Dental Treatment Research Articles

Imaging Findings, Complications, and Mimics after Common and Advanced Dental Procedures.

Various new dental treatment methods have been introduced in dental clinics, and many new materials have been used in recent years for dental treatments. Dentistry is divided into several specialties, each offering unique treatments, such as endodontics, implantology, oral surgery, and orthodontics. CT and MR images after dental treatment reveal a variety of hard- and soft-tissue changes and dental materials, which often cause image artifacts. Familiarity with posttreatment changes and dental materials is crucial to avoid misinterpretation of image artifacts as true pathologic features, identify complications, and evaluate for recurrent disease. It also is necessary to be aware of conditions that mimic posttreatment changes and know how to differentiate them at imaging. The authors focus on the imaging of expected and unexpected post-dental treatment changes and characteristics of dental materials on CT and MR images in the head and neck region. The article is divided into five sections: (a) imaging after dental implant treatment, (b) imaging after oral surgery, (c) imaging after endodontic treatment, (d) imaging after orthodontic treatment, and (e) imaging effects of dental treatments. Strategies are provided for distinguishing true pathologic features from posttreatment changes, and the importance of understanding dental procedures, the materials used, and their appearances at radiologic imaging is highlighted. Ultimately, this knowledge can enhance radiologists' ability to interpret complex posttreatment imaging findings, improve diagnostic accuracy, and facilitate effective treatment planning for patients with a history of dental procedures. ©RSNA, 2025 Supplemental material is available for this article.

Dental management of people with congenital hemophilia: An integrative review of case reports and case series from a global scenario.

To analyze the various dental management strategies adopted to manage patients with hemophilia in a dental clinical setup. An electronic database search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Web of Science, and EMBASE databases from January 2000 to August 2023 for case reports and case series published in English language. Case reports addressing the dental treatments for people with hemophilia A/hemophilia B were included. Cases of acquired hemophilia and cases of hemophilia who are inhibitor positive were excluded. There was a total of 286 articles that were identified of which 24 reports were included for the review. This included 20 case reports and four case series which addressed various dental treatment procedures performed on people with mild/moderate/severe hemophilia A or hemophilia B. A total of 28 patients were presented with a mean age of 20.4 years. The pre-treatment factor ranged from 200 to 2500 IU and the post-treatment factor range was 1000-3000 IU. There was a wide range of variation in the utilization of prophylactic factors for dental treatment procedures among people with hemophilia. This variation highlights the need for larger prospective clinical studies that address the rationale for using clotting factor concentrate and its impact on dental treatment outcomes for individuals with mild, moderate, or severe hemophilia.

Assessment of silver-copper co-loaded mesoporous bioactive glass as an advanced pulp-capping material.

To evaluate the multifunctionality of silver-copper co-loaded mesoporous bioactive glass (MBG), with the goal of developing an advanced pulp-capping material. The synthesis of materials was conducted using the sol-gel method, following the approach described in previous studies but with some modifications. The composition included 80 mol% SiO₂, 15 mol% CaO, and 5 mol% P₂O₅, with additional components of 5 mol% silver, 5 mol% copper, or 1 mol% silver combined with 4 mol% copper, designated as Ag5/80S, Cu5/80S, or Ag1Cu4/80S, respectively. Furthermore, crystal phases, surface morphology, and ion-releasing activity were analyzed using X-ray diffraction (XRD), transmission electron microscopy (TEM), and inductively coupled plasma mass spectrometry (ICP-MS), respectively. Human umbilical vein endothelial cells (HUVECs) were employed to assess wound-healing effects, while human dental pulp stem cells (hDPSCs) were utilized to evaluate osteogenic effects. Textural analyses indicated that Ag1Cu4/80S was successfully synthesized using modified procedures, demonstrating comparable ion co-releasing activity. Ag1Cu4/80S exhibited low toxicity and high cell proliferation rates, with a migration rate of 46 %, significantly higher than the <10 % observed in other groups. In terms of osteogenesis, hDPSCs treated with Ag1Cu4/80S displayed enhanced alkaline phosphatase activity, with mineralization levels 1.6-fold greater than those of untreated controls. The synthesis of Ag1Cu4/80S was successfully optimized. This material demonstrated significant wound-healing and comparable osteogenic effects relative to other tested materials, highlighting its potential for dental applications. Ag₁Cu₄/80S demonstrated a comparable effect on osteogenesis, indicating its potential to promote mineralization and suggesting its applicability in dental treatments.

Treatment outcomes in adult patients experiencing dental anxiety: A comparative retrospective study.

To assess and compare the effectiveness of pharmacological and cognitive-behavioral modalities-behavioral methods (BM), nitrous oxide inhalation sedation (NOIS), and premedication with Diazepam-for alleviating anxiety during dental treatment, using completed treatment sessions and adverse outcomes as indicators. For 239 patients (515 dental records), 18-53 y/o, who underwent dental treatments under anxiety reduction measures, sessions under NOIS were categorized as "nitrous group" (456 sessions) versus premedication with Diazepam or behavioral strategies (control, 59 sessions). Outcomes were completed treatment sessions considering demographic and clinical parameters, and adverse outcomes during and between sessions. Adjusted logistic regression showed significantly higher odds of completing treatment sessions after NOIS (p = 0.014) as compared to controls. Univariate analyses demonstrated failure of anesthesia was higher in the control versus the nitrous group (p<0.001). Adverse outcomes were more frequent in controls (p=0.005). No significant effects of age, gender, and general health condition on completion rates of treatment plans were demonstrated. The complexity of the treatment plan had a significant effect on its completion (p = 0.03). NOIS modality yielded significantly superior outcomes as compared to BM and premedication with Diazepam, with no significant effects of age or gender on the completion of treatment plans.

The effects of compassionate care on oral health outcomes: A scoping review.

To access and synthesize the existing literature about the effects of compassionate care on oral health outcomes. A scoping review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles from six electronic databases: MEDLINE via the PubMed interface, Embase, Age-Line, Scopus, CINAHL, and Cochrane. Among 30 studies reporting on compassion in dental treatment, only two reported on the effects of compassionate care on oral health outcomes. One study is cross-sectional and evaluated oral health outcomes in children, while the other is a cohort study evaluating oral health outcomes in older adults. Each study used different tools to assess oral health outcomes. However, both studies used the Jefferson Scale of Physician Empathy (JSPE) to assess empathy among dental students, dentists, or dental hygienists. The retrieved studies used different methodologies and had discrepant results. More clinical studies investigating the effects of compassionate care on the outcomes of dental treatment are necessary.

Accuracy of teledentistry versus clinical oral examination for aged-care home residents: A pilot study.

The aim of this pilot study is to assess the feasibility of using the mobile photographic method (m-health) of teledentistry for oral screening and triaging of older patients living in aged care homes. The study took place in 2023 in four aged care facilities in Egypt. Three trained dentists performed clinical oral examinations of the participants and filled in the World Health Organization (WHO) oral health assessment form. Afterwards, five intraoral photographs were taken for each participant and independently examined by three calibrated dentists for caries detection and decision on intervention urgency for proper dental referral. Agreement between the testing modalities was analyzed using Cohen's kappa coefficient, and the significance level was set at p < 0.05 within all tests. The results indicated that teledentistry had higher specificity than sensitivity in caries detection compared to clinical examination. The level of agreement between the teledentistry examination and the clinical oral examination for caries assessment ranged from (k = 0.36) to (k = 0.58) showing fair to moderate agreement. Also, all teledentistry examiners showed almost perfect statistically significant intra-rater and inter-rater agreement for caries detection (K ≥ 0.82, p < 0.001). Moreover, intervention urgency scoring showed moderate to substantial agreement between the testing modalities with kappa values ranging from (k = 0.48) to (k = 0.65). The mobile photographic method of teledentistry offers a feasible model that helps in oral examination and triaging dental treatment of older patients living in aged care facilities. However, larger studies with proper sample size are required which will allow better generalizability of the results.

The differences patient anxiety level based on age, sex, education level and extraction experience in tooth extraction treatment at dental hospital IIK Bhakti Wiyata

Background: Dental anxiety is a significant concern in dental practice, impacting both patients and dentists. Patients experiencing anxiety and fear often exhibit heightened stress levels, which can complicate treatment procedures and negatively impact the overall patient experience. This anxiety, in turn, creates a considerable source of stress for dentists. Managing anxious patients requires additional time, patience, and communication skills, potentially increasing the emotional and psychological burden on dental professionals.Tooth extraction is also the biggest cause of dental anxiety. Purpose: This study aims to determine differences in patient anxiety levels based on gender, age, education level and experience of extraction using the Modified Dental Fear Survey (MDFS) method in tooth extraction treatment at RSGM IIK Bhakti Wiyata. Methods: This study used an analytic observational design with a cross sectional approach. The population of this study were all patients who had their teeth extracted at RSGM IIK Bhakti Wiyata. The sample were all patients who had their teeth extracted at RSGM IIK Bhakti Wiyata who met the criteria. The level of anxiety in the sample was measured using the Modified Dental Fear Survey (MDFS) questionnaire prior to tooth extraction. Results: There were differences in patient anxiety levels based on gender and extraction experience (P=0.00) and patient anxiety levels based on age (P=0.017) but there were no differences in patient anxiety levels based on education level in dental extraction treatment (P=0.122). Conclusion: Gender plays a crucial role, with women typically experiencing higher anxiety levels compared to men. Interestingly, age and educational background did not significantly influence anxiety.

Trends in dentomaxillofacial radiology.

Oral and maxillofacial diagnostic imaging is of paramount importance in dental clinical diagnosis, treatment planning, and follow-up procedures. Periapical radiographic examination and numerous panoramic systems are used in routine clinical dental practice. Cone beam CT is widely used and currently the method of choice in oral and maxillofacial implantology, endodontics, maxillofacial surgery, periodontics, degenerative temporomandibular joint disease, orthodontics, airway studies, sleep disorders, and forensic dentistry. Another innovative laboratory research tool that offers three-dimensional (3D) detailed high-resolution images of in vitro teeth and neighboring structures with submicrometric accuracy is microcomputed tomography. Ultra-high radiation doses, long scanning times, and high costs preclude its routine clinical use. In response to the high demand for a technique that could provide real-time images using a cost-effective, rapid, user-friendly, and portable technique without ionizing radiation, some authors proposed ultrasound imaging methods as an alternative to X-ray imaging techniques. Ultrasonography can be used in the dentomaxillofacial region for various diagnostic purposes such as salivary gland and superficial tissue examination. Recently, dedicated dental magnetic resonance imaging with appropriate software, hardware, sequences, and field of view tailored to fit dentomaxillofacial anatomy was introduced. Lately, 3D printing technologies and their application in dentistry has attracted attention. During 3D printing a given material is added in successive layers to create a 3D object. The application of this technology has the potential to decrease operation time and minimize operator bias and the possibility of procedural errors. Another hot topic regarding dentomaxillofacial radiology is artificial intelligence, which is a field related to computer science dedicated to developing systems or machines that can perform tasks traditionally associated with human intelligence. It is obvious that further investigation and research in the field of dentomaxillofacial radiology will make great contributions to diagnostic imaging for various dental specialties.

Case Study of a Broken Instrument in a Primary Tooth and Literature Review

Background: Root canal treatment is an important element of dental treatment, and broken instruments are one cause of endodontic treatment failure. Broken instruments are rarely reported in primary teeth because of their inherently wider and relatively straighter root canals. We describe a case of a patient with a broken instrument in a primary tooth and reviewed the literature across three databases. Case presentation: A boy aged 7 years and 2 months was referred to our hospital because of pain persisting despite multiple dental treatments. Radiographic examination revealed a broken instrument in the maxillary right primary second molar. The patient experienced dental fear, so the treatment proceeded with the use of behavioral management and nitrous oxide, after which his pain disappeared. At the age of 9 years and 2 months, eruption of the successive permanent teeth was confirmed, and no pathological findings were observed except enamel hypoplasia. We undertook a literature review across three databases and found only two articles about broken instruments in primary teeth, neither of which described the eruption of the permanent teeth. All three cases involved primary molars. Conclusions: We removed a broken instrument from the root of a primary molar and performed root canal treatment, resulting in a good outcome for the primary molar until it was replaced with successive permanent teeth. Although rare, broken instruments in the roots of primary molars do occur, and care should be taken during root canal treatment of primary molars.

Evaluation of the effect of dental caries, oral hygiene, and treatment need on oral health-related quality of life among Turkish orphan children and adolescents

BackgroundThe oral and dental health and related quality of life of orphan children and adolescents—who are considered a vulnerable population—are critical for both individual and public health.ObjectivesThis study aimed to investigate the status of the dental caries, oral hygiene, and dental treatment needs among a group of Turkish male orphan children and adolescents, as well as their impact on oral health-related quality of life.MethodsA total of 112 orphan children and adolescents aged between 9 and 17 years living in a residential care facility in Istanbul, Türkiye, were involved in this cross-sectional study. A comprehensive examination was conducted on each individual, encompassing the assessment of dental caries using the decayed, missing, and filled teeth (DMFT/dft) index, oral hygiene using the debris (DI-S), calculus (CI-S), and simplified oral hygiene (OHI-S) indices, and dental treatment need using the treatment need index (TNI). Oral health-related quality of life was evaluated using the validated Turkish version of the Child Oral Health Impact Profile-Short Form (COHIP-SF-19). The relationship between oral health-related quality of life and explanatory variables was evaluated using a multivariable linear regression model.ResultsThe mean age of the participants was 12 ± 1.79 years. The mean DMFT score was 4.57 ± 3.42, and the mean OHI-S score was 1.4 ± 0.52. Participants had a mean COHIP-SF-19 score of 57.79 ± 14.11, with 25% requiring at least one tooth to undergo radical treatment. Multivariable linear regression analysis indicated that the DMFT score (p = 0.009) and the need for radical treatment (TNI code 6) (p < 0.001) had a statistically significant impact on oral health-related quality of life among orphan children and adolescents aged 13–17.ConclusionsThis study underscores that dental caries and the need for radical treatment significantly impact the oral health-related quality of life of orphan children and adolescents.

ML-based tooth shade assessment to prevent metamerism in different clinic lights

The aesthetic understanding has found its place in dental clinics and prosthetic dental treatment. Determining the appropriate prosthetic tooth color between the clinician, patient and technician is a difficult process due to metamerism. Metamerism, known as the different perception of the color of an object under different light sources, is caused by the lighting differences between the laboratory and the dental clinic. The traditional trial-error color determination method, coupled with the high cost of instrumental color value determination, has prompted the need for alternative technologies. The integration of AI technologies into dental practices aims to minimize errors in tooth shade assessment, reduce equipment usage, eliminate the impact of clinic lighting on color detection, and decrease costs for patients, dentists, and laboratories. In this study, a machine learning (ML) based approach that can correctly detect tooth shade even under different clinical lights has been developed. A dataset consisting of 580 dental images taken under four different clinical lights and with five repetitions was created using the Vita color shade guide. Experimental studies were performed using the HSV color space, 6 different ML algorithms and color histograms. As a result, 97.93% accuracy rate was achieved by using cross-validation (cv = 5) in the classification of 29 color values ​​independent of clinical lights. It has been shown that the tooth colors can be determined with high accuracy using ML algorithms and metamerism can be prevented.

Risk factors and preventive measures for severe orofacial and neck infections: a three-year observational study

BackgroundThe purpose of this study was to identify the risk factors of severe orofacial and neck infections and the factors that could prevent them and reduce their severity.MethodsA three-year prospective observational study was conducted from 8.15.2016 to 8.31.2019 at a tertiary care hospital. 94 patients participated the study. The criteria for inclusion in the study were that the patients were adults with neck and severe orofacial infections that required treatment in hospital. Patients under the age of 18 and patients who did not consent to participate in the study were excluded. The responses to the questionnaire designed for this study were collected, as was supplemental data from medical records. The patient data were analyzed. Length of stay (LOS), intensive care unit (ICU) stay, complications and mortality were used as the main outcome variables, and various pre-admission factors and clinical and laboratory parameters were used as the predictor variables. The method used was univariate analysis.ResultsIn 79 (84.0%) cases, surgery confirmed an abscess and pus. Age (p = 0.001) and underlying diseases (p = 0.024) contributed to complications. Bulging of the lateral pharyngeal wall or laryngeal swelling on admission was significantly related to the need for intensive care treatment (p < 0.001). The spaces most often involved were the submandibular (n = 15; 16.0%), sublingual (n = 15; 16.0%) and parapharyngeal (n = 14; 14.9%) spaces. Sixty-three cases (67.0%) were of odontogenic origin, and 58.5% of the patients reported having attended previous health care appointments due to an acute dental problem. The patients with odontogenic infections had poor oral hygiene and most likely did not brush their teeth daily (p = 0.029). “Dishwater” pus was associated with longer hospitalization (p < 0.001), intensive care treatment (p < 0.001), and surgical revisions (p < 0.001). One lethal outcome (1.1%) was reported.ConclusionAge and underlying illnesses should be considered complicating factors, and lateral pharyngeal or laryngeal edema should be considered risk factors for ICU treatment. This study also emphasized the preventive role of good dental hygiene and the importance of patients’ follow-up treatment after acute dental interventions.

Role of Injectable Platelet-Rich Fibrin in the Management of Soft and Hard Tissue Periodontal Regeneration in Dentistry: Protocol for a Systematic Review.

Injectable platelet-rich fibrin (i-PRF) has the capacity to release great amounts of several growth factors, as well as to stimulate increased fibroblast migration and the expression of collagen, transforming growth factor β, and platelet-derived growth factor. Consequently, i-PRF can be used as a bioactive agent to promote periodontal tissue regeneration. We aim to compare and evaluate the effectiveness of i-PRF in periodontal tissue regeneration. We will conduct an electronic search in the following databases: PubMed, Cochrane Library, Google Scholar, Semantic Scholar, Scopus, and Web of Science. Papers will be restricted to those in English and to those that are randomized controlled trials comparing PRF or any other biomaterial with i-PRF for periodontal regeneration during dental treatment. The included papers in this review and the reference lists of pertinent reviews will be manually searched. The selection of studies, data extraction, and assessment will be carried out separately by 2 reviewers using the Risk of Bias 2 tool for the included research. The success of i-PRF will be evaluated by comparing the mean difference in periodontal regeneration of soft and hard tissues in terms of gingival recession, probing pocket depth, clinical attachment level, bone gain, and gingival width. The combined effect size measurements and the associated 95% CIs will be estimated using a random-effects model. The synthesis or work for this systematic review started in October 2023 and will last until December 2025. i-PRF may play a role in dentistry and could enhance soft and hard tissue regeneration. PROSPERO CRD42023464250; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=464250. PRR1-10.2196/65137.

Factors associated with dental care utilization among Iranian adult populations based on Anderson model

BackgroundThe utilization of dental care is affected by different factors. Despite the importance of dental care, there are significant disparities in its utilization among various population groups. The aim of this study was to identify the main factors of dental care utilization and the influences of the Health Transformation Plan (HTP) in Iran based on the Anderson model.Methods and materialsThis cross-sectional house-by-house study was conducted during Aug-Nov 2022 among 704 adult people in two cities under the coverage of the HTP and two cities out-side the plan using a multi-stage sampling method. Dental visit in the last year was considered as the utilization of the dental services. Independent Factors included the contextual, individual enabling, individual predisposing and individual need factors based on the Andersen model. Personal health behaviors were also assessed. Statistical analysis was conducted using Chi-square tests, simple and multivariable logistic regression models (α < 0.05).ResultsThe 63.1% of the participants covered by the HTP and 57.7% of the population outside the plan sought dental care in the past year. In the final model individuals in the 35–44 age group (OR = 1.5, 95% CI = 1.02–2.2), males (OR = 1.7, 95% CI = 1.2–2.5), single individuals (OR = 1.4, 95% CI = 1.01-2) and those with the perception of need for dental treatment (OR = 2.1, 95% CI = 1.3–3.4) had higher chance of dental visit. Better perceived oral health status was associated with lower chance of visiting the dentist (OR = 0.9, 95% CI = 0.8–0.9). Being covered by the HTP was not significantly in association with the chance of dental visit in the last year (p value = 0.19, OR = 0.78, 95%CI = 0.55–1.12).ConclusionThe predisposing factors including age, gender, marital status, and perceived oral health status and perceptions of dental need were the main factors in association with the dental utilization behavior among adults and the coverage by the HTP did not have significant effect on it.

Clinical Anatomy of the Maxilla

The upper jaw is the most important structure of the middle third of the face. It is of great functional and aesthetic importance, and is also a clinically critical area in which a variety of surgical interventions are performed, such as the installation of dental implants, cyst removal, and endodontic dental treatment. To avoid iatrogenic complications of these manipulations (bleeding and/or neurological disorders), detailed knowledge of maxillary anatomy is required. This review, based on modern literature data and our own observations, outlines the clinical anatomy of the upper jaw with a description of the features of its morphology, identified using cone beam computed tomography, a modern technology for visualizing the bone structures of the maxillofacial region used in clinical practice. A description of a number of structures, such as the accessory infraorbital foramina, canalis sinuosus, alveolo-antral artery, nasopalatine (incisive) canal and maxillary sinus septa, is absent in human anatomy textbooks for students and is not detailed in Russian-language medical journals. The article presents radiographic images of these structures, their linear dimensions, frequency of occurrence in the population, and provides classifications of individual variants of intraosseous canals. The practical significance of each of these anatomical variations is discussed. All images used in the article are original and have not been published previously.

Can a low-threshold check-up motivate older adults to schedule a dental visit? Study protocol for a randomized controlled trial

BackgroundMost oral diseases benefit from early detection by dental professionals. However, in the older population, regular dental attendance is low. This trial investigates whether a low-threshold check-up by a dental professional in a non-dental setting can motivate older persons to seek professional oral care.MethodsA total of 194 community-dwelling persons aged 65 years and older, without a dental check-up over the last 12 months, will be recruited for this randomized, controlled, two-arm, single-blinded, superiority trial with a 1:1 allocation ratio. The intervention group will receive an oral examination including tailored oral health information. They will also be informed about the importance of regular dental visits and will be provided with referral letters for the dental professional and the family physician and a list of nearby dentists. In the control group, the oral examination including tailored information will not be performed. This group will only receive flyers with general oral hygiene information and a list of nearby dentists. The primary outcome is whether or not the participants will contact a dental professional within four months after the intervention.DiscussionThis study examines the efficacy of a low-threshold dental check-up intervention to motivate older adults to contact a dental professional and reactivate them into primary oral care, addressing barriers to oral care such as low health literacy, subjective treatment need, and dental anxiety. Key strategies include enhancing oral health knowledge, identifying existing oral issues, and involving family physicians. The study, set to run from April 2024 to March 2025, aims to inform future evidence-based oral health promotion strategies for community-dwelling older adults.Trial registrationClinicalTrials.gov NCT06341959. Registered on 25 April 2024.

Oral health disparities in early childhood and intergenerational gaps among noncitizen migrants, Arabs, and Jews in South Tel Aviv, Israel

IntroductionDisparities in oral health are related to dental care knowledge, domestic oral hygiene practices and socioeconomic status. This cross-sectional study aimed to compare the oral hygiene and dental care practices of migrant, Arab, and Jewish children residing in Tel Aviv, Israel, and assess the influence of parental dental practices.MethodsData were collected from parents of children aged 3 to 6 years. Parents completed their own and their children’s oral health status, oral hygiene practices, dietary habits and dental care knowledge.ResultsOf the 504 children, 153 (30.4%) were migrants, 117 (23.2%) were Arabs, and 234 (46.4%) were Jews. Twice-daily tooth brushing was reported by 57.5% of migrant children, 47% of Arab children, and 63.7% of Jewish children (p = 0.001). Compared with Arab and Jewish children, migrant children had higher rates of tooth filling and urgent dental interventions under general anesthesia (22.9%, 11.1%, and 9%, respectively; p < 0.001). The parent‒child association for twice-daily tooth brushing was strong overall (69.8%), particularly among migrants (70.9%) and Jews (72.3%), but weaker among Arabs (63.0%), p < 0.01.ConclusionMigrant children exhibited better tooth brushing habits than Arab children did but required more urgent dental interventions, highlighting gaps in preventive care. The strong parent‒child link in oral hygiene, particularly among migrants and Jews, suggests that culturally sensitive, family-focused interventions could help reduce these disparities and improve dental health outcomes for underserved populations.

Impact of dental treatments under general anesthesia on oral health-related quality of life in children: a comprehensive meta-analysis

BackgroundChildren’s oral health significantly impacts their overall well-being, daily activities, and social interactions. Dental treatments under general anesthesia are often required for extensive dental problems, special health care needs, or dental phobias, particularly in pediatric populations. The objective of this meta-analysis was to systematically review and synthesize existing research on how dental treatments under general anesthesia affect the oral health-related quality of life (OHRQoL) in children.MethodsThe electronic databases such as PubMed, EMBASE, Ovid MEDLINE, Web of Science, and Scopus were systematically reviewed following PRISMA guidelines to identify studies evaluating OHRQoL changes after dental treatments under general anesthesia. Studies involving ECOHIS and COHRQoL scales in pre- and postoperative assessments were included. The mean differences between scale measurements before and after dental treatments under general anesthesia were reported as the standard mean difference (SMD), and effect sizes for Hedges’ g were classified as follows: small effect (0.2), medium effect (0.5), large effect (0.8). All meta-analysis statistical computation was carried out using the Hartung-Knapp-Sidik-Jonkman method for the random effects model.ResultsA total of 36 papers satisfied the inclusion criteria and were subsequently included in the investigation. In the pooled analysis, treatments under general anesthesia in children improved OHRQoL (ECOHIS) in the short term with a significantly large effect size (SMD = 1.66, 95% CI: 1.07–2.24, p < 0.001; τ2 = 2.18, I2 = 98.9, p < 0.001). Similarly, dental treatment under general anesthesia increased the COHRQoL score in children with a significantly large effect size (SMD = 1.32, 95% CI: 0.81–1.84, p < 0.001; τ2 = 0.78, I2 = 97.3, p < 0.001).ConclusionThe findings of this meta-analysis suggest that there was evidence that OHRQoL of children receiving dental treatment under general anesthesia improves with a large effect size in the short-term following treatment.

Effect of Dental Throat Pack Used Under General Anesthesia in Children with Special Healthcare Needs on Postoperative Nausea, Vomiting, and Sore Throat: A Randomized Clinical Trial.

Background/Objective: Throat packs are widely used during orofacial surgery to reduce the frequency of postoperative nausea and vomiting (PONV). However, evidence supporting their use is mixed, with associated risks such as postoperative sore throat and the possibility of being forgotten in situ. Methods: The aim of this study is to evaluate the effectiveness of throat packs in preventing PONV and postoperative sore throat during dental treatments under general anesthesia in children with special healthcare needs (SHCNs). Eighty children with SHCNs were randomized into two groups: throat packing (Group TP, n = 41) and no throat packing (Group n-TP, n = 39). A throat pack was used in Group TP, and PONV and sore throat were evaluated at 1, 2, and 4 h postoperatively. Statistical Package for Social Sciences (SPSS) version 23.0 was used for data analysis. The registration number at ClinicalTrials.gov is NCT06169306, registered on 28 December 2023. Results: Patients in Group n-TP showed significantly higher PONV values at 1 and 2 h postoperatively (p < 0.001, p = 0.019, respectively). Visual Analog Scale (VAS) values were also significantly higher in Group TP at 1 and 2 h postoperatively (p < 0.001, p = 0.002, respectively). Conclusions: Using throat packs in dental treatments under general anesthesia for children with SHCNs reduced the incidence of PONV but increased the incidence of postoperative sore throat.

Anaesthetic efficacy of intraligamentary injection compared to incisive nerve block using 3% mepivacaine hydrochloride: a randomized clinical trial

BackgroundIn dentistry, local anesthetic is frequently used to manage pain throughout several phases of dental treatments, including tooth extraction. The study aimed to compare the effectiveness of two techniques for controlling pain during mandibular exodontia (tooth extraction), specifically focusing on the pain experienced during injection and extraction of mandibular anterior and premolars teeth. The two techniques being compared are the intraligamentary injection technique (ILI) and the incisive nerve block technique (INB).Materials and methodsIn this study, 100 mandibular anterior and premolars and teeth that were indicated for extraction were included. The effectiveness of the two local anaesthesia techniques, intraligamentary injection technique (ILI) and incisive nerve block (INB), were compared using Modified Dental Anxiety Scale for Dental Extraction Procedure (MDAS-DEP) and visual analogue scale (VAS) during the injection and extraction stages of the procedure.ResultsA total of 100 participants (42 females, 58 males) with a mean age of 50.97 ± 11.59 years took part in the study. The mean VAS score in the INB group was 6.14 after injection and 3.86 after extraction, while in the ILI group, it was 5.46 and 2.90, respectively. There was a statistically significant difference between the two groups both after injection (p = 0.001) and extraction (p < 0.001), as well as within each group (Control: p < 0.001; Study: p < 0.001). For MDAS-DEP, the INB group had mean scores of 15.86 and 11.26 after injection and extraction, respectively, while the ILI group had scores of 15.68 and 10.94, showing a significant difference within each group after both injection (p < 0.001) and extraction (p = 0.001). However, no significant difference was found when comparing MDAS-DEP scores between the two groups from injection to extraction (p = 0.802).ConclusionThe intraligamentary injection technique (ILI) appears less painful during injection and provides profound pain relief during extraction. The results suggest that ILI can be used as a sole anaesthetic technique during extraction of lower anterior and premolar teeth.Trial registrationThis trial was retrospectively registered on 27/01/2023 with the identifier ISRCTN83272316 in Isrctn.com.