ABSTRACT
Dental treatment for anxious children is a great challenge for dentists. Pharmacologic techniques may lead to dental treatments with better safety and quality. The purpose of this study was to compare the sedative effect of chloral hydrate alone with chloral hydrate-hydroxyzine regimen in dental treatment of very anxious 3-5 year-old children. This study was a blind randomized cross-over trial. Each individual had his/her own control within each protocol. Furthermore, the two protocols were compared. Twenty children, who exhibited "definitely negative behavior" according to the Frankl scale, were assigned to receive oral chloral hydrate [45 mg/kg] for one session or a combination of chloral hydrate [40 mg/kg] and hydroxyzine [1.5 mg/kg] for the other session. The children's behavior during the treatment was observed and ranked by a blind examiner, based on NCBRS method. Also, the qualitative success rate was determined by Houpt rating scale for the overall behavior. The data were analyzed, using SPSS software and MANOVA test. Children in both treatment sessions presented better score for behavior than those in the first session [p < 0.001]. Based on the present findings, the following negative behaviors were significantly reduced in pharmacotherapy sessions: high had [p =0.041], crying [p <0.001], verbal protest [p =0.027] and oral resistance [p <0.001]. There was no statistically significant difference between the effect of the two pharmacologic regimens during treatment sessions [p >0.05]. Oral chloral hydrate [45 mg/kg] is recommended as a sedative agent for dental treatment of very anxious children as compared to the combination of chloral hydrate with hydroxyzine
ABSTRACT
There are different views about the optimal time for detection and prevention of maxillary canine impaction. With respect to the large individual variation in the timing of eruption of the teeth, it seems reasonable not to consider chronological age as a valid criterion in this regard. The aim of this study was to compare dental and chronological ages in the diagnosis of potential maxillary canine impaction. This analytical cross-sectional study was done on 2704 students aged 10-11 year in Mashhad. In the first group [1232 children], all of the children whose maxillary canine bulges were not palpable were suspected with impaction and referred for radiographic examination. In the second group [1472 children], the children whose canine bulges were not palpable were referred for radiographic examination if only the first premolars had erupted or were erupting. The condition of the lateral incisor teeth was inspected in children suspected with impaction. The data were analyzed by comparing the proportion of success and Fisher's exact test. From the children examined in the first group, 9.3% and from those examined in the second group, 5.5% were suspected with impaction in the clinical examinations. The application of dental age reduced the number of referrals for radiographic examination significantly [p <0.05]. There was an association between palatal position of the maxillary canines and anomalous lateral incisors [p <0.05]. Consideration of chronological age in early diagnosis of maxillary canine impaction may result in unnecessary radiographic examination. The number of referrals for radiographic examination will be significantly reduced when the developmental stage of dentition is considered