SynthesisFrontiers in medicine2026
Intranasal dexmedetomidine versus midazolam for pediatric dental sedation: a pooled analysis of clinical trials.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: The optimal intranasal sedative agent for pediatric dental procedures remains a subject of debate. We systematically reviewed and meta-analyzed head-to-head trials comparing intranasal dexmedetomidine, intranasal midazolam, oral midazolam-based regimens, and intranasal combination regimens for pediatric dental sedation. Methods: PubMed, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials were searched (2014-2025) in accordance with the PRISMA 2020 statement. The primary outcome was procedure success rate; secondary outcomes included onset time, sedation duration, satisfactory sedation rate, satisfactory behavior rate, and adverse events. Dichotomous outcomes were pooled as risk ratios (RR) and continuous outcomes as mean differences (MD), using a DerSimonian-Laird random-effects model; the certainty of evidence was rated using GRADE. All meta-analyses were performed in RevMan Web 5.4.1, with single-arm rates presented descriptively. Results: Seventeen studies involving 1,215 children aged 1-14 years met the inclusion criteria, including 15 studies randomized controlled trials (RCTs) and 2 non-randomized studies. For the primary comparison of intranasal dexmedetomidine versus intranasal midazolam, the procedure success rate showed RR of 1.29 (95% CI: 0.86, 1.94; I Conclusion: Intranasal dexmedetomidine and intranasal midazolam are both clinically effective for pediatric dental sedation. Intranasal dexmedetomidine achieved a comparable procedure success rate and satisfactory sedation rate to intranasal midazolam, while demonstrating a slower onset and longer sedation duration. No statistically significant differences were detected in the procedure success rate between intranasal and oral sedation regimens or between combined and single intranasal regimens. Further adequately powered head-to-head RCTs with standardized outcome definitions are needed. Systematic review registration: https://osf.io/qc34e/.
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