Factors affecting the parental knowledge, beliefs, and attitudes towards pediatric dental X-rays.

OBJECTIVES: To investigate the knowledge, beliefs, and attitudes towards pediatric dental radiography and its associated factors among Turkish parents seeking dental care for their children. MATERIALS AND METHODS: This cross-sectional study enrolled 483 parents of children aged 6-15 years. Data were collected using the questionnaire including socio-demographic characteristics, knowledge, beliefs, and attitudes based on The Health Belief Model and planned behavior theory. Descriptive, bivariate, and multivariate statistics were performed. RESULTS: More than half of parents had correct knowledge on their rights to access health information, the radiation risk and exposure from dental X-rays, children's vulnerability to radiation, and using lead apron. Most parents (70.4%) perceived dental X-rays as valuable. They had limited knowledge regarding the permanent damage and negative attitudes regarding its safety and goodness. There were positive correlations between knowledge-attitudes, knowledge-perceived benefits, and attitudes-perceived benefits (all p values < 0.01). Having a previous dental X-ray (p = 0.014) and not having parents' information needs (p = 0.007) were associated with higher attitudes. Increasing education levels, having a educational need and higher perceived benefit were found to be predictors of higher parental knowledge. CONCLUSION: Turkish parents had some knowledge and positive attitudes towards pediatric dental X-rays but not at optimum levels. Parents' education levels, information needs, and beliefs were the most important factors affecting parental knowledge. Attitudes towards radiation safety and goodness should be improved. CLINICAL RELEVANCE: These findings may provide useful insight to clinicians when developing theory-driven health education interventions on pediatric dental X-rays and identifiying the parents with low knowledge.

Turkish version of the faces version of the Modified Child Dental Anxiety Scale (MCDASf): translation, reliability, and validity.

OBJECTIVES: To cross-culturally adapt of MCDASf into Turkish and to evaluate reliability and validity of the Turkish version of MCDASf using explorative factor analysis (EFA), confirmatory factor analysis (CFA), and receiver operating characteristic (ROC) analysis to form a less time consuming and easy to understand tool for measuring dental anxiety. MATERIALS AND METHODS: A total of 300 children (174 females, 126 males) aged 6-12 years who were recruited at the Department of Paediatric Dentistry in RTEU at the first visit participated in the present study. For the internal consistency reliability, Cronbach's alpha was calculated. Intraclass correlation coefficients (ICCs) were calculated for test-retest reliability (n=67). Construct validity was determined by comparing with the Venham Picture Test (VPT). The factor structure was examined using EFA. CFA was used for dimensionality. The cut-off points of the Turkish version of MCDASf were plotted using a ROC curve. RESULTS: The Turkish version of MCDASf showed high internal consistency (0.703) and an excellent ICC value (0.827). Good correlations were found between the global scores of MCDASf and VPT (r=0.632). Three factors were identified from EFA and verified with CFA. Discriminant validity was supported by high scores of females and younger children (p<0.05). The cut-off point was assigned as >24.50. The area under the ROC curve (AUC) was 0.921 (95% CI: 0.873-0.969). CONCLUSIONS: The Turkish version of the MCDASf is a reliable and valid scale that satisfied psychometric properties. CLINICAL RELEVANCE: The Turkish version of MCDASf is a usable tool for the measurement of dental anxiety among Turkish speaking children.

Comparative evaluation of various herbal extracts on biofilms of Streptococcus mutans and Scardovia wiggsiae: An in vitro study.

BACKGROUND: Owing to their strong antimicrobial properties, Helichrysum arenarium (HA), Anzer thyme (AT), and Stevia rebaudiana (SR) have been commonly used in medicine. AIM: This study aimed to evaluate antimicrobial activities of HA, AT, and SR against S. mutans and S. wiggsiae in biofilms formed on primary teeth. DESIGN: Fifty enamel samples were divided into two groups: mono-species biofilm and two-species biofilm. Each biofilm group was divided into five subgroups (n = 5): group 1, HA; group 2, AT; group 3, SR; group 4, CHX (positive control); and group 5, distilled water (negative control). Minimum inhibitory concentration and minimum bactericidal concentration were determined. The number of viable microorganisms was counted. The presence of microorganisms was examined using a scanning electron microscope, and mineral analysis was performed using energy-dispersive X-ray analysis. RESULTS: In the mono-species biofilm, CHX was significantly more effective against S. mutans than other groups (p < .001). Furthermore, HA, AT, and SR groups showed significantly lower colony counts of S. mutans than distilled water (p < .05). In the two-species biofilm group, AT, SR, and CHX were significantly more effective against S. wiggsiae than distilled water (p < .05). CONCLUSIONS: HA, AT, and SR have been suggested as effective natural alternatives to CHX against cariogenic bacteria.

Child and parent preferences for the appearance of dentists with respect to personal protective equipment in paediatric dentistry.

BACKGROUND: Personal protective equipment (PPE) gained particular importance during the COVID-19 pandemic. AIM: To assess child and parent preferences for dentists' appearance concerning their PPE and to determine the relationship between the child and parent preferences. DESIGN: A total of 250 children aged 6-12 years and their parents were enrolled in the study. Standardized pictures with different sexes, attires, eye protectors, hair protectors, masks, and gloves were shown to children and their parents separately, and they were asked to choose their preferences. The dental anxiety of the children and their parents was determined using the MCDASf and MDAS, respectively. Decayed, missing, and filled tooth (DMFT) indices were employed for the children. RESULTS: Children and parents preferred a dentist of the same sex as themselves (p < .05). Anxious children preferred cartoon-printed attire, and children with low anxiety mostly preferred white coats (p = .001). Children who preferred colored coats had higher DMFT (p < .001). Statistically significant differences were found in the attire and glove preferences between children and parents (p < .001). CONCLUSIONS: The production of white and child-friendly fluid-resistant disposable gowns should be considered. PPE with colored or cartoon print was preferred under the influence of factors that could positively affect anxiety.

Validity and reliability of the Turkish version of the Child Perceptions Questionnaire 8-10.

BACKGROUND: A reliable measurement tool is needed to gain more knowledge about Turkish children's oral health status that affects the quality of life. AIM: To develop a translated version of CPQ8-10 into Turkish language and evaluate its reliability, validity, and reproducibility. DESIGN: The intra-class correlation coefficient (ICC) was used for the test-retest reliability in the 50 children. For the internal consistency, 418 children aged 8-10 years were evaluated using Cronbach's alpha Coefficient. Construct validity and discriminant validity were calculated using Spearman's correlation analysis, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was also employed. RESULTS: The mean CPQ8-10 score was 13.3 ± 9.2. The translated Turkish version of CPQ8-10 showed high test-retest reliability (ICC = 0.90) and internal consistency (Cronbach's alpha = 0.82). A statistically significant correlation was observed between the scores of the CPQ8-10 and oral health and overall well-being, which revealed good construct validity (r = 0.50; P < .001 and r = 0.47; P < .001, respectively). Seven factors identified from EFA were statistically verified using CFA. Discriminant validity was supported by significant differences between CPQ and OHIS scores (P < .001). CONCLUSIONS: The translated version of CPQ8-10 to the Turkish language is reliable, valid, and reproducible for use in the Turkish culture in this age group.

The effects of cavity disinfection on the nanoleakage of compomer restorations: an in vitro study.

PURPOSE: Cavity disinfection, in addition to routine caries removal methods, is recommended to eliminate the microorganisms. The aim of this study was to compare the effect of various systems Er,Cr:YSGG lasers, diode lasers and FotoSan and agents Corsodyl; Cervitec and Cervitec Plus and Fluor Protector-on the nanoleakage of compomer restorations when used for cavity disinfection. MATERIALS AND METHODS: A total of 40 intact human deciduous molar teeth containing Black V cavities (3×2×1.5 mm) on the buccal and lingual surfaces parallel to the cementoenamel junction were randomly divided into 8 groups according to the cavity disinfection methods. The antibacterial agents and systems were applied according to the manufacturer's instructions. Restorations were completed using a compomer. The restored teeth were then subjected to thermocycling for 500 cycles in a water bath at 5°C and 55°C with a dwell time of 30 seconds. After the thermocycling procedures, 1-mm sticks were obtained from the center of each cavity to prepare for the nanoleakage test. After the teeth were sectioned, they were immersed in 50 wt % ammoniacal silver nitrate solution for 24 hours and dipped in photo-developing solutions for 8 hours with fluorescent light irradiation. The samples were examined under a scanning electron microscope (SEM). The non-parametric Kruskal-Wallis and Mann-Whitney U test (p<0.05) were applied. RESULTS: The Er,Cr:YSGG laser group showed significantly less nanoleakage than all of the tested groups (p<0.01). The diode laser, Fluor protector and FotoSan groups showed similar nanoleakage to that of the control group (p>0.05). The Corsodyl (p<0.01) and Cervitec (p<0.001) groups showed significantly higher nanoleakage than the control group. CONCLUSION: Er,Cr:YSGG laser irradiation which showed lower nanoleakage scores from either control or tested groups can be recommended for cavity disinfection Additionally, a diode laser and FotoSan, which have antibacterial effects and no negative effect on leakage, can be used for cavity disinfection.

Myelodysplastic Syndrome Presenting With Diffuse Bone Marrow Uptake on 68Ga-PSMA PET/CT.

We present the case of a 67-year-old man with prostate cancer who had no findings of recurrence, except diffuse radiotracer uptake in the bone marrow in Ga-PSMA PET/CT. Bone marrow uptake was also represented as multiple focal increased spots without any corresponding lytic or sclerotic lesions in CT. MRI revealed a high and homogeneous T2 signal within the bone marrow, without any contrast-enhanced or diffusion-restricted lesions. Further workup, including a bone marrow biopsy, revealed the diagnosis of myelodysplastic syndrome.

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial.

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

Gamma Knife Radiosurgery for Arteriovenous Malformations: Clinical Series of 199 Patients.

AIM: Cerebral arteriovenous malformations (AVM) are pathological connections between arteries and veins without capillaries. Stereotactic radiosurgery (RS) is a proven and accepted treatment method for cerebral AVMs. Our objective was to analyze the factors influencing the clinical outcome in patients suffering from AVMs. MATERIAL AND METHODS: We retrospectively reviewed 199 patients who were treated with Gamma-Knife RS for intracranial AVMs between 13 October 2005 and 31 October 2010. There were 89 male, 110 female patients with a median age of 32 years (range, 3-74 years). Obliteration was assessed with MRI angiography and DSA imaging. RESULTS: Complete obliteration rate after RS was 71 % (141 out of 199), including second RS treatments. In terms of obliteration rates, there was no significant difference between patients younger and older than 21 years old (p=0.669). After RS, 3 patients died due to intracranial hemorrhage and 1 died of heart disease. Death from AVM was determined as 1.5 %. Intracranial hemorrhage was observed in 7 (3.5 %) patients post-RS. CONCLUSION: Obliteration was found to be associated with Spetzler-Martin Grade, Pollock-Flickinger Grade, AVM volume, RS dose, bleeding history before RS and no previous embolization before RS. Gamma knife RS is an effective treatment method for the treatment of AVMs both for pediatric and adult patients. It provides high obliteration and low mortality rates.

Antibacterial effects of fluoride varnish compared with chlorhexidine plus fluoride in disabled children.

PURPOSE: To evaluate the effects of fluoride varnish vs a combination of chlorhexidine-thymol varnish plus a gel containing chlorhexidine and fluoride on oral hygiene and caries prevention in disabled children. MATERIALS AND METHODS: Ninety patients aged 3-17 years who were treated under general anaesthesia were randomly assigned into three groups as follows: group 1: Fluor Protector (0.1% fluoride varnish); group 2: Cervitec Plus (1% chlorhexidine- 1% thymol varnish) + Cervitec Gel (0.2% chlorhexidine-0.2% sodium fluoride); group 3: control (toothbrushing only). Mutans streptococci (MS) and lactobacilli (LB) levels, visible plaque index (VPI) and gingival bleeding index (GBI) were evaluated at four stages: T0, before general anaesthesia; T1, one month after treatment; T2, six months after treatment; T3, twelve months after treatment. The data were evaluated using Kruskal-Wallis and Mann-Whitney U-tests (P < 0.05). RESULTS: Groups 1 and 2 showed significantly lower scores than group 3 for all parameters at T1 and T2. No statistically significant difference was detected among any of the the groups at T3 (P > 0.05). CONCLUSION: The use of materials that include both fluoride and chlorhexidine as routine treatment of children with disability may increase the success of restorations by improving oral hygiene, reduce the need for future restorative treatments and thus the need for general anaesthesia.

The effect of an erbium, chromium: yttrium-scandium-gallium-garnet laser on the microleakage and bond strength of silorane and micro-hybrid composite restorations.

OBJECTIVE: The aim of this in vitro study was to compare the microleakage and bond strength of Class V silorane-based and universal micro-hybrid composite restorations prepared either with diamond bur or with an erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser. MATERIALS AND METHODS: A total of 160 molar teeth were used for microleakage assessment and shear bond strength (SBS) test. The specimens were prepared using either diamond bur or 3 W-, 4 W- and 5 W-20 Hz Er, Cr:YSGG laser irradiation. All specimens were subjected to thermocycling (500 times at 5 ± 2°C to 55 ± 2°C, dwell time 15 s and transfer time 10 s). Microleakage was assessed using a 0.5% basic-fuchsin solution. The bond strengths were determined using a microtensile tester at a crosshead speed of 0.5 mm/min. The Kruskal Wallis test was used for the analysis of microleakage and a one-way analysis of variance test was used to analyze the SBS (P < 0.05). RESULTS: No statistically significant differences were found (P > 0.05) between Er, Cr:YSGG laser and bur preparation methods regarding microleakage and bond strength values. CONCLUSION: Irradiation with Er, Cr:YSGG laser was confirmed to be as effective as conventional methods for preparing cavities before adhesive restorations.

Effects of different types of adhesive systems on the microleakage of compomer restorations in Class V cavities prepared by Er,Cr:YSGG laser in primary teeth.

The aim of this in vitro study was to evaluate the effects of different types of adhesive systems on the microleakage of compomer restorations in Class V cavities prepared by erbium, chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) laser. There were five test groups according to the type of adhesive applied to the cavities: Adper Single Bond 2 (Group 1), Scotchbond Multi-Purpose Plus (Group 2), Xeno III (Group 3), Clearfil Protect Bond (Group 4), Prime&Bond NT (Group 5). Dye penetration was evaluated under a stereomicroscope, and data were statistically analyzed by Kruskal-Wallis and Wilcoxon Signed Ranks tests. Gingival margins showed significantly higher microleakage than occlusal margins in all the test groups (p<0.05). Groups 1 and 2 showed significantly less microleakage than Group 5 (p<0.05), and there were no statistically significant differences among Groups 3, 4, and 5 (p>0.05). None of the dentin bonding agents eliminated microleakage completely, and higher microleakage scores were observed along the gingival margin than the occlusal margin.

The LMA CTrach™ in morbidly obese and lean patients undergoing gynecological procedures: a comparative study.

PURPOSE: The tracheas of obese patients may be more difficult to intubate than those of normal-weight patients. The aim of this study was to compare the airway management quality in morbidly obese and lean patients with use of the LMA CTrach. METHODS: After Ethics Committee approval, 60 adult patients (30 morbidly obese patients with body mass index >40 kg/m² and 30 lean patients with body mass index <30 kg/m²) scheduled to undergo gynecological surgery were enrolled in this prospective study. The induction of anesthesia was standardized using propofol, fentanyl, and rocuronium. Ventilation and intubation success rates, time taken to achieve successful ventilation, and intubation through the CTrach and airway complications were recorded. RESULTS: The CTrach was successfully inserted and adequate ventilation through the CTrach was achieved in 59 patients (98%). Only 1 patient in the lean group was not able to ventilate through the CTrach. We were successful in endotracheal intubation, either under vision or blind, in 56 patients (93%). We were able to view the larynx in 51 patients (85%). Total intubation time was significantly longer in morbidly obese patients, 69 (311) s, than in lean patients, 33 (107) s [median (range)] (P < 0.001). CONCLUSIONS: We concluded that the time to intubate the trachea in obese patients was significantly longer than in lean patients when the LMA CTrach was used.

Retreatment of a resected tooth associated with a large periradicular lesion by using a triple antibiotic paste and mineral trioxide aggregate: a case report with a thirty-month follow-up.

INTRODUCTION: Trauma to the teeth and supporting structures is a frequent problem among children. Endodontic treatment is necessary for 41.3% of traumatized teeth. Two of the most important criteria for successful endodontic treatment are the elimination of microorganisms and apical sealing. A combination of antibiotic drugs (metranidozole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. For cases in which apical sealing is difficult, specific materials to plug the apical region have been advocated. Mineral trioxide aggregate (MTA) has become the material of choice because it is biocompatible and has bacteriostatic action. METHODS: This case report describes the nonsurgical retreatment of a traumatized tooth that had already undergone unsuccessful apical resection associated with a large periradicular lesion. A combination of antibiotic drugs was used as an intracanal medicament, and MTA was used to obtain a hermetic seal of the lateral tooth that had undergone unsuccessful apical resection. RESULTS: On follow up, the tooth was clinically and radiographically asymptomatic for 30 months. CONCLUSIONS: The results of this case show that MTA and triple antibiotic paste can be used clinically in the treatment of an unsuccessfully resected tooth associated with a large periradicular lesion.