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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...

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Effectiveness of Various Pain Control Methods in Managing MIH-A Systematic Review and Meta-Analysis.

Mohammed B Q Alfarra1, Tarun Walia1,2, Mawada Abdelmagied1,2

  • 1Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.

International Journal of Paediatric Dentistry
|June 29, 2026
PubMed
Summary

Effective pain management for molar-incisor hypomineralisation (MIH) in children is challenging. A multimodal approach using pharmacological, desensitising, and behavioural strategies, including 4% articaine, shows promise for improved pain control and anaesthetic success.

Keywords:
Articainedental anxietyibuprofenmolar–incisor hypomineralisationnon‐pharmacological interventionspain management

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Published on: January 5, 2024

Area of Science:

  • Pediatric Dentistry
  • Pain Management
  • Dental Anesthesia

Background:

  • Molar-incisor hypomineralisation (MIH) poses significant challenges for pain control in children.
  • Affected teeth exhibit altered enamel and heightened pulp sensitivity, leading to poor local anaesthesia response.
  • Effective pain management is critical for successful dental treatment outcomes in pediatric patients with MIH.

Purpose of the Study:

  • To evaluate the efficacy of pharmacological, desensitising, and behavioural strategies for pain management in children and adolescents diagnosed with MIH.
  • To assess the effectiveness of different interventions in improving pain control and anaesthetic success in pediatric dental patients with MIH.

Main Methods:

  • A systematic literature search was conducted for studies published between 2001 and 2024.
  • Included study designs were randomised controlled trials, randomised crossover studies, and clinical trials.
  • A random-effects meta-analysis evaluated anaesthetic success rates for 4% articaine, with risk of bias and certainty of evidence assessed.

Main Results:

  • Thirteen studies were selected, with six included in the meta-analysis.
  • Pooled success rates for 4% articaine were 0.849 (inferior alveolar nerve block) and 0.915 (intraosseous injection), indicating improved efficacy over 2% lidocaine.
  • Pre-emptive ibuprofen, laser desensitisation, and virtual reality distraction demonstrated benefits in reducing pain and anxiety.

Conclusions:

  • An individualized, multimodal pain management strategy appears beneficial for children with MIH.
  • Further high-quality comparative studies are necessary to establish definitive clinical protocols for managing pain in MIH patients.
  • Optimizing pain control is essential for effective dental care in pediatric populations with molar-incisor hypomineralisation.