Influence of gag reflex on removable prosthetic restoration tolerance according to the patient section of the short form of the Gagging Problem Assessment Questionnaire.

PURPOSE: To assess removable prosthetic restoration tolerance according to the patient section of the short form of the Gagging Problem Assessment Questionnaire (GPA-pa SF) and the influence of gender, education level and prosthesis type and denture-related mucosal irritation on the GPA-pa SF scores before treatment and over a period of two months after prosthesis insertion. MATERIALS AND METHODS: 130 participants who required removable prosthesis were surveyed with a standard form that included questions regarding age, gender, education level, dental attendance, and prosthetic restoration type. Participants answered the GPA-pa SF before restoration (T0) and 1 day (T1), 2 days (T2), 15 days (T3), 1 month (T4), and 2 months (T5) after prosthesis insertion. RESULTS: Of the 130 participants, 110 participants completed the prosthetic restoration procedure, but only 93 of these were able to use the prosthesis over the two-month period. The mean GPA-pa SF score obtained at T0 was higher than the scores obtained at the other periods in the total of the sample. Significant difference was present between mean scores obtained at T0-T1 and T2-T3 than scores obtained at other periods (P<.05). Female participants and participants with denture-related mucosal irritation had higher GPA-pa SF scores at all time points analysed. Significant difference was present between mean GPA-pa SF scores obtained at T2-T3 than scores obtained at other periods for females and participants with denture-related mucosal irritation (P<.05). Education level and prosthesis type did not significantly influence the GPA-pa SF score at any time point analysed (P>.05). CONCLUSION: GPA-pa SF scores were higher before the restoration procedure began, and decreased over time with the use of prosthesis. Gender and denture-related mucosal irritation affected the GPA-pa SF scores.

Teeth number anomalies in permanent dentition among non-syndromic dental patients.

The aim of this study was to establish teeth number anomalies in relation to gender, tooth type, location, distribution pattern and the association between frequently missing teeth among a group of dental patients in Turkey. A total of 378 non-syndromic patients (240 females and 138 males) with an age range of 7-45 (x +/- SD = 22.07 +/- 3.6) having evidence of absent or excess teeth were evaluated in the study. Pearson Chi-square, Fisher's exact, McNemar and Kappa coefficients were used for statistical analysis. 237 patients had a total of 546 congenitally missing teeth and 141 had 185 excess teeth. Congenitally missing teeth were more commonly seen rather than the presence of supernumerary teeth. Difference was determined in the frequent locations of congenital missing and supernumerary teeth. The most frequent missing tooth type was found to be the mandibular second premolar (26.6%), while the majority of supernumerary teeth were located in the anterior region of the maxillary arch (37.9%). Both teeth number anomalies were more commonly seen among females. In hypodontia cases the occurrence of symmetrical agenesis of laterals and second premolars in maxilla; centrals and second premolars in mandible was notable. Agenesis of mandibular centrals was found to be associated with maxillary lateral agenesis in males. Also higher prevalence of molar teeth agenesis was determined in the occurrence of at least 4 teeth agenesis. These findings will serve as information about the contemporary demographic pattern of teeth number anomalies among non-syndromic Turkish dental patients and can provide evidence that agenesis of some teeth symmetrically or together are the products of the same genetic mechanisms.

Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity?

OBJECTIVE: The aim of this study was to evaluate and establish any similarity between the associated symptoms, pathologies, positions, and angulation types of bilateral occurring mandibular third molars among a group of young adult patients. STUDY DESIGN: A total of 342 patients (167 females, 175 males), aged between 20 and 25 years (mean: 22.2, SD: 1.8) participated in the study. Clinical and radiographic examinations were performed. Eruption status, mucosal and bony coverage type, presence of pain, pericoronitis, suppuration, ulceration, caries in third molar, distal caries in second molar, bone loss, root resorption, or cyst or tumor formation was investigated in addition to the position and the angulation of each tooth. Patients having at least one completely or partially erupted mandibular third molar were classified as group 1 and patients having bilateral impacted mandibular third molars were classified as group 2. RESULTS: No significant difference was found between the symptoms and pathologies related with the mandibular right third molar (RM) and the left third molar (LM) among both groups and genders (P > .05). In the total sample, no significant difference was found between the RM and the LM in terms of mucosal coverage type, bony coverage type, and position both in group 1 and group 2 (P > .05); but gender had an influence on the bony coverage type and ramus distance of the RM and the LM in group 2 (P < .05). In the total the sample, symmetry was present for horizontal or distoangular and vertical or distoangular angulations in group 1 and group 2, respectively. Gender was found to also have an impact on angulation symmetry. CONCLUSION: In most cases, a similarity was present between the symptoms and pathologies related with the bilateral mandibular third molars; but symmetry in position and angulation differed according to eruption status, angulation type, and gender.

Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics.

AIM: The purposes of this research were to investigate factors influencing patients' satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. MATERIALS AND METHODS: A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, chi2 test and multiple logistic regression analyses. RESULTS: According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0%) and whitening of teeth was the most-desired dental treatment (49.0%). Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. CONCLUSION: Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

The use of a microscope for restorative treatment decision-making on occlusal surfaces.

Using an operating microscope, this study assessed the effect of 16x magnification on the restorative treatment of posterior teeth and compared the results against an unaided visual examination in vitro. Three dentists examined 300 premolars and molars at different times using an unaided visual examination and an operating microscope at 16x magnification. The observers examined the occlusal surfaces of teeth according to a patient model and selected a treatment protocol based on the following scale: 0: No Active Care (NC); 1: Preventive Care (PC) and 2: Operative Care and Preventive Care (OC+PC) advised. According to the results, there was good intra-observer agreement and moderate interobserver agreement with both techniques. No significant difference was found between the treatment using an unaided visual examination and that using an operating microscope. The use of a microscope at 16x magnification did not aid in the restorative treatment decision-making on occlusal surfaces.

Dietary habits and oral health related behaviors in relation to DMFT indexes of a group of young adult patients attending a dental school.

OBJECTIVES: The aim of the present study was to investigate the dietary habits and oral health related behaviors in relation to the dental health status in terms of decayed, missing and filled teeth (DMFT index) of a group of young adults attending to a dental school located in a major city in Turkey. STUDY DESIGN: A total of 416 young adults (247 females and 169 males) with an age range of 18-25 (Mean 23.2 sd 0.97) attending the Oral Diagnosis department participated in the study. The patients completed a questionnaire including questions about demographic factors, dietary habits and oral health related behaviors. Subsequently, the DMFT index and plaque index was calculated. Descriptive statistics, Mann Whitney U/ Kruskal Wallis Variance analysis, Chi-square/Fisher's Exact tests and multiple linear regression analysis were used for statistical analysis of the data when applicable. RESULTS: According to the results of the study, approximately 70% of the patients had regular main meals and a very high snacking rate (76.9%) was present. Although not at a high rate, most of the patients brushed their teeth regularly twice a day (44.2%) and approximately half used other hygiene aids in addition to brushing (43.8%). The median of the DMFT index was 5 and a majority of the patients had moderate plaque accumulation which could be seen with the naked eye (45.0%). Dental plaque had the most significant effect on the DMFT index. CONCLUSION: In conclusion, advice, including importance of regularity of main meals, decrease in snacking frequency, regular brushing twice a day and the use of other oral hygiene aids for the elimination of dental plaque would be helpful to enhance the dietary habits and oral health related behaviors of young adult Turkish patients.

Dental fear and anxiety levels of patients attending a dental clinic.

OBJECTIVE: The aim of this study was to evaluate the anxiety levels of patients attending a university oral diagnosis clinic. Avoidance, felt physiologic responses, and the most fear-producing stimuli of dental treatment were also evaluated. METHOD AND MATERIALS: A total of 1,437 patients were asked to complete a questionnaire consisting of the Dental Anxiety Scale (DAS), Dental Fear Scale (DFS), and questions about age, gender, education level, and frequency of dental visits. The patients were grouped according to gender and divided into 5 age categories. Statistical analysis was made by descriptive statistics, two-proportion z test, analysis of variance, Tukey's Honestly Significant Difference test, and Scheffé test. RESULTS: The mean DAS score was 9.52 (SD 4.08) for females, 7.96 (SD 3.30) for males, and 8.76 (SD 3.80) for the total sample. There was no statistically significant difference between the mean DAS scores of age groups. Patients with a primary school education and those who had never visited the dentist had the highest anxiety scores. According to the DFS, the most felt autonomic response was increased heart rate, and the most fear-producing stimuli were the sight of the needle (25.1%) and sensation of the injection (24.1%). Of the patients 10.5% avoided calling for an appointment, and 4.9% canceled or did not appear for appointment. CONCLUSION: Some patients are afraid of some of the stimuli involved with dental treatment. This could affect the patient-dentist relationship and the dental treatment plan; therefore, before dental treatment, patients' anxiety and fear levels should be assessed.

Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope.

This study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra-oral camera and operating microscope, respectively. There was a statistically significant difference between the intraoral camera and the other two methods (p<0.05), while there was no significant difference between the unaided visual examination and operating microscope (p>0.05). As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.

The assessment of unaided visual examination, intraoral camera and operating microscope for the detection of occlusal caries lesions.

This study compared the efficiency of unaided visual examination, intraoral camera and operating microscope according to a visual scoring system (ERK) at occlusal caries detection. A total of 84 extracted human molars were mounted to create mouth models with a premolar in contact on both sides. The models were examined in a phantom head simulating clinical conditions by four observers using the three techniques: unaided visual examination, an intraoral camera and on operating microscope according to the ERK scale. The teeth were than sectioned in a mesio-distal direction and examined under a stereomicroscope with 10x magnification for histological validation. The sensitivity, specificity, positive predictive and negative predictive values were calculated for the four observers with three techniques and statistical analyses were performed using Friedman and DUNN tests, while strength of agreement was determined by calculating Kappa values. From the data, mean sensitivity values were cal. culated as 0.26, 0.43, 0.49 and mean specificity values as 0.87, 0.80 and 0.73 for unaided visual examination, intraoral camera and operating micro scope, respectively. The Kappa values ranged between 0.187 and 0.301 for visual examination, 0.328 and 0.459 for intraoral camera and 0.363 and 0.516 for operating microscope. As a result, the use of an intraoral camera and operating microscope improved occlusal caries detection according to the ERK scale.

Approximal carious lesion depth assessment with insight and ultraspeed films.

This study evaluated the efficiency of a new E/F-speed film, Insight, at the determination of approximal carious lesion depths compared with Ultraspeed. Radiographs of 80 extracted human molars and premolars were taken with both films under standardized conditions. The presence or absence of caries and depth of lesions was determined by three observers using a predetermined scale. The actual status of each surface was determined histologically. Observer responses were assessed with the Gamma measure of association test. Differences between the observers' agreement levels were not significant. The efficiency of Insight and Ultraspeed at true depth diagnosis was found to be 54.9%; 55.8% and Gamma values were found to be 0.883 and 0.922, respectively, at p<0.001. The difference between the two films was not statistically significant (p=0.852). This study suggested that there was no statistically significant difference between the two films at detecting the depths of approximal carious lesions.

The efficiency of three different films and radiovisiography in detecting approximal carious lesions.

OBJECTIVE: The aim of this study was to evaluate the efficiency of Ultraspeed, Ektaspeed Plus, and Insight radiographic films, and radiovisiography in detecting approximal carious lesions. METHOD AND MATERIALS: Eighty approximal surfaces of 40 extracted human molars and premolars were evaluated. Radiographs of teeth blocks were taken with three different films and radiovisiography under standard conditions. The presence or absence of approximal caries was evaluated by three observers according to a five-point confidence scale. The actual status of each surface of the teeth was histologically determined from the teeth sections. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios of the imaging modalities were calculated, and observer responses were assessed with Kendall's tau and Spearman's rho tests. RESULT: The sensitivity values for Ultraspeed, Ektaspeed Plus, Insight, and radiovisiography were 0.39, 0.48, 0.45, and 0.49, respectively, while the specificity values were 0.91, 0.88, 0.84, and 0.90, respectively. The difference in detecting approximal carious lesions between the systems was not statistically significant. CONCLUSION: This study suggests that there is no significant difference between the four imaging modalities in detecting approximal carious lesions.

Common errors on panoramic radiographs taken in a dental school.

The aim of this study is to evaluate the frequency of common errors seen on panoramic radiographs taken in the Radiology Department of a dental school by trained assistants. Four hundred and sixty radiographs were evaluated for 20 categories of common errors. Out of the evaluated radiographs, 37.61% were found to be error-free. The most common errors were found to be the palatoglossal airspace shadow of air above the tongue due to the patient not raising the tongue against the palate (46.30%) and the superimposition of hyoid bone with the mandible (26.30%) respectively. The least common error was found to be dirty or bent films (0.21%). The quality of panoramic radiographs could be enhanced by improving radiographic technique.