Dentoskeletal Effects of Multi P® Prefabricated Functional Appliance on Class II Div I Children in Late Mixed Dentition

Objectives: Prefabricated functional appliances have therapeutic effects similar to those of custom-made functional appliances. This study aimed to assess the dentoskeletal effects of Multi P® prefabricated functional appliance on Class II Div 1children in late mixed dentition.Methods: This open label trial was conducted on 18 children aged 9-12 years with Cl II Div 1 malocclusion due to mandibular deficiency during a 9-month period. Written informed consent was obtained from the parents. Multi P ® (RMO, Strasbourg, France) was used by the patients 4 hours/day and overnight (minimum of 8 hours) in conjunction with specific exercises (pressing the teeth in the recorded occlusion, pressing the tongue against the palate and uninostril breathing). Patients were visited monthly. Study casts and cephalometric radiographs were obtained before and after the treatment. Data were analyzed using paired samples t-test and McNemar’s test.Results: The Go-Gn (P=0.029) and Me-N (P=0.021) distances significantly increased following the use of appliance while overjet (P<0.0001), absolute overbite (P=0.002) and the Wits appraisal (P=0.019) significantly decreased. Other understudy angles did not change significantly.Conclusion: Multi P® appliance decreases the jaw base discrepancy and corrects the overjet and overbite

Comparison of sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine in pediatric dentistry

Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premedication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Results. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P<0.05) in favor of the chloral hydrate group. Conclusion. The results showed a significant difference in the sedation level induced between the two groups. Midazolam/chloral hydrate combination more effectively improved the co-operation for dental treatment

A Multidisciplinary Approach to the Treatment of Traumatically Intruded Immature Incisors. A 6-Year Follow-Up

This report presents a case of 10 years old girl who was referred to the pediatric dentistry clinic sustaining a severe trauma led to crown fracture and intrusive luxation of immature maxillary incisors. Antibiotic therapies were initiated at first visit, and after surgical exposure both intruded and extruded teeth were endodontically treated by calcium hydroxide. Orthodontic repositioning was performed and root canal filling with gutta-percha was accomplished. Six years after orthodontic repositioning, clinical and radiographical examinations revealed satisfactory apical and periodontal conditions

Atlas of Pediatric Oral and Dental Developmental Anomalies

A quick reference diagnostic guide for students and clinicians, covering a wide range of oral and dental developmental anomalies in children and adolescents Written by world-renowned pediatric dentists, this easily accessible, well-illustrated reference covers a wide range of oral and dental developmental anomalies in children and adolescents, and includes rare as well as more common conditions. Divided into two parts, the first part is dedicated to normal tissue initiation, formation, and development in the orodental region. The second part offers comprehensive pictorial descriptions of each condition and discussions of the treatment options available. •A useful, quick reference atlas helping students and clinicians diagnose a wide range of oral and dental developmental anomalies in children and adolescents •Highly illustrated with clinical photographs •Describes both common and rare conditions, and explores treatment options Atlas of Pediatric Oral and Dental Developmental Anomalies is an excellent resource for undergraduate dentistry students, postgraduate pediatric dentistry students, and pediatric dental practitioners

Comparison of oral Midazolam-Ketamine and Midazolam-Promethazine as sedative agents in pediatric dentistry

Background: Investigation was designed to evaluate the behavioral changes in children receiving dental treatment while they have been administered combination of Midazolam/Ketamine or Midazolam/Promethazine. Materials and Methods: This was a randomized double blind clinical trial with cases being selected from those uncooperative children aged 2 to 6 years from those referred for treatment under general anesthesia. Anxiety score of all cases were recorded before any attempt using Frankel′s anxiety scoring system with those in negative category being included. Cases with at least a pair of similar size cavities on similar teeth were selected with each tooth being randomly allocated for one sedative regimen group. To avoid sequence effect, half of the patients received one regimen at the first visit while the other half received the other regimen as the first. Each case served as control for him or herself to reduce influencing factors. Child′s reaction was recorded before, during, and at the end of dental procedure. SO2 as well as Pulse rate were recorded as the most critical vital signs. Collected data were then analyzed using analysis of variance (ANOVA) and paired t-test. Results: Patients′ mean age was 3.5 years with 43% being male. Only 10% of the Ketamine/Midazolam group showed considerable amount of change in their behavior with a statistical significant difference being presented (P=0.029). Conclusion: Under the current circumstances, Ketamine/Midazolam combination provided sufficient sedative effect in lower doses. However, Midazolam/Promethazine combination did not produce similar results

Comparison of nitrous oxide/midazolam and nitrous oxide/promethazine for pediatric dental sedation: A randomized, cross-over, clinical trial

Background: This study compared the safety and efficacy of nitrous oxide (N2O)/midazolam and N2O/promethazine for dental treatment of uncooperative children. Materials and Methods: In this randomized, cross-over, clinical trial investigation Eighteen healthy uncooperative children with a pair of similar teeth requiring the same treatment were included.Combination of N2O/midazolam was given in one visit, where N2O/promethazine was administrated in the other appointment for each patient in a cross-over manner. Oxygen saturation and heart rate as well as behavior parameters according to Houpt behavior scales were recorded. Postoperatively, patients' anxiety and parents' satisfaction were assessed by visual analog score and a questionnaire, respectively. Data were analyzed using Wilcoxon' s signed rank test and Paired t-tests with a P value set at 0.05. Results: Physiologic parameters were within normal limit in both groups. Children in midazolam group were significantly deeper sedated compared to other groups. In the first phase, children sedated with midazolam behaved superiorly in comparison to promethazine, while there was no difference at the final phase of the treatment between the two groups. Conclusion: Both of the drug combinations resulted in acceptable, efficient, and safe sedation outcomes

Sedative Effect of Oral Midazolam/Hydroxyzine versus Chloral Hydrate/Hydroxyzine on 2-6 Year-Old Uncooperative Dental Patients: A Randomized Clinical Trial.

Different drugs are used for conscious sedation in pediatric dentistry either single or in combination. This study assessed the comparative effect of midazolam/hydroxyzine and chloral hydrate/hydroxyzine on 2-6 year-old uncooperative children needing dental treatment.A double blind cross-over randomized clinical trial was designed and 16 children aged 2-6 years with ASA1 status who were judged with negative to definitely negative behavior (according to Frankl) were chosen. Cases were divided randomly into two groups. The first group received midazolam/hydroxyzine (MH) at the first visit while the second group received chloral hydrate/hydroxyzine (CHH) as the first medication. Both groups received the other regimen at the second visit. Midazolam 0.5mg/kg and chloral hydrate 50mg/kg with 1mg/kg hydroxyzine were administered. Cases were subsequently assessed for sedation and then dental treatment was performed. Blood oxygen saturation (SpO2) and pulse rate (PR) were measured before and after drug administration, as well as during and after dental treatment. The Houpt scale was also used for the level of sedation before, during and after treatment. Data were analyzed using Wilcox-on signed rank test and the paired t-test.Sedative success rate was 64.3% in cases of MH and 33.3% in CHH. The difference between groups was significant (P=0.046). The success rate was significantly different between groups at different measurement stages as well (