Class III malocclusion poses a challenging dilemma for the clinician because these children have of growth patterns that differ from that of children with class I malocclusion. The mandible grows more rapidly than the maxilla, exacerbating the class III malocclusion as the child go through adolescence. Ever since Clark described a version of the twin block, it has steadily gained popularity in the management of early class III malocclusion in children. However, not many cases are reported in the literature on its use in deciduous dentition. This article tries to provide an insight into the reverse twin block appliance and reports two cases of early class III malocclusion treated using reverse twin block.

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.

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