Li-Chuan Chuang

Purpose Intravenous sedation has been well accepted to allow dental restoration in uncooperative children while avoiding aspiration and laryngospasm; however, intravenous anesthetics such as propofol may lead to undesired effects such as respiratory depression and delayed recovery. The use of the bispectral index system (BIS), a monitoring system reflective of the hypnotic state, is con-troversial in the reduction in the risk of respiratory adverse events (RAEs), recovery time, the in-travenous drug dosage, and post-procedural events. The aim of the study is to evaluate whether BIS is advantageous in pediatric dental procedures. Methods A total of 206 cases, aged 2–8 years, receiving dental procedures under deep sedation with propofol using target-controlled infusion (TCI) technique were enrolled in the study. BIS level was not monitored in 93 children whereas it was for 113 children, among which BIS values were maintained between 50–65. Physiological variables and adverse events were recorded. Statistical analysis was conducted using Chi-square, Mann Whitney U, Independent Samples t and Wilcoxon signed tests, with a p value of p value < 0.05) and discharge time (63.4 ± 23.2 vs. 74.5 ± 24.0 min, p value < 0.001) between these two groups. Conclusions The application of BIS in combination with TCI may be beneficial for young children undergoing deep sedation for dental procedures.

We conducted this retrospective study to identify potential clinical, polysomnographic, and cephalometric predictors for the treatment outcomes of a tongue-beaded oral appliance (OA) in children with obstructive sleep apnea syndrome (OSAS). In total, 63 patients—50 boys and 13 girls ranging in age from 4 to 16 years—underwent OA treatment nightly for at least 6 months. A baseline digital lateral cephalometric radiograph was obtained for each patient. Multivariate logistic regression analysis was performed to examine predictors for the treatment outcome based on the clinical and cephalometric measurements. Overall, 28 patients responded to the treatment (post-treatment improvement > 50% or apnea–hypopnea index (AHI) < 1/h), and 35 did not (post-treatment improvement < 50% and AHI ≥ 1/h). Significantly larger cranial base angle (SNBa), smaller lower gonial angle (LGo Angle), and shorter length of anterior cranial base (SN) were found in responders. Smaller lower gonial angle (LGo Angle) and smaller anterior cranial base (SN) predict a favorable outcome for pediatric OSAS using a tongue-beaded OA. This finding will equip practitioners with additional insights when selecting suitable candidates for OA therapy in pediatric patients.

Bioaerosols produced by dental procedures may affect indoor air quality and cause infections in dental healthcare workers. To provide air quality data that can be used to protect dental healthcare workers, this study evaluated the air quality and its influencing factors in the dental department of the Chang Gung Memorial Hospital in Taiwan. The study was a cross-sectional study design. Indoor air quality (IAQ) evaluations were conducted in six locations: pediatric dentistry, craniofacial orthodontic dentistry, periodontal dentistry, and general practice dentistry, instrument washing room, and patient waiting area. The measured air quality parameters included temperature, relative humidity, and concentrations of CO₂, total volatile organic compounds (TVOCs), suspended particulate matter (PM), and bacteria. TVOCs concentrations at all six sampling stations were found to exceed the indoor air quality standards prescribed by the Taiwan Environmental Protection Agency. The highest concentrations of atmospheric PM₁₀, PM_2.5, and PM₁ were found in the periodontal dentistry department, while the lowest concentrations occurred in the patient waiting area. The detection rate for Gram-positive bacteria was highest in the pediatric department (25%) and lowest in the instrument washing room (9%). Micrococcus luteus and Bacillus cereus were the primary pathogens detected. The dental departments of the hospital had a serious TVOCs pollution. The air quality of dental departments deserves long-term surveillance and attention.