Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis
<i>Background and Objectives</i>: Dental procedures can be distressing, particularly for patients who are anxious or uncooperative. In such cases, effective sedation not only facilitates the clinician’s work but also enhances patient comfort and acceptance of dental care. Nitrous oxide (...
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2025-05-01
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| author | Francesca Piccialli Marco Fiore Roberto Giurazza Fabrizio Falso Vittorio Simeon Paolo Chiodini Diana Russo Luigi Laino |
| author_facet | Francesca Piccialli Marco Fiore Roberto Giurazza Fabrizio Falso Vittorio Simeon Paolo Chiodini Diana Russo Luigi Laino |
| author_sort | Francesca Piccialli |
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| description | <i>Background and Objectives</i>: Dental procedures can be distressing, particularly for patients who are anxious or uncooperative. In such cases, effective sedation not only facilitates the clinician’s work but also enhances patient comfort and acceptance of dental care. Nitrous oxide (N<sub>2</sub>O) has been widely employed as a sedative agent in dental practice. This systematic review aimed to assess the efficacy and safety of N<sub>2</sub>O compared to alternative sedative agents and techniques in dental surgical procedures. <i>Materials and Methods:</i> This review protocol was prospectively registered on PROSPERO (CRD42020213429) and conducted in accordance with PRISMA guidelines. <i>Results:</i> A total of 1809 records were screened (1134 from Embase, 638 from PubMed, and 37 from CENTRAL). The meta-analysis focused on the following three primary outcomes: 1. Patient satisfaction: Eight studies comprising 422 participants (165 treated with N<sub>2</sub>O and 176 with other sedatives) were included. 2. Recall of the procedure: Five studies with a total of 288 patients (68 receiving N<sub>2</sub>O and 64 other agents) assessed patients’ ability to recall tooth extraction. 3. Successful completion of the procedure: Three studies involving 1578 patients (434 treated with N<sub>2</sub>O and 989 with alternative sedation methods) were analyzed. <i>Conclusions:</i> No statistically significant differences were observed between N<sub>2</sub>O and other sedative techniques across all outcomes evaluated. Safety could not be adequately assessed as none of the included studies systematically investigated this outcome. Further high-quality research is warranted to rigorously evaluate the safety profiles of various sedation strategies in dental surgery. |
| format | Article |
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| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-74d035cfd03d440bb6845dfd50b1d2d22025-08-20T01:56:17ZengMDPI AGMedicina1010-660X1648-91442025-05-0161592910.3390/medicina61050929Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-AnalysisFrancesca Piccialli0Marco Fiore1Roberto Giurazza2Fabrizio Falso3Vittorio Simeon4Paolo Chiodini5Diana Russo6Luigi Laino7Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 2, 80138 Naples, ItalyDepartment of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 2, 80138 Naples, ItalyDepartment of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 2, 80138 Naples, ItalyDepartment of Critical Care, AORN Ospedali dei Colli, Via Leonardo Bianchi, 80131 Naples, ItalyMedical Statistics Unit, Department of Public, Clinical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMedical Statistics Unit, Department of Public, Clinical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMultidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMultidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy<i>Background and Objectives</i>: Dental procedures can be distressing, particularly for patients who are anxious or uncooperative. In such cases, effective sedation not only facilitates the clinician’s work but also enhances patient comfort and acceptance of dental care. Nitrous oxide (N<sub>2</sub>O) has been widely employed as a sedative agent in dental practice. This systematic review aimed to assess the efficacy and safety of N<sub>2</sub>O compared to alternative sedative agents and techniques in dental surgical procedures. <i>Materials and Methods:</i> This review protocol was prospectively registered on PROSPERO (CRD42020213429) and conducted in accordance with PRISMA guidelines. <i>Results:</i> A total of 1809 records were screened (1134 from Embase, 638 from PubMed, and 37 from CENTRAL). The meta-analysis focused on the following three primary outcomes: 1. Patient satisfaction: Eight studies comprising 422 participants (165 treated with N<sub>2</sub>O and 176 with other sedatives) were included. 2. Recall of the procedure: Five studies with a total of 288 patients (68 receiving N<sub>2</sub>O and 64 other agents) assessed patients’ ability to recall tooth extraction. 3. Successful completion of the procedure: Three studies involving 1578 patients (434 treated with N<sub>2</sub>O and 989 with alternative sedation methods) were analyzed. <i>Conclusions:</i> No statistically significant differences were observed between N<sub>2</sub>O and other sedative techniques across all outcomes evaluated. Safety could not be adequately assessed as none of the included studies systematically investigated this outcome. Further high-quality research is warranted to rigorously evaluate the safety profiles of various sedation strategies in dental surgery.https://www.mdpi.com/1648-9144/61/5/929nitrous oxidesedativesdental procedurespatient safetysystematic reviewmeta-analysis |
| spellingShingle | Francesca Piccialli Marco Fiore Roberto Giurazza Fabrizio Falso Vittorio Simeon Paolo Chiodini Diana Russo Luigi Laino Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis Medicina nitrous oxide sedatives dental procedures patient safety systematic review meta-analysis |
| title | Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis |
| title_full | Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis |
| title_fullStr | Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis |
| title_full_unstemmed | Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis |
| title_short | Efficacy and Safety of Nitrous Oxide (N<sub>2</sub>O) Inhalation Sedation Compared to Other Sedative Agents in Dental Procedures: A Systematic Review with Meta-Analysis |
| title_sort | efficacy and safety of nitrous oxide n sub 2 sub o inhalation sedation compared to other sedative agents in dental procedures a systematic review with meta analysis |
| topic | nitrous oxide sedatives dental procedures patient safety systematic review meta-analysis |
| url | https://www.mdpi.com/1648-9144/61/5/929 |
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