Journal of dental anesthesia and pain medicine最新文献

{"title":"Efficacy of the TuttleNumbNow anesthesia protocol for mandibular first molars: a retrospective study.","authors":"Gregory K Tuttle, Carter K Newell, LaDawn Boucher, Jill Taylor, Jared J Tuttle","doi":"10.17245/jdapm.2026.26.2.133","DOIUrl":"10.17245/jdapm.2026.26.2.133","url":null,"abstract":"<p><strong>Background: </strong>Inferior alveolar nerve block (IANB) is the standard anesthetic approach for mandibular first molars; however, it has well-documented limitations, including variable success rates, delayed onset, higher anesthetic dose requirements, and potential complications. The TuttleNumbNow (TNN) anesthesia protocol introduces intraosseous (IO) injections as the primary anesthetic modality, followed by infiltration and IANB as a last resort. This approach seeks to provide rapid site-specific anesthesia at reduced pharmacological doses. This study evaluated the clinical efficacy of the TNN protocol for mandibular first molar procedures in a private practice setting.</p><p><strong>Methods: </strong>This retrospective observational study reviewed patient records from Tuttle Family Dental (Orem, Utah, USA) between January and December 2023. Eligible cases included patients undergoing composite restorations, crown preparations, or crown seating on the mandibular first molars, where anesthesia was administered according to the TNN protocol. Data were extracted from Eaglesoft electronic dental records and categorized as follows: no anesthetic, single-agent TNN (articaine 4% with epinephrine 1:100,000 or mepivacaine 3% without epinephrine), dual-agent TNN, or conversion to IANB. Descriptive statistics summarized the anesthetic regimens, and Fisher's exact test assessed the association between procedure type and IANB conversion.</p><p><strong>Results: </strong>In total, 184 cases (74 composites, 57 crown preparations, and 53 crown seats) were included. One-quarter of the procedures (47; 24.9%) required no local anesthesia. Of the 137 cases requiring anesthesia, 88 (64.2%) were managed with a single agent, 41 (29.9%) with dual agents, and 8 (5.8%) required an IANB. Overall, 129 of the 137 cases (94.2%) were successfully completed without IANB. The need for IANB was significantly associated with procedure type (P = 0.0008), occurring most frequently during crown preparations (7 of 57 cases, 12.3%).</p><p><strong>Conclusion: </strong>The TNN anesthesia protocol achieved profound anesthesia in 94.2% of mandibular first molar cases without requiring IANB, demonstrating its effectiveness as a primary anesthetic strategy. Compared with traditional IANB, the TNN approach offers rapid-onset, site-specific anesthesia while reducing patient anesthetic exposure and postoperative complications. These findings support reframing IO anesthesia from a secondary \"rescue\" technique to an effective first-line modality. Prospective multicenter studies are warranted to validate its efficacy in broader patient populations.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"133-141"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641115","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":"Dexmedetomidine attenuates nociceptive responses compared with propofol during intravenous sedation for dental surgery: a prospective observational study.","authors":"Saori Tada, Yukie Nitta, Yoko Kudo, Makiko Shibuya, Shigeru Takuma, Kanta Kido","doi":"10.17245/jdapm.2026.26.2.121","DOIUrl":"10.17245/jdapm.2026.26.2.121","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine (DEX) is an α₂-adrenergic agonist widely used for intravenous sedation. Its pharmacological properties suggest autonomic modulatory effects; however, these remain insufficiently characterized during operative procedures. This pilot study compared autonomic responses to surgical stress of DEX and propofol (PPF) during third molar extraction using the Analgesia Nociception Index (ANI), a heart rate variability-derived marker of autonomic balance.</p><p><strong>Methods: </strong>Adults aged ≥18 years undergoing extraction of mandibular third molars under intravenous sedation were prospectively enrolled. Sedation was maintained with either DEX or PPF infusion following a small pre-induction dose of midazolam. ANI was continuously recorded using a High-Frequency Variability Index module, with a 240-s moving average considered equivalent to ANI. The primary outcome was the minimum ANI value within each predefined 5-min intraoperative interval; percent change from baseline (%Δx) was also calculated to account for interindividual variability. Hemodynamic and respiratory variables were evaluated as secondary outcomes. Protocol deviations or incomplete ANI data prompted exclusion. Between-group comparisons were performed using the Wilcoxon rank-sum test, and p-values were interpreted descriptively given the exploratory study design.</p><p><strong>Results: </strong>Thirty patients were enrolled, 24 (n = 12 per group) of whom were included in the final analysis. The baseline demographics, sedation depth (Ramsay Sedation Scale 3-4), and procedural characteristics were comparable. The minimum intraoperative ANI values were consistently higher with DEX; between-group differences were observed at 5-10, 10-15, 15-20, and 25-30 min after surgery onset (all unadjusted P < 0.05). The %Δx values were positive or near zero with DEX, whereas PPF showed progressively negative values with wider dispersion; ANI values intermittently fell below 50 only in the PPF group. Blood pressure was lower with DEX, whereas cardiorespiratory parameters remained similar. Patient State Index (PSI) during sedation was higher with DEX, but intraoperative PSI values were comparable.</p><p><strong>Conclusion: </strong>DEX was associated with greater intraoperative autonomic stability than PPF during intravenous sedation despite similar clinical sedation depths. These findings reflect the distinct pharmacological profiles of both agents. ANI monitoring provides objective insights into autonomic modulatory responses during sedation. Larger randomized trials are required to confirm these preliminary findings.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"121-132"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640774","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":"Large language models approach specialist-level accuracy in dental pain diagnosis: a comparative evaluation of four models.","authors":"Jensen Jiahe Li","doi":"10.17245/jdapm.2026.26.2.155","DOIUrl":"10.17245/jdapm.2026.26.2.155","url":null,"abstract":"<p><strong>Background: </strong>Dental pain is the most common chief complaint in oral healthcare and involves multiple disease types. An accurate diagnosis is crucial for treatment decisions. Large language models (LLMs) have great potential for medical diagnosis; however, their accuracy in dental pain diagnosis has not been systematically evaluated. The objectives of this study were to evaluate the diagnostic accuracy of four advanced LLMs for dental pain and analyze the key factors affecting diagnostic performance.</p><p><strong>Methods: </strong>A comparative study was conducted using 320 dental pain cases from authoritative sources covering eight disease categories. Four state-of-the-art LLMs were evaluated: DeepSeek-R1, ChatGPT-4o, Claude-3.5 Sonnet, and Gemini Pro 2.0. A blinded evaluation was performed by senior experts. The primary outcome was overall diagnostic accuracy, and the secondary outcomes included performance across disease types, complexity levels, and confidence levels.</p><p><strong>Results: </strong>DeepSeek-R1 achieved the highest diagnostic accuracy (83.8%), followed by ChatGPT-4o (82.8%), with no significant differences. Pulpal disease had the highest accuracy (88.1%), whereas neurological pain had the lowest (59.4%). The case complexity significantly affects the accuracy. The AI models demonstrated significant time advantages, representing a 94.2% faster diagnostic speed than human experts.</p><p><strong>Conclusion: </strong>Latest-generation LLMs, particularly DeepSeek-R1 and ChatGPT-4o, achieved diagnostic levels approaching those of specialist physicians while providing substantial time efficiency gains. These findings support the application of AI in oral medicine by using confidence-based stratified implementation strategies.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"155-167"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641063","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":"Effects of experimental clenching and grinding on the masseter muscles and the autonomic nervous system: a preliminary study.","authors":"Yuichiro Ohta, Tomoyasu Noguchi, Yumi Ohtawa, Tomotaka Takeda, Ken-Ichi Fukuda","doi":"10.17245/jdapm.2026.26.2.143","DOIUrl":"10.17245/jdapm.2026.26.2.143","url":null,"abstract":"<p><strong>Background: </strong>Bruxism has been widely discussed. The concepts of normobruxism and pathobruxism have recently been proposed. Severe pain in the masticatory muscles, which may be caused by pathobruxism, needs to be addressed. However, a clear causal relationship between bruxism and chronic pain in the masticatory muscles has not been elucidated. In addition, the effects of clenching and grinding on the body and their differences remain unclear. In particular, no studies have examined the effects of bruxism-like jaw movements on the peripheral tissues of the masticatory muscles and the autonomic nervous system.This study aimed to investigate the effects of bruxism on the masseter muscles and autonomic nervous system and to examine the differences between clenching and grinding.</p><p><strong>Methods: </strong>A total of 18 healthy volunteers, including 8 men (age: 31.3 ± 2.9 years) and 10 women (age: 28.9 ± 3.2 years) who had consented to participate in the study. We experimentally instructed them to clench and grind; measured the dynamic changes in oxygenation, electromyography, and heart rate variability (HRV); and assessed the subjective degree of fatigue.</p><p><strong>Results: </strong>Oxygenation, clenching, and tissue oxygen saturation (StO₂) and oxyhemoglobin (OxHb) levels decreased, whereas deoxygenated hemoglobin (dOxHb) levels increased. No change in grinding occurred; however, significant differences in muscle usage and subjective fatigue were observed between clenching and grinding. No significant differences were identified in HRV.</p><p><strong>Conclusions: </strong>Tissue oxygenation differed significantly between clenching and grinding. Clenching resulted in a significant ischemic state, which rapidly recovered after clenching stopped. Grinding did not affect tissue oxygenation.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"143-153"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640904","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":"<i>Porphyromonas gingivalis</i> and pain modulation: a narrative review.","authors":"Ho-Yang Hsu, Cheng-Chuan Ko, Yen-Chin Liu","doi":"10.17245/jdapm.2026.26.2.109","DOIUrl":"10.17245/jdapm.2026.26.2.109","url":null,"abstract":"<p><strong>Background: </strong>Although the relationship between gut bacteria and pain is increasingly well understood, research on the role of oral bacteria in pain remains limited. <i>Porphyromonas gingivalis</i> (<i>P. gingivalis</i>), a major pathogen in periodontal disease, is known to drive the progression of infection in the oral cavity, leading to inflammation and tissue destruction. However, unlike other conditions, patients with periodontal disease exhibit variable pain responses. This unique presentation suggests that <i>P. gingivalis</i> exerts multifaceted effects on pain modulation.</p><p><strong>Methods: </strong>The bibliographic databases of PubMed, Embase, Google Scholar, and the Cochrane Library were searched for original and reviewed <i>in vitro</i>, animal, and human studies. Key data on pain, inflammation, and neuroimmune pathways were extracted. Studies that did not address pain mechanisms or were limited to non-oral/systemic conditions without a clear link to orofacial pain were excluded.</p><p><strong>Results: </strong>This review summarizes the current evidence on how <i>P. gingivalis</i> influences inflammation and pain, highlighting the interactions between its cell wall components (e.g., lipopolysaccharide and fimbriae), metabolic byproducts (e.g., nitric oxide and butyric acid), and the host immune response.</p><p><strong>Conclusion: </strong>The diverse pain manifestations in <i>P. gingivalis</i>-induced periodontitis may reflect the different stages of disease. Early pain suppression may result from bacterial immune evasion, wherein therapies adjunctive to scaling and root planing, such as host modulation therapy or gingipain inhibitors, may help restore host immunity and improve clinical outcomes.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"109-120"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641217","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":"Perioperative pressure ulcer prevention and skin protection strategies in a patient with epidermolysis bullosa undergoing long-duration surgery.","authors":"Asami Ishii, Takaya Ito, Miki Yokoyama, Mana Nakamura, Kouichi Sugita, Sayaka Asano, Aki Kawauchi, Shigeru Maeda","doi":"10.17245/jdapm.2026.26.2.169","DOIUrl":"10.17245/jdapm.2026.26.2.169","url":null,"abstract":"<p><p>Dominant dystrophic epidermolysis bullosa (DDEB) is a rare inherited skin disorder characterized by extreme fragility of the skin and mucosa that poses significant challenges for anesthetic management. Herein, we report a case of a 65-year-old woman with DDEB who underwent a 13-hour surgery for mandibular cancer under general anesthesia. To prevent skin and mucosal injuries, meticulous perioperative strategies were implemented, including the use of barrier films and pressure-relieving pads and avoiding adhesive devices. High-flow nasal cannula oxygenation enabled awake fiberoptic intubation without the need for mask ventilation, minimizing the risk of blister formation and airway trauma. Despite the prolonged duration, no pressure ulcers or new skin injuries developed, other than minor epidermal peeling of the lips. This case demonstrates that comprehensive preoperative planning and intraoperative protection can ensure safe anesthesia in patients with DDEB undergoing long surgical procedures.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"169-174"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641077","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":"Efficacy of tenoxicam for postoperative dental pain: a systematic review of randomized controlled trials.","authors":"Maryam Altuhafy, Diya Kamdar, Junad Khan","doi":"10.17245/jdapm.2026.26.2.91","DOIUrl":"10.17245/jdapm.2026.26.2.91","url":null,"abstract":"<p><p>Postoperative pain commonly follows dental procedures, and appropriate analgesic selection plays a critical role in its management. This systematic review evaluated the efficacy and safety of tenoxicam compared with other pharmacological agents for postoperative dental pain control. Indexed databases, including PubMed, EMBASE, Ovid, Scopus, Web of Science, and the Cochrane Library, were searched through August 2025. Risk of bias was assessed using the Cochrane Risk of Bias tool for interventions. Nine randomized controlled trials met the inclusion criteria and covered a range of dental procedures, including third molar extraction, endodontic treatment, orthodontic adjustment, and implant surgery. Comparators included placebo, ibuprofen, diclofenac, flurbiprofen, meloxicam, methylprednisolone, and rofecoxib. Pain outcomes were measured primarily with the Visual Analogue Scale at multiple postoperative time points. Across studies, tenoxicam showed analgesic efficacy that was generally superior or comparable to other agents, with several trials reporting statistically significant reductions in pain scores at both early and later postoperative intervals. Most studies had low overall risk of bias, although some raised concerns related to allocation concealment and outcome reporting. Tenoxicam appears to be an effective and well-tolerated option for postoperative dental pain management. Study heterogeneity and domain-level bias concerns indicate a need for additional high-quality trials to confirm these findings and support routine clinical use.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 2","pages":"91-107"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641057","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":"Perioperative management with close renal function monitoring in a dental patient receiving SGLT2 inhibitor therapy for non-diabetic chronic kidney disease.","authors":"Shinichiro Kira, Chiharu Arai","doi":"10.17245/jdapm.2026.26.1.87","DOIUrl":"10.17245/jdapm.2026.26.1.87","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 1","pages":"87-90"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121625","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":"Syncope in dentistry: risk factors, preventive strategies, and management.","authors":"Jia Xuan Li, Aviv Ouanounou","doi":"10.17245/jdapm.2026.26.1.29","DOIUrl":"10.17245/jdapm.2026.26.1.29","url":null,"abstract":"<p><p>Vasovagal syncope is the most common medical emergency in dental practice and is characterized by a transient loss of consciousness during treatment. It may present as an isolated incident triggered by a specific stimulus or as a manifestation of an underlying systemic condition. Understanding the pathophysiology, clinical presentation, and progression of syncope is essential for accurate diagnosis and effective management. Early recognition of the three phases of presyncope, syncope, and recovery enables timely intervention and reduces the risk of complications. This review summarizes the current evidence on risk factors, preventive measures, and behavioral and pharmacological management strategies specific to dental settings. It also examines the dental procedures frequently associated with syncope and outlines the diagnostic workup to exclude alternative diagnoses. By integrating clinical insights with practical recommendations, this review supports dental professionals in the safe and effective management of vasovagal syncope in routine care.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 1","pages":"29-40"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121569","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":"Comparison of electroencephalogram waveforms in older patients with/without dementia after administration of midazolam: a prospective, observational comparative study.","authors":"Megumi Hayashi, Yoshinari Morimoto, Lou Mikuzuki","doi":"10.17245/jdapm.2026.26.1.41","DOIUrl":"10.17245/jdapm.2026.26.1.41","url":null,"abstract":"<p><strong>Background: </strong>Sedation with midazolam in older patients with severe dementia can cause reactions that differ from those encountered in healthy individuals. We hypothesized that one reason for this is that electroencephalogram (EEG) responses to midazolam in patients with severe dementia may differ from those encountered in healthy individuals. In this study, we aimed to examine the effects of midazolam on EEG findings in older patients with severe dementia and compare them with those observed in older adults without dementia.</p><p><strong>Methods: </strong>We included 25 patients aged ≥ 60 years, and allocated them to either the dementia (13 patients) or non-dementia (12 patients) group. Participants with a Mini-Mental State Examination score of ≤ 23, Functional Assessment Staging of Alzheimer's disease stage 6 or 7, and/or Clinical Dementia Rating of being \"severe\" were considered to have severe dementia. EEG electrodes were attached to patients' frontal pole (Fp2). Midazolam was administered until a modified Observer's Assessment of Alertness/Sedation (OAA/S) score of 2 was attained. Chi-square test, Mann-Whitney U test, and Wilcoxon signed-rank test were performed to assess between-group differences. Differences were considered statistically significant at P < 0.05.</p><p><strong>Results: </strong>The power of the delta wave at baseline and immediately before treatment was higher in patients with dementia than that in the patients without dementia. Conversely, the power of the alpha wave was lower in the dementia group in the sedated state of the OAA/S 2. Regarding the changes within each group, the theta and beta waves in the dementia group decreased after midazolam administration.</p><p><strong>Conclusion: </strong>Regarding EEG waveforms in the frontal pole, administration of midazolam significantly decreased the power of the fast wave (alpha wave) and increased the power of the slow wave (delta wave) in older patients with severe dementia compared with that in older patients without cognitive decline.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"26 1","pages":"41-51"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121571","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}