Evaluation of pediatric dentists' knowledge and approaches to tooth discoloration.

In recent years, esthetic expectations have come to the fore in pediatric dentistry, as in every field of dentistry. Therefore, to better meet patients' expectations, the steps taken to determine and improve the current level of knowledge of pediatric dentists on tooth discoloration gain importance. This study aims to measure the knowledge levels of pediatric dentists regarding tooth discoloration. A 33-questioned survey created online was emailed to pediatric dentists between March and December 2021. The first part included four multiple-choice and two open-ended questions regarding demographic characteristics. The second part was to measure the participants' knowledge of tooth discoloration. The last part was to evaluate the clinical approaches of the participants. Participants who agreed to answer all of the questions were included in the study (n = 129). The knowledge levels of the participants were scored according to the accuracy of their answers. The data were statistically analyzed using descriptive statistics and chi-square tests. Of the pediatric dentists who participated in this study, 16.3% had high knowledge, 79.8% had medium knowledge, and 3.9% had insufficient understanding of tooth discoloration. There was no correlation between time since dental school graduation and time spent practicing as a pediatric dentist (p > 0.05). The group with the highest average level of knowledge was the group most frequently encountered with tooth discoloration in the clinic (p ≤ 0.05). On average, pediatric dentists had moderate knowledge of tooth discoloration. The group with the highest average expertise in this field was the group that most frequently encountered and treated tooth discoloration. Information on tooth discoloration due to systemic factors was insufficient. To increase the knowledge level of pediatric dentists about the causes and treatments of tooth discoloration, it may be beneficial to establish training programs during and after specialization education.

Shear bond strength of calcium silicate-based cements to glass ionomers.

BACKGROUND: A shear bond strength between the biomaterial and restorative material is crucial for minimizing bacterial microleakage and ensuring a favorable long-term prognosis for vital pulp therapy. This study aimed to conduct a comparative evaluation of the shear bond strength between calcium silicate-based biomaterials utilized in vital pulp treatment and various glass ionomer cement materials, both with and without the application of adhesive agents. METHODS: A total of 270 acrylic blocks, each featuring cavities measuring 4 mm in diameter and 2 mm in depth, were prepared. Calcium silicate-containing biomaterials (ProRoot MTA, Medcem Pure Portland Cement, and Medcem MTA), following manufacturers' instructions, were placed within the voids in the acrylic blocks and allowed to set for the recommended durations. The biomaterial samples were randomly categorized into three groups based on the restorative material to be applied: conventional glass ionomer cement, resin-modified glass ionomer cement, and bioactive restorative material. Using cylindrical molds with a diameter of 3.2 mm and a height of 3 mm, restorative materials were applied to the biomaterials in two different methods, contingent on whether adhesive was administered. After all samples were incubated in an oven at 37 °C for 24 h, shear bond strength values were measured utilizing a universal testing device. The obtained data were statistically evaluated using ANOVA and post-hoc Tukey tests. RESULTS: The highest shear bond strength value was noted in the Medcem MTA + ACTIVA bioactive restorative material group with adhesive application, while the lowest shear bond strength value was observed in the ProRoot MTA White + Equia Forte HT Fil group without adhesive application (P < 0.05). CONCLUSION: Activa Bioactive Restorative may be considered a suitable restorative material in combination with calcium silicate-based biomaterials for vital pulp treatment. The application of adhesives to calcium silicate-based biomaterials can effectively address the technical limitations.

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

BACKGROUND: The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment. METHODS: Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria. RESULTS: A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia. CONCLUSIONS: The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.

Does repeated autoclave sterilization cause changes in the color and fragility of fiberglass reinforced resin crowns?

BACKGROUND: Since the effects of sterilization on the Fiberglass Reinforced Resin Crowns (FRRCs) is not well-known the aim of current study was to evaluate the effects of autoclave sterilization on the fracture resistance, color stability, and surface composition of FRRCs. METHODS: A total of 48 crowns were used. The crowns were divided into three groups according to the sterilization number: no sterilization (Control Group), one sterilization (Group 1), and four sterilizations (Group 2). The microstructure of the three crowns from each group was evaluated using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) spectroscopy. Thirteen FRRCs from each group were first used for color stability testing and then for the fracture resistance analysis. One-way analysis of variance (ANOVA), one-way repeated measures ANOVA, and paired t-tests were used in the statistical analysis. RESULTS: EDX results revealed that the weight% of surface silicon atoms in group 2 was significantly higher. Some crack lines could be observed on the SEM images. Statistically significant differences were found in color stability following the first and fourth sterilization cycles (p < .01). The increase in the sterilization cycle did not statistically decrease the fracture resistance of the FRRCs (p = .055); however, overall, a decreasing trend was observed in fracture resistance as the sterilization cycle increased. CONCLUSIONS: Autoclave sterilization caused some changes in the surface elemental composition and surface morphology of FRRCs. Avoiding unnecessary FRRC trials is important to reduce the number of sterilizations.

Effect of different polishing techniques on surface properties and bacterial adhesion on resin-ceramic CAD/CAM materials.

OBJECTIVES: The aim of this study is to evaluate the adhesion of Streptococcus mutans on the surface of CAD/CAM materials with various surface treatments. METHODS: Vita Enamic, Lava Ultimate, and Cerasmart materials were used in this study. A total of 90 samples were prepared (n = 10). After various finishing and polishing procedures (non-polished, manual polished, and glazed), surface roughness (SR) measurements, surface free energy (SFE), and elemental and topographic analysis with FIB-SEM/EDX were used to evaluate the samples' surface properties. To improve bacterial adhesion, CAD/CAM materials were covered with sterile artificial saliva containing mucin for pellicle formation and incubated for 1 h at 37 °C. Bacteria were then inoculated into the pellicle-coated specimens, and incubation was performed at 37 °C for 24 h. Bacterial adhesion was determined as × 105 CFU/mL and monitored using FIB-SEM analysis. The Kolmogorov-Smirnov test was used to statistically analyze the normality of the distribution; the groups were then compared using one-way ANOVA and Tukey's test. RESULTS: The SR of the control group was statistically higher in all materials (p < 0.05). There were no statistically significant differences in SR between all materials in the non-polished and manual polished groups (p > 0.05). The Vita Enamic control group exhibited the highest SFE value. The highest S. mutans adhesion was observed in non-polished (p < 0.05). Vita Enamic samples had higher CFU than other groups. CONCLUSIONS: Non-polished surfaces showed higher SR and bacterial adhesion. Polishing processes affected the surface properties and bacterial adhesion. CLINICAL RELEVANCE: Care must be taken in polishing restorations to minimize the risk of bacterial adhesion and recurrent caries. TRIAL REGISTRATION: In this study, the materials used for dental treatments are in vitro evaluated. Due to that, this study is not registered to clinical trials.

Can zirconia crowns be the first restorative choice after endodontic treatment of primary teeth?

OBJECTIVE: Early loss of primary teeth due to caries can cause temporary or permanent problems, such as occlusion disorders, aesthetic problems, nutritional problems, abnormal habits, and speech disorders. Although the development of restorative materials has led to significant improvements, failures are still frequent. The purpose of this study was to evaluate the success rates of zirconia crowns compared to other crowns for the restoration of endodontically treated teeth with excessive loss of material. METHODS: A total of 45 teeth of patients aged under 10 years, including primary molars and anterior teeth, requiring restoration after root canal treatment, were included in this randomized, non-blinded clinical study. Stainless steel (SSC), zirconia (ZC), and strip (SC) crowns were used and compared clinically and radiographically during a six-month follow-up period. Parents were asked to fill out a questionnaire at one week and six months to evaluate the parent and child satisfaction levels. The patients' pain and discomfort levels were assessed using a visual analogue scale. The Mann-Whitney U, Chi-Squared and Friedman and Cochran Q tests were used for statistical comparisons using IBM SPSS Statistics version 23 (IBM, Armonk, NY, USA). RESULTS: The six-month follow-up evaluations revealed no significant differences in clinical outcomes between the SSC, ZC, and SC groups. There were no significant differences between the groups with respect to parent and child satisfaction. CONCLUSION: The clinical outcomes of ZCs were comparable to those of the other crowns. ZCs could be a choice for aesthetic purposes, with the disadvantage of a higher cost.

Attitudes and predictive factors of psychological distress and occupational burnout among dentists during COVID-19 pandemic in Turkey.

The aim of this study was to evaluate the factors affecting the ability and willingness of dentists to work during the COVID-19 pandemic and the effect of this situation on occupational burnout. A 51-question survey, including demographic and pandemic questions and the Maslach Burnout Inventory (MBI), was used as a data collection method and administered to dentists in Turkey via the internet in two stages. A link to the survey (onlineanketler.com) was sent to the participants by e-mail or social media (WhatsApp©). A total of 442 dentists in the first stage and 264 dentists in the second stage answered the questionnaire. The second stage of the survey only applied to dentists who are assigned within the scope of COVID-19 measures in Turkey. Standard descriptive statistics, the chi-square test, independent samples t test and the Kruskal-Wallis test were used for statistical analysis. Most of the participants showed higher stress levels. Occupational burnout levels of participants according to filiation service (serve/FP, did not serve/FN) were 34.4% and 17.6%, respectively. The FP group showed significantly higher stress levels than the FN group. It is important to consider how these results, collected during an infectious disease epidemic, reflect the effects of psychological distress and burnout on dental staff. Trial Registration Number and Date of Registration: NCT04605692-10/27/2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-01764-x.

Microbiota of Endodontically Infected Primary and Permanent Teeth.

Purpose: Differences in the endodontic microbiome of permanent and primary teeth during the mixed dentition period are still unknown. The purpose of this study was to examine bacterial diversity in endodontically infected primary and permanent teeth using 16S rRNA gene sequencing and the QIIME 2 (Quantitative Insights Into Microbial Ecology 2) bioinformatics pipeline. Methods: Microbial samples from endodontically infected primary (n equals 15) and permanent (n equals 15) maxillary or mandibular molar teeth were subjected to next-generation sequencing analysis based on examination of the hypervariable V3 to V4 region of the 16S rRNA gene. Statistical analysis was performed using R software. Results: Of 1,664,926 reads and 2,237 operational taxonomic units, 14 phyla, 89 families, and 236 genera were identified. Firmicutes were the most commonly detected phyla in both endodontically infected primary and permanent root canals. Bacteroides and Proteobacteria were more common in primary teeth, whereas Actinobacteria and Verrucomicrobia were more common in permanent teeth. The overall canal microbiota composition was similar in endodontically infected primary and permanent teeth (P=0.338). Conclusions: This study provides a comprehensive assessment of microbiota composition in endodontically infected primary and permanent teeth and gives a deeper insight into the origin of the root canal infections.

A pilot study of a deep learning approach to submerged primary tooth classification and detection.

AIM: The aim of the study was to compare the success and reliability of an artificial intelligence (AI) application in the detection and classification of submerged teeth in panoramic radiographs. MATERIALS AND METHODS: Convolutional neural network (CNN) algorithms were used to detect and classify submerged molars. The detection module, based on the stateof- the-art Faster R-CNN architecture, processed a radiograph to define the boundaries of submerged molars. A separate testing set was used to evaluate the diagnostic performance of the system and compare it with that of experts in the field. RESULT: The success rate of the classification and identification of the system was high when evaluated according to the reference standard. The system was extremely accurate in its performance in comparison with observers. CONCLUSIONS: The performance of the proposed computeraided diagnosis solution is comparable to that of experts. It is useful to diagnose submerged molars with an AI application to prevent errors. In addition, this will facilitate the diagnoses of pediatric dentists.

Ectopic eruption of maxillary permanent first molars: Predictive factors for self-corrected and impacted outcome.

OBJECTIVE: The aim of this study was to describe the occurrence, angulation and mesialisation ratio of the ectopic eruption of the maxillary permanent first molar (PFM) and its correlation with the pathological resorption of maxillary primary second molar (PSM). METHODS: This retrospective study was performed using the subsequent panoramic radiographs of 11.924 child patients aged 6-10 years. Ectopic eruption status is categorised as self-corrected and impacted types. To evaluate the differences between the two groups (self-corrected and impacted), the angulation of PFM, mesialisation ratio of PFM, and degree of adjacent PSM root resorption were also assessed. The data were statistically analysed using ANOVA and chi-square tests. Pearson correlation was used to analyse whether a quantitative relationship exists between PFM mesialisation ratio and PSM root resorption. RESULTS: Ectopic eruption frequency was determined as 0.83%. The distribution of ectopic eruption according to gender shows a higher prevalence in males than females. In most cases of ectopic eruption, the eruption status was impacted. The impacted PFMs showed more negative vertical and positive horizontal angle between the PSM and PFM. There was no significant difference between eruption status and angles. Mesialisation ratio of impacted PFMs was significantly higher than self-corrected PFMs. There was significant difference between the PFM mesialisation ratio and the degree of PSM root resorption. CONCLUSION: Even if eruption disturbances do not occur frequently, making an early diagnosis is important to begin treatment at an optimal time. Although the relationship between horizontal and vertical angles and the ectopic eruption pattern is controversial, it is one of the clinical determinants. The mesialisation ratio of the impacted type was significantly higher than the self-corrected type. Self-correction of PFM was reduced in PSM with grade III and IV root resorption.

The effect of two different irrigation needles on post-operative pain after pulpectomy in primary molar teeth: A randomized clinical study.

BACKGROUND: Post-operative pain (PP) following pulpectomy is of concern for endodontic patients and dentists. AIM: This study evaluated the intensity of PP following pulpectomy in primary maxillary molars, using two irrigation needles. DESIGN: One hundred patients in ages ranging from 6-9 years requiring pulpectomy for asymptomatic primary teeth with non-vital pulp were included in the study. The participants were randomly assigned to two groups of 50 patients each, according to the type of irrigation needle used, that is, a conventional open-ended needle and a double side-vented needle. The teeth were obturated and then permanently restored. The presence of PP was assessed after six, 12, 24, 48, and 72 hours, and finally after one week, using a four-point pain intensity scale. The PP scores were then statistically analysed. RESULTS: In 6, 12, and 24 hours time intervals, patients who had their teeth irrigated with the open-ended needle exhibited more intense PP than those who had their teeth irrigated with a double side-vented needle (P < .05). After 48 hours, 72 hours, and 1 week, however there was no significant difference between the groups (P > .05). CONCLUSIONS: Side-vented needles may be preferred in order to decrease PP at the first 24 hours after pulpectomy in primary molars.

Knowledge of Parents about Bruxism in their Children / Conocimiento de los padres sobre el bruxismo en sus hijos

ABSTRACT Objective: Bruxism is a jaw muscle activity disorder characterized by clenching or grinding of the teeth and can be seen in both children and adults. The purpose of this study is to evaluate the parental knowledge about bruxism in children. Methods: A cross-sectional study was conducted with 265 parents whose children were attended at University of Mersin pediatric dentistry and oral and maxillofacial surgery clinics. Children's ages varied from 6 months to 16 years old. A 20-questioned questionnaire was used to collect the data. IBM SPSS Statistics 22 for statistical analysis (SPSS IBM, Turkey) program was used for the analysis. Results: A total of 265 parents (159 were female and 106 were male) participated in the study. The majority of the parents were between the ages of 31-40 (60.8%). The rate of clenching and grinding of teeth during sleep (21.5%) was higher than the rate when they were awake (7.2%). The ratio of the parents seeking treatment for their children because of this harmful habit was very low (3.8%). The majortiy of parents (37.7%) reported that they seek help from dentists. The participants believed that bruxism was associated with dental problems (33.6%) and emotional factors (32.8%). A significant difference was found between the educational background of the parents and the ability to define bruxism. Conclusion: Parents had inadequate knowledge about bruxism in children and this was mostly related to the educational background of the parents.

RESUMEN Objetivo: El bruxismo es un trastorno de la actividad muscular de la mandíbula que se caracteriza por apretar o rechinar los dientes y se pueden ver tanto en niños como en adultos. El propósito de este estudio es evaluar el conocimiento de los padres sobre el bruxismo en sus niños. Métodos: se realizó un estudio transversal con 265 padres cuyos hijos fueron atendidos en las clínicas de Odontología Pediátrica y Cirugía Oral y Maxilofacial de la Universidad de Mersin. Las edades de los niños variaron de 6 meses a 16 años. Se utilizó un cuestionario de 20 preguntas para recopilar los datos. Para el análisis estadístico de los datos se utilizó el programa IBM SPSS Statistics 22 (SPSS IBM, Turquía). Resultados: Un total de 265 padres (159 mujeres y 106 hombres) participaron en el estudio. La mayoría de los padres tenían entre 31 y 40 años (60.8%). La tasa de niños que apretan y rechinan los dientes durante el sueño (21.5%) fue mayor que la tasa de los que lo hacen cuando están despiertos (7,2%). La proporción de padres que buscan tratamiento para sus hijos debido a este hábito dañino fue muy baja (3.8%). La mayoría de los padres (37.7%) informaron que buscan ayuda de los dentistas. Los participantes creían que el bruxismo estaba asociado con problemas dentales (33,6%) y factores emocionales (32,8%). Se encontró una diferencia significativa entre la formación académica de los padres y la capacidad de definir bruxismo. Conclusión: Los padres tenían un conocimiento inadecuado sobre el bruxismo en niños y esto estaba relacionado principalmente con la formación educativa de los padres.