Comparison of oral midazolam and triclofos in conscious sedation of uncooperative children.

OBJECTIVE: To compare the safety and efficacy of two orally administered conscious sedation agents, Triclofos 70mg/kg and Midazolam 0.5mg/kg in pediatric dental patients. STUDY DESIGN: In this cross over study twenty four sedation sessions were carried out with twelve children between the age group of 3 to 9 years. Children exhibiting negative behavior according to Frankl behavior rating scale (Rating No.2) were selected. Patients were randomly assigned to receive oral midazolam 0.5mg/kg or triclofos 70mg/kg. The alternate drug was administered at the next appointment. Patients' behavioral responses were recorded using a scoring system established by Houpt et al and modified by Badalaty et al considering the degree of sleep, body movement, crying and overall behavior Scoring was done for both midazolam and triclofos session as well as for the session which was tried without medication. Ratings were made during all the procedures like injection of LA, extraction, cavity preparation, restoration and pulp therapy. Statistical analysis was done using Friedman test and Wilcoxon sign rank test. RESULTS: Both the drugs showed significantly higher scores when compared to the session which was tried without medication although the scores for midazolam were significantly higher than triclofos. CONCLUSION: Oral midazolam in a dose of 0.5mg/kg is more effective in regulating patient behavior when compared to triclofos.

Influencia del dique de goma en la tranquilidad y en el comportamiento del paciente infantil durante el tratamiento dental / No disponible

Propósito: Los objetivos de este estudio fueron: 1. Evaluar la aceptación del dique de goma por parte del paciente infantil mediante un cuestionario elaborado para el presente estudio. 2. Evaluar la ansiedad del paciente antes, durante y después del tratamiento; y el nivel de colaboración del paciente infantil durante el tratamiento, con y sin el dique de goma. 3. Evaluar los elementos del tratamiento que son más desagradables para el paciente infantil. Material y Métodos: En este estudio participaron 140 niños (de entre4 y 12 años) divididos en dos grupos: A tratamiento con dique de goma (obturaciones y tratamientos pulpares); y B tratamiento sindique de goma (sellados de fosas y coronas metálicas preformadas).Ambos grupos se dividieron en subgrupos por edad (4-6, 7-9 y de 10-12 años). En ambos grupos (A y B) se registró: 1. la ansiedad autoevaluada por el paciente mediante la Escala analógica de Carasantes, durante y después del tratamiento; 2. El nivel de colaboración mediante la Escala de Venham evaluada por el operador; 3. Se realizó un cuestionario sobre la aceptación de los elementos utilizados durante el tratamiento con o sin el dique de goma. 4. Cuál de los elementos utilizados durante el tratamiento era el más desagradable para el paciente infantil. Resultados: El menor nivel de ansiedad según la escala analógica de caras fue durante el tratamiento de obturación con el dique de goma en un 19.01% (p<0.0005).El menor nivel de ansiedad según la escala de Venham fue durante el tratamiento de obturación con el dique de goma en un 15,49% (p<0.000).Según el tipo de tratamiento (p<0.000), el elemento más desagradable para el paciente ha sido la anestesia local en un 12.5% de los casos de obturaciones y la turbina en un 25% de los casos de tratamiento pulpar. Sin el dique de goma, el elemento más molesto han sido los sabores en un 19,77% de los casos de tratamiento desellados de fisuras y la turbina en un (..) (AU)

Aim: The aims of this study were: 1. Assess children's acceptance of the rubber damm by means of a specific test for this study. 2. Assess children’s anxiety during the dental treatment; 3. Assess patients ‘behavior during the dental treatment with or without the rubber damm; 4. Assess which dental elements was the most discomfortable for children. Material and methods. The study was conducted among 140 patients aged between 4 and 12 years old who were referred to treated groups: Group A Treatment with rubber damm (fillings and pulpartreatments), and Group B Treatment without rubber damm (sealants and crowns). Each group was referred to aged group (4-6, 7-9, and10-12 years). Both groups were assessed: 1. The Children's anxiety before, during and after the dental treatment was assessed using Facial Image Scale by the patient. 2. The Children's behaviour during dental treatment using Venham's Clinical Rating of cooperative behaviour by the operator. 3. A survey was used to know the children’s acceptance about treatment with or without rubber damm 4. Assess which element used during the treatment was the most discomfortable for children using a specific questionnaire of different dental elements used for this study. Results: By the Facial Image Scale, the lowest anxiety level was observed in the filling group with the rubber damm, with 19% of the cases (p<0.0005).By the Venham Scale, the lowest anxiety level in children was observed in the filling group with the rubber dam with 15. 49% of the cases(p<0.000).According to the treatment (p<0.000), the most discomfortable element for children was local anestesia in filling group (12.5%), turbine(25%) in pulpar treatment group, both with the rubber damm. And without the rubber damm group, the most discomfortable element was flavour (19.77%) in sealant group and turbina (16,28%) in (..) (AU)