Remineralization effect of NaF, NaF with TCP, NaF with CPP-ACP and NaF with CXP varnishes on newly erupted first permanent molars: A randomized controlled trial.

INTRODUCTION: The aim of this study was to evaluate the remineralization effect of NaF, NaF with TCP, NaF with CPP-ACP and NaF with CXP varnishes on newly erupted first permanent molars using laser fluorescence (LF) method. The study was a randomized, double-blind, controlled trial with four parallel groups. METHODS: The study was carried out in 48 high caries-risk children (DMFS >8), aged 6-7 years with newly erupted permanent first molars (initial lesion with 13 < LF value<30). A total of 140 teeth were divided randomly into four groups (n = 35): G1.Duraphat Varnish containing 5% NaF, G2. Clinpro™ White Varnish containing 5% NaF with TCP, G3.Embrace™ Varnish containing 5% NaF with CXP, G4. MI Varnish containing 5% NaF with CPP-ACP. All dental treatments of the patients were completed before the varnish application. The varnishes were applied to the targeted teeth at baseline, 1 and 3 months. Patients were called for follow-up appointments at 1, 3 and 6 months, and LF scanning was used to monitor mineralization changes. Data were analysed statistically by Wilcoxon signed-rank and Mann-Whitney U-tests. RESULTS: In total, 40 children (122 teeth) completed the trial. At the end of 6 months, the amount of reduction in LF values (indicating remineralization) are as follows: NaF with CXP(6.87 ± 4.32) < NaF with TCP(7.36 ± 7.05) < NaF(7.40 ± 7.03) < NaF with CPP-ACP(8.33 ± 4.90). All of the varnishes resulted in significant decrease in LF measurements and there was no significant difference between control (NaF alone) group and other groups. Only MI varnish had a significantly greater remineralization effect than Embrace™ Varnish (p < 0.05). CONCLUSION: As a non-invasive approach, CPP-ACP, TCP and CXP containing NaF varnishes have the potential to remineralize initial caries lesions on permanent first molars in high caries-risk children.

Thermal, morphological, and spectral changes after Er, Cr:YSGG laser irradiation at low fluences on primary teeth for caries prevention.

The aim of this study was to determine the temperature increase in the pulp chamber and possible thermal effects on molecular structure of primary teeth during the irradiation with Er,Cr:YSGG laser. Primary central incisors were divided into three groups (n = 20). Labial surfaces in each group were irradiated by Er,Cr:YSGG laser within different power and frequencies as following groups: I: 0.25 W, 20 Hz, II: 0.50 W, 20 Hz, III: 0.75 W, 20 Hz. A thermocouple was placed inside the pulp chamber so that the temperature increments were recorded during the enamel irradiation. Morphological changes of enamel surfaces were experimentally evaluated by SEM. Fourier-transform infrared spectroscopy and RAMAN analyses were carried out to determine the differentiations in the molecular structure. The experimental results obtained were analyzed statistically by means of one-way analysis of variance. Statistically significant differences were detected between groups (p < .05). Group III exhibited the highest values for the temperature parameters. Besides, the conical craters, cracks, and formation of ablation areas were observed for all the groups. Also, it was obtained that the hydroxyapatite lost the hydroxyl ions due to the thermal effect of the laser. Temperature rise throughout the Er,Cr:YSGG laser irradiation for prevention of primary enamel demineralization presented a positive correlation with the laser output power level. The formations of adverse morphological and spectral changes were detected on the surface of teeth after the laser application. On this basis, the Er,Cr:YSGG laser applications should be treated with much more caution considering enamel surface and pulpal tissues in primary teeth.

Antibacterial activity of fluoride varnishes containing different agents in children with severe early childhood caries: a randomised controlled trial.

OBJECTIVES: The aim of this study was to compare the antibacterial activity of fluoride varnishes containing different agents in children with severe early childhood caries (S-ECC). MATERIALS AND METHODS: The study was conducted in 92 children with S-ECC. Patients who completed dental treatment under general anaesthesia were included in the study. Patients were divided randomly into four groups: 5% sodium fluoride (SF) control group (n = 23), 5% SF with tricalcium phosphate (TCP) (n = 23), 5% SF with xylitol-coated calcium and phosphate (CXP) (n = 23) and 5% SF with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (n = 23). Saliva mutans streptococci (MS) and lactobacilli (LB) levels were evaluated by taking saliva samples at baseline (T0), 1 month (T1) and 3 months (T2) after treatment. RESULTS: All groups showed a significant decrease in MS and LB levels at T1 (P < 0.05) except the CXP group. Only the TCP group exhibited significantly decrease MS and LB levels indicating less than 105 CFU at both T1 and T2 compared with the other groups (P < 0.05). CONCLUSION: Fluoride varnish with TCP provided significantly more reduction in MS and LB levels than other fluoride varnishes. CLINICAL RELEVANCE: Fluoride varnish with TCP had a significant antibacterial effect against cariogenic bacteria until the end of the third month. Long lasting antibacterial effect provides additional advantage for reducing bacteria levels in children. CLINICAL TRIALS REGISTRATION NUMBER: NCT03625310.

Effect of Er,Cr:YSGG Laser on the Prevention of Primary and Permanent Teeth Enamel Demineralization: SEM and EDS Evaluation.

Objective: To evaluate in vitro the effect of the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser on resistance of primary and permanent human enamel to demineralization using water cooling and fluoride coapplication as variable parameters. Methods: Enamel specimens were prepared from extracted primary and permanent teeth (n = 225 each). The specimens were separated into 15 subgroups (n = 15/group) based on laser application at three different power settings (0.25, 0.50, and 0.75 W), laser application with and without water cooling, and application of acidulated phosphate fluoride (APF) gel before laser treatment. Morphological changes were assessed with scanning electron microscopy (SEM), and the specimens' chemical contents were determined with energy-dispersive X-ray spectroscopy. Results: In both the primary and permanent teeth, the highest Ca and P content was observed in the noncooled 0.75 W laser group (p < 0.05), irrespective of APF pretreatment (p > 0.05). The Ca and P content for the noncooled APF +0.75 W laser group was lower than that for the APF group and the noncooled 0.75 W laser group. For both dentitions, the F mass content for the APF+laser groups was significantly higher than laser-only groups (p < 0.05). Under SEM, both the primary and permanent enamel exhibited cracks, craters, and surface roughness without water cooling, consistent with increased power output. Conclusions: Er,Cr:YSGG laser application at 0.75 W without water cooling increased enamel resistance to demineralization. Compared with topical APF application, Er,Cr:YSGG laser application barely improved enamel resistance against demineralization, and coapplication did not result in a synergistic effect.

Postoperative morbidity in pediatric patients following dental treatment under general anesthesia.

PURPOSE: The aims of this study were to investigate post-operative complications in pediatric patients 24 and 72 hours after general anesthesia (GA) and to identify any associations between dental procedures and complications. MATERIALS AND METHODS: One hundred and thirty three healthy pediatric patients who had undergone dental treatment under GA (age range: two to nine years) were included in this study. The project was designed as a prospective, observational study supported by a questionnaire that collected data on children's post-operative complaints. Preoperative data were obtained from patients' files and included age, gender, medical condition and admission type (inpatient or outpatient) variables. The postoperative complaints were assessed either by phone contact or by face-to-face interviews using a questionnaire 24 and 72 hours after treatment. RESULTS: 69.9% of children reported one or more complaints after 24 hours and 35.3% after 72 hours. Coughing and pain (27.1%), inability to eat (24.8%), psychological changes (24.1%) and a sore throat (21.1%) were the most common complaints during the first day. After 72 hours, the severity and rate of the complications decreased significantly (p < 0.05). CONCLUSION: Post-operative complaints following dental treatment under GA tended to be of mild severity and were mainly limited to the first day after the procedure.

Prevalence of dental anxiety in 7- to 11-year-old children and its relationship to dental caries.

OBJECTIVES: The aims of this cross-sectional study were to evaluate the level of fear of dental procedures among schoolchildren and assess the relationship between caries experience and fear of dental procedures. SUBJECTS AND METHODS: 275 children aged 7-11 years were recruited for the study. Before conducting a dental examination, each subject was asked to independently complete a Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) questionnaire. Children having a score of > or =38 were included in the group 'with dental fear' while those scoring <38 were placed in the 'without dental fear' group. All dental examinations were performed on the school premises according to WHO criteria. RESULTS: Mean CFSS-DS value was 28.1, and the number of children who experienced dental fear was 40 (14.5%). It was found that Decayed, Missing and Filled Surface Index (DMFS-dfs) increased significantly with increasing CFSS-DS values. Fear scores were highest for 'Choking' (3.3), 'Injections' (2.6) and 'Having somebody put instruments in their mouth' (2.6). No significant differences in fear scores between boys and girls were found in this study. CONCLUSIONS: The data showed prevalence of dental fear in the 7-11-year-old children of this study. Dental fear scores decreased with increasing age.

Clinical evaluation of a colored compomer in primary molars.

OBJECTIVE: The purpose of this study was to evaluate the clinical performance of a new colored compomer material, Twinky Star, in primary molars. SUBJECTS AND METHODS: Eighty class II restorations were placed in a total of 36 subjects and the clinical success of the restorations was evaluated after 12 months based on modified US Public Health Services criteria. RESULTS: The failure rate of the restorations was 3.9% (3 out of 77) and the clinical success of the restorations, measured by anatomic form, marginal integrity, marginal discoloration, surface texture, maintenance of interproximal contact and secondary caries, was acceptable. CONCLUSION: The clinical success of the colored compomer material, Twinky Star, indicates that it could be a good alternative to tooth colored compomers.