Sedative and behavioral effects of atomized intranasal midazolam in comparison with nebulized midazolam for children undergoing dental treatment: A randomized clinical trial.

BACKGROUND: Fear and anxiet are significant barriers of dental care in children. Sedation emerged as a valuable behaviour guidance technique to manage uncooperative children. AIM: To evaluate the sedative and behavioral effectiveness of midazolam administered via nebulizer in comparison with intranasal atomizer in the behavior management of anxious children during dental treatment. STUDY DESIGN: Two-arm randomized clinical trial with 68 children (3-5 years) assigned to receive nebulized midazolam (NEB MDZ) and atomized intranasal midazolam (AIN MDZ) during dental treatment. The onset time, sedation levels, and behavior of children were documented. The data were analyzed using the Wilcoxon signed-rank test and Mann-Whitney U tests. RESULTS: Significant differences between the two groups in terms of onset time, sedation level, and behavior of children during the dental treatment. AIN MDZ was associated with a significantly faster onset time compared with NEB MD, (p < .001). Children who received NEB MDZ exhibited deeper levels of sedation compared with AIN MDZ group (p = .02). During the administration of local anesthesia, notable statistical differences were observed between the behavior of the two groups (p = .02). CONCLUSIONS: Midazolam administered via either nebulizer or intranasal atomizer was the effective route of administration and proved effective in the management of anxious children undergoing dental treatment. AIN MDZ, however, exhibited a faster onset time, whereas children receiving NEB MDZ demonstrated superior behavior compared with those receiving AIN MDZ.

Effect of sonic oscillation on penetration and marginal adaptation of filled-resin-based fissure sealants.

OBJECTIVES: To evaluate the effect of sonic oscillation on penetration depth and marginal adaptation of resin-based fissure sealants. METHOD AND MATERIALS: Thirty-six extracted human third molars were randomized into three groups: in the HF group, teeth were sealed with a filled-resin-based sealant (Helioseal F); in the Sonic-HF group, teeth were sealed with Helioseal F and subjected to sonic oscillation (Compothixo Device, 140 Hz vibration frequency and ± 150 µm amplitude) before curing; in the CO group, teeth were sealed with an unfilled-resin-based sealant (Clinpro). All teeth were thermocycled for 1,500 cycles at 5°C and 55°C, then sectioned buccolingually into four sections (mesial, two middle, and distal). Sections were evaluated under SEM for marginal adaptation and scored. For penetration depth, three independent measurements from each tooth were recorded under SEM, and data were subjected to statistical analysis. RESULTS: The group subjected to sonic oscillation (Sonic HF) resulted in significantly superior penetration depth and marginal adaptation compared with the HF group, but with no significant difference compared with the CO group. CONCLUSIONS: Sonic activation of resin-based sealant increased penetration depth into fissures and marginal adaptation to the enamel wall without decreasing filler load or compromising sealant mechanical properties.

Improving oral health-related quality of life for a child with Hunter's syndrome: A case report and review of literature.

INTRODUCTION: Hunter's syndrome (HS) is a severe metabolic disorder with heterogeneous multisystemic manifestations including orodental features. The heterogeneity of manifestations of HS, complicate the provision of proper dental care. CASE REPORT: A 12 years old male was diagnosed with HS and referred for a comprehensive oral rehabilitation after he failed to receive proper dental care. He was complaining of fractured infected central incisors due to trauma, multiple caries, and poor oral hygiene. Despite his negative behaviour and poor dental history, dental treatment was provided under local anesthesia, using basic behaviour guidance techniques. The treatment outcomes had a positive impact on his behavior toward dental treatment and his oral health. During the first year follow up, there was a significant improve in his oral health-related quality of life assessed by Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire. CONCLUSION: This report highlighted the importance of proper referral and treatment of the necessary dental needs for patients with HS. Pediatric dentists need to work together with pediatricians to promote oral health, and formulate educational programs to eliminate barriers to necessary dental care suitable for each patient's need.