Success of Dental Treatments under Behavior Management, Sedation and General Anesthesia.

OBJECTIVE To present comparative study aims to assist the practitioner to choose between behavior modification (BM) techniques, pharmacologic sedation (N2O-O2 alone or combined with midazolam 0.5 mg/ kg) or routine general anesthesia (GA) for the most successful approach in enabling pediatric dental care. STUDY DESIGN Dental records of 56 children treated in a university dental clinic between 2006-2016 were reviewed, and data on age, gender, required treatment (amalgam restorations, composite restorations, pulpotomy, and stainless steel crowns [SSC]), treatment approaches and therapeutic success at final follow-up were retrieved. RESULTS Treatment under GA had the best success rates compared to both BM and pharmacologic sedation. N2O-O2 alone had a 6.1-fold greater risk of failure compared to N2O-O2+midazolam (p- <0.008). Amalgam restorations had a 2.61-fold greater risk of failure than SSC (p- <0.008). CONCLUSIONS The GA mode yielded significantly greater success than the N2O-O2 mode alone. There were no significant differences in success rates between GA and combined midazolam 0.5 mg/kg+N2O-O2. When choosing restoration material, it is important to remember the high success rate of SSC compared to amalgam restoration.

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