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Restorative

Dental Procedure Success in Pediatric Patients treated under General Anesthesia vs. “Cooperative” Conscious Sedation vs. “Uncooperative” Conscious Sedation: A Retrospective Study

123 - Dental Procedure Success in Pediatric Patients Based on Pharmacological Adjunct

Friday, May 23, 2025
2:00 PM - 2:20 PM MDT
Has Audio

    Presenting Author(s)

  • James H. Kwan, DDS (he/him/his)

    Resident - Pediatric Dentistry
    University of Texas Health Science Center-Houston
    University of Texas Health Science Center-Houston
    Houston, Texas, United States

    • Co-Author(s)

  • Brett T. Chiquet, DDS, PhD (he/him/his)

    Professor and Chair, Department of Pediatric and Community Dentistry
    University at Buffalo School of Dental Medicine
    University at Buffalo School of Dental Medicine
    Buffalo, New York, United States

  • BA

    Bhavini Acharya, BDS

    Pediatric Dentistry Graduate Program Director
    University of Texas Health Science Center-Houston
    Houston, Texas, United States

  • BW

    Ben F. Warner, DDS, MD, MS

    UT Health - Houston

    • Research Mentor(s)

  • Brett T. Chiquet, DDS, PhD (he/him/his)

    Professor and Chair, Department of Pediatric and Community Dentistry
    University at Buffalo School of Dental Medicine
    University at Buffalo School of Dental Medicine
    Buffalo, New York, United States

    • Program Director(s)

  • BA

    Bhavini Acharya, BDS

    Pediatric Dentistry Graduate Program Director
    University of Texas Health Science Center-Houston
    Houston, Texas, United States

Purpose: To compare dental procedure failure rates in pediatric patients based on general anesthesia (GA), cooperative/positive conscious sedation (pCS), and uncooperative/negative conscious sedation (nCS).

Methods: A retrospective review analyzed dental treatments under GA or CS. Of 1,758 charts reviewed, 621 met inclusion criteria, covering 4,322 procedures. Patients were ≤8 years old, ASA I or II, with 24–48 months of clinical and radiographic follow-up. Data collected included procedure date, ASA status, pharmacological/ behavior group, tooth site, procedure type, time to failure, and failure reason. Descriptive statistics and chi-square tests were performed (p <.05 considered significant).

Results: Stainless steel crowns showed no significant failure rate differences by sedation type (p=.805) but failed significantly due to external root resorption (p=.004). Amalgam and resin class I and V restorations failed more under nCS (p=.0009, p=.0001), with recurrent decay as the primary failure reason. Pulpotomy failure was significantly higher with nCS (p=.001). Anterior restorations failed more than posterior ones (p=.0014), while maxillary-mandibular position was not significant. ASA classification alone did not impact failure rates (p=.95).

Conclusion: Sedation type influences restoration failure rates, with uncooperative CS linked to higher failures in amalgam, resin, and pulp therapies. Anterior restorations failed more frequently, regardless of sedation type. Stainless steel crowns demonstrated consistent success, independent of cooperation and/or pharmacological adjunct, reinforcing their role in high-risk pediatric care.