Mittal N, Goyal A, Jain K, Gauba K
J Clin Pediatr Dent. 2015 Spring;39(3):284-91. doi: 10.17796/1053-4628-39.3.284.
Despite the voluminous literature addressing the safety and efficacy of various sedative agents in the pediatric dental setting, the quality literature to form evidence based pediatric dental sedation practice is not available. Our search through PUBMED showed that during 1985-2012, a total of 184 original research papers on pediatric dental sedation were reported, and midazolam clearly dominated with 88 trials on this agent. Despite these large numbers of papers, Cochrane Review was able to pool a weak evidence in favor of midazolam. Data pooling from five heterogeneous high risk of bias trials showed that oral midazolam is associated with more cooperative behavior when compared to a placebo. Further, a very weak evidence regarding efficacy of nitrous oxide was collected from two trials, which could not be pooled. These findings draw attention to the need to address the shortcomings in the current state of pediatric dental sedation research. The present article has been focused on the current status of pediatric dental sedation research, and the limitations in the current research methodology. This paper also suggests recommendations for future research in the field of pediatric dental sedation.
尽管有大量文献论述了各种镇静剂在儿童牙科治疗中的安全性和有效性,但目前尚无高质量的文献来形成基于证据的儿童牙科镇静实践。我们通过PubMed检索发现,在1985年至2012年期间,共报道了184篇关于儿童牙科镇静的原创研究论文,其中咪达唑仑明显占主导地位,有88项关于该药物的试验。尽管有大量此类论文,但Cochrane系统评价仅能汇总出微弱的证据支持咪达唑仑。对五项存在异质性且偏倚风险高的试验进行数据汇总后发现,与安慰剂相比,口服咪达唑仑与更高的合作行为相关。此外,从两项试验中收集到了关于一氧化二氮疗效的非常微弱的证据,无法进行汇总。这些发现凸显了有必要解决儿童牙科镇静研究现状中的不足之处。本文重点关注儿童牙科镇静研究的现状以及当前研究方法的局限性。本文还对儿童牙科镇静领域未来的研究提出了建议。