Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

{"title":"Drill irrigation during in vitro drilling with three static computer-assisted implant surgery systems.","authors":"T Moya-Martínez, A Jorba-García, S Lobos-Grimaldi, I Valdés-Berritzbeitia, J Bara-Casaus, R Figueiredo, E Valmaseda-Castellón","doi":"10.4317/medoral.27560","DOIUrl":"10.4317/medoral.27560","url":null,"abstract":"<p><strong>Background: </strong>Static computer-assisted implant surgery (sCAIS) allows for accurate implant placement. However, the currently available systems usually block drill irrigation, increasing the risk of overheating and tissue damage. The present in vitro study evaluates the volume of irrigation solution that passes through the guide sleeve during implant drilling with different sCAIS systems.</p><p><strong>Material and methods: </strong>The volume of irrigation solution that passed through a designed guide sleeve was measured on a 5ml syringe. The following sCAIS systems and groups were evaluated: A sleeve-in-sleeve with drill handle system (Straumann® sCAIS system); an integrated sleeve-in-drill system (RealGuide™ Z3D sCAIS system), and an integrated sleeve-in-drill system with irrigation channels (Adin® sCAIS system). The control group had neither drill handle nor sleeve-in-drill. The first pilot drill from each system was used, and drilling was performed for 10 seconds. The experiment was repeated 10 times for each group, and a blinded investigator measured the amount of irrigation solution in ml/s. A descriptive and bivariate analysis was performed.</p><p><strong>Results: </strong>The median volume of irrigant collected over 10 seconds was: Sleeve-in-sleeve group, 0.35 (IQR: 0.04) ml/s; sleeve-in-drill group, 0.07 (IQR: 0.04) ml/s; sleeve-in-drill system with channels group, 0.46 (IQR: 0.12) ml/s; and control group, 0.54 (IQR: 0.02) ml/s. The differences between groups were statistically significant (p=0.0001), except for the Adin sCAIS® system, which was not different from the control group (p=0.085).</p><p><strong>Conclusions: </strong>Within the limitations of the study, the volume of irrigation seems to be influenced by the design and sCAIS system used. Although all guides impeded irrigation, the Adin® sCAIS system facilitated irrigation the most.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e356-e362"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative 15 mg of melatonin for reducing anxiety and post-traumatic stress disorder symptoms in mandibular third molar surgery: A randomized double-blind placebo-controlled clinical trial.","authors":"H-H Rosa, C Ruppel, N-D Trappel, R-C Goncalves, M-C Bortoluzzi","doi":"10.4317/medoral.27846","DOIUrl":"10.4317/medoral.27846","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the efficacy of a single 15 mg preoperative sublingual dose of melatonin in reducing anxiety as the primary outcome, and its effects on psychomotor performance, postoperative sleep quality, and early post-traumatic stress symptoms as secondary outcomes in patients undergoing mandibular third molar surgery.</p><p><strong>Material and methods: </strong>Forty-eight patients were randomly allocated to receive either melatonin (n=24) or an identical placebo (n=24) sublingually 45 minutes before surgery. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) and a Visual Analog Scale for Anxiety (VAS-A) at baseline, 45 minutes post-medication, and post-surgery. Intraoperative anxiety was measured with the surgeon-rated Interval Scale of Anxiety Response (ISAR). Psychomotor performance was evaluated with the Digit Symbol Substitution Test (DSST) at baseline and 45 minutes post-medication. Sleep quality was recorded via a patient diary for three postoperative nights, and post-traumatic stress symptoms were screened one week post-surgery using the Impact of Event Scale-Revised (IES-R).</p><p><strong>Results: </strong>After adjusting for baseline scores using ANCOVA and GLM, no significant effect of melatonin was observed on state anxiety at any time point. Regarding secondary outcomes, no significant differences were observed in psychomotor performance, intraoperative anxiety from the surgeon's perspective (ISAR), postoperative sleep quality across the three nights, or early post-traumatic stress symptoms. The intervention was well tolerated, with no adverse events reported.</p><p><strong>Conclusions: </strong>A single 15 mg preoperative dose of sublingual melatonin did not demonstrate any significant benefit over placebo in reducing perioperative anxiety, improving psychomotor performance, enhancing postoperative sleep quality, or preventing early post-traumatic stress symptoms in patients undergoing mandibular third molar surgery.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e390-e398"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes comparison between fibula and DCIA free flaps in head and neck reconstructive surgery: Implications for donor site selection.","authors":"M Guerrero-Martín, F Almeida-Parra, P Guerrero-Martín, V Vega-Barreto, J Acero-Sanz","doi":"10.4317/medoral.28000","DOIUrl":"10.4317/medoral.28000","url":null,"abstract":"<p><strong>Background: </strong>Donor site selection for bone tissue reconstruction in head and neck surgery has remained a matter of debate since the advent of microsurgical techniques. Both the fibula and the deep circumflex iliac artery (DCIA) free flaps offer specific advantages but also present distinct morbidity profiles that must be considered to provide optimized and personalized reconstructive treatment for each patient.</p><p><strong>Material and methods: </strong>A retrospective morbidity analysis was conducted on 66 osseous free flaps (fibula and DCIA) used for head and neck reconstructive surgery at Ramón y Cajal University Hospital over a 6-year period (2018-2024). Surgical variables, as well as local and systemic complications, were analyzed.</p><p><strong>Results: </strong>Reconstruction with the DCIA free flap was associated with a threefold higher risk of developing systemic infections not related to surgical site (47.37% vs. 21.28%; OR=3.33; 95% CI=1.07-10.41) compared with the fibula free flap. No statistically significant differences were observed between the two groups regarding free flap failure, surgical site infections, postoperative bleeding, microvascular complications, or donor site morbidity.</p><p><strong>Conclusions: </strong>the DCIA free flap may be associated with a higher risk of systemic infections. Therefore, for patients with predisposing factors for systemic infections, the fibula free flap might represent a safer donor site. These findings could help refine donor site selection and improve individualized planning in head and neck reconstructive surgery.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e485-e489"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CBCT-based quantification of intrabony root volumes in adult natural teeth: An exploratory study.","authors":"J Su, W Du, Y Yang, Z Wang, S Li, Y Fan, Y Cai, X Peng, P Ye","doi":"10.4317/medoral.27700","DOIUrl":"10.4317/medoral.27700","url":null,"abstract":"<p><strong>Background: </strong>Alveolar ridge preservation (ARP) is critical for implant dentistry outcomes, yet current graft material selection lacks standardized intrabony root volume benchmarks. This study aimed to establish baseline data for intrabony root volumes of adult teeth using CBCT.</p><p><strong>Material and methods: </strong>This single-center cross-sectional study included 100 adults (50 males, 50 females) with complete natural dentition. CBCT-derived intrabony root volumes were measured for 10 target tooth positions using Mimics software. Volumetric data were analyzed for differences across tooth positions, jaw locations, and genders using parametric or nonparametric tests.</p><p><strong>Results: </strong>Intrabony root volumes varied by tooth position (first molar, first premolar, canine, lateral incisor, central incisor), with the largest volumes in upper first molars and smallest in lower central incisors. The intrabony root volumes of all target maxillary tooth positions were significantly higher than those of their mandibular homonymous counterparts (all P<0.01). Males exhibited significantly larger intrabony root volumes than females across all tooth positions (P<0.001).</p><p><strong>Conclusions: </strong>This exploratory study preliminarily establishes comprehensive reference data for adult intrabony root volumes across tooth positions, jaw locations, and genders, which may inform the development of tailored bone substitutes to address clinical limitations in graft volume estimation.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e378-e385"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological disorders and their influence on the development of periodontal disease in adolescents. A systematic review.","authors":"B Alagarda-Lauwers, L Peñarrubia-Martínez, M García-Selva, E González-Angulo, A Cases-Sánchez, C Fons-Badal","doi":"10.4317/medoral.27999","DOIUrl":"10.4317/medoral.27999","url":null,"abstract":"<p><strong>Background: </strong>Periodontal disease is among the most prevalent oral conditions worldwide. Psychological disorders, typically diagnosed during the first two decades of life, have gained greater importance in recent years. Although the relationship between both conditions has been briefly studied, findings remain inconsistent. The objective of this systematic review is to analyze the involvement of psychological disorders on the development and progression of gingivitis and periodontitis.</p><p><strong>Material and methods: </strong>This systematic review followed PRISMA guidelines and was registered in the PROSPERO (CRD420250651846). Searches were performed in PubMed, Scopus, Embase, and Cochrane Library using the equation: \"(periodontal disease) AND ((adolescents) OR (teenager)) AND (psychological disorder)\". Studies conducted in animals, adults, or with unrelated disorders were excluded Results: A total of 17 articles met the inclusion criteria. Adolescents with psychological disorders consistently showed poorer levels of periodontal health compared to controls, sharing several common risk factors among the pathologies.</p><p><strong>Conclusions: </strong>The general trend reflects a greater predisposition and prevalence of periodontal pathology symptoms in subjects with psychological disorder. Despite the promising findings, further research using standardized methodologies is required.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e478-e484"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latin American and Caribbean contributions to oral pathology/medicine journals: Cross-sectional study.","authors":"S Trezena, L-M Ferreira, J-P Nascimento, A-M Santos, F-E Oliveira, A-R Santos-Silva, D-R Martelli, H Martelli-Júnior","doi":"10.4317/medoral.27934","DOIUrl":"10.4317/medoral.27934","url":null,"abstract":"<p><strong>Background: </strong>To analyze the representation of Latin American and Caribbean (LAC) countries in international journals of Oral Pathology and Oral Medicine (OP/OM), focusing on authorship and editorial board participation.</p><p><strong>Material and methods: </strong>Cross-sectional scientometric study. Editorial board data were extracted from six OP/OM journals. Publications indexed in Web of Science (1978-2025) were analyzed to identify contributions from LAC-affiliated researchers.</p><p><strong>Results: </strong>Only 13.2% of 410 editorial board members were affiliated with LAC institutions, mostly from Brazil (8.3%). Among 27,188 articles, 3,734 (13.7%) had LAC-affiliated first or senior authors, generating 53,588 citations (11.3%). A strong correlation was found between editorial participation and publication volume (ρ=0.92; p=0.008). Oral Diseases had the highest share of LAC publications (22.1%), while Medicina Oral, Patología Oral y Cirugía Bucal had the highest citation percentage from LAC (27.2%). Scientific output was concentrated in Brazil (75.7%), while 11 LAC countries had no publications.</p><p><strong>Conclusions: </strong>Contributions to OP/OM journals from LAC have increased, particularly in Brazil and Mexico. However, editorial under-representation and regional disparities persist, especially among smaller and Caribbean countries. Expanding editorial diversity and strengthening regional collaborations are essential strategies for amplifying LAC's participation in the global PO/OM research.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth vitality preservation following odontogenic keratocyst enucleation: Systematic review and clinical implications.","authors":"M Santmartí-Oliver, A-F Stran-Lo-Giudice, F-G Fernández-Tresguerres, C-M Cobo-Vázquez, C-M Martínez-Pereda, J-L Martínez","doi":"10.4317/medoral.27666","DOIUrl":"10.4317/medoral.27666","url":null,"abstract":"<p><strong>Background: </strong>Odontogenic keratocysts are locally aggressive jaw lesions with a high recurrence rate, often involving the roots of adjacent teeth. The management of these teeth remains controversial, with no consensus on the necessity of prophylactic endodontic treatment prior to enucleation. Therefore, the purpose of this study was to assess the tooth vitality response of teeth involved in the cystic lumen of odontogenic keratocysts after enucleation and evaluate the suitability of prophylactic root canal therapy.</p><p><strong>Material and methods: </strong>A comprehensive search was conducted in PubMed, Scopus, and Web of Science following PRISMA guidelines, along with a manual search for relevant clinical articles published up to January 2025. Inclusion criteria required explicit postoperative vitality assessment of teeth involved in odontogenic keratocysts treated by enucleation, with a follow-up period of at least 6 months.</p><p><strong>Results: </strong>Four studies met inclusion criteria, analyzing 19 teeth in 5 patients, with a mean follow-up of 50 months (range: 10-84). Overall, 87.5% of teeth retained positive pulp vitality after surgery. Vitality was assessed using cold and/or electric pulp testing. All studies used 3D imaging for lesion evaluation. Longer follow-up periods were significantly associated with reduced vitality retention.</p><p><strong>Conclusions: </strong>Despite limited data, preserving pulp vitality in teeth adjacent to odontogenic keratocysts appears both viable and clinically beneficial. This conservative approach may help avoid unnecessary endodontic procedures, especially in the absence of definitive signs of necrosis. However, long-term follow-up remains essential to monitor vitality changes over time. Further high-quality studies are necessary to establish predictive success factors and standardized clinical protocols.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical factors related to dental implant failure: A cross-sectional multicentre study on 1,308 dental implants.","authors":"Á-O Salgado-Peralvo, A Murillo-Rodríguez, F-J Díaz-Prada, J-L Megía-Martín-Peñasco, P Galarza-Estebaranz, Ó Lado-Baleato, M Pérez-Sayáns","doi":"10.4317/medoral.28046","DOIUrl":"10.4317/medoral.28046","url":null,"abstract":"<p><strong>Background: </strong>Implant failure is equivalent to the loss of the implant, which entails biological and economic costs and reduces patient's trust in healthcare professionals. The objective of this study was to estimate the cumulative failure rate of 1,308 implants and identify patient-related and surgical factors associated with implant failure.</p><p><strong>Material and methods: </strong>Data for this retrospective multicentre study were extracted from six private clinics between June 2006 and December 2022. Patient-related factors, surgical techniques, and implant-related variables were evaluated. Multivariate mixed Cox proportional hazards models and Lasso regularisation were employed to identify predictors of implant failure.</p><p><strong>Results: </strong>A total of 1,308 implants (510 patients) were inserted, with a failure rate of 2.4% over a mean follow-up period of 38.31±32.54 months. The selected mixed Cox regression models showed that three variables were independently associated with implant failure: Postoperative implant infection (Hazard Ratio [HR]=6.6 [95% CI: 1.8-23.9]; p=0.004), previous implant failure (HR=8.3 [95% CI: 2.6-26.6]; p<0.001), and heavy smoking (>20 cigarettes per day) (HR=99.3 [95% CI: 30.7-321.3]; p<0.001).</p><p><strong>Conclusions: </strong>With the limitations of the present study, the cumulative implant failure rate was low (2.4%). Nevertheless, strict control of smoking habits and infection risk factors is essential, since implant replacement after failure constitutes and independent risk factor for subsequent failure.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral findings in intensive care unit patients.","authors":"W Rodrigues-da-Silva, A-P Sobral, H-A Gomes-de-Oliveira, A-X Briano, A-C Albuquerque, L-F Gominho, L-S Cavalcanti, U-D Cavalcanti, K Romeiro","doi":"10.4317/medoral.27639","DOIUrl":"10.4317/medoral.27639","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate oral changes in patients admitted to an intensive care unit (ICU).</p><p><strong>Material and methods: </strong>Retrospective, cross-sectional, descriptive study. The following data were collected at a high-complexity referral centre in northeastern Brazil between 2021 and 2024: gender, age, ventilatory support, dental condition, and type of oral change.</p><p><strong>Results: </strong>A total of 2,692 patients admitted to the ICU were evaluated; 52.1% of these patients were male and the mean age was 69.98 years (±19.53). Oral changes were identified in 58.41% of the patients, with odontogenic infections being the most prevalent (61.49%), followed by clinical conditions suggestive of salivary changes (15.05%) and soft-tissue lesions (9.85%). The presence of oral changes was significantly associated with males (p<0.001) aged from 50 to 59, and from 60 to 69 years (p<0.001), ventilatory support (p=0.037), being partially dentate (p<0.001), and the number of teeth (p<0.001).</p><p><strong>Conclusions: </strong>These data permit a characterization of the oral health status of this patient profile, reinforcing the importance of the dentist as a member of the multidisciplinary team.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midazolam versus midazolam-promethazine combination for oral sedation in third molar surgery: A randomized split-mouth trial.","authors":"D Castanha, T-C Lessa, E-S Martins-de-Araújo, T Ismaely-de-Andrade, G-M Beserra, E-G Onofre-de-Araújo, F-A Araújo, E-S Andrade","doi":"10.4317/medoral.28014","DOIUrl":"10.4317/medoral.28014","url":null,"abstract":"<p><strong>Background: </strong>Oral sedation is widely utilized in dental surgical practice for anxiety management during third molar extractions. Midazolam is one of the most frequently employed drugs; however, the clinical benefits of its association with promethazine have not yet been clearly established.</p><p><strong>Material and methods: </strong>This is a randomized, double-blind, split-mouth clinical trial. Eighteen anxious patients were included, all with indications for bilateral extraction of impacted or semi-impacted mandibular third molars, presenting similar surgical difficulty on both sides. In one session, patients received 15mg of midazolam alone (Group A), and in another, 15mg of midazolam combined with 25mg of promethazine (Group B). Sedation levels (Ramsay scale), anxiety (Corah scale), and physiological parameters were evaluated.</p><p><strong>Results: </strong>There was no statistically significant difference in the depth of sedation between the groups (p>0.05). Oxygen saturation and heart rate showed slight, statistically significant variations at specific time points in Group B (p<0.05), although without relevant clinical repercussions. Blood pressure and respiratory rate remained stable across both protocols.</p><p><strong>Conclusions: </strong>The association of promethazine with midazolam did not increase sedative efficacy compared to midazolam alone. However, it demonstrated clinical safety, proving to be a viable alternative in sedative drug protocols.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}