scholarly journals Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial

2017 ◽  
Vol 10 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Fernando M Baeder ◽  
Daniel F Silva ◽  
Ana CL de Albuquerque ◽  
Maria TBR Santos
Keyword(s):  
Clinical Trial ◽  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Test Analysis ◽  
Significance Level ◽  
Dental Procedures ◽  
Chi Squared ◽  
Student’S T

ABSTRACT Introduction Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Aim This study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR). Materials and methods A total of 77 CP patients >3 years of age with a mean age of 11.8 (± 6.4) years were evaluated in a rehabilitation center. Stress control was measured at the following time points: T1 (presedation), T2 (induction), T3 (sedated patient), and T4 (end). Student's t-test, the Chi-squared test, analysis of variance (ANOVA), and the McNemar test were used. The significance level was 5%. Results Sedation ranged between 10 and 60% N2O, with an average of 35.6% (± 10.4). The RR did not vary among the times (p = 0.12). The HR and VS varied significantly between times (p < 0.001), as significantly higher values of HR were observed at T1. Conclusion Conscious sedation with N2O during dental care controls stress in CP patients, as verified by a decrease in HR, and does not promote respiratory depression. Higher concentrations of N2O are recommended for CP patients with tachycardia. Clinical significance Sedation modifies behavior during dental procedures, facilitating patient collaboration. How to cite this article Baeder FM, Silva DF, de Albuquerque ACL, Santos MTBR. Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial. Int J Clin Pediatr Dent 2017;10(4):384-390.

scholarly journals Risk of respiratory depression at use of nitrous oxide on individuals with cerebral palsy: a clinical trial

2021 ◽  
Vol 10 (13) ◽  
pp. e198101320774
Author(s):  
Fernando Martins Baeder ◽  
Daniel Furtado Silva ◽  
Ana Carolina Lyra de Albuquerque ◽  
Dênis Clay Lopes dos Santos ◽  
Andrea Pavanello ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Respiratory Depression ◽  
Dental Care ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Outpatient Setting ◽  
Significance Level ◽  
Significant Difference ◽  
N2o Titration

The dental care for individuals with cerebral palsy (CP) often result in the referral of patients for general anesthesia. Conscious sedation with nitrous oxide (N2O) could be an alternative resource, from a behavioral and physiological point of view, and could favor dental care in an outpatient setting. This study aimed to evaluate the influence of conscious sedation with N2O on respiratory rate (RR) and oxygen saturation (SpO2) in the dental treatment of individuals with CP. Seventy-seven patients with CP, over 3 years old, regardless of gender and ethnicity, were evaluated with the measurement of N2O titration, RR and SpO2 in four moments: initial, 5 minutes after sedation, 10 minutes after anesthesia and 5 minutes after removal of the N2O. Student's t test and ANOVA F were used, with a significance level of 5%. The variation in N2O titration did not generate significant variation in RR (p = 0.122). There was a significant difference in SpO2 between T1 and other times. It can be said that conscious sedation is not influenced by N2O titration, does not cause respiratory depression or any clinically significant change in SpO2, confirming the safety of use in an outpatient setting.

scholarly journals Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Galeotti ◽  
Annelyse Garret Bernardin ◽  
Vincenzo D’Antò ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Tina Gentile ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Adverse Effects ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Young Patients ◽  
Dental Patients ◽  
Dental Procedures ◽  
Significant Difference ◽  
Disabled Patients

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment.Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy

2004 ◽  
Vol 28 (4) ◽  
pp. 279-284 ◽  
Author(s):  
Juan Pablo Loyola-Rodriguez ◽  
Ana Alicia Aguilera-Morelos ◽  
Miguel Angel Santos-Diaz ◽  
Veronica Zavala-Alonso ◽  
Claudia Davila-Perez ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
School Setting ◽  
Adolescent And Young Adult ◽  
Dental School ◽  
Discharge Process ◽  
Oral Rehabilitation ◽  
Anterior Teeth

The purpose of this report is to find the use of different alternatives for dental treatment, from general anesthesia to conventional techniques, in patients affected by cerebral palsy (CP) in a dental school setting.The sample was divided into two groups: (1) children, and (2) adolescents and young adults; 38 patients (20 female and 18 male) with diagnostic of CP were included. Risks and benefits of conscious sedation and general anesthesia were written into a consent form and these were discussed with parents or guardians of each affected patient.The mean age was 7.14 ± 2.2 years for children's group and 18.5 ± 3.06 years for adolescent and young adult group.Most children (77.3%) were classified as ASA II with a level of behavior I-II according to Frankl's scale and these patients were treated under general anesthesia (GA). For patients that were classified as of positive behavior with little necessity of dental procedures, independent of the medically compromised level, dental treatment was done with conventional techniques or with conscious sedation. Dental frequency procedures were as follows: composites, dental prophylaxis, and dental extractions in children; in adolescents and adults, important to point out is that in anterior teeth and molars endodontic treatment, and surgical procedures increased in frequency. The mixture sevoflurane-propofol worked well during pre-, peri-, and post-operative procedures. During the discharge process, most patients needed a recovery of 20-40 minutes, after which they were awake and oriented, breathing comfortably with stable vital signs. It was concluded that GA with sevoflurane-propofol and conscious sedation are an excellent tool to provide dental treatment in CP patients in a dental school setting without most of the major postoperative complications, such as nausea and vomiting.

scholarly journals Current Novel Caries Diagnostic Technologies: Restorative Dentists’ Attitude and Use Preferences

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1387
Author(s):  
Hani M. Nassar ◽  
Hanin E. Yeslam
Keyword(s):  
Dental Treatment ◽  
Treatment Plan ◽  
Cross Sectional Study ◽  
Ease Of Use ◽  
High Price ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Significance Level ◽  
Chi Squared ◽  
Diagnostic Technologies

Early detection of caries lesions is key to a successful restorative dental treatment plan. The aim of this study was to investigate the preferences and attitude of graduate restorative dentistry residents (RDRs) regarding novel caries diagnostic technologies (NCDT) and to provide a brief overview of available technologies for both specialized and general dental practice. This cross-sectional study used an online questionnaire (17 questions) concerning RDRs’ attitude, preferences, and insights regarding five available NCDTs. It was distributed among twenty RDRs at a local government dental school following a review session about NCDTs. Collected responses were analyzed statistically using one-way analysis of variance (ANOVA), chi-squared with Bonferroni correction, and Kruskal-Wallis tests at a 0.05 significance level. Sixty-five percent of RDRs reported an interest in NCDTs as a discussion topic and almost half of them were positive towards their use, however, sixty percent of respondents were hesitant to diagnose caries solely using NCDTs. Fiber-optic-transillumination (FOTI) systems were ranked the best overall and with regard to all the investigated criteria (p < 0.05). Chosen reasons for FOTI included price followed by ease of use. In general, high price rated as the most perceived reason for not choosing a given NCDT followed by low practical applicability. Meanwhile, ease of use followed by relevant application ranked as the main reported reasons to choose an NCDTs.

scholarly journals Bacteriemia during endodontic treatment in relation to the technique of biomechanical preparation: randomized clinical trial

2005 ◽  
Vol 13 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Adriane Tenório Dourado ◽  
Arnaldo de França Caldas Junior ◽  
Diógenes Ferreira Alves ◽  
Creso Abreu Falcão
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Blood Cultures ◽  
Endodontic Treatment ◽  
Significance Level ◽  
Exact Test ◽  
Group I ◽  
Three Samples ◽  
Root Canal System ◽  
Student’S T

OBJECTIVE: The aim of this randomized clinical trial was to evaluate the frequency of bacteriemia during endodontic treatment, with comparison between two techniques for biomechanical preparation of the root canal system. MATERIALS AND METHODS: The sample comprised 50 patients aged 16 to 52 years, of both genders, which were divided into 2 groups with 25 patients each. Group I underwent biomechanical preparation by the step-back technique, and Group II was treated by the rotary technique with nickel-titanium instruments (K3). Patients were submitted to antisepsis of the oral cavity with chlorhexidine digluconate and three samples of blood were collected for blood culture: preoperatively, immediately after the biomechanical preparation and 10 minutes later. The significance level adopted was 5.0%, and analysis was performed by descriptive and inferential statistics by means of the Fisher's exact test, Fisher-Freeman-Halton test and Student's t test. Data were analyzed on the Statexact and SPSS softwares. RESULTS: All blood cultures achieved before and immediately after preparation were negative. On the other hand, with regard to the blood cultures collected 10 minutes after preparation, one (4%) positive case was found for Group I. However, this difference was not statistically significant (p = 0.50). CONCLUSION: The frequency of bacteriemia was low and observed just for Group I.

Oxygen Saturation and Pulse Rate Change in Children during Sedation with Oral Midazolam and Nitrous Oxide

2018 ◽  
Vol 42 (6) ◽  
pp. 461-464
Author(s):  
Sigalit Blumer ◽  
Rabea Iraqi ◽  
Roly Bercovich ◽  
Benjamin Peretz
Keyword(s):  
Nitrous Oxide ◽  
Oxygen Saturation ◽  
Pulse Rate ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Retrospective Chart Review ◽  
Pediatric Dentistry ◽  
Oral Midazolam ◽  
Clinically Significant

Objective: We aimed to examine if changes in oxygen saturation and pulse rate of pediatric patients during conscious sedation with midazolam and nitrous oxide are associated with child's behavior, midazolam dose, the type and duration of the treatment and demographic parameters. Study Design: This study was a retrospective chart review of consecutive pediatric patients, aged 2.5–12.5 years, who had undergone conscious sedation for dental treatment with oral midazolam (with or without nitrous oxide) between January 2011 and September 2015 at the Department of Pediatric Dentistry of Tel Aviv University. Oral midazolam was administered according to the patients' weight, either at 0.4 mg/kg, 0.5 mg/kg or at a maximum dose of 10 mg. In all cases pulse rate and oxygen saturation were monitored every 15 minutes during treatment, Results: 147 sedation sessions (82 of females and 65 of males) were included in the study. Sedation was successful in 80% of cases. Children with poor behavior scores had statistically significant different mean saturation levels, albeit within normal range, during the treatment (p&lt;0.012) as well as a clinically significant higher mean pulse rate (p=0.0001), compared to children with good or excellent behavior scores. Treatment duration, the type of dental procedure or the patients' weight were not correlated with the change in oxygen saturation or pulse rate during the treatment. Conclusions: Poor behavior of pediatric patients does not affect oxygen saturation, but it increases the pulse rate of children under sedation with midazolam and nitrous oxide.

Comparison of Three Conscious Sedation Regimens for Pediatric Dental Patients

2007 ◽  
Vol 31 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Javier Torres-Pérez ◽  
Israel Tapia-García ◽  
Miguel Ángel Rosales-Berber ◽  
Juan Francisco Hernández-Sierra ◽  
Amaury de Pozos-Guillén
Keyword(s):  
Clinical Trial ◽  
Chloral Hydrate ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Rating Scale ◽  
Dental Treatment ◽  
Clinical Success ◽  
Dental Patients ◽  
Group A ◽  
Group B

The aim of this study was to compare the clinical success of three conscious sedation regimens for pediatric dental patients. A clinical trial was performed wherein dental treatment was administered to pediatric patients ASA I and II under conscious sedation.. Fifty-four children were divided into three groups of 18 patients each, randomly assigned. Group A received hydroxyzine (2mg/kg 2 h before treatment and a subsequent dose of 1 mg/kg 20 min before treatment) orally; group B received 0.50mg/kg midazolam mixed with 1.5 mg/kg hydroxyzine 20 min before treatment orally; group C received chloral hydrate, 50 mg/kg mixed with 1.5mg/kg hydroxyzine 20 min before treatment orally. The Ohio State Behavioral Rating Scale (OSBRS) showed statistically significant differences between groups B and C with respect to group A. The regimens of midazolam or chloral hydrate mixed with hydroxyzine represent excellent choices for conscious sedation regimens for pediatric dental patients.

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