Objectives: The objectives of this study are to evaluate the efficacy of midazolam as a means of conscious sedation in pediatric odontology through three routes of administration: oral, rectal and nasal administration, to compare the efficacy of these different routes and to assess the general safety of Midazolam. Materials and Methods: Thirty healthy non-cooperating (ASAI) patients (levels 1 and 2 on the FRANKL scale), aged 2 to 5 years and requiring a minimum of three dental sessions were recruited. Each patient received three sessions of sedation, using a different route of administration each time: oral (0.5 mg/kg), rectal (0.3 mg/kg) and nasal (0.2 mg/kg). The assessment of the behavior throughout the dental care was made using the Houpt scale. Physiological parameters(heart rate and oxygen saturation) were measured every five minutes to assess tolerance. Results: The three routes of administration of midazolam were considered effective since all patients presented a behavior allowing a complete management without interruption of care except for one patient. The sedative effect of the oral and rectal routes was similar, as to the nasal route, it was judged to be clinically better but without any statistically significant differences. The most accepted route of administration by patients was the oral one followed by the nasal and rectal routes. No intolerance to midazolam was observed. Conclusion: Midazolam is an effective sedative for dental care, acceptable by patients and well tolerated regardless of the route of administration.
Introduction: According to data from the World Health Organization (WHO), cancer is diagnosed each year in about 300,000 children aged 0-19 years, with 1,000 new cases recorded each year in Morocco, in the population under 15 years of age. Anticancer therapies (chemotherapy, radiotherapy, surgery, biphosphonates ...) are often accompanied by various side effects sometimes disabling, those oral are very variable. The main manifestations described are: mucitis, xerostomia, infections, bleeding complications, caries, periodontal disease and dental anomalies, loss of taste, temporomandibular ankylosis, odontoradionecrosis, osteoradionecrosis, or radionecrosis related to biphosphonate use. In the literature, several studies focus on the relationship between childhood cancer, its treatment and its effect on the oral cavity. However, with the changes in protocols for the management of children with cancer, several studies have shown that advances in cancer therapy have had an impact on previously recognized oral complications. Aim: To analyze previously published systematic reviews on the oral manifestations of antimitotic therapy in children with a specific focus on their prevalence, prevention and management,in addition to highlighting the level of evidence from these reviews.
Aim: To assess the impact of oral health on the quality of life in children with acute leukemia. Methods: Forty children (age 11 to 14 years) with acute leukemia from the Pediatric Oncology and Hematology Departments of the 20th August Hospital Casablanca and the Pediatrics Department P3 at Abderrahim Harouchi Hospital Casablanca, Morocco were surveyed. Data was collected via an administered questionnaire. The questionnaire is a translated version of the Child-Oral Impacts of Daily Performance Questionnaire in Arabic (validated in Morocco). Results: The most commonly reported problems were: dental tartar, teeth position abnomalities, tooth decay, dental sensitivity and oral ulcerations. The overall prevalence of oral problems impacting upon daily activities (eating, speaking, cleaning teeth, relaxing, sleeping, smiling, showing teeth, studying and being in touch with other children) over the last 3 months was 52.5%. The most frequently affected daily activity was eating difficulties (45%) while the most frequently reported problem was oral ulcerations. Conclusion: Studies have confirmed that children over the age of 11 are able to perceive their general and oral health as well as its impact on their daily lives. The current study showed that oral problems on top of general health complications among children with acute leukemia lead to a deterioration in their quality of life, which is already affected by malignancy and chemotherapy.
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