ABSTRACT
Background: General anesthesia in dentistry has been widely utilized in cases of uncontrollable fear/anxiety and uncooperative patients, patients of young age, and those allergic to local anesthesia and with other existing systemic diseases. These people usually require re-treatment owing to their weak immunity. Our study investigates the frequency and the prevalence of re-treatment in patients and candidates for dental procedure under general anesthesia in Isfahan during 1393-1396. Materials and Methods: The present cross-sectional study randomly chose 162 patients who were candidates for dental procedures. Patients who came in for re-treatment twice or more during this period were identified and their records were requested from the archives. Demographic data, reason for using general anesthesia, underlying disease, physical condition, and mental condition were all gathered through a questionnaire. The causative etiology of re-treatment was identified by examining the patients' medical records including restorations, denervation, tooth extraction, filling, and pulpotomy. Statistical analysis was performed using the SPSS software (version 25) and tests such as Kolmogorov-Smirnov Z-test, Spearman, and Chi-square test. P < 0.05 was considered statistically significant. Results: The findings of the present study showed that 92.25% of patients needed dental re-treatment during their second visit. The most needed treatment was in the second repair session and the least was related to prosthetics. It was also noted that 42.15% of patients needed dental treatment at the third visit and the highest need for treatment was in the third prosthesis session and the lowest reason was related to tooth restoration and extraction. Conclusion: The most needed treatment was in the second session of endodontic treatment, and in the third session, tooth extraction was one of the required treatments, which indicates the progression of dental problems in the interval between treatments.
ABSTRACT
Background: Remifentanil is a short-acting synthetic opioid, seems to facilitate hospital discharge, induce less agitation and better recovery quality. The aim of this study was to investigate the effects of remifentanil on the quality of recovery among healthy children who were candidate for dental procedures under general anesthesia. Materials and Methods: This study was a double blind randomized controlled clinical trial on healthy children who referred to the Department of Pediatric dentistry, School of Dentistry, Isfahan University of Medical Sciences. Both groups were anaesthetized using 5 mg/kg thiopental sodium, 1 µg/kg fentanyl and 0.6 µg/kg atracurium. The first group received propofol to maintain anesthesia and the second group was given remifentanil along with propofol. Then, the time span to regain consciousness, level of agitation during recovery and time of discharge were monitored and compared between the two groups. Data were analyzed using the Mann-Whitney U-test, and the Kruskal-Wallis test at P < 0.05 level of significance. Results: Findings showed that the propofol + remifentanil group recovered faster than the propofol group. Chi-square test showed a significant difference in recovery time between the two groups (P < 0.05). About 45 min after regaining consciousness, the mean pediatric anesthesia emergence delirium score in the propofol group was 4.02 ± 2.19 and was significantly higher than the propofol + remifentanil group (3.02 ± 2.83) (P < 0.05). In addition, the mean Postanesthetic Discharge Scoring System score in the propofol group was 6.04 ± 1.74 and was significantly higher than the propofol + remifentanil group (7.58 ± 2.14) (P < 0.05). Conclusion: Combination of propofol and remifentanil significantly reduced the time taken for recovery, discharge and agitation level compared to propofol.
ABSTRACT
STATEMENT OF THE PROBLEM: Alveolar bone resorption associated with periodontal disease is a common finding and generally irreversible. It impairs mastication and causes esthetic problems for patients. Bisphosphonates are the most commonly used antiresorptive agents for bone diseases. PURPOSE: Considering the risk of bisphosphonate-related osteonecrosis of the jaw, this study aimed to assess the effect of 2% risedronate gel on calvarial bone defects in rabbits. MATERIALS AND METHOD: In this animal study, critical-size defects of 8mm were created in the calvaria of 20 New Zealand white rabbits. In group 1 (n=10), 2% risedronate gel was applied into the right side defect while the left side defect remained empty and served as control. In group 2 (n=10), placebo gel was applied into the right side defect, while the left side defect remained empty and served as control. Five rabbits in each group were sacrificed at 1month and the remaining five at 2 month, post-operatively, and tissue samples were collected for histomorphometric analysis. Histomorphometric assessments included bone fill, degree of inflammation, number of osteoblasts, number of osteoclasts, and foreign body reaction at the site. Data were statistically analysed using SPSS version 25 via the Dunn test and Kruskal-Wallis test. RESULTS: No bone remodeling was noted in any group at 1 month. The risedronate group showed significantly higher bone fill than the other groups after 2 months (p= 0.016). At 2 months, the number of osteoblasts was significantly higher in the risedronate group (p< 0.05). The groups were not significantly different in terms of inflammation score at 1 (p= 0.31) or 2 (p=0.69) months. Foreign body reaction was not observed in any group at any time point. No osteoclast was detected in any group at any time point. CONCLUSION: Risedronate gel showed superior efficacy with regard to regeneration of rabbit calvarial bone defects compared to the placebo and control groups.
ABSTRACT
Background: This study aimed to assess and compare the type of dental procedures performed under general anesthesia for healthy and disabled children. Materials and Methods: This descriptive, cross-sectional study evaluated 361 dental records of children who received dental treatments under general anesthesia in the operating room of Torabinejad Research Center during 2011-2013. Patients with mental or physical disability were categorized as disabled. The age and gender of patients, number of treated teeth, duration of general anesthesia, type of tooth, and type of dental treatment such as extraction, pulp therapy, placement of stainless steel crowns, composite restoration, preventive resin restoration (PRR), fissure sealant treatment, and fluoride therapy were separately recorded for the healthy group and patients with disability. Data were analyzed using one-way ANOVA, and independent sample t-test at P < 0.05 level of significance. Results: Of 361 patients, 263 patients were healthy and 102 patients had disability. Of all disabled children, 48% had physical and 52% had mental disability. Among patients with physical disability, allergy (40%), followed by cardiovascular diseases (26%) were the most common. Mental retardation (54%) followed by cerebral palsy (10%) were the most common mental disabilities. Number of extracted teeth was significantly higher in disabled children (P = 0.006). Furthermore, disabled children received significantly lower PRR (P = 0.015), fissure sealant treatment (P = 0.003), fluoride therapy (P = 0.002), and pulp therapy (P < 0.001) compared with healthy children. Conclusion: Tooth extraction has a higher frequency in disabled children; while, attempts are made to preserve the teeth as much as possible in healthy children.
