Naotaka Kishimoto, Toru Yamamoto, Rina Sakagami, Kenji Seo
{"title":"Respiratory monitoring during intravenous sedation using a digital auscultation device.","authors":"Naotaka Kishimoto, Toru Yamamoto, Rina Sakagami, Kenji Seo","doi":"10.17245/jdapm.2025.25.3.215","DOIUrl":"10.17245/jdapm.2025.25.3.215","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"215-217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304260","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}
Toru Yamamoto, Naotaka Kishimoto, Shigenobu Kurata, Yutaka Tanaka, Kenji Seo
{"title":"Kampo medicine in dental anesthesia: a promising adjunct for perioperative management.","authors":"Toru Yamamoto, Naotaka Kishimoto, Shigenobu Kurata, Yutaka Tanaka, Kenji Seo","doi":"10.17245/jdapm.2025.25.3.223","DOIUrl":"10.17245/jdapm.2025.25.3.223","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"223-226"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304259","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}
Saša Marin, Denis Abdihodžić, Nataša Milinković, Dajana Čelić, Adriana Arbutina, Aleksandra Đeri, Nataša Trtić, Irena Kuzmanović Radman
{"title":"Bifid mandibular canal assessment and its relevance to local anesthesia.","authors":"Saša Marin, Denis Abdihodžić, Nataša Milinković, Dajana Čelić, Adriana Arbutina, Aleksandra Đeri, Nataša Trtić, Irena Kuzmanović Radman","doi":"10.17245/jdapm.2025.25.3.183","DOIUrl":"10.17245/jdapm.2025.25.3.183","url":null,"abstract":"<p><strong>Background: </strong>The frequent use of cone-beam computed tomography (CBCT) has drawn attention to the anatomical variations of the mandibular canal (MC). This study aimed to analyze the bifid mandibular canal (BMC) types, frequency, and impact of inferior alveolar nerve block (IANB).</p><p><strong>Methods: </strong>This study included 142 CBCT scans. For the analysis of the BMC types, an established classification method was used. CBCT sagittal and transverse planes were used to analyze the occurrences, dimensions of the BMC types, and differences based on the sex and age of patients.</p><p><strong>Results: </strong>The frequency of BMC was 9.2%. There were no statistically significant differences in the occurrence related to sex (P = 0.317), age (P = 1.000), or localization (P = 0.317). The average BMC diameter ranged from 1.2 to 2.5 mm. The largest BMC diameter was in the retromolar region.</p><p><strong>Conclusion: </strong>The high incidence of BMC must be considered during IANB. Untimely identification of anatomic variations in the MC can lead to IANB anesthesia failure, as well as intraoperative and postoperative complications.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304254","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":"Clinical evaluation of different types of injection systems and comparison of pain acceptance in palatal anesthesia in pediatric patients: a randomized controlled split-mouth study.","authors":"Halenur Altan, Büşra Almas","doi":"10.17245/jdapm.2025.25.3.191","DOIUrl":"10.17245/jdapm.2025.25.3.191","url":null,"abstract":"<p><strong>Background: </strong>Local dental anesthesia is the most commonly used method for eliminating pain during dental treatment. Palatal injections, which are routinely used to extract deciduous molars, may be poorly tolerated by pediatric patients. The aim of this study was to evaluate the pain acceptance and anesthetic efficacy of the Comfort-In needle-free injection compared with the traditional injection method in upper deciduous molars requiring extraction.</p><p><strong>Methods: </strong>Patients between the ages of 4 and 10 years who were admitted to our clinic and required extraction of their maxillary deciduous molars under local anesthesia were included in our study. Infiltration anesthesia with a conventional dental injector was applied to one of the symmetrical teeth, and a Comfort-in jet injection system was applied to the other. The Index of Dental Anxiety and Fear (IDAF-4C) anxiety scale was administered to children. The Wong-Baker Pain Rating Scale (WBPRS) and Face, Legs, Activity, Cry, Consolability (FLACC) scales were applied to the children during the injection. The physiological parameters of the children were evaluated using pulse oximetry. Data were analyzed using IBM SPSS V23 software (SPSS Inc., IBM Co., Somers, NY, USA). The significance level was set at P < 0.050.</p><p><strong>Results: </strong>No significant difference was observed between Comfort-In jet injection and conventional dental anesthesia in terms of Frankl scores (P = 0.180), pulse rate (P = 0.569), oxygen saturation (P = 0.615), and FLACC total values (P = 0.082). IDAF-4C anxiety levels were low in most of the included children. The categorical distribution of the WBPRS showed a statistically significant difference according to the method used (P = 0.022).</p><p><strong>Conclusions: </strong>We concluded that the Comfort-In jet injection system is as effective as the gold standard of infiltration anesthesia with a conventional dental syringe and that the Comfort-In jet injection system is acceptable to patients in the postoperative period. Needle-free jet injection is a promising alternative to palatal needle injection for palatal infiltration anesthesia in the maxillary first molars.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"191-199"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304255","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":"Comparative evaluation of efficacy and safety of nitrous oxide and midazolam for conscious sedation in pediatric dental patients: a systematic review and meta-analysis.","authors":"Manali Khole, Pankaj Chavhan, Arunkumar Sajjanar, Shreya Shah, Prachi Salvi","doi":"10.17245/jdapm.2025.25.3.161","DOIUrl":"10.17245/jdapm.2025.25.3.161","url":null,"abstract":"<p><p>Children's fear of dental treatment can create challenges for dentists in managing their behavior, which may hinder the provision of proper dental care. The use of sedative agents can alleviate anxiety and control behaviors in pediatric dental patients. Nitrous oxide and midazolam are the two most commonly used pharmacological agents for behavioral management in pediatric dental care. However, evidence supporting their efficacy and safety is unclear. This systematic review and meta-analysis aimed to consolidate the most robust evidence on the efficacy and safety of nitrous oxide versus midazolam for conscious sedation in pediatric dental patients aged 3 to 16 years. As per the predefined protocol, a systematic review methodology was employed to search electronic databases. Titles and abstracts were screened, and the full text was reviewed by two authors. The included trials compared nitrous oxide and midazolam as single sedatives in children aged 3 to 16 undergoing dental treatment. These trials compared nitrous oxide with oral, intravenous, transmucosal, or intranasal midazolam. Data on the methods, participants, interventions, outcomes, and results were extracted, and each trial was assessed for risk bias. Of the seven articles, two had a moderate risk of bias and five had a high risk. The overall results showed no statistically significant differences between the two interventions (P = 0.64). Despite the limitations of this systematic review and meta-analysis, the present study provides important information regarding the efficacy of both sedatives. However, well-designed and well-documented clinical trials are still required. In addition, guidelines for the standardization of the criteria and definition of success in procedural sedation need to be developed.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"161-182"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304257","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":"Articaine as a potential alternative to lidocaine in Japanese dental practice.","authors":"Toru Yamamoto, Takutoshi Inoue, Mitsuhiro Yoshida, Soju Seki, Naotaka Kishimoto","doi":"10.17245/jdapm.2025.25.3.219","DOIUrl":"10.17245/jdapm.2025.25.3.219","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"219-221"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304253","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":"Effectiveness of origami and puzzle game in alleviating dental anxiety and pain perception during local anesthesia administration in children: a randomized clinical trial.","authors":"Puvvada Sravya, Svsg Nirmala","doi":"10.17245/jdapm.2025.25.3.201","DOIUrl":"10.17245/jdapm.2025.25.3.201","url":null,"abstract":"<p><strong>Background: </strong>Children experience anxiety in unfamiliar dental environments, impacting their behavior and impeding dental treatment. Local anesthetic infiltration (LA) induces anxiety in children. Distraction is recommended to alleviate the pain and anxiety associated with LA administration. Origami and puzzle games are promising, economical, nonpharmacological techniques to minimize dental anxiety and can enhance intellectual and cognitive development. This study aimed to evaluate the effectiveness of origami and puzzle games as distraction techniques for reducing dental anxiety and pain during local anesthesia infiltration in children aged 5-10 years during local anesthesia infiltration.</p><p><strong>Methods: </strong>Fifty-two healthy children, aged 5-10 years, undergoing dental procedures requiring local anesthesia were chosen and divided into two groups. Each group comprised 26 children as determined by simple randomization. Group I: Puzzle game group; Group II: Origami group. In both groups, a physiological measure (pulse rate by pulse oximeter) was measured prior to, during, and following LA administration, while the face, legs, activity, cry, and consolability (FLACC) scale was used to record anxiety levels before and after the intervention. The FLACC Scale, an objective measure, was used to record pain perception during LA administration, whereas the faces pain scale, a subjective measure, was used to record pain perception following LA administration. This was followed by the needful treatment. Pulse rates were compared between the two groups using independent and paired t-tests for inter-and intragroup assessments, respectively. The Wilcoxon signed-rank test and Mann-Whitney U test were used to analyze anxiety and pain scores.</p><p><strong>Results: </strong>Intragroup comparisons of pulse rates before, during, and after LA administration were statistically significant (P < 0.001). Inter-group comparison of pulse rates was also statistically significant during LA administration (P = 0.04); however, there was no significant difference before intervention and after LA administration. However, after the intervention, the mean anxiety scores were significantly reduced in the puzzle game group (P = 0.004). The mean pain scores of the FLACC and Faces Pain Scale-Revised were lower (P < 0.001) in the puzzle game group than in the origami group.</p><p><strong>Conclusion: </strong>Puzzle games were the most effective in lowering children's pain and anxiety during LA administration.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"201-213"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304258","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}
Gunjan Barot, Megha Patel, Chhaya Patel, Miyola Cia Fernandes, Foram Patel, Miral Mehta
{"title":"Comparative effectiveness and safety of dexmedetomidine and midazolam in pediatric dental sedation: a systematic review and meta-analysis.","authors":"Gunjan Barot, Megha Patel, Chhaya Patel, Miyola Cia Fernandes, Foram Patel, Miral Mehta","doi":"10.17245/jdapm.2025.25.3.147","DOIUrl":"10.17245/jdapm.2025.25.3.147","url":null,"abstract":"<p><p>Dental fear and anxiety are prevalent challenges in pediatric dentistry. Sedation is crucial for managing these issues, ensuring a positive treatment experience, and enabling the safe and effective care of young patients who may otherwise be anxious or uncooperative. This systematic review and meta-analysis aimed to synthesize and compare existing evidence, offering a comprehensive evaluation of the performance of dexmedetomidine and midazolam in terms of sedation quality, onset of action, recovery time, and potential side effects in pediatric patients. The systematic review was registered with PROSPERO (registration number: CRD42024566935) and followed the PRISMA guidelines, including seven randomized controlled trials published between 2011 and 2024. The examined data focused on mask acceptance, parental separation, emergence delirium, satisfactory sedation, and the overall success of the sedation protocol. Risk of bias was assessed using the Cochrane Collaboration and ROBINS-I tools. Data were aggregated and weighted using Review Manager, followed by meta-analysis. To evaluate the pooled effect, heterogeneity, and potential publication bias, we used STATA 17.0, with statistical significance set at P < 0.05. Intranasal dexmedetomidine has demonstrated outcomes comparable or superior to those of midazolam in pediatric dental sedation. Midazolam exhibited a faster onset of action (10-57 min) than did dexmedetomidine (10-47 min), although the difference was not statistically significant. Parental separation outcomes favored dexmedetomidine with a statistically significant pooled effect, whereas mask acceptance and satisfactory sedation showed no significant differences. Dexmedetomidine significantly reduced emergence delirium compared with midazolam, suggesting a safer recovery profile. Both dexmedetomidine and midazolam have demonstrated effectiveness in managing pediatric dental patients, providing dependable sedation with similar results for parental separation and mask acceptance. Although midazolam exhibits a quicker onset of action and facilitates more rapid sedation, dexmedetomidine has the advantage of a lower incidence of emergent delirium, providing an additional layer of postoperative comfort. These results suggest that, although the choice of sedative may be influenced by the clinical need for faster onset or reduced postoperative complications, both agents effectively achieve satisfactory sedation, ensuring procedural comfort and promoting patient cooperation in pediatric dental settings.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"147-159"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304256","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}
Douglas W Beals, H Dexter Barber, John R Francis, Trever Siu, Chase Irwin, MacKenzie Andrews
{"title":"Education regarding opioid prescription within oral and maxillofacial surgery residency programs: a survey study.","authors":"Douglas W Beals, H Dexter Barber, John R Francis, Trever Siu, Chase Irwin, MacKenzie Andrews","doi":"10.17245/jdapm.2025.25.2.123","DOIUrl":"10.17245/jdapm.2025.25.2.123","url":null,"abstract":"<p><strong>Background: </strong>The inappropriate use of opioids in the United States continues to pose a significant challenge to public health. For a look into how the next generation of practitioners may be trained, this survey study sought to evaluate the current opioid prescribing patterns among Oral and Maxillofacial Surgery (OMFS) residency programs in the United States.</p><p><strong>Methods: </strong>A 16-question survey was sent to 100 residency program directors, with responses from 27 programs. The survey aimed to assess the program's strategies for postoperative pain management, including the use of opioids, non-opioids, and other available modalities such as localized long-acting bupivacaine.</p><p><strong>Results: </strong>The results showed that 74% of the responding programs still taught the use of opioid prescriptions for third-molar removal, and 40% of the surveyed programs used prescription narcotics for other extractions as well. One-third of residency programs have adopted the use of localized long-lasting bupivacaine to limit the amount of narcotic medication required for dentoalveolar procedures.</p><p><strong>Conclusion: </strong>This study highlights the implications of these prescription habits and raises questions regarding future improvements to OMFS resident training programs.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 2","pages":"123-132"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813294","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 efficacy of sweet solutions on dental injection related pain: a systematic review of randomized controlled trials.","authors":"Maryam Altuhafy, Tanvi Kaur Ahuja, Junad Khan","doi":"10.17245/jdapm.2025.25.2.83","DOIUrl":"10.17245/jdapm.2025.25.2.83","url":null,"abstract":"<p><p>Oral flavored solutions are effective for pain management. The intraoral application of sweet solutions at the injection site or on the tongue before local anesthetic administration leads to lower self-perceived pain than any other intervention. This systematic review aimed to evaluate the effect of sweet taste on injection pain in patients undergoing dental procedures. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42024571962 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An initial electronic search without a time limit up to September 2024 revealed 1,087 studies from indexed databases (PubMed, Scopus, Embase, Cochrane, and Web of Science). The Cochrane Bias Assessment Tool was used to evaluate the risk of bias. After eliminating duplicate and automated records, 103 studies were screened for inclusion. After reviewing the titles and abstracts and assessing the eligibility of the studies, three were excluded and eight RCTs were considered appropriate for inclusion and analysis. This review highlights that all the included studies reported significantly reduced pain perception after sweet solutions, regardless of the specific type or concentration.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 2","pages":"83-96"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813298","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}