Background and aims. There are several known sedative drugs, with midazolam and ketamine being the most commonly used drugs in children. The aim of this study was to compare the effect of intranasal and oral midazolam plus ketamine in children with high levels of dental anxiety.Materials and methods.A crossover double-blind clinical trial was conducted on 23 uncooperative children aged 3-6 (negative or definitely negative by Frankel scale), who required at least two similar dental treatment visits. Cases were randomly given ketamine (10 mg/kg) and midazolam (0.5 mg/kg) through oral or intranasal routes in each visit. The sedative efficacy of the agents was assessed by an overall success rate judged by two independent pediatric dentists based on Houpt’s scale for sedation. Data analysis was carried out using Wilcoxon test and paired t-test.Results. Intranasal administration was more effective in reduction of crying and movement during dental procedures compared to oral sedation (P<0.05). Overall behavior control was scored higher in nasal compared to oral routes at the time of LA injection and after 15 minutes (P<0.05). The difference was found to be statistically significant at the start and during treatment. However, the difference was no longer significant after 30 minutes, with the vital signs remaining within physiological limits. Recovery time was longer in the intranasal group (P<0.001) with a more sleepy face (P=0.004).Conclusion.. Intranasal midazolam/ketamine combination was more satisfactory and effective than the oral route when sedating uncooperative children.
A numerical investigation is provided to study the residual stress states in multi-pass TIG welding of stainless steel SUS304 pipe. An uncoupled thermomechanical three-dimensional finite element model is developed using the ABAQUS software for a circular weld design around the pipe. The effects of weld pass numbers, electrode moving speed, and heat input on the internal and external surface tensions of the pipe are investigated. The simulation results show that by increasing the welding speed, the axial tensile stresses decrease on the pipe surfaces. In the case of hoop stress, as the welding speed raises, the tensile and compressive stresses are increased for both two- and three-pass welding. However, the width of the stress zone becomes narrower in higher welding speeds. The hoop stresses, in comparison with the axial stresses, are more strongly influenced by the welding speed and the heat input. Furthermore, using the three-pass welding process results in much lower stresses in comparison with the two-pass one.
Background. Functional appliances are frequently used to stimulate mandibular growth in cases of Class II malocclusion with mandibular deficiency. Many studies have reported improved pharyngeal airway passage (PAP) dimensions following functional appliance therapy in children.Objectives. The present study aimed to assess changes in the airway dimensions following the treatment of Class II malocclusion patients with the twin-block and Seifi appliances.Material and methods. Lateral cephalograms of 37 patients with Class II malocclusion and mandibular deficiency treated with the twin-block appliance (n = 20) or the Seifi appliance (n = 17) were assessed in this before-and-after study. The preoperative and postoperative lateral cephalograms were compared to determine changes in the airway dimensions at the level of the palatal plane (PP), the occlusal plane (OP) and the 2 nd -4 th cervical vertebrae (C2-C4) in the 2 groups. The results were analyzed with the t test and the one-way analysis of covariance (ANCOVA).Results. After treatment, significant changes occurred in the point A-nasion-point B (ANB) and sellanasion-point B (SNB) skeletal cephalometric indices in the twin-block appliance group, and in ANB, SNB and incisor-mandibular plane angle (IMPA) in the Seifi appliance group. The airway dimensions at the level of PP, OP and the 3 rd cervical vertebra (C3) significantly increased postoperatively as compared to the baseline in the twin-block appliance group (p < 0.05). The increases in the airway dimensions at the level of PP and C3 in the twin-block appliance group were significantly greater than in the Seifi appliance group (p < 0.05).Conclusions. The treatment of Class II Division I malocclusion with the twin-block appliance significantly increased the airway dimensions at the level of PP, OP and C3, whereas the Seifi appliance did not cause any significant changes in the airway dimensions.
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