: an in vitro study.

PURPOSE: The purpose of this study was to compare temperature rises in the pulp chamber induced by halogen, plasma arc, and conventional light-emitting diode (LED) curing units with that induced via a new generation LED-curing unit (VALO) in extra power mode. METHODS: A Class I cavity was prepared on the occlusal surface of 80 extracted caries- free mandibular third molars, which were filled with a microhybrid composite. A thermocouple wire was inserted into the pulp chamber of each tooth to measure temperature changes. RESULTS: The greatest temperature increases were observed during polymerization of composite resin with a halogen curing unit (3.2 degrees Celsius), followed by plasma arc curing (2.07 degrees Celsius) and VALO curing (1.44 degrees Celsius); the lowest temperature rise was with conventional LED curing (1.01 degrees Celsius). CONCLUSION: There were no statistically significant differences between conventional LED and VALO curing in extra power mode regarding pulp chamber temperature increases when polymerizing composite resin.

In vitro bond strength and fatigue stress test evaluation of different adhesive cements used for fixed space maintainer cementation.

OBJECTIVE: The purposes of this research were to (1) compare the shear-peel bond strength (SPBS) of a band of a fixed space maintainer (SM) cemented with five different adhesive cements; and (2) compare the survival time of bands of SM with each cement type after simulating mechanical fatigue stress. MATERIALS AND METHODS: Seventy-five teeth were used to assess retentive strength and another 50 teeth were used to assess the fatigue survival time. SPBS was determined with a universal testing machine. Fatigue testing was conducted in a ball mill device. RESULTS: The mean survival time of bands cemented with R & D series Nova Glass-LC (6.2 h), Transbond Plus (6.7 h), and R & D series Nova Resin (6.8 h) was significantly longer than for bands cemented with Ketac-Cem (5.4 h) and GC Equia (5.2 h) (P < 0.05). CONCLUSION: Although traditional glass ionomer cement (GIC) cement presented higher retentive strength than resin-based cements (resin, resin modified GIC, and compomer cement), resin based cements, especially dual cure resin cement (nova resin cement) and compomer (Transbond Plus), can be expected to have lower failure rates for band cementation than GIC (Ketac-Cem) in the light of the results of the ball mill test.

Shear bond strength of a new low-shrinkage flowable composite for orthodontic bracket bonding.

PURPOSE: The purpose of this study was to determine the shear bond strength (SBS) and adhesive remnant index (ARI) value a new generation low-shrinkage flowable composite compared to a conventional bonding adhesive and several flowable composites. METHODS: One hundred and fifty sound human premolars extracted for orthodontic treatment were randomly divided into five groups of 30 teeth each. Brackets were bonded to the teeth in each group with a conventional bonding composite, three flowable composites, and a new generation flowable composite. SBS values of these brackets were recorded via an Instron testing machine. ARI scores were determined after the failure of brackets. RESULTS: There was a statistically significant difference between flowable composites (P<.01). The mean bond strength for the conventional bonding composite group was significantly greater than that of each of the other four groups (P<.001). There were significant differences (chi-square=29.02; P=.00) among the groups. CONCLUSION: The demineralization and microleakage-inhibiting effects and simple application of the new low polymerization shrinking flowable composite indicate that it might be considered for clinical use in orthodontic patients, especially those with inadequate oral hygiene.

Prevalence of dental anomalies in the permanent dentition of children with Down syndrome.

PURPOSE: The purpose of this study was to evaluate the prevalence of various congenital dental anomalies in the permanent dentition of Turkish children with Down syndrome. METHODS: The sample consisted of 216 diagnostic records of children diagnosed with Down syndrome. All subjects had a clinical examination as well as radiographs and photographs taken. Anomalies in the permanent dentition were documented. RESULTS: There was a high incidence of dental anomalies, the most frequent being taurodontism (81 percent), rotation (28 percent), hypodontia (26 percent), tooth impaction (18 percent), ectopic eruption (14 percent), microdontia (13 percent), and hyperdontia (9 percent). Differences in prevalence of congenitally missing teeth, structural anomalies, and positional anomalies reached a statistically significant level regarding gender (P<.05). CONCLUSION: Turkish children with Down syndrome presented a high incidence of anomalies affecting the permanent dentition, and, in most cases, individuals presented with more than one anomaly.

Evaluation of shear bond strength of two resin-based composites and glass ionomer cement to pure tricalcium silicate-based cement (Biodentine®).

OBJECTIVES: Tricalcium silicate is the major constituent phase in mineral trioxide aggregate (MTA). It is thus postulated that pure tricalcium silicate can replace the Portland cement component of MTA. The aim of this study was to evaluate bond strength of methacrylate-based (MB) composites, silorane-based (SB) composites, and glass ionomer cement (GIC) to Biodentine® and mineral trioxide aggregate (MTA). MATERIAL AND METHODS: Acrylic blocks (n=90, 2 mm high, 5 mm diameter central hole) were prepared. In 45 of the samples, the holes were fully filled with Biodentine® and in the other 45 samples, the holes were fully filled with MTA. The Biodentine® and the MTA samples were randomly divided into 3 subgroups of 15 specimens each: Group-1: MB composite; Group-2: SB composite; and Group-3: GIC. For the shear bond strength (SBS) test, each block was secured in a universal testing machine. RESULTS: The highest (17.7 ± 6.2 MPa) and the lowest (5.8 ± 3.2 MPa) bond strength values were recorded for the MB composite-Biodentine® and the GIC-MTA, respectively. Although the MB composite showed significantly higher bond strength to Biodentine (17.7 ± 6.2) than it did to MTA (8.9 ± 5.7) (p < 0.001), the SB composite (SB and MTA = 7.4 ± 3.3; SB and Biodentine® = 8.0 ± 3,6) and GIC (GIC and MTA = 5.8 ± 3.2; GIC and Biodentine = 6.7 ± 2.6) showed similar bond strength performance with MTA compared with Biodentine (p = 0.73 and p = 0.38, respectively). CONCLUSIONS: The new pure tricalcium-based pulp capping, repair, and endodontic material showed higher shear bond scores compared to MTA when used with the MB composite.

Postoperative discomfort of dental rehabilitation under general anesthesia.

OBJECTIVE: To find out postoperative discomfort in children undergoing dental rehabilitation under general anesthesia (DRGA). METHODS: This study involved 78 (4 to 10 year-old) healthy patients who were scheduled for DRGA and were needed extensive dental treatment because of severe caries, and showed high dental fear and/or behavioral management problems. The children had to be fit for DRGA administration by fulfilling the American Society of Anesthesiologists physical status I or II and no associated mental health or communication problems. Data were collected by structured interview either face to face (immediately post operation) or using a telephone (post operation after discharge). One of the study's investigators recorded all data related to the immediate postoperative period during the child's stay in the post-anesthesia care unit (PACU). The questionnaire consisted of questions related to postoperative problems experienced by the patient in the period after their day-stay attendance. The questionnaire, consisting of questions regarding and generally related to the child's activities. In addition, pain was assessed using the face, legs, activity, cry, consolability (FLACC) scale. RESULTS: The prevalence of postoperative problems was 46 out of 78 (59%). The mean FLACC score was 1.8 (SD=2.1). Some of the patients having more than one reported problem. Forty-one percent of the children showed nasal discomfort (P<0.01). Thirty-three percent and 43% of the children experienced throat or mouth discomfort. The most common experienced postoperative symptom after DRGA was bleeding. Nasal bleeding, however, was an uncommon complication and did not cause serious morbidity or mortality in children intubated nasotracheally. In addition, postoperative discomfort was related to number of the extractions. Children who had 4 or more extractions were more likely to experience pain. Findings associated with other bodily functions were assessed. Nausea and vomiting were reported in 20.5% of children. Twenty-six children (18%) had a fever. Thirty-nine (50.0%) parents reported that their children had problems eating. CONCLUSION: Post-operative discomfort was more with 4 or more extraction done under DRGA and that nasal bleeding was noted a uncommon post-operative symptom.

Evaluation of shear bond strength of two resin-based composites and glass ionomer cement to pure tricalcium silicate-based cement (Biodentine®)

Objectives: Tricalcium silicate is the major constituent phase in mineral trioxide aggregate (MTA). It is thus postulated that pure tricalcium silicate can replace the Portland cement component of MTA. The aim of this study was to evaluate bond strength of methacrylate-based (MB) composites, silorane-based (SB) composites, and glass ionomer cement (GIC) to Biodentine® and mineral trioxide aggregate (MTA). Material and Methods: Acrylic blocks (n=90, 2 mm high, 5 mm diameter central hole) were prepared. In 45 of the samples, the holes were fully filled with Biodentine® and in the other 45 samples, the holes were fully filled with MTA. The Biodentine® and the MTA samples were randomly divided into 3 subgroups of 15 specimens each: Group-1: MB composite; Group-2: SB composite; and Group-3: GIC. For the shear bond strength (SBS) test, each block was secured in a universal testing machine. Results: The highest (17.7±6.2 MPa) and the lowest (5.8±3.2 MPa) bond strength values were recorded for the MB composite-Biodentine® and the GIC-MTA, respectively. Although the MB composite showed significantly higher bond strength to Biodentine (17.7±6.2) than it did to MTA (8.9±5.7) (p<0.001), the SB composite (SB and MTA=7.4±3.3; SB and Biodentine®=8.0±3,6) and GIC (GIC and MTA=5.8±3.2; GIC and Biodentine=6.7±2.6) showed similar bond strength performance with MTA compared with Biodentine (p=0.73 and p=0.38, respectively). Conclusions: The new pure tricalcium-based pulp capping, repair, and endodontic material showed higher shear bond scores compared to MTA when used with the MB composite. .

Dental age assessment for different climatic regions.

OBJECTIVE: The aim of this study was to evaluate the impact of several aspects of climate, such as temperature and altitude, on dental maturation. MATERIALS AND METHODS: The total sample consisted of 944 panoramic radiographs (473 Turkish children from Central Anatolia [228 girls and 245 boys] and 471 Turkish children from Eastern Anatolia [222 girls and 249 boys]). The children aged between 7.0 and 14.9 years. The radiographs were randomly selected from 2 cities in Turkey, Kayseri and Erzurum. Independent t tests and paired t tests were performed to compare sex, location, and age to determine the relationships between tooth developments. RESULTS: The Central Anatolian children were approximately 0.2 to 3.0 years more advanced in dental maturity than the Eastern Anatolian subjects. CONCLUSIONS: The development standards proposed by Demirjian are affected by climatic factors. However, further research and detailed information to gather data are needed.

Three-dimensional evaluation of the pharyngeal airway volumes in patients affected by unilateral cleft lip and palate.

INTRODUCTION: Patients affected by cleft lip and palate often have complaints of snoring and respiratory difficulties during sleep. The purposes of this study were to evaluate nasopharyngeal, oropharyngeal, and total airway volumes of patients affected by unilateral cleft lip and palate and to compare them with a well-matched control group without unilateral cleft lip and palate using cone-beam computed tomography. METHODS: The study sample consisted of 60 patients (26 girls, 34 boys) divided into 2 groups: unilateral cleft lip and palate (20 boys, 10 girls; 8 right sided, 22 left sided; mean age, 14.6 ± 3.2 years) and no cleft (control group; 14 boys, 16 girls; mean age, 14.8 ± 2.8 years). Nasopharyngeal, oropharyngeal, and total airway volumes of the subjects in both groups were calculated 3 dimensionally with cone-beam computed tomography. Group differences in relation to cleft side, sex, and cleft presence were statistically tested at P <0.05. RESULTS: Patients affected by unilateral cleft lip and palate had similar airway volumes regardless of the side of the cleft. In addition, no statistically significant differences were found between the sexes in the 2 groups. Patients affected by unilateral cleft lip and palate had smaller nasopharyngeal, oropharyngeal, and total airway volumes when compared with the control group. The difference for oropharyngeal airway volume (-4036.7 mm(3)) was statistically significant (P <0.05), whereas nasopharyngeal volume (-21.6 mm(3)) and total airway volume (-4057.3 mm(3)) differences were not significant (P >0.05). CONCLUSIONS: Patients affected by unilateral cleft lip and palate had decreased volumes of oropharyngeal (P <0.05) and total (P >0.05) airways compared with the well-matched control group without unilateral cleft lip and palate.

Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia.

PURPOSE: This study's purpose was to investigate how young children's and parent/caregivers' oral health-related quality of life and children's dental fears were affected by dental rehabilitation under general anesthesia (DRGA). METHODS: A consecutive clinical sample of dyads of parents/caregivers and their four- to six-year-old children who received DRGA were surveyed before and after DRGA. Parents/caregivers responded through a self-administered questionnaire [Early Childhood Oral Health Impact Scale (ECOHIS)], and children received a dentist-administered questionnaire [children's fear survey schedule-dental subscale (CFSS-DS)]. RESULTS: The final sample consisted of 311 children/caregiver dyads. One to six teeth were extracted in 91 percent of children. There was a 44 percent decrease in total ECOHIS scores following treatment (P<.001). Overall child impact section scores decreased 34 percent following treatment (P<.001), and family impact section scores decreased 65 percent (P<.001). CFSS-DS anxiety scores after dental treatment were significantly higher for 14 of 15 situations/conditions assessed (P<.001). There was a trend of higher CFSS-DS scores in children who received increasing numbers of extractions. CONCLUSION: Children's and parent/caregivers' quality of life improved after the children received dental rehabilitation under general anesthesia, and children's fears increased for all situations tested. The number of extractions the children received was associated with increased levels of fear.

Effect of palonosetron on postoperative nausea and vomiting in children following dental rehabilitation under general anesthesia.

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of three different intravenous (IV) doses of palonosetron compared with placebo for the prevention of postoperative nausea and vomiting (PONV) in children undergoing dental rehabilitation under general anesthesia (DRGA) in the first 24 hours after discharge. METHODS: A total of 286 children who were classified with an American Society of Anesthesiologists physical status of I and II, between three and 13 years old (mean=6.13 years old), and undergoing DRGA were enrolled in this study. The children were randomized to receive one of the three doses of palonosetron (0.0025 mg, 0.0050 mg, or 0.0075 mg) or placebo immediately before induction of anesthesia. RESULTS: Compared with placebo, the incidence of PONV was significantly lower in the palonosetron groups (P<.05). However, there were no statistically significant differences among the palonosetron groups regarding the number of children with PONV during all time periods after anesthesia (P<.05). CONCLUSION: A single 0.0025 mg intravenous dose of palonosetron is recommended for further evaluation, as it appears to be an effective dose for prevention of postoperative nausea and vomiting in children undergoing dental rehabilitation under general anesthesia.