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Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis

Author

Listed:
  • Claudia Salerno

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

  • Silvia Cirio

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

  • Giulia Zambon

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

  • Valeria D’Avola

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

  • Roberta Gaia Parcianello

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

  • Cinzia Maspero

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
    Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy)

  • Guglielmo Campus

    (Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland)

  • Maria Grazia Cagetti

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy)

Abstract

This systematic review and meta-analysis was aimed to investigate the conscious sedation efficiency in patients with intellectual disability undergoing dental treatment (PROSPERO CRD42022344292). Four scientific databases were searched by ad-hoc prepared strings. The literature search yielded 731 papers: 426 were selected, 42 were obtained in full-text format, and 4 more were added after hand searching. Fourteen studies were finally included, 11 of which were included in the meta-analysis (random effect model). A high heterogeneity in the drugs used and route of administration was retrieved. Success rate, occurrence of side effects, and deep sedation occurrence were combined to give an overall efficiency of each drug. N 2 O/O 2 reported the highest efficiency (effect size = 0.90; p < 0.01) and proved to be more efficient when used alone. Nine papers reported a success rate of sedation of 80% or more. The prevalence of side effects (6 studies) ranged from 3% to 40%. Enteral and parenteral benzodiazepines showed the same overall efficiency (effect size = 0.86). No meta-analysis has yet been conducted to define the most effective and safest way to achieve conscious sedation in patients with intellectual disability; nitrous oxide appears to be the best choice to perform conscious sedation in patients with intellectual disability undergoing dental treatment.

Suggested Citation

  • Claudia Salerno & Silvia Cirio & Giulia Zambon & Valeria D’Avola & Roberta Gaia Parcianello & Cinzia Maspero & Guglielmo Campus & Maria Grazia Cagetti, 2023. "Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 20(3), pages 1-21, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:1779-:d:1040096
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    Cited by:

    1. Annelyse Garret-Bernardin & Paola Festa & Giorgio Matarazzo & Arina Vinereanu & Francesco Aristei & Tina Gentile & Simone Piga & Elena Bendinelli & Maria Grazia Cagetti & Angela Galeotti, 2023. "Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study," IJERPH, MDPI, vol. 20(5), pages 1-11, February.

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