Background: Dental fear and anxiety are highly prevalent in children, resulting in avoidance or incomplete dental treatment; sedation emerges as a possible behavioral management strategy. This umbrella review aimed to provide a structured and critical synthesis of the available knowledge on sedative single-agent efficacy and routes of administration employed for achieving sedation (excluding deep sedation/general anesthesia) during dental procedures in children for behavior management, as well as to evaluate acceptability and satisfaction for child, caregiver, and provider, and to assess the influence of clinical setting and provider. Methods: In line with the PRISMA statement, the protocol was registered on PROSPERO (CRD420251043738), and 18 systematic reviews were included and synthesized qualitatively. Results: Single-agent sedation was safe and effective for managing behavior in children during dental procedures, with midazolam and nitrous oxide being the most studied agents. Different routes of administration showed distinct characteristics in onset, recovery time, adverse effects and cooperation, while agent selection appeared influenced by clinical setting and provider type. However, data on acceptability and satisfaction from children, caregivers, and providers remains limited. Conclusions: Evidence suggests potential effectiveness of selected agents and routes in appropriately monitored settings, but data heterogeneity precludes strong comparative recommendations. Further studies are therefore needed to address the existing gaps in pediatric dental sedation.
Background and Objectives: To evaluate the influence of proximal box design on primary stability and adhesive bond strength of indirect partial bonded restorations (IPBR) in posterior teeth. Materials and Methods: Thirty extracted human third upper molars were randomly assigned to three groups (n = 10 each): Group A, butt joint overlay-type restorations with proximal box (height-to-depth ratio 1:2–1:3); Group B, proximal box with height-to-depth ratio 1:1; and Group C, flat bevel preparation as control. Specimens underwent standardized preparation: immediate dentin sealing, restoration with overlays, and cementation with Panavia V5 adhesive resin cement. Mechanical measurements were performed to assess the tensile bond strength 48 h post-cementation using a universal testing machine. Finite element analysis (FEA) was also carried out to evaluate stress distribution at the adhesive interface. Data were analyzed by ANOVA with the Bonferroni post hoc tests. Results: Group A exhibited significantly higher bond strength values (403.7 ± 37.5 N) compared with Group B (340.4 ± 32.7 N; p < 0.01) and Group C (324.8 ± 33.3 N; p < 0.01). No significant difference was observed between Groups B and C. FEA corroborated the experimental findings, showing more homogeneous stress distribution for Group A and higher stress concentrations in Groups B and C. Conclusions: Proximal box design significantly affects the primary stability and bond strength of IPBR in vitro. A deeper proximal box with favourable geometric features enhances adhesive performance and stress distribution. Within the limitations of this study, these findings suggest potential clinical benefits, although further in vivo studies under dynamic conditions are needed to confirm long-term restoration performance.