Volume 35, Issue 3 pp. 500-509
ORIGINAL ARTICLE

Sedative and behavioral effects of atomized intranasal midazolam in comparison with nebulized midazolam for children undergoing dental treatment: A randomized clinical trial

Amira Abdelhafeez Elkhatib

Corresponding Author

Amira Abdelhafeez Elkhatib

Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt

Correspondence

Amira Abdelhafeez Elkhatib, Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.

Email: [email protected]

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Yousr Nader Mowafy

Yousr Nader Mowafy

Faculty of Dentistry, Alexandria University, Alexandria, Egypt

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Tamer A. M. Ghoneim

Tamer A. M. Ghoneim

Faculty of Medicine, Alexandria University, Alexandria, Egypt

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First published: 10 September 2024
Citations: 1

Abstract

Background

Fear and anxiet are significant barriers of dental care in children. Sedation emerged as a valuable behaviour guidance technique to manage uncooperative children.

Aim

To evaluate the sedative and behavioral effectiveness of midazolam administered via nebulizer in comparison with intranasal atomizer in the behavior management of anxious children during dental treatment.

Study Design

Two-arm randomized clinical trial with 68 children (3–5 years) assigned to receive nebulized midazolam (NEB MDZ) and atomized intranasal midazolam (AIN MDZ) during dental treatment. The onset time, sedation levels, and behavior of children were documented. The data were analyzed using the Wilcoxon signed-rank test and Mann–Whitney U tests.

Results

Significant differences between the two groups in terms of onset time, sedation level, and behavior of children during the dental treatment. AIN MDZ was associated with a significantly faster onset time compared with NEB MD, (p < .001). Children who received NEB MDZ exhibited deeper levels of sedation compared with AIN MDZ group (p = .02). During the administration of local anesthesia, notable statistical differences were observed between the behavior of the two groups (p = .02).

Conclusions

Midazolam administered via either nebulizer or intranasal atomizer was the effective route of administration and proved effective in the management of anxious children undergoing dental treatment. AIN MDZ, however, exhibited a faster onset time, whereas children receiving NEB MDZ demonstrated superior behavior compared with those receiving AIN MDZ.

CONFLICT OF INTEREST STATEMENT

There are no conflicts of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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