Frontiers in dental medicine最新文献

{"title":"A systematic review of a novel alloplast carbonate apatite granules.","authors":"Martha E Nunn, Courtney Rudick, Masahiko Nikaido, Takanari Miyamoto","doi":"10.3389/fdmed.2024.1418039","DOIUrl":"10.3389/fdmed.2024.1418039","url":null,"abstract":"<p><p>The objectives of this study are to provide a systematic review of a novel alloplastic hard-tissue grafting material, carbonate apatite granules (CO3Ap-granules), to provide a clinical case presentation of CO3Ap-granules in periodontal surgery. The following three electronic databases were searched independently by two of the authors (MN) and (CR): National Library of Medicine [MEDLINE (PubMed) and ClinicalTrials.gov], EMBASE (OVID) and the Cochrane Central Register of Controlled Trials (CENTRAL). After searching electronic databases, select journals in periodontics and implantology were also manually searched. Of the 43 studies identified from the systematic review, the following classifications were determined: (1) <i>in vitro</i> studies - 5 studies, (2) animal studies - 28 studies, (3) clinical studies - 7 studies, (4) reviews - 3 studies. Results from selected animal studies and all human studies were summarized. These results demonstrate that the novel alloplast CO3Ap-granules has the potential ability to stimulate new bone formation while CO3Ap-granules simultaneously resorb over time. Replacement of CO3Ap-granules with new bone formation has been shown to be comparable to autogenous bone grafting with one study showing superior results to a bovine-derived xenograft.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1418039"},"PeriodicalIF":1.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in oral hygiene tools: a mini review on recent developments.","authors":"Sucharitha Palanisamy","doi":"10.3389/fdmed.2024.1442887","DOIUrl":"10.3389/fdmed.2024.1442887","url":null,"abstract":"<p><strong>Background: </strong>This review examines advancements in oral hygiene aids and their impact on gingival and periodontal health. As periodontal diseases are widespread, effective hygiene is vital. Enhancements in traditional tools and innovations have improved oral hygiene status. Clinical evidence confirms these innovations improve gingival and periodontal health, though proper use and patient adherence are crucial.</p><p><strong>Methodology: </strong>A comprehensive literature search was conducted using MeSH terms like \"Gingivitis/prevention & control*\", \"Dental Plaque/prevention & control*\", \"Dentifrices\", \"Electrical Equipment and Supplies*\", \"Toothbrushing\", \"Equipment Design\", \"Anti-Infective Agents/therapeutic use\", \"Oils, Volatile/therapeutic use\", \"Dental Devices, Home Care\", \"Dentifrices*/therapeutic use\", \"Vibration\", \"Gingivitis*/drug therapy\", \"Gingivitis*/prevention & control\", \"Gingival Hemorrhage/prevention & control\", \"Anti-Inflammatory Agents/pharmacology\", \"Chlorhexidine/pharmacology\", \"Mouthwashes/pharmacology\", \"Anti-Bacterial Agents/pharmacology\", \"Mouthwashes/therapeutic use\", \"Anti-Infective Agents, Local*/therapeutic use\", \"Mouthwashes/chemistry*\", \"Plant Extracts/therapeutic use*\", \"Sodium Dodecyl Sulfate/therapeutic use*\", \"Treatment Outcome\", \"Oral Hygiene/methods\", \"Toothpastes/therapeutic use*\", \"Hyaluronic Acid/therapeutic use\", \"Chronic Periodontitis*/therapy\", \"Periodontal Attachment Loss/therapy\", \"Probiotics*/therapeutic use\", \"Oral Hygiene*\", \"Periodontal Index\" and so on. This search utilized PubMed and Google Scholar, restricted to English-language publications from 2018 to 2024. The screening process involved reviewing titles, abstracts, and keywords, focusing on randomized clinical trials only. Inclusion criteria focused on novel innovations in conventional oral hygiene methodologies. A total of 86 randomized clinical trial articles met the inclusion criteria.</p><p><strong>Results: </strong>Recent innovations in traditional oral hygiene tools have markedly enhanced oral hygiene levels and patient compliance. These newer innovations demonstrate substantial efficacy in plaque control and gingival health. Clinical outcomes underscore their pivotal role in improving oral hygiene standards, promoting reduced gingivitis and enhanced patient adherence to oral care regimens.</p><p><strong>Conclusion: </strong>Advanced oral hygiene aids significantly improve gingival and periodontal health. However, patient adherence and correct usage are crucial for their optimal performance. Incorporating advanced oral hygiene aids into daily practices is essential for achieving optimal periodontal health, and continuous education is necessary to ensure their effective use.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1442887"},"PeriodicalIF":1.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of inflammatory mediators in dental pulp inflammation and the potential for their control.","authors":"Nobuyuki Kawashima, Takashi Okiji","doi":"10.3389/fdmed.2024.1426887","DOIUrl":"10.3389/fdmed.2024.1426887","url":null,"abstract":"<p><p>Dental pulp is a mesenchymal connective tissue located inside the rigid encasement of the dentin. When bacteria or bacterial products invade the dental pulp, inflammation known as pulpitis is induced in this tissue. Various mediators produced during the course of pulpitis profoundly modify the pathophysiology of the inflammation. Typical mediators include cytokines, chemokines, nitric oxide, reactive oxygen species, matrix metalloproteinases, proteases, neutrophil extracellular traps, neuropeptides, and eicosanoids. Controlling these mediators may potentially lead to the healing of pulpitis and the preservation of pulp tissue. This review discusses these mediators and further explores the possibility of controlling them.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1426887"},"PeriodicalIF":1.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful ulcerations associated with COVID-19 in an adolescent patient: a case report.","authors":"David O Danesh, Kyulim Lee, Rebecca G Wallihan, Janice A Townsend, Ira Mulo, Ashok Kumar","doi":"10.3389/fdmed.2024.1412439","DOIUrl":"10.3389/fdmed.2024.1412439","url":null,"abstract":"<p><p>Oral lesions associated with SARS-CoV-2 (COVID-19) include aphthous-like ulcers, herpetiform eruption of vesicles and erosions and other findings. Reactive infectious mucocutaneous eruption (RIME) has recently been used to describe non-<i>Mycoplasma pneumoniae</i> pathogens that can lead to rash and mucositis. RIME secondary to SARS-CoV-2 infection is consistent with reports in the literature. The patient in this case report is significant in that it involves only the oral mucosa, although there are cases reported where mucosal involvement is limited to one site. The degree of mucosal involvement in our case report was in the presence of an acute COVID-19 infection without ocular or genital involvement. Oral lesions associated with COVID-19 infection vary in presentation. This paper adds to the understanding of systemic manifestations of COVID-19 infection and provides a reference of clinical findings, management, and interdisciplinary collaboration for caring for this patient.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1412439"},"PeriodicalIF":1.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health knowledge, attitudes, and practices of paediatric nurses caring for hospitalized children.","authors":"Ashley Fletcher, Shauna Hachey, Tracy Doyle","doi":"10.3389/fdmed.2024.1426697","DOIUrl":"10.3389/fdmed.2024.1426697","url":null,"abstract":"<p><strong>Objectives: </strong>Nurses are well positioned to provide oral care to hospitalized children. This study explores pediatric hospital nurses' knowledge, attitudes, practices and perceived barriers to providing oral care.</p><p><strong>Methods: </strong>Using a descriptive cross-sectional design, previously validated surveys were adapted based on input from key stakeholders and administered to all nurses and staff providing patient care on inpatient units (<i>N</i> = 239) of a pediatric hospital.</p><p><strong>Results: </strong>The survey response rate was 40% (<i>N</i> = 96), providing a margin of error of 7.59% (95% C.I.). Most participants were unaware that caries is infectious (51%, <i>n</i> = 49) and caries-producing bacteria is transmissible (35%, <i>n</i> = 34). The majority (57%, <i>n</i> = 52) of participants did not recall oral care content within their formal education or oral care continuing education (88%, <i>n</i> = 81), despite high interest (87%, <i>n</i> = 80). Oral care was rated by most as a priority (85%, <i>n</i> = 81), yet the majority (74%, <i>n</i> = 69) believed it is under performed. More nurses with 6 or more years of experience placed a high or very high value on prioritizing oral health (p = 0.005). Furthermore, most nurses do not assess oral health on admission (63%, <i>n</i> = 60), routinely incorporate oral health into the care plan (45%, <i>n</i> = 43), or document oral care (60%, <i>n</i> = 56). Commonly reported barriers include lack of patient cooperation, medical status, and competing needs.</p><p><strong>Conclusions and outcome: </strong>Despite nurses valuing the importance of oral care and their willingness to learn, oral care practices are lacking, and barriers exist. Future investigation is required to further explore the findings related to barriers to care and lack of practice. These results and future findings will be used to guide institutional oral care policy and education.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1426697"},"PeriodicalIF":1.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspective: Advancing the science regarding temporomandibular disorders.","authors":"Richard Ohrbach, Alexandre F DaSilva, Mildred C Embree, John W Kusiak","doi":"10.3389/fdmed.2024.1374883","DOIUrl":"10.3389/fdmed.2024.1374883","url":null,"abstract":"<p><p>This Special Issue was initiated in response to the call for improved research by the National Academies of Sciences, Engineering, and Medicine (NASEM) (United States) Consensus Study Report on Temporomandibular Disorders (TMDs), a set of putatively localized musculoskeletal conditions. In this Special Issue, the importance of systems biology for TMDs emerges from each of three separate publications. The importance of systems biology to patients is anchored in two domains-laboratory research and clinical observation. The three publications fully speak to the underlying goals in the NASEM recommendations for initiatives: that research on TMDs needs to broaden, that integration between basic and clinical science needs to improve, and that while better evidence is needed, clinicians need to utilize the evidence that already exists. All three of these initiatives, taken together, would lead to better understanding of these complex diseases and to better care of patients with these diseases.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1374883"},"PeriodicalIF":1.5,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions-a retrospective study.","authors":"A Basic, S Blomqvist, G Charalampakis, G Dahlén","doi":"10.3389/fdmed.2024.1293202","DOIUrl":"10.3389/fdmed.2024.1293202","url":null,"abstract":"<p><strong>Introduction: </strong>Aerobic gram-negative bacilli (AGNB) are not part of the resident oral microflora but are occasionally found in high abundance under inflammatory dysbiotic conditions at various oral niches. The aim of the present study was to investigate the identity and antibiotic susceptibility of AGNB isolated from patients in Sweden with mucosal lesions, periodontitis, and peri-implantitis, with special attention to antibiotic resistance and on the presence of phenotypic Extended Spectrum Beta-Lactamase (ESBL) isolates.</p><p><strong>Materials and methods: </strong>Microbiolgical samples were harvested from 211 patients in total, experiencing mucosal lesions (<i>N</i> = 113), periodontitis (<i>N</i> = 62), or peri-implantitis (<i>N</i> = 36). The growth of AGNBs was semiquantified by selective and non-selective culture and the strains were isolated, identified, and tested for antibiotic susceptibility. A total of 251 AGNB strains, occurring in moderate to heavy growth (>100 CFU/ml sample), indicating a dysbiotic microbiota, were identified. The disc diffusion method was used for screening of the antibiotic susceptibility of the isolates. Phenotypic identification of ESBL isolates was based on resistance to ceftazidime and/or cefotaxime.</p><p><strong>Results: </strong>The most commonly detected AGNB isolates in oral inflammatory dysbiotic conditions were fermentative species belonging to <i>Enterobacteriaceae</i> e.g. <i>Citrobacter</i> spp.<i>, Enterobacter</i> spp.<i>, Escherichia coli, Klebsiella</i> spp<i>,</i> and the non-fermentative environmental <i>Burkholderia cepacia, Pseudomonas</i> spp., and <i>Stenotrophomonas maltophilia</i>. No clear trends were seen in frequency of the various species in samples from mucosal lesions, severe periodontitis, and peri-implantitis cases. The 138 <i>Enterobacteriaceae</i> isolates and 113 environmental AGNB isolated showed a high antibiotic resistance in general against antibiotics commonly used in dentistry (Amoxicillin, Amoxicillin + Clavulanic acid, Ampicillin, Clindamycin, Doxycycline, Erythromycin, Oxacillin, PenicillinV, and Tetracycline). The majority of these isolates were susceptible to ciprofloxacin. Ten isolates (4.1%) were phenotypically classified as ESBL positive. The ESBL isolates were predominantly found among isolates of <i>S. maltophilia</i>, while only one ESBL positive isolate was found among <i>Enterobacteriaceae</i>.</p><p><strong>Conclusions: </strong>Phenotypically identified ESBL isolates can occasionally be present among oral AGNB strains isolated in abundance from the dysbiotic microbiota occurring in cases with oral mucosal lesions, severe periodontitis, or peri-implantitis.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":"1293202"},"PeriodicalIF":1.5,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of visual acuity screening in dental education amongst undergraduate dental students: a straightforward method","authors":"Jaya Pindoria, S. Abela, Matthew Maguire, Martyn Sherriff, D. Bister","doi":"10.3389/fdmed.2023.1337909","DOIUrl":"https://doi.org/10.3389/fdmed.2023.1337909","url":null,"abstract":"Visual acuity plays a pivotal role in a dental professional's daily performance and screening the students' field of vision in their early formative years ensures successful undergraduate programmes.To compare near and distance visual acuity and stereopsis in first-year and final-year dental students and investigate students' perception of their vision.This was a cross-sectional study involving 100 KCL first- and final-year dental students that underwent assessment of their vision and completed a self-perception questionnaire. Near visual acuity was assessed using a standardised near vision test chart, distance visual acuity using COMPlog (Clinical Vision Measurement Systems Ltd, London, UK) computerised software and stereopsis using the Frisby stereotest. On the basis of the Mann–Whitney test, no statistical differences were found between the first-year and final-year students’ near and distance visual acuity, nor in stereopsis difference at a significance level of α = 0.05. The null hypothesis was accepted.84% of first-year students and 94% in final-year students attained the highest binocular near visual acuity score of 0.50M. Distance visual acuity scores showed a median ETDRS (Early Treatment Diabetic Retinopathy Study) Letters score 94 in the first-year group and 95 in the final-year group. 8% of students were found to have correctable refractive errors in distance visual acuity. The majority of students across both year groups were able to discern 20 s arc of smallest disparity. Final-year students reported worrying about their eyesight significantly more than the first-year students.No statistically significant differences were found in near and distance visual acuity, and stereopsis, between first-year and final-year dental students. However, 8% of students were identified with undiagnosed, correctable refractive errors. The importance of students' vision in clinical dentistry is highlighted and regular eye examination is recommended.","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"88 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139440503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic enhancement of hydrophobic dental adhesives: autonomous strengthening, polymerization kinetics, and hydrolytic resistance.","authors":"Burak Korkmaz, Erhan Demirel, Qiang Ye, Anil Misra, Candan Tamerler, Paulette Spencer","doi":"10.3389/fdmed.2024.1373853","DOIUrl":"10.3389/fdmed.2024.1373853","url":null,"abstract":"<p><p>The leading cause of composite restoration failure is recurrent marginal decay. The margin between the composite and tooth is initially sealed by a low-viscosity adhesive, but chemical, physical, and mechanical stresses work synergistically and simultaneously to degrade the adhesive, destroying the interfacial seal and providing an ideal environment for bacteria to proliferate. Our group has been developing self-strengthening adhesives with improved chemical and mechanical characteristics. This paper reports a self-strengthening adhesive formulation that resists hydrolysis-mediated degradation by providing intrinsic reinforcement of the polymer network through synergistic stimulation of free-radical polymerization, sol-gel reaction, and hydrophobicity. Hydrophobic resin formulation (NE1) was developed using HEMA/BisGMA 28/55w/w and 15 wt% MPS. Control (NC1) contained HEMA/BisGMA 28/55 w/w and 15 wt% MES. The polymerization kinetics, water sorption, leachates, and dynamic mechanical properties of the resin samples were investigated. The NC1 and NE1 samples showed comparable polymerization kinetics, degree of conversion and water sorption. In contrast, NC1 showed significantly higher levels of HEMA and BisGMA leachate, indicating faster degradation in ethanol. At day 3, cumulative HEMA leachate for NC1 was tenfold greater than NE1 (<i>p</i> < <i>0.05</i>). Dynamic mechanical properties were measured at 37 and 70°C in both dry and wet conditions. Under dry conditions, the storage moduli of NC1 and NE1 were comparable and the glass transition temperature (<i>T</i> _g) of NC1 was statistically significant lower (<i>p</i> < 0.001) than NE1. Under wet conditions, the storage modulus of NC1 was lower than NE1 and at 70°C there is a threefold difference in storage modulus. At this temperature and under wet conditions, the storage modulus of NC1 is statistically significantly lower (<i>p</i> < 0.001) than NE1. The results indicated that in the wet environment, NE1 provided lower chain mobility, higher crosslink density, and more hydrogen bonds. The newly formulated methacrylate-based adhesive capitalizes on free-radical polymerization, sol-gel reactions, and hydrophobicity to provide enhanced mechanical properties at elevated temperatures in wet environments and hydrolytic stability under aggressive aging conditions.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"5 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents’ satisfaction and children's acceptance of nasal compared to oral midazolam for sedation in two consecutive pediatric dental treatments: a randomized controlled study","authors":"Avia Fux-Noy, Qamar Saadi, A. Shmueli, E. Halperson, Diana Ram, M. Moskovitz","doi":"10.3389/fdmed.2023.1296823","DOIUrl":"https://doi.org/10.3389/fdmed.2023.1296823","url":null,"abstract":"Midazolam, by either the oral or the nasal route, is safe and effective in reducing anxiety and improving behavior in children during dental procedures. Aim: to compare both children's acceptance and parents’ satisfaction with midazolam premedication, when administered as an oral syrup or as a nasal spray and explore whether there were positive or negative changes in acceptance during consecutive dental treatment visits.Randomized controlled study among uncooperative 2–6-year-old children who needed at least two similar dental treatments. On each visit, the acceptability of the medication was assessed as good, fair, or poor. The duration of crying after medication administration was recorded. Additionally, parents were asked to rank their satisfaction with the mode of administration.The study group included 60 children; 30 patients received midazolam orally and 30 nasally. Route of administration did not correlate with medication acceptance in the first (p = 0.11) and second visit (p = 0.61). However, in the oral group, medication acceptance of 73% of children deteriorated on the second visit, compared to 33% in the nasal group (p = 0.01). Parents of children in the oral group expressed less satisfaction with premedication administered on the second visit than did parents of children in the nasal group, p = 0.00. Poor medication acceptance at the first visit (p = 0.014) and oral route of administration (p = 0.014) were found to be predictors of poor medication acceptance at the second visit.Acceptance of premedication is expected to deteriorate after the first treatment visit, especially in the oral route of administration. Dentists should consider nasal spray administration for young pediatric patients who need more than one dental treatment. Parents should be prepared for possible resistance or refusal by children.ClinicalTrials.gov, identifier NCT02679781.","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"131 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}