Abstract Aims: This prospective clinical observation study aims to assess the correlation between saliva LL-37 levels, periodontal status, and their impact on wound healing in patients undergoing oral surgical procedures. Materials and Methods: A total of 50 individuals were recruited: 25 patients diagnosed with chronic periodontitis (designated as group I) and 25 periodontally healthy subjects (designated as group II). Probing pocket depth (PPD), Clinical attachment loss (CAL), and bleeding on probing (BOP) were documented. Saliva LL-37 and serum C-reactive protein (CRP) concentrations were measured by ELISA. Post-operative wound recovery was evaluated using the Inflammatory Proliferative Remodeling (IPR) scale. Results: At baseline, Group I had significantly higher levels of LL-37 (46.13±15.49) than Group II (periodontally healthy (3.61 ±2.59) (p-value = 0.000). LL-37 saliva level remained significantly higher in the periodontitis group post-operatively (p value= 0.000). Serum level of CRP followed the same trend as did LL-37, with a significant difference between the two study groups at baseline and post-operatively. Group I, delayed healing was reported, represented by the poor healing scale (IPR score =3.7±2.51) and a negative correlation with salivary LL-37 levels (r= -0.67, p < 0.01). A strong positive correlation was found (r = 0.83) between LL-37 and CRP levels at baseline and post-operatively. Conclusion: High LL-37 levels are associated with chronic periodontal inflammatory conditions and correlate with delayed healing post-surgery. Assessing LL-37 levels may function as a potential biomarker to mirror surgical risk and design preoperative interventions in dental patients.
Aims: The present study aimed to analyze the frequency of congenitally missing maxillary lateral incisors and evaluate gender-related differences among children in Duhok City, Iraq. Materials and Methods: The study was conducted by collecting 600 ortho pantomographs (OPGs) of patients aged 6–14 years from a private dental center in Duhok. Patients with prior extractions, craniofacial anomalies, or orthodontic treatment were omitted. The presence of unilateral or bilateral maxillary lateral incisor agenesis was recorded, and statistical analysis was performed via Fisher’s exact test, with significance usually at p<0.05. Results: Total prevalence of maxillary lateral incisor agenesis was 5.67%. Female patients confirmed a significantly higher prevalence (7.74%) related to males (3.45%) (p<0.0001). Bilateral agenesis was more common than unilateral cases. Side-specific analysis illustrates slight differences: the left side is commonly affected in females and the right side in males. Conclusion: Maxillary lateral incisor agenesis is less common, because % is 5% among children in Duhok, with a higher incidence in females. Early detection and multidisciplinary management are essential for heightening esthetic and functional results. Further studies are recommended to discover innovative genetic and environmental risk factors.
Aims: The present study aimed to evaluate physics forceps and conventional forceps with regard to their impact on dimensional changes of the tooth socket, specifically buccolingual and mesiodistal dimensional changes, immediately after tooth extraction. Materials and Methods: A prospective randomized clinical study of 48 patients requiring posterior tooth extractions was undertaken. The patients were randomly divided into two equal groups: one group received extractions using conventional forceps, and the other group received extractions using physics forceps. Immediately after tooth extractions, the buccolingual and mesiodistal dimensional changes of the tooth sockets were measured using calibrated plastic rulers and were compared with the root trunk dimensional changes. Socket dimensional changes were calculated and statistically analyzed using an independent samples t-test with significance set at P ≤ 0.05. Results: The results of this study showed that the dimensional changes of the tooth sockets using conventional forceps were greater than those using physics forceps, specifically concerning buccolingual dimensional changes, which were 1.667 ± 0.916 mm for conventional forceps and 1.208 ± 0.414 mm for physics forceps, with a statistically significant difference of P = 0.031. On the other hand, there were no statistically significant differences in dimensional changes of tooth sockets using both forceps concerning mesiodistal dimensional changes, which were 0.729 ± 0.389 mm for conventional forceps and 0.750 ± 0.329 mm (P = 0.842). Root fractures were only recorded in the conventional forceps group, with no complications recorded for the extractions in both groups. Conclusion: Physics forceps were associated with significantly lower buccalingual socket expansion compared to conventional forceps, implying better bone preservation. The changes in the mesiodistal direction were comparable for both extraction methods used. The physics forceps could be considered a better alternative for situations where alveolar bone preservation is critical, for example, in preparation for implant placement in the future.
Aims: This study aimed to assess the effect of incorporating different concentrations of MgO nanoparticles on some mechanical properties of room-temperature vulcanized) RTV) maxillofacial silicone material. Materials and Methods: A total of 120 silicone specimens were constructed,40 specimens for each mechanical property, which are tear, tensile, and hardness groups, and each group was divided into four subgroups according to MgO Nps concentration (0%, 1%, 2%, and 3%) groups with 10 specimens for each one. Silicone and MgO Nps were mixed and cured according to their standardization procedures. Tear and tensile strength were estimated by utilizing a universal testing machine; Shore A hardness was estimated with a durometer. Fourier transform infrared spectroscopy (FTIR) was used to check the chemical integrity and molecular interactions between silicone and MgO NPs. Results: One-way ANOVA showed that the addition of MgO NPs significantly changed the mechanical properties of silicone elastomers (p ≤ 0.05). Both tear and tensile strength reached their highest values at 2% MgO Nps, followed by 1% MgO Nps, and then declined at 3% MgO Nps concentration. Post-hoc pairwise comparison reveals no significant difference between the 1% and 3% groups for the tear strength test and no significant difference between the control and 3% groups for tensile strength. Shore A hardness increased as the concentration of MgO NPs increased from 1% to 3%, with a significant difference among all groups. FTIR showed the same peak intensities in the control and experimental groups, indicating that no changes or molecular interactions had occurred. Conclusion: The incorporation of MgO nanoparticles affected the tested mechanical properties of RTV maxillofacial silicone. The concentration of 2% was considered the ideal percentage of MgO NPs for both tear and tensile strength; higher concentrations further increase surface hardness but reduce the overall material strength parameter.
Aims: The present study aimed to employ CBCT technology to investigate the prevalence, gender distribution, and classification (following Archer's 1975 method) of impacted maxillary canines in Duhok City in order to establish a standard for local clinical practice Materials and Methods: In this retrospective cross-sectional study, 4,368 CBCT scans from various private clinics and dentistry centers in Duhok City between 2021 and 2026 were examined. The study sample comprised 2,111 males and 2,257 females, aged 12 to 60 years. Archer's categorization was used to identify and classify impacted maxillary canines. SPSS version 29 was used for statistical analysis. Associations were found using Chi-square and Fisher's exact tests, with a P < 0.05 threshold for statistical significance. Results: Out of the entire sample, 162 individuals (3.6%) had at least one maxillary canine impacted. The frequency was much higher in women (2.6%) than in males (1.1%). The next most prevalent categories were Class II (buccal), Class I (palatal), and Class III (mixed labial–palatal). Archer Class IV (impaction inside the alveolar process) accounted for 1.8% of cases. There was a statistically significant correlation found between gender and both the kind of impaction and the impaction status. Conclusion: The prevalence of impacted maxillary canines in Duhok City was relatively elevated compared to other previous studies on the same population (in Duhok City), more than or higher than other populations (in other cities)
Aims: The present study aimed to examine the incidence of dentists who prescribe antibiotics following extraction, identify the most often prescribed antibiotic, and ascertain the rationale behind antibiotic prescriptions. Materials and Methods: A cross-sectional study was conducted among 150 dentists working in both private and governmental hospitals in Erbil City. Data regarding antibiotic prescribing practices following tooth extraction were collected using a structured questionnaire. The frequency of antibiotic prescription, indications for use, and the types of antibiotics prescribed were analyzed descriptively. Results: Approximately 77% of the participating dentists reported prescribing antibiotics following dental extraction procedures. Facial swelling was identified as the most common indication for antibiotic administration (63%). Amoxicillin was the most frequently prescribed antibiotic, accounting for 65% of prescriptions. Conclusion: The majority of dentists prescribe antibiotics following extraction. The primary rationale for prescribing antibiotics was facial edema. The most often utilized antibiotic was amoxicillin.
The clinical manifestations of the adverse effects of drugs in the oral cavity are diverse. New therapeutic agents have revolutionized the treatment of various studies focusing on the basic clinical manifestations of oral drug reactions, such as ulcers, infections, xerostomia, lichenoid reactions, pigmentation, white lesions, hyperplasia, paresthesia, osteonecrosis, angioedema, and malignancy. Dentists who provide oral health care should be familiar with these assays because they will encounter them in their practice.
Aims: This study aimed to assess the mechanical properties (Flexural strength, Compression strength, and hardness) and accuracy (trueness and precision) of plant-based resin as dental models in relation to conventional resin. Materials and Methods: Sixty specimens for mechanical properties (20 specimens for each test) evaluation and 20 dental models were fabricated using two types of 3D printing resins (plant-based and conventional) printed by an LCD 3D printer with 75 µm layer thickness and zero-degree printing orientation. The mechanical performance was assessed through flexural strength, compressive strength, and hardness testing. Dimensional accuracy was evaluated by digitally scanning the printed models with a lab scanner and analyzing the datasets using Geomagic Control X software. Results: Descriptive analysis and an independent samples t-test were performed. The results show that the plant-based resin exhibited equivalent values to those of the conventional model resin for flexural strengths (49.81±3.47 MP, 48.41±4.14 MP respectively), compressive strengths (4127.39±1.1MP, 127.3±0.59 MP respectively), and hardness (70.68±0.49 and 70.72± 1.12 respectively). No statistically significant differences (p=0.105) were observed between the two resin types in terms of model trueness, whereas the plant-based resin demonstrated higher precision than the conventional resin (0.184±0.04 and 0.257± 0.09 mm, respectively). Conclusion: Plant-based resins demonstrate mechanical and dimensional properties comparable to those of conventional 3D-printed model resin. Plant-based resin shows superior precision to conventional resin.
Aims: This study aimed to evaluate the necessity of level IIb dissection in patients within an Iraqi cohort. Materials and Methods: The histopathological and clinical data of 50 patients with oral squamous cell carcinoma (29 males and 21 females), treated between June 2018 and June 2020, were analyzed. Histopathological studies were conducted on 857 lymph nodes, including 143 from level IIb, after immunohistochemical staining with cytokeratin 5/6. Statistical tests assessed predictors of level IIb involvement. Results: Level IIb involvement was observed in only 2 cases (4%) with concurrent level IIa metastasis. No isolated level IIb involvement was detected. Primary tumor location (p =0.03) was a significant predictor of level IIb involvement. Other variables, such as age (p-value = 0.2675), sex (p-value = 0.503), grade (p-value = 0.1), DOI (p-value = 0.617), size (p-value = 0.319), and neck status (p-value =0.099), showed no significant association with level IIb involvement. Conclusion: Routine dissection of level IIb is unnecessary in clinically negative oral squamous cell carcinoma cases and should be reserved for clinically positive or advanced diseases. Further studies incorporating advanced diagnostics are needed to refine clinical guidelines.
Aims: The present study aimed to evaluate the influence of Chitosan nanoparticle irrigants at two concentrations (0.2% and 0.5%) and compare them with other irrigants on the push-out bond strength of obturation endodontic sealers. Materials and Methods: Fifty-four human lower premolar teeth with single, straight roots were extracted and utilized. Teeth were prepared to a 12 mm length. Biomechanical preparation of the canal was carried out through the ProTaper universal system. Six Groups were developed depending on the final irrigation. GI: 0.2% Chitosan nanoparticles (CNPs), GII:0.5% Chitosan nanoparticles (CNPs), GIII: 17% Ethylenediaminetetraacetic acid (EDTA), GIV: 3% Sodium hypochlorite (NaOCl), GV: 2% Chlorohexidine (CHX), and GVI: Distilled water as the control group. Afterward, the groups were subdivided into 3 subgroups (n=3) based on the sealer used: (A) AH Plus sealer, (B) MTA Fillapex sealer, (C) EndoFill sealer. F3 gutta-percha cone and a single cone procedure were used to fill all samples with sealer. From each sample, three slices, 2 mm thick, were cut at 3, 7, and 11 mm from the apex. They were labeled coronal, middle, and apical in that order. A universal testing machine was used to analyze push-out bond strength (POBS), and a stereomicroscope with a 40X magnification was utilized to examine the mode of failure. Then, the data were collected and analyzed statistically. Results: The highest mean Push-out bond strength (POBS) at the apical third is Chitosan nanoparticles (CNP), followed by Ethylenediaminetetraacetic acid (EDTA), then Sodium hypochlorite (NaOCl), 0.5% Chitosan nanoparticles (CNP) significantly differs from 0.2% Chitosan nanoparticles (CNP). Chlorohexidine (CHX) increased Push-out bond strength POBS of AH Plus sealer and MTA Fillapex at coronal and middle, respectively. The lowest mean Push-out bond strength (POBS) is Sodium hypochlorite (NaOCl) and distilled water Conclusion: Chitosan nanoparticles (CNPs) are a new final washing improve bond strength of resin-based and MTA-based sealers better than 17% Ethylenediaminetetraacetic acid (EDTA). And 2% Chlorohexidine (CHX) is as effective as chitosan nanoparticles (CNPs) in improving bond strength of resin-based AH Plus, MTA Fillapex and EndoFill sealers.
Aims: The present study aimed to assess the accuracy of surgical guides fabricated using two different 3D printers, two resins, and different occlusal designs (OS: original shape; GS: groove sealing). Materials and Methods: Forty surgical guides were printed on a digital light processing (DLP) printer and a Liquid Crystal Display (LCD) printer, with two resin types (SG guide and V-guide) and two occlusal designs. The region where the implant was planned was digitally removed from the cast, allowing passive positioning of the implant through the guide. A scan body was inserted in the implant, and the cast was scanned with an intraoral scanner. The planned implant was compared with the actual implant position. Six measurements representing the accuracy of implant placement: (depth, angular, global apical, horizontal apical, global coronal, and horizontal coronal) deviations. Descriptive statistics and a multivariate analysis of variance (MANOVA) were conducted. Results: The DLP printer and GS group exhibited lower mean deviation and standard deviation across all measured parameters. Printer type had a statistically significant multivariate effect (Wilks’ Lambda = 0.015, p< 0.001, Partial η² = 0.985). The resin type had no multivariate effect on the combined dependent variables, as indicated by Wilks’ Λ = 0.727, p = 0.161. Occlusal shape showed a significant multivariate effect (Wilks’ Lambda = 0.015, p<0.001). The univariate tests revealed that printer type and the shape of the occlusal surface had a statistically significant effect on all six deviation parameters (p < 0.001 for all); however, resin type had a significant effect only on horizontal coronal deviation (p = 0.018). Conclusion: The DLP printer was more accurate than the LCD printer. Also, the accuracy of a surgical guide can be improved by sealing the occlusal surface grooves directly before fabricating the guide. The accuracy of both SG and V-guide resins was the same
Aims: To systematically evaluate the effectiveness, clinical outcomes, material performance, patient satisfaction, and technological limitations associated with 3D-printed try-ins for complex ceramic veneers. Data Sources: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar covering publications from January 2010 to September 2025. Study Eligibility Criteria: Peer-reviewed studies assessing 3D-printed try-ins within ceramic veneer workflows were included. Eligible designs comprised clinical trials, experimental studies, observational studies, and systematic reviews reporting quantitative or qualitative outcomes. Case reports, editorials, non-English articles, and studies unrelated to ceramic veneers or try-in fabrication were excluded. Materials and Methods: This review examines its impact on clinical outcomes, patient satisfaction, and technological limitations. A systematic search of PubMed, Scopus, Web of Science, and Google Scholar from 2010 to 2025 identified 2,173 records, of which 19 studies met the inclusion criteria following PRISMA guidelines. Data extraction focused on study characteristics, digital workflows, material properties, clinical outcomes, and technological considerations Results: Most included studies were published after 2020 and originated primarily from Europe and Asia, with significant contributions from the United States. The studies showed significant differences in the properties of test materials between 3D-printed try-ins and conventional mock-ups. The 3D-printed try-ins had 25-55% greater tensile and compression strength, and flexural strength was increased by 70-100%. They also demonstrated superior fatigue resistance, volumetric stability, and cell proliferation. Overall, 3D printing improved precision, durability, and patient satisfaction, though material standardization and long-term validation remain necessary. Conclusion: 3D-printed try-ins provide improved mechanical performance, precision, and clinical workflow efficiency in complex ceramic veneer procedures compared with conventional techniques. Despite promising outcomes, standardized materials, optimized printing protocols, and long-term clinical validation are necessary to support broader clinical adoption
Aims: To systematically evaluate the clinical outcomes, esthetic results, and patient satisfaction concerning prosthetic rehabilitation approaches (implant-supported crowns and fixed dental prostheses) following orthodontic space opening in patients with maxillary lateral incisor agenesis. Materials and Methods: A systematic review following PRISMA guidelines was conducted. Electronic databases (PubMed, Scopus, Web of Science, Google Scholar, Cochrane Library) were searched from 2012 to 2024. The risk of bias was assessed using the ROBINS-I and the Newcastle-Ottawa Scale. Results: Out of 379 initially identified publications, 7 studies met the inclusion criteria. The data indicate implants demonstrate superior survival rates (95-100%) compared to bridges (75-90%), particularly resin-bonded bridges. Both modalities showed comparable esthetic outcomes, with high patient satisfaction rates (85-95%). However, space closure with canine camouflage demonstrated better overall esthetic and periodontal outcomes compared to prosthetic replacement. Conclusions: Although implants and bridges are viable options, space closure with canine camouflage is the preferred treatment when feasible. The choice between prosthetic modalities should be individualized based on patient factors, bone availability, and long- term maintenance considerations. High-quality comparative studies with extended follow-up are needed.
Aims: To highlight the transformative role of Artificial Intelligence in enhancing orthodontic diagnostic precision, optimizing treatment planning methodologies, and revolutionizing patient-centred care paradigms. Materials and Methods: Narrative review of current literature on Artificial Intelligence applications in orthodontics. Conclusions: Artificial Intelligence can improve the precision and efficiency in orthodontics, but still necessitates an orthodontist's supervision and elevates ethical and data security concerns.
Aim: The present study aimed to assess the shear bond strength of various types of prosthetic teeth and different surface treatments bonded to a 3D-printed denture base resin. Materials and Methods: A 3D-printed denture base resin was used, and three types of denture teeth, acrylic, composite, and 3D-printed teeth, were tested. A total of 120 maxillary right central incisors were used, with 40 specimens for each tooth type. Each tooth type was divided into four subgroups based on surface treatment. The four subgroups were: control (no treatment), air abrasion, bur roughening, and dichloromethane (DCM) treatment. Shear bond strength testing was performed using a universal testing machine. The collected data were statistically analyzed using SPSS version 22. Results: No significant difference was found among the three types of artificial teeth in terms of shear bond strength to the 3D-printed denture base. However, air abrasion and dichloromethane surface treatments significantly increased the shear bond strength for all types of teeth compared to the control groups. Conclusion: The type of prosthetic tooth does not affect the shear bond strength to a 3D-printed denture base resin. However, shear bond strength can be enhanced by using air abrasion or dichloromethane surface treatments for all types of teeth.
Aims: The present study aimed to examine histologically and compare the immunohistochemical expression of myeloperoxidase between dental apical abscess and granuloma. Materials and Methods: The research involved examining teeth with periapical lesions that were treated with surgery by a skilled surgeon and then studied histologically through post-surgical biopsy samples of the affected region. A set of 60 samples. Twenty granulomas, twenty abscesses, and twenty normal controls were analyzed histologically and immunohistochemically using antibodies targeting myeloperoxidase. Results: Histological examination showed that abscesses had a level of inflammatory cell infiltration (Grade III) higher than granulomas (Grade II) and normal control, with a p value of 0·000 indicating a notable variance in tissue damage between these two conditions; abscesses displayed more extensive tissue damage in comparison to granulomas. In addition to this finding, there was an increase in myeloperoxidase expression detected through analysis within dental abscesses when compared to granulomas; this points towards enhanced inflammatory activity, in abscesses, evidenced by elevated myeloperoxidase levels. Conclusion: The results demonstrate a distinction in tissue damage between abscesses and granulomas, with abscesses showing more pronounced destruction compared to granulomas. The elevated levels of myeloperoxidase in abscesses indicate significant tissue damage. Moreover, analysis of myeloperoxidase could provide perspectives into the pathophysiology of these lesions.
Aims: The current study aimed to evaluate the healing process of the oral mucosa over a submucosal contact with Titanium and Composite resin. Materials and Methods: 24 male New Zealand rabbits were subjected to this study. 12 received a titanium particle in the submucosal tissue, and the other 12 received a composite resin particle. using histological examination of the collected samples. the measuring parameters were the inflammatory cells infiltration, granulation tissue formation, reepithelization and two immunohistochemical tests using cluster of differentiation 31 and matrix metalloproteinase 3 expression in the collected samples to Determine the best material that permits for mucosal healing in contact with the examined two materials and assuring any complications that may arise during the healing of the mucosal soft tissue that is in contact with the mentioned materials. Results: the results parameters showed similar results with a slight advantage to the titanium material. No significance was noted in the three and seven-day results, while 14-day results show statistical significance favoring Titanium in the parameters of granulation tissue formation, reepithelization, and matrix metalloproteinase 3 expression. Conclusion: Titanium shows superior soft tissue healing to the composite resin. But the clear difference will start after 2 weeks
Aims: The present study aimed to evaluate the remineralization potential of grape seed (GS) oil incorporated into a prepared paste with different concentrations and compare it with casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACPF) on enamel caries induced on debonded enamel surfaces. Materials and Methods: Forty-four sound permanent premolars were gathered for this study. After mounting, bracket bonding, and then debonding, the teeth were arbitrarily divided into four groups. The artificial enamel caries was created by immersing the samples in a demineralization solution. The enamel surface treated with: Group I (n=11), Control negative (artificial saliva), Group II (n=11), CPP-ACFP paste. Group III(n=11) 5% GS (paste1). Group IV(n=11) 10 % GS (paste2). 8 specimens were exposed to Surface Micro Hardness test (SMH), and 3 were exposed to Scanning Electron Microscope with Energy Dispersive X-ray Spectroscopy (SEM-EDX) after a period of 30 days of treatment. Results: The results of SMH exhibited a highly statistically significant difference in surface micro-hardness after treatment between the study groups, and the greatest mean value of surface microhardness was seen in 5 % GS (paste1). EDX results exhibited no statistically significant difference after treatment among the study groups. SEM observations showed that a protective layer was formed on the surface of the treated groups. Conclusion: The grape seed oil used in this study displayed a potential remineralization effect in artificial carious lesions on enamel
Aims: This study aimed to evaluate the fracture resistance of different CAD/CAM ceramic crowns following standardized endodontic access preparation and repair using two restorative protocols. Materials and Methods: Ninety extracted human maxillary premolars were prepared for full-coverage crowns and restored with lithium disilicate (LD), yttria-stabilized tetragonal zirconia polycrystal (ZR), or polymer-infiltrated ceramic (VE) (n=30 per group). Each group was subdivided into three subgroups (n=10): intact crowns, crowns with access preparation repaired using a porcelain repair kit (GC), and crowns repaired with composite resin (Filtek Z350 XT). Endodontic access cavities were standardized using a custom template and prepared with diamond burs under water cooling. Specimens underwent thermomechanical loading, followed by fracture testing in a universal testing machine. Data were analyzed using one-way ANOVA and Duncan multiple range tests (α=0.05). Results: ZR crowns exhibited the highest fracture resistance across all conditions (mean intact: 3887.3 N; GC repair: 3371.7 N; composite repair: 2955.3 N), followed by LD (2742 N; 2281.5 N; 1960.2 N) and VE (1849.4 N; 1397.8 N; 1281.2 N). Access preparation significantly reduced fracture resistance in all materials (p<0.05). Repair using GC yielded significantly higher fracture resistance than composite in ZR and LD, but not in VE. Most failures (60%) were unfavorable, with oblique cusp fractures predominating. Conclusion: Endodontic access preparation significantly weakens CAD/CAM crowns regardless of material or repair method, although all tested crowns (ZR, LD, and VE) maintained fracture resistance above maximum reported masticatory forces (500–700 N). Zirconia crowns demonstrated superior mechanical performance, and GC-based repair provided better strength recovery in ZR and LD.
Aims: The present study aimed to evaluate the efficacy of intranasal sedation with Midazolam on reducing anxiety in patients undergoing surgical removal of impacted mandibular third molars. Materials and Methods: Thirty healthy individuals of both genders were included in this study of both genders; their ages ranged between 18-40 years, who were looking for surgical removal of impacted mandibular third molars under local anesthesia, and they possessed moderate to severe grades of anxiety. Patients were randomly assigned to two groups: the Midazolam group included fifteen patients who were premedicated with intranasal Midazolam using a nasal spray in a concentration of 0.2 mg/kg body weight ten minutes before surgery; the Placebo group included fifteen patients who received an oral Placebo of glucose powder capsules one hour before surgery. The following parameters were assessed: systolic blood pressure, diastolic blood pressure, and anxiety score. Results: Regarding systolic blood pressure measurements, there was a statistically significant difference between the Midazolam and Placebo groups after drug administration. There was a highly significant difference between the Midazolam and Placebo groups during the surgical procedure, as well as at the end of the surgical procedure. Regarding diastolic blood pressure measurements, there was a highly statistically significant difference between the Midazolam and Placebo groups after drug administration, during the surgical procedure, and at the end of the surgical procedure. Regarding anxiety, there was a highly significant difference between the Midazolam and Placebo groups post-operatively. Conclusion: Intranasal administration of Midazolam is recommended as a safe, reliable, and effective conscious sedation for anxious patients during the surgical removal of impacted mandibular third molars.
