Comparison of the HugeMed video laryngoscope with the Macintosh direct laryngoscope for nasotracheal tracheal intubation in children undergoing dental treatment: a randomized controlled clinical study.

OBJECTIVES: The aim of this study was to compare the performance of the HugeMed® videolaryngoscope with a direct Macintosh laryngoscope for nasotracheal intubation. METHODS: Eighty-eight children aged 4-10 years were randomly assigned to either the HugeMed® videolaryngoscope (HVL) or the Macintosh direct laryngoscope (MDL) group. Intubation difficulty, glottic view grade, time-to-intubation, number of tracheal intubation attempts, use of external laryngeal manipulation and Magill forceps, recovery time, pediatric-anesthesia-delirium-scale (PAEDS) scores, pain due to tracheal intubation, and laryngeal bleeding were evaluated. RESULTS: Easy tracheal intubation incidence was higher in the HVL group than that in the MDL group (p = 0.001). Glottic view was better in the HVL group as compared to the MDL group (p = 0.027). There was no difference between the groups in terms of time-to-tracheal intubation, number of tracheal intubation attempts, Magill forceps usage, pain, and bleeding due to tracheal intubation. The need for external laryngeal manipulation (p = 0.004) and PAEDS scores (p = 0.006) were higher in the MDL group than those in the HVL group. CONCLUSION: HugeMed® videolaryngoscope may provide easier tracheal intubation, create a better glottic view, and significantly reduce the need for additional manipulation compared to the Macintosh direct laryngoscope, for nasotracheal intubation. CLINICAL TRIAL REGISTRATION: www.clinicaltrial.gov identifier is NCT05121597.

Efficacy of orthoMTA, retroMTA and ferric sulphate as pulpotomy agents in primary molars: a randomized clinical trial.

Purpose: The purpose of this study is to evaluate the clinical and radiographic success rates of RetroMTA, OrthoMTA, and ferric sulfate as pulpotomy agents in primary molars. Materials and methods: Ninety-six primary second molars from 32 children aged 5 to 9 years were enrolled in this study. The teeth were randomly divided into three groups based on the pulpotomy agent used: O-MTA, R-MTA, and FS. Clinical and radiographic follow-up examinations were conducted at 3, 6, 9, and 18 months postoperatively. Results: At the end of the study period, 84 teeth were evaluated. The clinical success rates were 75% for FS, 96.4% for O-MTA, and 92.8% for R-MTA groups. In the radiographic analysis, the success rates at the 18-month follow-up period were 50% for FS, 85.8% for O-MTA, and 82.2% for R-MTA groups. According to the Chi-square test and Kaplan-Meier survival analysis, there was a statistically significant difference among the success rates and survival probabilities of the groups (p<0.05). Conclusion: OrthoMTA and RetroMTA demonstrated better treatment outcomes for pulpotomy of primary second molars than ferric sulfate at the 18-month follow-up period.

Efficacy of Preemptive Analgesia on Postoperative Pain Control in Children Who Underwent Full-Mouth Dental Rehabilitation Under General Anesthesia: A Randomized Controlled Clinical Trial.

AIMS: To evaluate the efficacy of intravenous preemptive analgesia on postoperative pain in children undergoing dental rehabilitation under general anesthesia. METHODS: In this prospective randomized clinical trial, 70 children aged 3 to 7 years were scheduled for dental treatment and randomized into two groups: the control group or the preemptive group. Patients received 15 mg/kg of intravenous paracetamol either before the start of treatment (preemptive group, n = 35) or at the end of treatment (control group, n = 35). Postoperative pain scores were recorded at 1, 2, 4, 6, 8, 12, and 24 hours using the Wong-Baker FACES Pain Rating Scale (WBFS). Additionally, the need for rescue analgesic and the total opioid consumption of the patients were recorded during the first 24 hours postoperative. RESULTS: The pain scores in the preemptive group were significantly lower than those in the control group at the postanesthesia care unit and at 2, 4, and 8 hours postoperative (P < .05). However, there were no statistically significant differences in pain scores between groups at 12 and 24 hours postoperative. Need for rescue analgesics and total intravenous fentanyl consumption were significantly higher in the control group than in the preemptive group (P < .05). The percentage of children who received medication for pain relief at home was higher in the control group than in the preemptive group, but the difference was not statistically significant (P > .05). CONCLUSION: Preemptive use of intravenous paracetamol reduces postoperative pain scores and postoperative opioid consumption. However, there is a need to evaluate pain levels in children who receive comprehensive dental treatment under general anesthesia after hospital discharge for effective postoperative pain control.

Gingival crevicular fluid levels of interleukin-18 and tumor necrosis factor-alpha in type 1 diabetic children with gingivitis.

OBJECTIVE: This study aimed to evaluate the levels of interleukin-18 and tumor necrosis factor-alpha in gingival crevicular fluid of diabetic children with gingivitis. METHODOLOGY: Eighty-eight children (44 with type 1 diabetes mellitus and 44 systemically healthy) were recruited for the study. The children were divided into four subgroups based on their periodontal and systemic condition: (1) systemically and periodontally healthy children (H), (2) systemically healthy children with gingivitis (G), (3) periodontally healthy children with T1DM (T1DM + H), and (4) children with T1DM and gingivitis (T1DM + G). The plaque index, gingival index, probing pocket depth, and GCF volume were recorded. The IL-18 and TNF-α levels in GCF were determined by ELISA. RESULTS: The clinical periodontal parameters, GCF IL-18 level, and TNF-α level were similar between diabetic and systemically healthy children (p > 0.05). The gingivitis subgroups had a significantly higher GI, PI, PPD, GCF volume, and TNF-α total amounts than the H subgroups (p < 0.0001). The IL-18 concentrations in the gingivitis subgroups were significantly lower than in the periodontally healthy subgroups. CONCLUSIONS: In diabetic children with good metabolic control, T1DM did not affect the GCF levels of IL-18 and TNF-α in the presence of gingivitis. However, increased GCF TNF-α levels in children with gingivitis confirm that TNF-α is closely related to gingival inflammation. CLINICAL RELEVANCE: Type 1 diabetes mellitus is not associated with GCF interleukin-18 and tumor necrosis factor-alpha levels in children with gingivitis.

The effect of the Er: YAG laser on the clinical success of hydrophilic fissure sealant: a randomized clinical trial.

PURPOSE: The aim of this study was to assess the effect of the Er:YAG laser on the clinical success of a hydrophilic fissure sealant over 12 months. SUBJECT AND METHODS: This study was conducted on 132 permanent first molars from 44 (19 girls and 25 boys) patients aged 7-11 years. The teeth were divided into three groups. The first group (Group A-control) of teeth were etched with phosphoric acid, the second group of teeth (Group L) were etched with an Er:YAG laser, and the third group of teeth (Group A+L) were etched with both the Er:YAG laser and phosphoric acid. Clinical evaluations were performed at baseline and at 3-, 6-, 9- and 12-month follow-up visits. The data were analyzed with Pearson chi-square tests, Cochran Q tests and Kaplan-Meier analysis. RESULTS: At the end of the 12 months, total retention rates were 72.7%, 59.1%, and 65.9% in the acid group, the laser group and the laser and acid group, respectively. Although there was no statistically significant difference between group retention rates (p>0.05), the lowest retention rate was found in the laser group at the end of the 12-month follow-up period. No new caries were observed in any group during the study period. CONCLUSION: Etching with the Er:YAG laser, phosphoric acid or a combination of both methods provided similar results for the clinical success of hydrophilic based fissure sealant.

Oral health status and oral health related quality of life in adolescent workers.

BACKGROUND AND AIM: Oral health status and oral health related quality of life (OHRQoL) of working adolescents has been very little reported in literature. Therefore, this study aimed to determine oral health status and OHRQoL in a group of adolescent workers. METHODS: This cross-sectional study was conducted in an apprentice training center in western Turkey between December 2016 and January 2017. The study group population was 585, and the sample size was 514 students between 14 and 18 years old. The Decayed, Missing, and Filled Teeth (DMFT) Index, the Turkish version of the Oral Health Impact Profile-14 (OHIP-14), and a form requesting the socio-demographic information of the students were used as data collection tools. Permissions were obtained from the relevant school, parents, students, and ethical committee. The data were analyzed using descriptive statistics, the Student's t-test, and the Pearson correlation coefficient. RESULTS: The results showed significant relationships between the tooth brushing frequency, dental visit frequency, dental trauma history, smoking, and the OHIP-14 subdomains (p < 0.05). CONCLUSION: Poor oral health and a lack of good oral health attitudes may have negative impact on the oral health related quality of life (OHRQoL) of working adolescents. Dental health education programs in collaboration with schools and dental health services may be beneficial for promoting oral health and improving the OHRQoL of working adolescents.

Evaluation of oral health status of children in pretreatment and after treatment for 18 month.

OBJECTIVE: Dental caries is an important public health issue worldwide. In developing countries preventive dentistry is not common; hence, oral and dental health problems continue to generate serious economic and social issues. The aim of this study was to assess oral health and the incidence of dental caries in systemically healthy children aged 3-14 years, provide education on oral hygiene motivation, conduct the necessary preventive and restorative procedures, and reassess caries development at the 6-, 12-, and 18-month post-treatment follow-up. METHODS: Systemically healthy children aged 3-14 years who applied to the Paediatric Dentistry Clinic, Faculty of Dentistry, Adnan Menderes University (ADU) were included in the study. The subjects were evaluated for oral health status and incidence of dental caries based on surveys and clinical examination, motivation for oral hygiene with necessary training, completion of preventive and restorative treatments, and development of dental caries at the 6-, 12-, and 18-month post-treatment follow-up. RESULTS: The study included 320 patients, aged 3-14 years (mean age 8.08 ± 3.45 years). In children included in the study, the average decayed (d), missing (m) and filled (f) primary teeth (dmft) value was 3.81 (min-max: 0-16), decayed (D), missing (M) and filled (F) permanent teeth (DMFT) value, 1.49 (min-max: 0-6), decayed (d), missing(m) and filled(f) primary teeth surface (dmfs) value, 10.11 (min-max: 0-40), and decayed (D), missing (M) and filled (F) permanent teeth surface (DMFS) value, 2.09 (min-max: 0-12). CONCLUSIONS: For the protection and maintenance of oral and dental health in dentistry, preventive approaches should be the first concern and conservative therapeutic methods should be given priority after occurrence of any dental pathology. In addition, one-time examinations are not sufficient, and children should be examined at least twice a year. This study showed that the incidence of dental caries declined in children who underwent periodical examination and preventive dental treatment.

Recovery characteristics of total intravenous anesthesia with propofol versus sevoflurane anesthesia: a prospective randomized clinical trial.

BACKGROUND: Pediatric dental procedures are performed under anesthesia because children may be uncooperative in the dental clinic due to their young age. Emergence delirium (ED), which involves a variety of behavioral disturbances that are frequently observed in children following emergence from general anesthesia, remains an unclear phenomenon. The aim of this randomized controlled trial is to compare the incidence of ED in children who underwent full mouth dental rehabilitation under either sevoflurane (SEVO) anesthesia or propofol-based total intravenous anesthesia (TIVA). PATIENTS AND METHODS: One hundred and twenty children with American Society of Anesthesiologists status I-II, aged ≥3 and ≤6 years, undergoing dental rehabilitation were assigned to receive either TIVA or SEVO. ED and postoperative pain were evaluated by a blinded investigator using the Pediatric Anesthesia Emergence Delirium scale and the Face, Legs, Activity, Cry, Consolability scale every 5 min. The recovery time, satisfaction levels of parents or guardians, extubation time, duration of the operation, and type of dental procedure were also recorded. RESULTS: Data of 116 subjects were analyzed. The incidence of ED was higher after SEVO than after TIVA (65.5 vs 3.4%, P=0.00). Greater postoperative pain was observed in the SEVO group (median 3 vs 1, P=0.000). A statistically significant, moderate correlation (rs=0.46, P<0.0001) was found between the Face, Legs, Activity, Cry, Consolability and Pediatric Anesthesia Emergence Delirium scores. A higher parental satisfaction level was observed in the TIVA group. CONCLUSION: A lower incidence of ED and a higher parental satisfaction level were observed after TIVA. Moreover, TIVA resulted in a more comfortable postoperative period due to reduced postoperative pain, and the extubation time and recovery time were not increased.

Comparison of oral dexmedetomidine and midazolam for premedication and emergence delirium in children after dental procedures under general anesthesia: a retrospective study.

BACKGROUND: Premedication is the most common way to minimize distress in children entering the operating room and to facilitate the smooth induction of anesthesia and is accomplished using various sedative drugs before the children are being transferred to the operating room. The aim of this study was to compare the effect of oral dexmedetomidine (DEX) and oral midazolam (MID) on preoperative cooperation and emergence delirium (ED) among children who underwent dental procedures at our hospital between 2016 and 2017. PATIENTS AND METHODS: The medical records of 52 children, who were American Society of Anesthesiologists I, aged between 3 and 7 years, and who underwent full-mouth dental rehabilitation under general anesthesia (GA), were evaluated. Twenty-six patients were given 2 µg/kg of DEX, while another 26 patients were given 0.5 mg/kg of MID in apple juice as premedication agents. The patients' scores on the Ramsay Sedation Scale (RSS), Parental Separation Anxiety Scale (PSAS), Mask Acceptance Scale, Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and hemodynamic parameters were recorded from patients' files. The level of sedation of children had been observed just before premedication and at 15, 30, and 45 min after premedication. The data were analyzed using a chi-square test, Fisher's exact test, Student's t-test, and analysis of variance in SPSS. RESULTS: The Mask Acceptance Scale and PSAS scores and RSS scores at 15, 30, and 45 min after premedication were not statistically different (p>0.05) in both groups, whereas the PAEDS scores were significantly lower in the DEX group (p<0.05). CONCLUSION: Oral DEX provided satisfactory sedation levels, ease of parental separation, and mask acceptance in children in a manner similar to MID. Moreover, children premedicated with DEX experienced lesser ED than those premedicated with MID.

Microtensile Bond Strength of Polyacid-modified Composite Resin to Irradiated Primary Molars.

AIM: This study evaluated the influence of various doses of radiotherapy on the microtensile bond strength (pTBS) of compomer resin to dentin and enamel in primary molars. MATERIALS AND METHODS: Thirty-five intact primary molars were collected and divided into seven groups. Teeth were irradiated with doses from 10 to 60 Gy, except for the control group. Compomer restorations were performed, and enamel-compomer resin beams and dentin-compomer resin beams were tested at a crosshead speed of 1 mm/min. RESULTS: No statistically significant difference was found between the irradiated tooth enamel and the control group (F = 1.1468; p = 0.194). However, statistically significant differences were evident among the dentin groups (F = 11.050; p < 0.001). CONCLUSION: Radiation may not cause a significant difference in the pTBS of compomer resin to primary tooth enamel, but appears to dose dependently decrease its bond strength to primary tooth dentin. CLINICAL SIGNIFICANCE: Radiotherapy may affect the success rate of compomer fillings in primary teeth, especially in deeper cavities with exposed dentin.

Postoperative discomfort and emergence delirium in children undergoing dental rehabilitation under general anesthesia: comparison of nasal tracheal intubation and laryngeal mask airway.

BACKGROUND: Several studies have identified side effects of general anesthesia with endotracheal intubation, such as laryngeal pain, dysphonia, and postoperative nausea and vomiting (PONV). The laryngeal mask airway (LMAw) is believed to decrease these side effects. The aim of this trial was to compare postoperative discomfort, emergence delirium, and recovery time of patients who received either an LMAw or nasotracheal intubation (NTI). PATIENTS AND METHODS: A total of 70 children were randomly assigned to the LMAw group (n=35) or the NTI group (n=35). Both groups underwent mask induction with 8% sevoflurane. The NTI group received muscle relaxant, whereas the LMAw group did not. Postoperative laryngeal pain, dental pain, dysphonia, and PONV were assessed immediately and at 1 hour and 6 hours postoperatively. The Wong-Baker Faces Scale was used to evaluate the patients' self-reported pain. In addition, decayed, missing, and filled teeth (dft/DMFT) values, dental procedure type, number of dental procedures, duration of the dental operation, duration of anesthesia, recovery time, emergence delirium, pediatric dentist's access to the mouth, and parents' satisfaction levels were recorded. Data were analyzed using descriptive statistics, chi-square tests, and two-sample t-tests. RESULTS: The incidence of postoperative laryngeal pain was significantly higher in the NTI group immediately (97.2% vs. 8.5%, P=0.00), 1 hour (94.2% vs. 0%, P=0.00), and 6 hours postoperatively (25.7% vs. 0%, P=0.00). There were no statistically significant differences between the two groups in dental pain scores, dft/DMFT values, duration of anesthesia, duration of the dental operation, number of dental procedures, the incidence of PONV, or pediatric dentist's access to the mouth (P>0.05). Emergence delirium and recovery time were significantly higher in the NTI group (P<0.05). CONCLUSION: The LMAw provided a more comfortable postoperative period than NTI for children who underwent full-mouth dental rehabilitation under general anesthesia.

The Effect of Oral Dexmedetomidine Premedication on Preoperative Cooperation and Emergence Delirium in Children Undergoing Dental Procedures.

INTRODUCTION: The aim of this study was to detect the effect of 1 µg/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. MATERIALS AND METHODS: The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group (n = 50) received 1 µg/kg DEX in apple juice, and the control group (n = 50) received only apple juice. The patients' scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded. The data were analyzed using chi-square test, Fisher's exact test, Student's t-test, and analysis of variance in SPSS. RESULTS: RSS scores were significantly higher in the DEX group than group C at 15, 30, and 45 min (p < 0.05). More children (68% easy separation, 74% satisfactory mask acceptance) in the DEX group showed satisfactory ease of parental separation and mask acceptance behavior (p < 0.05). There was no significant difference in the PAEDS scores and mean hemodynamic parameters of both groups. CONCLUSIONS: Oral DEX administered at 1 µg/kg provided satisfactory sedation levels, ease of parental separation, and mask acceptance in children but was not effective in preventing emergence delirium. The trial was registered (Protocol Registration Receipt NCT03174678) at clinicaltrials.gov.

Immediate Postoperative Pain and Recovery Time after Pulpotomy Performed under General Anaesthesia in Young Children.

BACKGROUND: The aim of this retrospective study was to compare immediate postoperative pain scores and need for rescue analgesia in children who underwent pulpotomies and restorative treatment and those who underwent restorative treatment only, all under general anaesthesia. METHODS: Ninety patients aged between 3 and 7 years who underwent full mouth dental rehabilitation under general anaesthesia were enrolled in the study and reviewed. The experimental group included patients who were treated with at least one pulpotomy, and the control group was treated with dental fillings only. The Wong-Baker FACES scale was used to evaluate self-reported pain and need for rescue analgesia. The data were analysed using the Kruskal-Wallis test, two sample t-tests, chi-square tests, and Pearson's correlation analysis. RESULTS: Ninety percent of the children experienced postoperative pain in varying degrees of severity. Immediate postoperative pain scores in experimental group were found to be significantly higher than in control group (x2 = 24.82, p < 0.01). In the experimental group, 48% of the children needed rescue analgesia, compared with only 13% of the children in the control group (x2 = 13.27, p < 0.05). CONCLUSION: Children who underwent pulpotomy treatment had higher postoperative pain scores and greater need for rescue analgesia than control group who underwent only dental fillings.

Autoextraction of Permanent Incisors and Self-Inflicted Orodental Trauma in a Severely Burned Child.

Autoextraction is one type of self-injurious behaviour. In the literature, self-injurious behaviours are observed in syndromes and genetic conditions. However, to the best of our knowledge, SIB and autoextraction in a severely burned patient have not been reported to date. This report describes the self-inflicted trauma and autoextraction in a severely burned child, and the management of the child during and after burn treatment.

Bond strength and microleakage of self-adhesive and conventional fissure sealants.

The aim of this study was to compare the shear bond strengths (SBS), failure modes (adhesive, cohesive, or mixed), and marginal microleakage occurrence of conventional resin (CR)-based, glass ionomer (GI)-based, and self-adhesive resin (SAR)-based fissure sealants with or without prior phosphoric acid (PA) etching. Fifty extracted premolars were randomly and equally assigned into five groups -G1:PA+CR, G2:PA+GI, G3:GI, G4:PA+SAR, and G5:SAR. Prior PA etching significantly (p<0.05) increased the SBSs of sealants. Adhesive failure mainly occurred in teeth treated with SAR- or GI-based fissure sealants, and cohesive failure mainly occurred in PA-etched teeth. Microleakage occurrence differed significantly (p<0.05) among the five groups of treated teeth. We concluded that conditioning of a tooth's enamel surface is crucial to creating strong bonds and leak-free sealing between tooth and fissure sealant.

Dental Treatments under the General Anesthesia in a Child with Keratitis, Ichthyosis, and Deafness Syndrome.

KID syndrome is a rare genodermatosis characterized by keratitis, ichthyosis, and sensorineural deafness. Although the dermatological, ophthalmologic, and sensorineural defects are emphasized in the literature, oral and dental evaluations are so superficial. In this case report, dental and oral symptoms of a three year and five months old boy with KID syndrome, suffering severe Early Childhood Caries (s-ECC) and dental treatments done under General Anesthesia (GA) were reported.