Dental caries is the most prevalent chronic condition among Argentine children, with distribution and severity strongly shaped by social and territorial inequalities. This study evaluated caries treatment needs and their spatial and socio-economic associations among preschool children in Buenos Aires.

An ecological population study was conducted among 54 337 6-year-old children attending public schools in Buenos Aires. Caries severity was measured using the Caries Treatment Needs Index (CTNI) by calibrated examiners.

Socio-economic indicators included individual health coverage, neighbourhood housing prices, distance to the nearest primary health centre, population density and the proportion of households with unsatisfied basic needs. Analyses comprised descriptive statistics, multivariate regression, ORs and spatial autoregressive models.

Overall, 67.9% of children had treatment needs (CTNI >2) and 17.5% had high needs (CTNI >10), with significant heterogeneity across municipalities (p

Caries treatment needs in Buenos Aires follow a clear socio-economic and spatial gradient, with both individual and neighbourhood disadvantage independently associated with increased needs and highlighting the need for targeted, territorially focused public health strategies.

To map and characterise economic evaluations (EEs) and provider-level cost/resource reporting related to direct posterior restorative alternatives following the European Union (EU) dental amalgam phase-out.

Scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance.

PubMed, Embase, Web of Science, CINAHL and LIVIVO (ZB MED search portal for life sciences (Germany)).

Peer-reviewed studies (English/German; 1 January 2021–22 February 2026) reporting EEs or cost/resource-use components for direct posterior restorations in permanent teeth.

Data were charted using a predefined extraction framework focusing on analytic perspective, time horizon, modelling approach and granularity of provider-level resource components. Two reviewers independently screened records and charted data; disagreements were resolved by discussion and, if needed, by consultation with a third reviewer.

Six studies met the inclusion criteria (four model-based or trial-based EEs; two cross-sectional surveys). Most analyses adopted payer, societal or mixed perspectives and used decision-analytic models with medium- to long-term horizons. Outcomes included cost per complication-free month, cost per tooth-year retained and lifetime cost projections. Detailed provider-level reporting (eg, chair time, personnel allocation, overheads or warranty-related retreatment burden) was limited, and survey evidence relied on self-reported estimates. Heterogeneity in methods and metrics precluded quantitative synthesis.

Economic evidence regarding direct posterior restorative alternatives after the EU amalgam phase-out is sparse and primarily based on modelled or reimbursement-derived inputs from payer, societal or mixed perspectives, rather than explicitly measured provider-level microcosting. Greater transparency in analytic perspective and microcosting components may support evidence-informed adaptation to restorative material substitution policies.

Inadequate alveolar bone is a critical challenge for the placement of implants. The tenting screw technique has been demonstrated to be effective for bone augmentation. However, no previous systematic reviews have addressed the clinical outcomes of the tenting screw technique for guided bone regeneration (TS-GBR). Thus, we aimed to conduct a meta-analysis to systematically assess the clinical outcomes of TS-GBR.

We will search eight databases to identify relevant studies. Clinical trials that report the outcomes of bone augmentation with the application of the tenting screw technique and that meet the inclusion criteria will be included. Two authors will independently conduct the literature search and data extraction. The risk of bias of the included studies will be assessed with the Cochrane Risk of Bias 2.0 tool, Risk of Bias in Non-randomised Studies of Interventions tool, Newcastle-Ottawa Scale or Joanna Briggs Institute Checklist on the basis of the study design. Weighted means will be calculated. R software will be used to perform the data analysis. A funnel plot will be generated to assess publication bias. The quality of evidence for each outcome will be assessed with the Grading of Recommendations Assessment, Development and Evaluation framework.

Ethical approval is not applicable since this is a protocol for a systematic review and meta-analysis that does not include actual patients or require data privacy. We will summarise the currently available data related to TS-GBR. The results will be published in a peer-reviewed journal.

CRD420251043324.

Periodontitis and chronic kidney disease (CKD) are inter-related conditions that can significantly impact patient health. This study aims to evaluate the efficacy of active non-surgical periodontal therapy (NSPT) combined with supportive periodontal care (SPC) in reducing tooth loss and improving masticatory function in patients with CKD and stage III periodontitis.

This randomised controlled trial will recruit 86 patients diagnosed with both stage III periodontitis and CKD. Participants will be randomly assigned at a 1:1 ratio to either an experimental group receiving active NSPT supplemented with SPC or a control group receiving oral hygiene instruction with scheduled periodontal monitoring. The intervention will last for 24 months, with assessments conducted at baseline and 3, 6, 12, 18 and 24 months. The primary outcome is the incidence of tooth loss due to periodontitis over the 2-year follow-up period. Secondary outcomes include the number of lost teeth, masticatory function, clinical periodontal parameters and oral health-related quality of life.

The study protocol and informed consent form were approved by the Institutional Ethics Committee of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SH9H-2022-T404-1). Findings will be disseminated to participants and published in peer-reviewed journals.

ChiCTR2300068923.

To assess the factors influencing dentists’ choice of restorative materials for posterior restorations, with a particular emphasis on the perceived influence of social media on patient preferences among general dental practitioners in Palestine.

Cross-sectional web-based survey.

A total of 550 general dentists practising in Palestine were invited between May and December 2023 through convenience and snowball sampling via social media platforms; 390 responded, and 350 complete responses were included in the final analysis.

No specific intervention was applied; this was an observational, questionnaire-based study.

Dentists’ selection of restorative materials (composite, amalgam or high-viscosity glass-ionomer cement (HVGIC)) for posterior restorations in relation to tooth type, patient age, oral hygiene, moisture control, financial status and social media influence.

Descriptive statistics, ² tests and multinomial logistic regression were used to examine associations and control for potential confounders.

Material selection varied significantly by tooth type (p

Patient-related factors were the main determinants of material selection, whereas practitioner demographics played a minimal role. HVGICs are preferred for paediatric and elderly patients because of their suitability for age-specific clinical needs. The influence of social media, assessed in this study as dentists’ perceptions rather than direct measures of patient behaviour, underscores its growing role in shaping dentists’ impressions of patient expectations and highlights the importance of evidence-based guidance and public education to support patient-centred, clinically appropriate restorative decisions.

Oral health is an integral part of overall health and well-being, yet oral diseases remain highly prevalent, affecting an estimated 3.7 billion people worldwide. The greatest burden arises from periodontitis, tooth loss and oral cancers, while untreated dental caries continue to be the most common condition globally. Despite advances in preventive technologies, community-based programmes and clinical innovations, the global burden of oral diseases has not proportionately declined. This highlights a persistent evidence–practice gap in oral health, where effective interventions have not been translated into routine practice at scale. Implementation research provides a valuable lens to understand how oral health interventions can be adopted, adapted and sustained in diverse real-world contexts. However, evidence on implementation strategies, frameworks and contextual factors in oral health remains fragmented, with no comprehensive synthesis to date.

The review will follow Joanna Briggs Institute methodology for scoping reviews. A three-step search strategy will be applied to locate published and unpublished literature, including PubMed, Scopus, PsycINFO, Embase and grey literature sources such as World Health Organisation and Centers for Disease Control and Prevention publications, government and non-governmental organisation reports and academic theses. No date restrictions will be applied. Duplicates will be removed using Zotero. Following screening and full-text review in JBI SUMARI, data will be extracted using a predesigned tool and synthesised descriptively. Results will be presented in evidence tables and a narrative synthesis, supported by figures and thematic mapping of strategies, frameworks and contextual factors.

Ethics approval is not required for this scoping review. The findings will be disseminated through peer-reviewed journal publications and conference presentations.

Early childhood caries (ECC) continues to be a public health problem. The application of silver diamine fluoride (SDF) is a simple, non-invasive procedure. This study aims to evaluate SDF’s effectiveness, acceptability and oral health-related quality of life (OHRQoL) compared with atraumatic restorative treatment in managing ECC.

An open-label parallel superiority randomised clinical trial will be conducted involving children aged 2–5 years. Participants will include children with at least one active cavitated lesion (ICDAS 5+) of their primary teeth, with no signs of pulp involvement. The trial will occur at preschools in the La Araucanía and Metropolitan Regions of Chile from 2025 to 2027. The primary outcome variable will be the caries lesion arrest, acceptability and OHRQoL. We will also determine the presence of any adverse effects. Evaluations will be carried out at 6 and 12 months. A sample of 234 teeth with carious lesions per group is estimated. The primary inferential analysis will be performed on an intention-to-treat basis; a per-protocol analysis will be conducted for adverse effects. For caries lesion arrest, a multilevel logistic regression model adjusted for significant covariates will be used to account for within-child clustering. The acceptability will be assessed through quantitative and qualitative methods. The magnitude of change in OHRQoL between baseline and follow-up will be quantified using effect size estimates derived from the early childhood health impact scale survey data.

This study’s implementation benefits the study population, and the ethical principles of research have been considered and approved by the Science Committee of the University, Resolution N°049_19. The results and conclusions of the clinical trial will be published in academic conferences and peer-reviewed journals.

NCT06786975.

Hyperdivergent skeletal class II malocclusion in adolescents is characterised by mandibular retrognathia with excessive vertical growth and clockwise mandibular rotation, which can worsen facial profile and airway-related morphology. Although mandibular advancement approaches are commonly used, they may increase the vertical dimension and are suboptimal for patients with long-face patterns. This randomised controlled trial aims to evaluate a micro-implant-assisted protrusion correction technique designed to flatten the occlusal plane and promote counterclockwise mandibular rotation, thereby improving facial profile and pharyngeal space.

This trial is registered at the Chinese Clinical Trial Registry (ChiCTR; ChiCTR2100054105). This is a two-arm, multicentre, randomised, parallel-controlled trial. Ninety adolescents will be recruited from Shanghai Stomatological Hospital, Zhongshan Hospital (Fudan University), and Xinhua Hospital (Shanghai Jiao Tong University School of Medicine), and will be randomly allocated (1:1) to the test or control group. The control group will receive conventional anterior teeth retraction, whereas the test group will receive a micro-implant-assisted vertical control protocol with occlusal plane flattening. The primary outcome is the change in the A point–nasion–B point angle. Secondary outcomes include changes in the occlusal plane, incisor and molar heights, and facial height. Measurements will be assessed at baseline, at the end of treatment and at 12 months after treatment completion.

This study was approved by the Ethics Committee of the Shanghai Stomatological Hospital (approval no. (2022)006). The results of this study will be made available in peer-reviewed journals.

ChiCTR2100054105.

To identify behavioural and household factors associated with poor oral hygiene among Japanese kindergarten children in a population with high health awareness, using the Debris Index-Simplified (DI-S) as a clinical proxy for early oral hygiene deterioration.

Cross-sectional study.

Seven kindergartens in Sapporo city, Japan.

Of the 1229 kindergarten children invited, 871 provided parental consent (consent rate: 70.9%). Among them, 675 children aged 1–6 years who completed both the questionnaire and oral examination (completion rate: 54.9%). Most post-consent losses were due to logistical and staffing constraints. Children were stratified into ≤3 year and ≥4 year academic classes.

The primary outcome was oral hygiene status based on the DI-S scores (categorised as good (DI-S=0) or poor (DI-S>0). The secondary outcome was the presence of dental caries, defined as decayed, missing and filled primary teeth: dmft≥1. Multivariable logistic regression was used to estimate associations between poor oral hygiene and behavioural and household factors.

Among the 675 children, 168 children (24.9%) exhibited poor oral hygiene (DI-S>0) and 89 children (13.2%) had dental caries (dmft≥1). In multivariable analysis adjusted for demographic, dental and dietary variables, poor oral hygiene was significantly associated with being from a multiple-child household (OR 1.67, 95% CI 1.16 to 2.42) and irregular juice consumption (OR 1.60, 95% CI 1.07 to 2.38). Age-stratified analysis revealed that these associations persisted among those in the ≥4 year class, with additional significance for infrequent tooth brushing (

In a high health awareness Japanese preschool population, poor oral hygiene was independently associated with household composition and juice consumption, rather than traditional dental behaviours. These findings suggest the need to broaden preventive strategies beyond routine dental guidance to include family structure and dietary patterns, particularly in low-prevalence settings. Differential associations between DI-S and caries experience emphasise the utility of early clinical indices in oral health promotion.

The aims of this study were to investigate the factors affecting career satisfaction within the Pakistani dental community and to assess demographic characteristics as significant predictors of professional satisfaction.

Cross-sectional survey.

Data were collected from registered dentists across urban and rural areas of Pakistan via an electronic survey distributed through professional forums, social media groups and email lists to ensure nationwide representation.

A total of 600 registered dental surgeons were selected across Pakistan using single-stage cluster sampling, with inclusion based on a permanent Pakistan Medical and Dental Council licence, excluding temporary licence holders, non-consenting individuals and those practising abroad.

Career satisfaction was measured using the validated Dentist Satisfaction Survey, which assessed various factors affecting professional fulfilment.

Of 600 participants, 566 valid responses were received, with n=134 (23.67%) men and n=432 (76.33%) women, and a mean age of 33.7±7.4 years. Most were early-career (68.9%), with a mean professional satisfaction score of 3.13±1.35. Gender, provincial background and work experience significantly influenced satisfaction, while current working status did not. Participants were neutral on career domains, such as auxiliary staff quality, professional relations, professional time, management and work-life balance, but had positive views on doctor-patient relationships. Many expressed dissatisfaction with their income, and 35.69% found dentistry stressful. While 26.15% would not recommend dentistry, 30.04% would support their child’s choice to pursue it. Despite uncertainty about career fulfilment, most dentists remained strongly committed to their profession and did not plan to change careers in the near future.

This study highlights factors influencing career satisfaction among Pakistani dentists, offering insights to improve well-being and career fulfilment and inform policy reforms aimed at enhancing professional retention and mental well-being.

Photobiomodulation (PBM) has shown promising effects in managing postoperative pain following conventional periapical surgery, although current evidence remains limited. This study aims to assess the effect of PBM on postoperative pain 24 hours after periapical surgery.

A randomised, controlled, double-blind trial will include 34 patients undergoing periapical surgery in the maxillary region, randomly assigned to an experimental group (n=17) or control group (n=17). The experimental group will receive PBM (GaAlAs diode laser, 808 nm, 100 mW, 4 J/cm², applied at five vestibular points) and placebo ibuprofen immediately and 24 hours postoperatively. The control group will receive simulated PBM and active ibuprofen. The primary outcome is postoperative pain assessed by the visual analogue scale at 24 hours. Secondary outcomes include pain at the seventh day, paracetamol intake, oedema, ecchymosis, soft tissue status and temperature at 24 hours and 7 days. Radiographic evaluation of healing will be performed at 1 and 3 months. Statistical analysis will be conducted based on data distribution, using repeated measures ANOVA (Analysis of Variance) or non-parametric equivalents for longitudinal outcomes, and appropriate tests for categorical variables. Significance will be set at p

The study was approved by the Human Research Ethics Committee of Universidad Católica del Uruguay (process no. 220914). Results will be disseminated to participants, healthcare professionals, the public and scientific communities.

NCT05935306.

Oral health research provides evidence for policy and practice, yet no study has comprehensively mapped the scope of oral health research in Malaysia. The COVID-19 pandemic has also created a great impact on oral healthcare in Malaysia, including the dental care delivery. Additionally, there is a notable lack of research focusing on oral health during and after the COVID-19 pandemic. Therefore, this scoping review will aim to map the landscape of oral health research conducted in Malaysia and identify key topics, study designs, populations studied and gaps in the literature, in order to inform future research priorities and policy, particularly in the post-COVID-19 era.

The methodology draws on Arksey and O’Malleys’ seminal framework for the scoping review and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. We will search five major electronic databases—PubMed, Scopus, ProQuest, Cochrane and Web of Science—as well as selected grey literature sources (eg, theses, dissertations and conference proceedings) for studies published in English from January 2014 to December 2024. Studies of any design related to oral health in Malaysia will be included. Two reviewers will be performing title and abstract screening, in which they will be working independently. The included publication will undergo a full-text review, and references cited in these studies will be examined following the inclusion criteria. The PRISMA-ScR flow diagram will be used as a guide throughout the process. Data will be extracted, analysed and charted according to key categories identified in the included publications. A narrative synthesis and descriptive statistics will be presented.

The results of this scoping review will illustrate an overview and provide a better understanding regarding the oral health research in the Malaysian context; whether research has already been conducted, is currently ongoing and is still needed; and which areas should be prioritised for future investigation. As this review will use publicly available literature, formal ethics approval will not be required. The findings will be submitted for publication in an open-access peer-reviewed journal, presented at national and regional conferences and shared with Malaysian dental professional bodies and relevant stakeholders.

The protocol of this scoping review is registered with the Open Science Framework and is available at osf.io/hjq6m.

Dental caries is the most common oral disease worldwide, affecting up to 90% of children globally. It can lead to pain, infection and impaired quality of life. Early prevention is a key strategy for reducing the prevalence of dental caries in young children. Valid and reliable diagnostic or prognostic tools that enable accurate individualised prediction of current or future dental caries are essential for facilitating personalised caries prevention and early intervention. However, no efficacious tools currently exist in early childhood—the optimal period for disease prevention. We aim to develop and validate diagnostic and prognostic prediction tools for dental caries in young children, using a combination of environmental, physical, behavioural and biological early life data.

Data sources include two prospective studies, with a total sample size of approximately 600 children. These cohorts have collected detailed demographic, antenatal, perinatal and postnatal data from medical records and parent-completed questionnaires and biological samples including a dental plaque swab. Candidate predictor variables will include sociodemographic characteristics, health history, behavioural and microbiological characteristics. The outcome variable will be the presence, incidence or severity of dental caries diagnosed using the International Caries Detection and Assessment System. Statistical and machine learning approaches will be used for selection of predictor variables and model development. Internal validation will be conducted using resampling methods (i.e., bootstrapping) and nested cross-validation. Model performance will be evaluated using standard performance metrics such as accuracy, discrimination and calibration. Where feasible, external validation will be performed in an independent cohort. Model development and reporting will be guided by the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) statement and the Prediction model Risk Of Bias Assessment Tool (PROBAST) guidelines.

This study has ethical and governance approval from The Royal Children’s Hospital Melbourne Human Research Ethics Committee (HREC/111803/RCHM-2024). Results of this study will be published in peer-reviewed journals and presented at scientific conferences.

Infant2Child: ACTRN12622000205730—pre-results; MisBair: NCT01906853—post results.

To assess the performance of a Vision Transformer (ViT)-based deep learning model in classifying oral mucosal diseases (OMD) and to explore the value of the integrated model for clinical support.

A pilot study that combines publicly available datasets with integrated modelling.

Developed an EfficientNet-B0 convolutional neural network and a ViT-B16 model, and tested three integration strategies: average method, weighted method and geometric average method. Evaluation metrics included accuracy, F1 score and inference speed. Diagnostic subject performance was compared between general dentists and oral specialists to validate model efficacy.

The integrated model outperformed individual models, with the geometric average integration method achieving an accuracy of 94.32%. When used by general dentists, the diagnostic time was reduced from 241 s to 112.4 s, with an accuracy rate of 93%.

The ViT-enhanced integrated system can improve the classification efficiency of OMD and provide support for non-specialist doctors. However, validation with larger datasets is needed in future research.

Children with limited access to dental care can be negatively impacted by reduced frequency of oral health monitoring, delays in diagnosis of dental disease and increased waits for dental care, resulting in them experiencing more disease (extent and amount). Smartphone-based intraoral photography has been cited as having the potential to improve oral health monitoring for children through screening; however, it has not been well evaluated, and its limitations are unclear. The picture-perfect study aims to assess diagnostic accuracy, feasibility and acceptability to determine whether remote photographic monitoring can be effectively integrated into pathways of dental care for children aged 6-16 years.

Observational, cross-sectional, mixed-methods study with three workflows: Workflow 1: development of user-friendly, comprehensive guidance to help parent/carers (parents) take high-quality intraoral photographs of their children’s mouths. The guidance will be codesigned with parents and healthcare professionals. Workflow 2: diagnostic accuracy using intraoral photographs taken by a parent of their children will be evaluated by comparing clinicians' diagnoses from the photographs to gold-standard clinical visual-tactile examinations. Parent–child dyads (n=110) will be recruited to capture intraoral photographs using positioning aids, guidance and smartphones provided by the research team. The diagnoses will focus on plaque accumulation, gingival health, restoration status and dental caries. Diagnostic accuracy will be assessed using sensitivity, specificity, positive predictive value, negative predictive value and area under the curve. Workflow 3: assessment of feasibility and acceptability will be through task completion rates, photograph quality and participant feedback. Qualitative interviews and an online survey will capture parents’ and children’s experiences. Observational data will provide insights into practical challenges.

This study, approved by the National Health Service (NHS) Research Ethics Committee (Integrated Research Application System [IRAS]: 24/EE0137), will be conducted in adherence to the Declaration of Helsinki and Good Clinical Practice (GCP) guidelines. Written informed consent will be obtained from all participating parents, with age-appropriate assent from children prior to enrolment. Participants have the right to withdraw at any time without explanation, and their data will be anonymised to ensure privacy and confidentiality. Study findings will be disseminated through peer-reviewed journals, conference presentations and reports to relevant stakeholders.

The study protocol has been registered on the Open Science Framework: https://doi.org/10.17605/OSF.IO/WX29D.

The primary objective was to determine peritraumatic distress among orthodontic patients during the COVID-19 lockdown. And the secondary objective was to determine the relationship between peritraumatic distress in relation to different appliance types.

Cross-sectional study.

Primary hospital between May and June 2022.

Patients in the process of orthodontic treatment, able to read Mandarin online, provided informed consent for the use of the data recorded and completed the questionnaire within a reasonable time.

None.

The demographic information and orthodontic urgencies were collected using online questionnaires. The peritraumatic distress symptoms were assessed by the COVID-19 Peritraumatic Distress Index (CPDI). The temporomandibular joint (TMJ) pain was evaluated using a Visual Analogue Scale.

A total of 480 participants were enrolled, including 331 with fixed appliances, 131 with clear aligners and 18 with removable appliances. For all participants, the median CPDI score was 12 (4, 19). Higher CPDI scores were observed in participants with urgency (14 (6, 21) vs 8 (2, 15), p18 years (β=0.271, p

The study suggested that during catastrophic events such as the COVID-19 lockdown, orthodontic urgencies may exacerbate patients’ peritraumatic distress, especially among adult patients and those who suffer from TMJ pain.

Caries risk assessment and management (CRAM) conducted by primary care providers is critical for preventing early childhood caries. Yet, the implementation of these preventive strategies remains understudied in low- and middle-income countries. This study aims to evaluate the implementation and effectiveness of a CRAM intervention in Chinese primary care settings.

We will conduct a hybrid type II stepped-wedge cluster randomised controlled trial across nine primary healthcare institutions in Luzhou City, China. Institutions will be randomly allocated into three intervention waves. Primary care providers will be trained to deliver CRAM. The two primary outcomes are (1) the proportion of primary care providers completing all CRAM procedures and (2) improvements in parents’ home-based oral care practices for children under age 3. Secondary outcomes include children’s oral health-related quality of life, time to first caries incidence, and the cost-effectiveness of the intervention. Qualitative interviews will explore barriers and facilitators to implementation.

The study protocol has received approval from the Ethics Committee of West China Hospital, Sichuan University. Study findings will be disseminated through peer-reviewed journal publications and presentations at academic conferences. Research summaries and policy briefs will be developed for key stakeholders and decision-makers at the local, provincial and national levels.

ChiCTR2400090741.

Pain during supragingival scaling is often uncomfortable for patients, causing varying degrees of fear and anxiety, thus affecting patient comfort and compliance during treatment and reducing the effectiveness of treatment. Nitrous oxide/oxygen mixtures have the advantages of analgesic and sedative effects and are well tolerated. The purpose of this study is to explore the safety and effectiveness of a fixed inhaled nitrous oxide/oxygen mixture analgesia technology in the process of supragingival scaling and to provide empirical evidence for patients to reduce pain and reduce anxiety during supragingival scaling.

This is a randomised, double-blind, placebo-controlled trial that is expected to enrol 120 patients. We will recruit patients undergoing supragingival scaling procedures. Participants will be allocated randomly to either the intervention group (A) or the control group (B) in a 1:1 ratio. Dental hygienists, dental assistants, patients and the collector of the data will all blind themselves to the study. Nurses who carry out the intervention will give doctors envelopes containing the patient’s identification code and the group to which they have been assigned (Group A or Group B). Group A will be given the standard treatment plus a premixed combination of nitrous oxide and oxygen, while Group B will receive oxygen alone in the standard treatment without any sedative analgesics, all under uniform conditions. Evaluations will take place prior to treatment (T0), at 5 min into the intervention (T1), at 15 min during the intervention (T2) and 5 min following the treatment (T3). The primary outcomes will be pain scores and anxiety scores, which will be assessed using the Numeric Rating Scale and the Visual Analogue Scale for Anxiety. Secondary outcome indicators in this study will include patients’ vital signs, side effects and physician and patient satisfaction.

This study was approved by the Medical Ethics Committee of the 960th Logistics Support Force of the People’s Liberation Army. Written informed consent form will be obtained from each participant. Results will be submitted for publication in peer-reviewed journals.

ChiCTR2400090261.

Protocol version 1.1.