Advances in pediatric dentistry: new approaches to pain control and anxiety reduction in children - a narrative review

Remi, Ravi Vijaya; Anantharaj, Athimuthu; Praveen, Prasanna; Prathibha, Rani Shankarappa; Sudhir, Ramakrishna

doi:10.17245/jdapm.2023.23.6.303

J Dent Anesth Pain Med

2023

DOI: 10.17245/jdapm.2023.23.6.303

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Advances in pediatric dentistry: new approaches to pain control and anxiety reduction in children - a narrative review

Ravi Vijaya Remi,

Athimuthu Anantharaj,

Prasanna Praveen

et al.

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Cited by 6 publications

References 70 publications

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A randomized controlled trial to assess parental satisfaction with computerized intraosseous anesthesia versus inferior alveolar nerve block in children

Alkhouli,

Al-Nerabieah,

Dashash

2024

Sci Rep

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This study aimed to compare parental satisfaction between two pediatric dental anesthesia techniques, computerized intraosseous anesthesia (CIA) and inferior alveolar nerve block (IANB). This study was designed as a split-mouth randomized controlled clinical trial. A total of 52 parents of children undergoing dental treatment were enrolled in the study. Each participant received both CIA and IANB anesthesia, with the order of administration randomized. Parental satisfaction was evaluated using the parental satisfaction of dental local anesthetic techniques scale (PSLAS). Statistical analysis revealed that parental satisfaction regarding CIA was higher than that for IANB with a significant difference (P ˂ 0.05). However, there was no difference regarding the age, gender or the education level of the parents. (P > 0.05). This study provides insights into parental satisfaction with pediatric dental anesthesia techniques and highlights the influence of socioeconomic factors on anesthesia decision-making. Within the limitations of this trial, it was concluded that CIA was significantly superior to IANB in overall parental satisfaction. However, parental satisfaction values were lower in CIA group regarding costs and concern from complications. In addition, it was concluded that there was no difference in satisfaction levels regarding the gender, age and education level of the parents.

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A randomized controlled trial to assess parental satisfaction with computerized intraosseous anesthesia versus inferior alveolar nerve block in children

Alkhouli,

Al-Nerabieah,

Dashash

2024

Sci Rep

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Different Uses of Conscious Sedation for Managing Dental Anxiety During Third-Molar Extraction: Clinical Evidence and State of the Art

Rosa,

Ronsivalle,

Fiorillo

et al. 2024

Journal of Craniofacial Surgery

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Dental anxiety, linked to avoiding dental treatment and heightened medical and surgical risks, prompted this systematic review. The objective is to synthesize existing evidence on conscious sedation techniques employed for managing dental anxiety in patients scheduled for third molar extraction surgery, aiming to identify optimal approaches and address knowledge gaps. This systematic review followed the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” checklist and the population, investigation, comparation, outcome framework. The protocol still needs to be registered. A thorough search was conducted, incorporating MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews until February 2024. Only randomized controlled trials were considered, following “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” guidelines. The risk of bias was evaluated following the Cochrane Handbook for Systematic Reviews of Interventions. Eighteen randomized controlled trials involving 2081 patients were included. Certain factors limited the feasibility of a meaningful meta-analysis, leading to a narrative synthesis. Conscious sedation with virtual reality showed an association with improved dental anxiety in 4 studies. One study reported reduced cortisol levels with midazolam compared with a placebo, whereas another noted significant variations in perioperative renin levels with remifentanil versus placebo. This review reveals inconclusive and conflicting findings regarding the role of conscious sedation in managing dental anxiety during third molar extraction surgery. Persistent uncertainties arise due to a need for consistent, standardized outcome measures. Addressing these limitations in study design is crucial for future research.

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Influence of computerized intraosseous anesthesia compared with traditional mandibular nerve block on children's behavior: A randomized clinical trial

Radwan,

Wassel,

El Geleel

et al. 2024

Int J Paed Dentistry

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BackgroundEffective pain management is crucial for the successful completion of dental procedures in children. Research has examined whether computerized intraosseous anesthesia (CIOA) could serve as a safe and viable substitute for the conventional inferior alveolar nerve block (IANB) technique in pediatric patients. This study investigates the efficacy of CIOA, aiming to determine its effectiveness as an alternative anesthesia method.AimThis study compared the efficacy of local intraosseous anesthesia using a computerized device (QuickSleeper 5) to conventional IANB anesthesia on cooperation and pain perception in children, using a randomized controlled trial design.DesignThe study included 88 healthy children, aged between 6 and 9 years, who required pulpotomy for their mandibular second primary molars. The study was approved by the local research ethics committee and registered at clinicaltrials.gov (NCT05193487). The heart rate and Venham behavior rating scale were recorded and analyzed. Categorical data were analyzed using Fisher's exact test. Age and heart rate were compared using an independent t‐test for intergroup comparison. The intragroup comparison was carried out using repeated measures ANOVA, followed by the Bonferroni post hoc test. The Mann–Whitney U‐test was used to analyze the Venham scale scores. The significance level was set at p < .05ResultsThe mean Venham score was slightly higher in the IANB group than in the CIOA group, but was not statistically significant (p = .852). One minute after anesthesia administration, the heart rate (beats per minute [BPM]) was significantly higher in the IANB group (92.30 ± 13.45) than in the CIOA group (83.20 ± 10.40) (p < .001). Additionally, there was a significant difference in heart rate values measured at different intervals within the IANB group.ConclusionThe QuickSleeper 5 device was found to be a feasible alternative for IANB in children over 6 years old.

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Advances in pediatric dentistry: new approaches to pain control and anxiety reduction in children - a narrative review

Cited by 6 publications

References 70 publications

A randomized controlled trial to assess parental satisfaction with computerized intraosseous anesthesia versus inferior alveolar nerve block in children

A randomized controlled trial to assess parental satisfaction with computerized intraosseous anesthesia versus inferior alveolar nerve block in children

Different Uses of Conscious Sedation for Managing Dental Anxiety During Third-Molar Extraction: Clinical Evidence and State of the Art

Influence of computerized intraosseous anesthesia compared with traditional mandibular nerve block on children's behavior: A randomized clinical trial

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