Children-Basel最新文献

{"title":"Sensory Integration Therapy for Preschool Children with Autism Spectrum Disorder and Co-Occurring Intellectual Disability: An Exploratory Single-Group Pre-Post Study.","authors":"Hirotsugu Nakamura, Kiyomi Tateyama, Kazuyo Nakaoka, Toshihiro Kato","doi":"10.3390/children13040569","DOIUrl":"10.3390/children13040569","url":null,"abstract":"<p><p><b>Background:</b> Occupational therapists often provide sensory integration therapy (SIT) as part of interventions for children with autism spectrum disorder (ASD). However, evidence supporting its effectiveness remains limited. Therefore, this study aimed to explore the potential benefits of once-weekly SIT for children with ASD and co-occurring intellectual disability. <b>Methods:</b> A non-blinded single-group pre-post study was conducted using SIT once a week for 8 weeks. Participants were children aged 2-6 years who had been diagnosed with ASD, had a developmental index score of ≤70, and were classified as having severe autism according to the Childhood Autism Rating Scale. Outcome measures included the Goal Attainment Scaling (GAS), Vineland Adaptive Behavior Scales, Second Edition (VABS-II), Short Sensory Profile (SSP), and Parenting Stress Index, Short Form (PSI-SF). Data were analyzed using the Wilcoxon signed-rank test to compare pre- and post-intervention results. <b>Results:</b> Ten children completed the full intervention protocol. Changes were observed in some domains of the GAS and VABS-II; however, these findings were characterized by substantial uncertainty and considerable variability across participants. In contrast, no apparent changes were observed in the SSP or PSI-SF. <b>Conclusions:</b> The findings of this study do not support the effectiveness of sensory integration therapy (SIT) and should not be interpreted as evidence of intervention-related benefit. Rather, the results should be considered as exploratory observations obtained under real-world clinical conditions. Future research employing more rigorous designs, including the use of control groups, larger sample sizes, and blinded assessments, is required.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disturbance Trajectories in Critically Ill Children Post-ICU Discharge: A Longitudinal Observational Study.","authors":"Wenchao Wang, Xiaorui Fan, Yuxia Yang, Jos M Latour, Guoping Lu, Ying Gu","doi":"10.3390/children13040568","DOIUrl":"10.3390/children13040568","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Sleep disturbances have an impact on children's physical and psychological development, yet little is known about the changes and factors influencing sleep after PICU discharge. To explore the trajectory of changes in sleep quality of critically ill children and to identify factors affecting sleep quality three months after Pediatric Intensive Care Unit (PICU) discharge. <b>Methods</b>: A longitudinal observation study was conducted between November 2022 and November 2023 at a tertiary children's hospital. The Children's Sleep Habits Questionnaire (CSHQ) was used at six time points: PICU-admission (T0), 1 week (T1), 2 weeks (T2), 1 month (T3), 2 months (T4), and 3 months (T5) after PICU discharge. The CSHQ is a 33-item parent-report outcome measure evaluating sleep problems. Total scores range between 33 and 99 points. A score of ≤41 indicates normal sleep; a score of >41 indicates sleep disturbance. Data were analyzed using the latent category growth model, univariate analysis, and multifactorial logistic regression. <b>Results</b>: Parents of 237 children completed all follow-up surveys. Prevalence of sleep disorders at T0-T5 of children with a score >41 were 46.5%, 83.5%, 69.7%, 54.3%, 50.2%, and 51.7%, respectively. General linear modeling revealed significant changes in CSHQ scores over time (F = 63.77, <i>p</i> < 0.05). The trajectories of identifying sleep changes were divided into three latent categories: High Sleep Disorder Group (n = 15, 6.33%), Moderate Sleep Disorder Group (n = 110, 45.2%), and No Sleep Disorder Group (n = 115, 48.52%). The trajectories were significantly different among preschool age, baseline sleep habit scores, surgery, and length-of-stay in pediatric wards (<i>p</i> < 0.05). The child's age and surgical history were independent factors of sleep disturbance. <b>Conclusions</b>: The observed peak in sleep disturbances at 1-month post-PICU suggests that this period may be a critical window to develop and implement targeted interventions to improve sleep. The persistent sleep disorders highlight the need for long-term monitoring.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Families Implementing Resilient Systems Together (FIRST).","authors":"Ariane Marie-Mitchell, Catherine A Tan, Elizabeth Park, Gabriela A Plascencia, Cameron L Neece","doi":"10.3390/children13040572","DOIUrl":"10.3390/children13040572","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Prior research suggests that it is possible to improve health outcomes in children with adverse childhood experiences (ACEs) through multi-component interventions that promote protective factors. We designed the Families Implementing Resilient Systems Together (FIRST) study to address the gaps in research on the potential effectiveness of screening for specific ACEs through pediatric practice. <b>Methods</b>: As part of our clinical quality improvement efforts to improve patient care for children impacted by ACEs, we trained a random sample of pediatricians on strategies to promote protective factors and encouraged them to make referrals to community health workers (CHWs) and parenting education resources. This manuscript describes our clinic data on practice changes associated with the FIRST physician training, and our data collection plan for our research study. <b>Results</b>: Physician training resulted in attitudinal shifts and measurable behavioral changes. Trained providers made referrals to CHWs for approximately 5-10% of well-child care visits. The majority (84%) of referrals were for multiple risk factors, most commonly ACEs and socioeconomic concerns. The most common ACEs were parental divorce/separation, parent-child verbal abuse, and caregiver mental health problems. <b>Conclusions</b>: FIRST training improves counseling, education and referrals for children exposed to ACEs. Our research study will evaluate the impact of the FIRST intervention and address important questions about associations between specific ACEs, protective factors, and biomarkers of toxic stress.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor Competence Profiles in Greek Primary School Children: A Cross-Sectional Multilevel Analysis of Skill-Specific and Contextual Variability.","authors":"Andreas Skiadopoulos, Dimitra Dimitropoulou, Theodoros Ellinoudis, Ermioni Katartzi, Christina Evaggelinou","doi":"10.3390/children13040567","DOIUrl":"10.3390/children13040567","url":null,"abstract":"<p><strong>Background/objectives: </strong>Motor competence is a key indicator of children's developmental readiness and an important component of health and well-being education. It is conceptualized as a latent construct shaped by both individual and contextual factors. The objective of this study was to examine the influence of sex, age and class context on motor competence, with particular emphasis on skill-specific and contextual variability.</p><p><strong>Methods: </strong>Motor competence was assessed in 312 Greek primary school children aged 6-12 years (156 girls) using the Movement Assessment Battery for Children-Second Edition. Standard scores for manual dexterity, aiming-catching, and balance were analyzed using a multilevel modeling approach.</p><p><strong>Results: </strong>Balance showed the highest standard scores, while manual dexterity was the lowest-performing domain. Boys outperformed girls in aiming-catching, with a modest effect. Age effects were domain-specific, with relative age within the classroom negatively associated with manual dexterity but not with other domains. Class-level factors explained substantial variance, indicating heterogeneity across classes.</p><p><strong>Conclusions: </strong>Motor competence in primary school children is strongly domain-specific and meaningfully associated with classroom context. Manual dexterity emerges as a potential priority for curriculum development, and age-related effects appear to operate selectively across domains.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Total Hip Arthroplasty After Childhood Septic Hip Arthritis: A Systematic Review and Meta-Analysis of Infection Risk and Surgical Complications.","authors":"Martina Ilardo, Marco Sapienza, Claudia de Cristo, Maria Agata Musumeci, Paola Torrisi, Noemi Di Paola, Alessia Caldaci, Andrea Vescio, Federico Canavese, Vito Pavone, Gianluca Testa","doi":"10.3390/children13040564","DOIUrl":"10.3390/children13040564","url":null,"abstract":"<p><p><b>Background</b>: Total hip arthroplasty (THA) for the late sequelae of childhood septic hip arthritis is technically demanding, and infection-related risk remains incompletely defined. This systematic review and meta-analysis address the research question: \"In adults undergoing THA after childhood septic arthritis of the hip, what is the incidence of post-THA infection, revision, and mechanical/neurologic complications?\" We systematically reviewed and meta-analyzed outcomes after THA in patients with septic hip arthritis diagnosed at ≤18 years. <b>Methods</b>: PubMed, Web of Science, Scopus, and the Cochrane Library were searched from inception to 31 December 2025 (PRISMA). Eligible studies reported THA outcomes after childhood septic arthritis and met a Methodological Index for Non-Randomized Studies (MINORS) threshold (≥9). A random-effects meta-analysis of events per hip was performed. <b>Results</b>: Nine studies were included; eight contributed to the quantitative synthesis (343 hips). The pooled incidence of any post-THA infection was 1.55% (95% CI 0.38-3.48; <i>I</i>² = 23.8%; 5/343); when microbiology was available, no relapse due to the index organism was reported and events were classified as new infections. The pooled incidence of revision for any cause was 4.99% (95% CI 2.27-8.70; <i>I</i>² = 43.4%; 15/334). Non-infectious complications were clinically relevant, including intraoperative fracture (6.95%) and nerve palsy (4.84%). Evidence was limited by retrospective designs and heterogeneous reporting. <b>Conclusions</b>: THA after childhood septic hip arthritis demonstrates a low risk of postoperative infection, with relapse of the original pathogen appearing rare in carefully selected quiescent cases, but a clinically meaningful burden of mechanical and neurologic complications. These findings underscore the importance of careful preoperative assessment, meticulous surgical technique, and highlight the limitations of the current evidence. The protocol was registered in PROSPERO (ID: CRD420261298181). No external funding was received.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Their Bodies Were Made to Move and Wriggle Right from the Word Go\": A Qualitative Exploration of Family Engagement with Fundamental Movement Skills in Early Childhood.","authors":"Robert J Flynn, Andy Pringle, Clare M P Roscoe","doi":"10.3390/children13040563","DOIUrl":"10.3390/children13040563","url":null,"abstract":"<p><p><b>Background:</b> Fundamental movement skills (FMS) underpin lifelong physical activity (PA) and health, yet many children are failing to meet age-appropriate standards. Caregivers hold a critical influence over children's motor development, but little is known about what helps or hinders family participation, including messaging. This study explored the determinants of family FMS engagement in the United Kingdom (UK) during early childhood, addressing unexplored gaps in how guidance reaches families and the role of grandparents in supporting children's motor development. <b>Methods:</b> Twenty-three semi-structured interviews were conducted with 15 caregivers and 8 educators, including 4 grandparents and 2 family hub practitioners who offered original insights. Eleven children aged 3-5 years completed a flexible draw-and-tell task, enabling inclusion of rarely represented 3-year-olds. Thematic analysis was deployed. <b>Results:</b> Families and outdoor spaces were pivotal to children's movement opportunities. However, awareness and understanding of FMS and UK PA guidance were poor, even among educators, disrupting dissemination of information to families. Greater emphasis on PA and FMS concepts within professional development, alongside clearer signposting to resources, more visible public-facing campaigns, and digital formats, could improve how families receive these messages. Tensions emerged between parents' concerns about grandparents' physical capability and grandparents' belief that they could adapt to support children's development. Unexpectedly, no children drew technology despite screen time frequently displacing active play, hinting at its normalisation and regulatory role in children's lives. <b>Conclusions:</b> To enhance family understanding, value, and participation in FMS, UK policy must evolve to become more visible, relatable, and responsive to diverse family needs.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Models for Training in Pediatric Otologic Surgery: A Systematic Review.","authors":"Elena Carlotto, Serena Cirillo, Stefania Marconi, Silvia Pisani, Mirko Bertozzi, Cesare Chiapperini, Simone Mauramati, Marco Benazzo, Pietro Canzi","doi":"10.3390/children13040562","DOIUrl":"10.3390/children13040562","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Temporal bone surgery in children is technically challenging due to their smaller anatomical structures, developmental differences, and the closer proximity of critical neurovascular structures. The limited availability of conventional training materials and pediatric cadaveric specimens has led to greater enthusiasm for simulation-based methods. The aim of this systematic review was to identify existing otologic simulation models and evaluate their anatomical accuracy, teaching effectiveness, and supporting evidence. <b>Methods</b>: In accordance with PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Library databases were searched for studies reporting simulation tools for pediatric otologic surgery. Articles describing three-dimensional printed (3DP) models, virtual reality (VR) platforms, cadaver specimens, and animal models were included. Studies focusing on children and providing educational outcomes were selected. The extracted data were synthetized and analytically discussed. <b>Results</b>: Thirteen studies met the inclusion criteria: nine on 3DP models and four on VR environments. No research involving cadavers or animals was identified. 3DP models exhibited consistent anatomical accuracy and notable educational advantages. Five studies used surveys for their evaluations, and three relied on expert observer assessments. The studies including validation analyses showed a high correlation between printed models and computed tomography (CT) images. VR systems supported anatomical reconstruction and segmentation tasks, as well as guided simulation exercises. However, most of the research consisted of feasibility studies with limited participant groups. <b>Conclusions</b>: Simulation-based training with 3DP and VR models could be ethical and accurate methods for obtaining relevant skills in pediatric otologic surgery. The reviewed data suggest that these tools may be suitable as a first-line step within an integrated, multimodal training pathway prior to direct patient contact.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evaluation of Hydrophilic and Hydrophobic Resin-Based Sealants in Uncooperative Children: A 24-Month Randomized Controlled Trial.","authors":"Hussein A Alharthy, Amani A Al Tuwirqi, Alaa A Nadhrin, Ala A Aljubour, Layla N Khogeer, Heba M Elkhodary","doi":"10.3390/children13040565","DOIUrl":"10.3390/children13040565","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dental caries continues to represent a major oral health concern in children, particularly in uncooperative patients, where effective sealant placement is often compromised. This study evaluated the long-term clinical performance of hydrophilic (UltraSeal XT hydro) and hydrophobic (Helioseal-F) resin-based sealants in uncooperative children aged 6-9 years, assessing retention and caries incidence over 24 months.</p><p><strong>Methods: </strong>In a split-mouth, double-blinded randomized controlled trial, 34 children (104 first permanent molars) were enrolled, with 31 participants (98 teeth) completing the study. Sealants were randomly assigned to hydrophilic or hydrophobic group, with assessments at 3, 6, 12, 18, and 24 months.</p><p><strong>Results: </strong>Complete retention declined progressively in both groups, from 59.2% to 2.0% in the hydrophilic group and from 42.9% to 0% in the hydrophobic group at 24 months, with no significant intergroup differences (<i>p</i> = 0.719). Caries-free rates decreased from 81.6% to 49.0% in the hydrophilic group and from 75.5% to 40.8% in the hydrophobic group (<i>p</i> = 0.293). Children with definitely negative behavior showed significantly lower retention at 6 and 12 months (<i>p</i> = 0.006 and <i>p</i> < 0.001) compared to those with negative behavior, although differences were not significant at 24 months.</p><p><strong>Conclusions: </strong>Overall, both sealants demonstrated comparable retention and cariostatic performance, indicating that material properties alone do not determine long-term success. Further research should focus on long-term follow-up and comparative evaluation of hydrophilic sealants in cooperative and uncooperative populations to better understand how patient behavior affects sealant performance.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Maternal Valaciclovir Therapy on Early Neurodevelopment in Congenital CMV Infection: A Retrospective Pilot Study.","authors":"Francesca Arcieri, Adele Vasta, Gregorio Volpe, Fabio Natale, Barbara Caravale, Daniele Di Mascio, Valentina D'Ambrosio, Michela De Cicco, Gianluca Terrin, Lucia Oliva, Costanza Prestianni, Giuseppina Liuzzi, Lucia Manganaro, Antonella Giancotti","doi":"10.3390/children13040566","DOIUrl":"10.3390/children13040566","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Maternal valaciclovir therapy is increasingly used to reduce fetal viral replication in cases of primary cytomegalovirus (CMV) infection during pregnancy. However, data on its impact on early neurodevelopmental outcomes remain limited. This study aimed to evaluate the association between prenatal valaciclovir exposure and early neurodevelopment in infants with confirmed congenital CMV infection (cCMV). <b>Methods</b>: In this retrospective monocentric cohort study, 30 infants with PCR-confirmed cCMV infection were assessed at 4-8 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants were stratified according to prenatal exposure to maternal valaciclovir. Univariate analyses and multivariable linear regression models were performed to evaluate the association between prenatal antiviral exposure and cognitive outcome, adjusting for brain MRI findings and selected clinical variables. <b>Results</b>: Fifteen infants (50%) were exposed to prenatal valaciclovir. Exposed infants demonstrated higher cognitive composite scores compared with unexposed infants (median 105 [IQR 100-110] vs. 90 [85-110]; <i>p</i> = 0.030). In multivariable analysis, prenatal valaciclovir exposure remained significantly associated with higher cognitive scores (β = 11.89, 95% CI 2.86-20.92; <i>p</i> = 0.012), while neonatal MRI abnormalities were not independently associated with outcome. No significant differences were observed in language or motor domains. The final model explained 30% of the variance in cognitive scores (R² = 0.30). <b>Conclusions</b>: Prenatal valaciclovir exposure was associated with higher cognitive composite scores after adjustment for selected covariates. Although causality cannot be inferred, these findings suggest a potential association with early neurodevelopmental outcomes and support the inclusion of functional neurodevelopmental endpoints in future prospective studies. These results should be considered exploratory and hypothesis-generating.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Dexmedetomidine Versus Ketamine for Sedation in Pediatric Dental Procedures: A Systematic Review and Meta-Analysis.","authors":"AbdulRahman Alasmri, Ali Alhijab, Shahad N Abudawood, Narmin Hilal, Heba Jafar Sabbagh","doi":"10.3390/children13040558","DOIUrl":"10.3390/children13040558","url":null,"abstract":"<p><p><b>Background:</b> Effective and safe sedation is essential in pediatric dental practice to manage anxiety, pain, and cooperation during procedures. <b>Objective:</b> This exploratory systematic review and meta-analysis aimed to synthesize available RCT evidence comparing dexmedetomidine and ketamine across different sedation strategies (premedication and procedural sedation) in children undergoing dental procedures. <b>Methods:</b> This study was conducted and reported in accordance with the PRISMA 2020 statement. A comprehensive literature search was performed across PubMed, Web of Science, Scopus, and ScienceDirect for studies between 1990 and 2026. Randomized controlled trials (RCTs) were included. The primary outcomes assessed were intraoperative and postoperative analgesia, heart rate, systolic and diastolic blood pressure (SBP and DBP), oxygen saturation (SpO₂), and recovery time. A meta-analysis of the extracted data was performed, and the risk of bias was assessed using the Cochrane risk of bias tool 2. <b>Results:</b> The review included four RCTs involving 178 children, with a mean age of 6.5-9.1 years. Intraoperative and postoperative analgesia did not differ significantly between groups (<i>p</i> = 0.09 and <i>p</i> = 0.08, respectively). Pooled analysis showed numerically lower heart rates with dexmedetomidine compared to ketamine, but the difference was not statistically significant (MD = -11.70; 95% CI: -29.27 to 5.86; <i>p</i> = 0.07). Systolic blood pressure was significantly lower with dexmedetomidine (MD = -6.69; 95% CI: -6.91 to -6.47; <i>p</i> = 0.002). Oxygen saturation did not differ significantly between groups (<i>p</i> = 0.35). Two studies were rated as having a low risk of bias. The remaining two had some concerns, related to unverified blinding and lack of outcome pre-specification. <b>Conclusions:</b> Based on limited and clinically heterogeneous evidence, both dexmedetomidine and ketamine appear to be viable options for sedation in pediatric dental settings, though no firm superiority conclusion can be drawn. Further randomized controlled trials with larger sample sizes and standardized sedation protocols are recommended to strengthen these findings and inform practice guidelines.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}