Aim:The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures. Methods and Materials:A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA).Results: There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05). Conclusions:Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients. Abstract © Seer Publishing

Aim:The aim of this article is to present a case of a phenobarbital-induced gingival hyperplasia (GH), discuss possible etiological mechanisms of drug-induced GH, and to present a concise review of the literature.Background: GH is a well-known complication associated with anticonvulsant phenytoin, antihypertensive calcium channel blockers, and immunosuppressant cyclosporine therapy. Sodium valproate and primidone has very rarely been found to cause GH. Report: An extremely rare case of phenobarbital-induced GH in a 28-year-old male patient who had received this drug for three years is presented. The histological examination of the lesion revealed a hyperplastic epithelium, epithelial acanthosis, and elongated rete ridges as well as obviously enhanced dense collagenous fibers and proliferation of fibroblasts. Summary:Phenobarbital-induced GH is a rare clinical entity which necessitates meticulous evaluation. However, it seems to show a benign behavior with reference to recurrence after surgical excision. Citation: LafziA, Farahani RMZ, Shoja MAM. Phenobarbital-induced Gingival Hyperplasia. J Contemp Dent Pract 2007 September; (8)6:050-056. Abstract © Seer Publishing

Aim:The aim of this study was to evaluate the age-specific effect of treatment duration on pediatric patient behavior. Methods and Materials:A total of 450 children 3 to 9 years of age were allocated into six consecutive age groups (n=75 for each group). All children received dental treatment procedures which included the fabrication of a Type 1 composite resin restoration, then a dental prophylaxis followed by fluoride therapy with each procedure requiring an average of 20 minutes. The children's behavior was evaluated at the end of each treatment period using the sound, eye, and motor (SEM) scale. Results:The results of a mixed analysis of variance (ANOVA) indicated a significant main effect of treatment duration, F (1.69, 255.01) = 188.29, P < 0.001, and of chronological age, F (1, 144) = 115.82, P < 0.001. Moreover, the main effects of time and chronological age was qualified by a significant interaction between time and chronological age, F (8.86, 255.01) = 115.82, P < 0.001. The beta weights (0.64 for age versus 0.44 for time) suggest chronological age contributes the most to predicting the behavior of children during dental treatment followed by the duration of treatment.Conclusion: Treatment duration may affect the behavior of pediatric patients parallel with chronological age and, thus, should be considered in the arrangement of the treatment plan.Clinical Significance: The findings of this study suggest appropriate pediatric behavior management should include thoughtful scheduling of appointments according to a treatment plan formulated with consideration of the effects of age and appointment length.

The aim of this clinical investigation was to determine the efficacy of distraction and counterstimulation in the reduction of pain during the administration of local anesthetics in pediatric dental patients. Methods and Materials: A total of 78 healthy children (male: 40, female: 38) ages four to five years (mean age: 4.72 years old) without any history of previous intraoral injection were included in the present study. The subjects had at least one carious primary molar. The subjects were randomly allocated into three groups. Group SA received topical anesthesia followed by an inferior alveolar nerve block (simple anesthesia). Group C+SA received counter stimulation using intraoral and extraoral finger vibration in addition to the Group SA protocol. Group CD+SA incorporated verbal distraction in addition to topical and local anesthesia and counterstimulation. A sound, eye, and motor (SEM) scale was used for quantification of pain reaction. Data were analyzed using an analysis of variance (ANOVA). Results: The SEM values for Groups SA, C+SA, and CD+SA was 8.25, 5.07, and 3.41, respectively. According to the SEM scale a severe pain reaction was observed in Group SA but not in the other groups. The pain reaction for Group SA was significantly higher than the two other groups (P<0.05). Moreover, the subjects in Group CD+SA exhibited significantly less pain compared to those in Group C+SA.

Aim The aim of this article is to report a case of bilateral multiple impacted supernumerary teeth. A discussion of possible mechanisms of development is also presented along with a concise review of the literature. Background Supernumerary teeth occur in the context of various scenarios in the primary and the permanent dentition. Multiple supernumerary teeth are a rare finding especially in the absence of associated syndrome or disease. Report A case of bilateral multiple impacted supernumerary teeth localized to the mandibular premolar region is reported. Some of the supernumerary teeth as well as the erupted premolars had persistent open apices. Coronal malformation of the right maxillary first premolar was another interesting finding. There was an absence of any concomitant disease. Summary The aforementioned combination of findings has not been reported previously. The anatomical, geometrical, and spatial relationships of supernumerary teeth with their erupted equivalents may shed light on some controversial aspects of the etiology. Citation Farahani RMZ, Zonuz AT. Triad of Bilateral Duplicated Permanent Teeth, Persistent Open Apex, and Tooth Malformation: A Case Report. J Contemp Dent Pract 2007 November; (8)7:094-100.