Comparison of oral and buccal midazolam for pediatric dental sedation: a randomized, cross-over, clinical trial for efficacy, acceptance and safety

Objective: Providing a safe and efficient dental treatment for a young patient is a challenge for the dentist and the child. The purpose of this study was to investigate the effectiveness, safety and acceptability of buccal midazolam in dental pediatric patients and to compare it with oral Midazolam

Methods: Eighteen uncooperative healthy children aged 2.5-6 years were randomized to each of buccal midazolam [0.3mg/kg] or oral midazolam [0.5mg/kg] at the first visit, the alternative has been used at the second visit in a cross-over manner. The study took place at pediatric dentistry clinic of Shahed University, Tehran, from November 2011 to June 2012. The patients' vital signs and behavioral scores were recorded. The patient, the operator and the observer were blinded to the applied medication. Post operatively, patients' and parents' satisfaction were assessed by Visual Analogue Score and a questionnaire respectively. The P-value was set at 0.05 for significance level

Findings: There were no significant differences in physiologic factors in the medication groups at time 0, 10, 20, 30 minutes and discharge. There was also no significant difference between the two groups in behavioral parameters. The majority of parents rated both sedative agents as "effective" or "very effective" and their children mostly were without anxiety or with minor anxiety

Conclusion: Buccal midazolam may be safely and efficiently used in sedation of pediatric dental patients

comparison of the antiplaque effectiveness of meridol [aminefluoride/ stannous fluoride] and irsha kids mouth rinses in 7-9 year-old children

Mechanical method of plaque control is still considered the most effective method in reducing microbial dental plaque, however, considering the limitations of this technique in children, the assistance of chemical plaque control methods have been suggested. The purpose of this study was to compare the effects of Meridol and kids Irsha mouth rinses on plaque accumulation in 7-9 year-old school children, referred to Community Dental Health Department of Zahedan Dental School in 2010. A double-blind clinical trial was conducted. Fifty samples were randomly allocated to four groups including Meridol, Kids Irsha, chlorhexidine [positive control] and normal saline [negative control]. Prophylaxis was done for all samples, and plaque index was determined for each sample after 48 hours on days 0 and 30. Samples used mouth rinses every day during this period. The data was analyzed with SPSS-17 using Kruskal-Wallis, Mann-Whitney and Sign tests. In this study, a significance level of p< 0.05 has been considered. At the end of the study, 45 samples attended for plaque index documentation. Plaque index was reduced significantly in all four groups on day 30 compared to day 0. Meridol, Kids Irsha, and saline groups did not show any significant difference with each other with respect to plaque reduction percentage between days 0 and 30, whereas chlorhexidine showed significant difference with Meridol, Kids Irsha and Saline [p=0.001]. The effect of Meridol and Kids Irsha mouth rinses on plaque reduction was not significant compared to that of Chlorhexidin

Prevalence of semi-erupted first permanent molar occlusal caries and evaluation of related clinical factors in children

Occlusal caries in semi-erupted first permanent molars may be the result of special anatomy, long eruption period and incomplete enamel calcification. The aim of this study was to evaluate the relationship between occlusal caries of those teeth and dmft, oral hygiene and plaque on the occlusal surface. Total of 193 semi-erupted first permanent molars were evaluated in 85 Zahedanian children concerning the occlusal caries, the amount of plaque on this surface, molar dmft, oral hygiene, dental arch, side and sex. The occlusal surface of 21.8% of the samples was decayed and there was only a significant correlation between the amount of plaque on the occlusal surface and also dmft with occlusal carries [p=0.03]. Too much plaque on the occlusal surface and dmft are related with occlusal carries

In vitro comparison of microleakage ot of nanofilled and flowable composites in restoring class V cavities in primary molars

Composite resins undergo microleakage due to polymerization shrinkage particularly when located in cementum or dentin. The purpose of this study was to compare the microleakage of flowable and nanofilled composites in Class V cavities extending on to the root in primary molars. Forty eight class V cavities in the cervical part of buccal and lingual surfaces of 24 intact mandibular second primary molars were prepared, with occlusal margins on enamel and gingival margins on cementum. After restoring cavities randomly with nanofilled or flowable composite by incremental technique, specimens were stored in distilled water for 24 hours, thermocycled, immersed in a basic Fuchsin solution for 24 hours and sectioned buccolingually. Microleakage was evaluated according to the depth of dye penetration along the restoration wall using a stereomicroscope. Data were analyzed by Mann- Whitney U test at a significance level of 0.05. Microleakage of flowable and nanofilled composites at the cervical margin showed no statistically significant difference, however occlusal margin in nanofilled composite exhibited significantly less microleakage than flowable composite [p=0.013]. In contrast to occlusal margin, there was no statistically significant difference in microleakage between the 2 composites on the gingival margin. Microleakage on the gingival wall was greater compared to occlusal wall for both composites

Oral and dental laser treatments for children: applications, advantages and considerations

It is of utmost importance to make children interested in and willing to use dental services in order to prevent and treat oral diseases. Therefore, pediatric dental practitioners need to learn new technologies such as lasers, in addition to basic principles. Lasers have opened new horizons in the treatment of both soft and hard oral tissue problems in children. The present article describes application of the most commonly used lasers and their advantages and considerations

Molar incisor hypomineralization: a study of prevalence and etiology in a group of iranian children

The aim of this study was to investigate the prevalence of molar incisor hypomineralization [MIH] and its relationship with systemic conditions in a group of Iranian children. The study population comprised of 433 7-9 year olds, from four schools in Zahedan, Iran. Subjects were evaluated clinically by one examiner, and at a separate session, their mothers completed a coded medical history questionnaire. Hypo-mineralized molars and incisors were recorded based on DDE [developmental defects of enamel] index and DMFT [number of decayed, filled and missing teeth] was determined. Statistical analyses were performed using Chi-square and independent sample t-tests. Fifty-five [12.7%] children showed MIH. The overall mean number of affected teeth was 0.2. The mean value of DMFT in MH children was greater than in normal children. Demarcated opacities were the most frequent [76%] enamel defect. Mother's and child's medical problems during prenatal, perinatal and post natal period were significantly remarkable in MIH children. The prevalence of MIH in a group of Iranian children was 12.7%. Prenatal, perinatal and post natal medical conditions were more prevalent in children affected by MIH

[Gingival evaluation of primary molar teeth restored with stainless steel crowns in pediatric department of Zahedan- Iran dental school- a retrospective study]

Stainless steel crowns [SSCs] are widely used in restoring severely damaged primary molar teeth. Since these crowns do not adapt ideally to tooth substance, they may lead to some changes in surrounding gingiva. This clinical study was performed to evaluate the effect of stainless steel crowns placed on primary molars on gingival structures. In this retrospective study, 117 crowns in eighty four 4-11 year old children attended to pediatric department of Zahedan dental school were evaluated. Convenience sampling method was done. Some clinical factors such as gingival index, tooth type, state of being either right or left molar, or upper or lower molar, time elapsed after cementation, crown marginal adaptation, excessive cementation around the margin of crown and the oral hygiene level were examined. Kruskal-Wallis and Mann-Whitney tests were used for data analysis through SPSS 15 software [P<0.05]. In our study only 11.1% of the evaluated crowns demonstrated clinically healthy gingival, and there was a significant correlation between upper and lower molar, crowns marginal adaptation and oral hygiene level with gingival index [P<0.05], while gingival index was not significantly affected by tooth type, tooth side, time elapsed after cementation and presence of excessive cement around the margin of crown and sex [P>0.05]. Stainless steel crowns had no harmful effect on the gingival provided performing standard preparation procedures especially in upper molars and stablishing proper marginal adaptation and good oral hygiene level

prevalence of bruxism and correlated factors in children referred to dental schools of Tehran, based on parents' report

Bruxism is defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. The aim of this study was to determine the prevalence of bruxism and correlated factors in children referred to dental schools of Tehran, based on parents' report. This cross-sectional descriptive study was conducted on 600 4-12 year-old children with a mean age of 7.4 +/- 2.4 years, who were referred to four dental schools in Tehran. After collecting information with questionnaire filled out by parents, chi[2] Fisher Test, Mann-Whitney and t-Test were used to analyze the data. The prevalence of bruxism was 26.2%. Bruxism begun in average at the age of 4.9 +/- 2 years. Also it occurred 2.6 times more in children who had a family history of bruxism [father-mother], compared to children who didn't have such a history. 87% of children with bruxism had a history of distressing events in their life, and 13% of children with bruxism did not report any history of distressing events in their life. In this study most common oral habit was nail biting. In study of parasomnias, drooling was the most, and snoring the least reported sleep disorder. Bruxism in children with drooling was twice more than in other children. The prevalence of bruxism in children with temporomandibular disorder was 63.6% and in children without TMD was 24.7%. Based on parents' report, 26.2% of children showed bruxism and there was a significant relation between bruxism and mother's job, family history, distressing event in life, parasomnias, especially drooling and sleep walking, TMD, hyperactivity, depression, acrophobia and lygophobia

[Evaluation of crown size distribution of upper anterior teeth in students and staffs of Shahid Beheshti University of Medical Sciences]

The artificial teeth are produced with same standards for all the ethnics and countries in the world. The purpose of this study was to establish a normative size distribution in a group of students and staffs of Shahid Beheshti University of Medical Sciences. 320 individuals participated in this descriptive study. A vernier caliper was used to measure the widest mesiodistal portion and the longest incisogingival portion of the crown directly in the mouth. A matrix band was marked to determine the total width of six anterior teeth on a curve. The present study showed that 33% of the studied sample in male group, had maxillary central width in the range of 8.5-8.99mm and 44.8% in female group were in the range of 8.00-8.49mm. The mean width of six upper anterior teeth was 52.56 mm in males with the range of 46-58.1 and 50.4 mm in females with the range of 44.42 - 55.28. Differences between antimeres are seen in laterals' width and length and Central's length. Male-female comparisons indicated the presence of sexual dimorphism. Many odontometric characteristics of this sample proved to be distinctly different from the corresponding characteristics of other studies with different racial origins this would mean that commonly available standard moulds might not to be fully suitable for all racial and ethnic group