Two-year clinical performance of sonic-resin placement system in posterior restorations.

OBJECTIVE: The objective of this split-mouth randomized controlled study was to compare the 2-year clinical performance of two restorative techniques and materials for posterior permanent carious teeth. METHOD AND MATERIALS: After signing informed consent, 30 patients aged between 7 and 16 received two Class 1 restorations on cavities on permanent first or second molar teeth performed with one of two systems: incrementally placed conventional posterior composite resin (Herculite Ultra, Kerr), and sonic-resin placement system (SonicFill, Kerr) with single-component self-etch adhesive system (Kerr) according to the manufacturers' directions. Two blinded observers evaluated the restorations at three times (baseline, and after 1 and 2 years) according to the US Public Health Service modified criteria. Kruskal-Wallis test and Mann-Whitney U-test were used to compare the clinical performance of the restorative systems. RESULTS: The restorative systems showed similar clinical performance at 2 years. At the end of 2 years in both groups, one restoration's marginal staining Alpha ratings decreased. In the same period, two restorations in the conventional group and one in the SonicFill group received Bravo ratings for color match and surface roughness scorings. CONCLUSION: The sonic-resin placement system demonstrated similar results to incrementally placed conventional composite resin in terms of clinical success. Considering the advantages of providing up to 5 mm in a single layer, and the adjustability of the viscosity, bulk-fill composite restorations seem to be a good alternative to posterior Class 1 composite restorations. CLINICAL RELEVANCE: This study suggests that a new dental material for bulk-fill technology exhibits similar clinical success to incrementally placed composite resin.

Comparison of the Potential Discoloration Effect of Bioaggregate, Biodentine, and White Mineral Trioxide Aggregate on Bovine Teeth: In Vitro Research.

INTRODUCTION: Tricalcium silicate cements can be used for pulp capping, pulpotomies, apical barrier formation in teeth with open apices, repair of root perforations, regenerative endodontics, and root canal filling. The aim of this study was to evaluate and compare the discoloration potential of 3 different tricalcium cements using a bovine tooth model. METHODS: Forty bovine anterior teeth have been used for the study. Crowns separated from the roots were randomly divided into 4 groups: the BioAggregate (IBC, Vancouver, Canada) group, the Biodentine (Septodont, Saint Maur des Fosses, France) group, the mineral trioxide aggregate Angelus (Angelus, Londrina, PR, Brazil) group, and the only blood group. Materials have been placed to the standardized cavities on the lingual surfaces of the crowns, and their contact with blood has been provided. The color values of the samples were measured with a digital tooth shade determinator (VITA Easyshade; VITA Zahnfabrik, Bad Sackingen, Germany) before the placement of the materials, after the placement of the materials, in the 24th hour, in the first week, in the first month, in the third month, and in the first year. The mean value of all groups was compared using the Tukey multiple comparison test (α = 0.05). RESULTS: All groups displayed increasing discoloration during a period of the first year. The "only blood group" showed the highest color change values, and it was followed as BioAggregate, mineral trioxide aggregate Angelus, and Biodentine, respectively. Statistically significant differences were found for Biodentine when compared with the only blood and BioAggregate groups (P < .05). CONCLUSIONS: Considering the results of the study, Biodentine is found to have the least discoloration potential among the tested materials.

Effects of fixed and removable space maintainers on halitosis.

BACKGROUND: The current study evaluated the effects of fixed and removable space-maintainers on halitosis and oral health of children. METHODS: Forty-three patients randomly selected between the ages 4-10 whom fixed or removable space maintainers were indicated in Gazi University, Faculty of Dentistry, Department of Pedodontics. The inclusing criteria were: caries-free (with/without restorations), with absence of periodontal diseases, without systematic disease, no mouth breathing and no use of antibiotics the 2-months period before the study. The patients were subdivided into two groups: the group treated with fixed space maintainers (group 1, n = 27), the group treated with removable space maintainers (group 2, n = 16). The the plaque index (PI), gingival index (GI), periodontal screening index (PSI), tongue coating index (TCI) records and the halitosis measurements were obtained at three time periods (T1: immediately after application, T2: 1 week after application, T3: 5 weeks after application). The measurement values of T1 served as control. RESULTS: No statistically significant difference was found in the PI, GI, PSI, TCI and halitosis measurements between T1-T2, T2-T3 and T1-T3 in both appliance groups and between the groups (p > 0.05). CONCLUSIONS: The fixed and removable space maintainers did not affect oral health status and halitosis significantly.

Dental Treatment of a Child with Pallister-Killian Syndrome.

The Pallister-Killian syndrome (PKS) is an extremely rare genetic disorder with an incidence estimated around 1/25000. PKS is a multiple congenital anomaly deficit syndrome caused by mosaic tissue limited tetrasomy for chromosome 12p. The presented report is the first confirmed case with PKS in Turkey. This report focuses on the orofacial clinical manifestations of an 6-year-old boy with PKS who was referred to the Department of Paediatric Dentistry clinic, Gazi University. It has been learned that the PKS was diagnosed 1 year after birth. Due to intellectual disability, it was decided to make the dental treatments under moderate sedation. Although significant tongue thrust and anterior open bite were determined, any oral appliances could not be applied because of the 2 epilepsy seizures in the last 2 years. The aim was to treat decayed teeth and set good oral hygiene in the patient's mouth. Still, there is a probability for epilepsy seizures. If epileptic seizures stop permanently, we can apply an oral appliance to block tongue thrust. The patient is now under control. In cases of systemic and oral findings such as PKS, conducting medical and dental approaches together will increase the life quality of patients.

Comparison of Topical 10 Percent Lidocaine and a Local Anesthetic System in Pediatric Dental Patients.

PURPOSE: The purpose of this study was to compare the effectiveness of a three-in-one injection comfort system (ICS) and 10 percent lidocaine pump spray in reducing injection pain in children. METHODS: Fifty eight- to 12-year-old children treated at a university pediatric dental clinic participated in this study. The Children's Fear Survey Schedule-Dental Subscale was used to select nonanxious children to participate. Contralateral tooth pairs were treated in two separate visits with random use of either ICS or lidocaine pump spray. The pain perception levels were assessed with heart rate changes, the Modified Behavioral Pain Scale (MBPS), and the Wong-Baker FACES Pain Rating Scale (WBFPRS). At the end of the second visit, children's preferences were noted. Kruskal-Wallis and Mann-Whitney U tests were performed to compare the results. RESULTS: No significant differences were found between the two groups in the MBPS and WBFPRS scores, and mean heart rate changes (P>.05). However, 68 percent of the children preferred ICS. CONCLUSIONS: Both ICS and 10 percent lidocaine pump spray presented the same efficacy in reducing injection pain.

Effects of oxidative irrigants on root dentin structure: Attenuated Total Reflection Fourier Transform Infrared Spectroscopy study.

AIM: The aim of this study was to compare the effect of oxidative irrigants on the organic and inorganic structure of root canal dentin. METHODOLOGY: Fifty human 2nd premolar roots were used in the study. The dentin specimens prepared from those teeth were immersed in liquid nitrogen for 15 min. The frozen composition was titrated in a mixer and the obtained dentin powder was kept frozen at -70°C until use. Ten groups of 50mg dentin powder were immersed in agents (A: Ozone for 100 or 200 sec, B: 5.25% NaOCl, C: 2.25% NaOCl, D: 2% Chlorhexidine, E: 0.9% NaCl (control)) for 5 or 10 min. An Attenuated Total Reflection Fourier Transform Infrared Spectrophotometer (ATR FT-IR) was used to analyze dentin powder. The data were statistically analyzed by using Kruskall-Wallis analysis of variance. RESULTS: In all groups, collagen degradation was significantly increased compared to the control and 2% CHX groups (p<0.05). The use of ozone increased collagen degradation significantly compared to the use of 2.25% NaOCl and 2% Chlorhexidine for 5 min (p < 0.05). No significant differences were observed between ozone and 5.25% NaOCl-treated groups (p > 0.05). CONCLUSIONS: The structural composition of human dentin was significantly affected by the use of oxidative irrigants at higher concentrations.

The effect of temperature on bisphenol: an elution from dental resins.

AIM: Bisphenol A (BPA) elution from baby bottles into content has been of great public interest and debate in recent year. Uncontrolled BPA elution due to temperature increase may create a risk factor for human health. However, dental resins that are used in pediatric dentistry also have BPA derivatives. The aim of this study is to evaluate BPA elution from dental resins and to determine the effect of temperature increase on this elution. MATERIALS AND METHODS: Four dental resins containing BPA derivatives (Filtek Z250, Filtek Supreme XT, Fissurit FX, and Admira) and a control group (BPA free G-aenial) were used in this study. Each specimen was stored in 2 ml of 75% ethanol-water solution at 37°C. Water at a temperature of 59°C ± 1°C (preferred temperature of hot drinks) was added to the study samples at certain time intervals (1, 6, 24 hours and 2, 3, 4, 5 and 6 days). The methanol samples were analyzed using high-performance liquid chromatography (HPLC). Data was analyzed using multivariate and repeated measures analysis of variance (p < 0.05). RESULTS: The study samples generally eluted more BPA than the control samples (p < 0.05). The greatest amount of BPA for an individual time period was measured after 6 hours for the groups A to D; the same was found after 24 hours for group E. CONCLUSION: While the BPA elution levels evaluated in the study samples were more than control samples, all measured values were under the reference levels and the amounts do not constitute a risk. CLINICAL SIGNIFICANCE: Resin-based dental materials can act as a source of BPA (within safety margins), especially when they react with hot water.

A retrospective study of traumatic dental injuries.

AIM: The prognosis of dental trauma cases varies depending on the time elapsed after the trauma before treatment started. The aim of this study was to examine epidemiological and dental data from traumatic injuries to primary and permanent teeth during the period from 2005 to 2010. MATERIAL AND METHODS: The examinations aimed to determine the age and sex distributions of patients, the causes of tooth injury, the type of teeth injured, the monthly distribution of the trauma, the time elapsed between injury and treatment, and the classification of the traumatized teeth and their treatments. RESULTS: The dental trauma records of patients with an average age of 9 years, including 120 girls (35.3%) and 220 boys (64.7%), were evaluated. The most commonly affected teeth were the maxillary central incisors (66.24%). The main cause was falls (70.1%). In primary dentition, subluxation (36.4%) was observed in the highest percentage of injured teeth, and in permanent dentition, the most common observation was uncomplicated crown fractures (44.9%). Only 18 patients (2.9%) were referred to the clinic within 1 h following the injury. The most frequent treatment for primary teeth was examination and follow up (63.9%). Restoration with composite resin (26.3%) and root canal treatment (28.6%) were the most common procedures for permanent teeth. CONCLUSION: It was revealed that although the most frequent type of injury in permanent dentition was uncomplicated crown fracture, the root canal treatment was the most common treatment in permanent dentition. This finding suggests that when the checkup time after the injury was delayed, the pulp could lose vitality. This finding reveals that it is important to inform the parents about dental trauma and the importance of bringing their children fast to a dentist in trauma cases.

Choice of anesthesia in molybdenum cofactor deficiency: A case report.

Molybdenum cofactor (MC) deficiency is defined as a progressive neurodegenerative and neurometabolic disease, characterized by convulsions, severe mental and motor retardation resistant to the treatment. Patients with MC deficiency usually need at least sedation for even minor interventions such as dental examination or treatment. Sedation or general anesthesia for these patients may be complicated due to accompanying disorders. However, we were unable to find any reports on anesthetic management of patients with MC deficiency in the literature. In this article, we intend to share our experience of a patient with MC deficiency, who had undergone dental treatment under deep sedation.

Comparison of laser fluorescence devices for detection of caries in primary teeth.

The aim of this in vivo study was to evaluate the performance of fluorescence-based devices in detecting occlusal caries lesions in primary molars compared with conventional methods. Two examiners assessed 44 occlusal surfaces of first and second primary molars in 20 patients using two fluorescence devices: DIAGNOdent (LF) and DIAGNOdent pen (LFpen). Teeth were also assessed by visual examination and bitewing radiograph. Histological examination served as the gold standard after extraction. By using the McNemar test, the sensitivity, specificity, accuracy, and area under the receiver operating curve were calculated as outer enamel (D1), inner enamel (D2) and dentine caries (D3) lesion thresholds. The intra- and inter-examiner reproducibility were calculated using the Cohen's unweighted kappa statistics. At the D1 threshold, the LFpen sensitivity was statistically higher than LF and radiographic examination (P < 0.001), whereas there was no statistically significant difference among the groups at the D2 and D3 thresholds (P > 0.05). All methods demonstrated the highest sensitivity values at D3. At the D1 and D2 thresholds, there were no significant differences between the LFpen specificity and the other methods. All methods presented similar performance in detecting all lesions considering the area under the receiver operating curve. The LFpen showed better performance than LF. Furthermore, visual examination and the LFpen device seem to be sufficient for detection of occlusal caries in primary molars.

Knowledge of dentists in the management of traumatic dental injuries in Ankara, Turkey.

PURPOSE: This study was designed to assess dentists' knowledge of emergency treatment of traumatic dental injuries (TDIs) in Ankara, Turkey. MATERIALS AND METHODS: A total of 154 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part was composed of 12 closed-ended questions related to knowledge of how to manage different types of TDIs in children. The questionnaires were answered by 133 general dental practitioners (GDPs) and 21 specialists. The survey data were statistically analysed using the chi-square test and ttest to assess dentists' knowledge. RESULTS: The results show that when the answers were compared, lower numbers of correct answers were noted for questions related to splinting time for avulsed teeth and appropriate treatment for complicated crown-fractured deciduous incisors with large pulp exposure. Greater numbers of correct answers were observed for questions related to the storage medium, systemic antibiotic usage for avulsed teeth and appropriate treatment for intruded primary teeth. The mean number of correct answers from specialists was not significantly greater than that from GDPs (P > 0.05). CONCLUSION: In conclusion, this survey showed a low level of knowledge of TDI management among the participants and highlights the need to improve dentists' knowledge of TDI treatment protocols.

Bond strength of adhesive systems to mineral trioxide aggregate with different time intervals.

INTRODUCTION: The aim of this study was to compare the shear bond strengths of various adhesive systems to white mineral trioxide aggregate (WMTA) with different time intervals. METHODS: Two hundred cylindrical acrylic blocks with a hole (4-mm diameter and 2-mm height) were prepared. The holes were filled with WMTA, and the specimens were allocated into 5 groups. Forty specimens were stored for 4, 24, 48, 72, and 96 hours at 37°C and 100% humidity. Each group was divided into 4 subgroups: group 1, All-Bond SE (Bisco Inc, Schaumburg, IL); group 2, All-Bond 3 (Bisco Inc); group 3, One-Step Plus (Bisco Inc); and group 4, control. After the application of adhesive systems, composite resin (Aelite, Bisco) was applied over the WMTA. Shear bond strengths were measured using a universal testing machine, and the data were subjected to 1-way analysis of variance and the Scheffé post hoc test. RESULTS: There was a significant difference between the 4-, 24-, 48-, 72-, and 96-hour measurements in all of the adhesive systems (P < .001). Among all time intervals, group 3 showed significantly higher bond strengths to WMTA than the other groups (P < .001). Groups 1 and 2 were similar (P = .365). CONCLUSIONS: It was concluded that if a longer waiting time can be practiced after the mixing of WMTA, higher shear bond strength measurements can be obtained. Also, when WMTA was used with total-etch adhesive systems, it showed better shear bond strength.

Conversion degrees of a colored compomer in different colors utilized by various curing times.

PURPOSE: Compomers are widely used in primary teeth and are manufactured in different colors in order to make dental treatment acceptable in children. The aim of this in vitro study was to evaluate the degree of conversion (DC) of different colored compomers and of compomers with various curing times. METHODS: Sixty three cylindrical samples were prepared from a colored compomer (Twinky Star). These samples were of 7 different color groups, with 9 samples of each color. Each group was divided into 3 sub-groups, according to the curing time (20-30-40 seconds) with a light emitting diode light curing unit. The DC values from 3 different regions and depths were evaluated with a Fourier Transform Infrared Spectrometer before and after curing procedures for all groups. Data were calculated by using the baseline values; statistical analyses were done by using ANOVA test. RESULTS: Significant differences in DC results before and after curing were found among the groups (P<0.05). For all curing times, the silver colored samples showed the poorest DC results, which ranged from 13% to 18%. CONCLUSIONS: It was concluded that DC values of different colors were variable. The material properties could be improved by defining the proper polymerization time for each color.

Effectiveness of Ozone with or without the Additional Use of Remineralizing Solution on Non-Cavitated Fissure Carious Lesions in Permanent Molars.

OBJECTIVES: The aim of this study was to evaluate the efficiency of ozone alone and with a re-mineralizing solution following application on initial pit and fissure caries lesions in permanent molars. METHODS: Forty children (9-12 years) having non-cavitated fissure caries lesions on bilateral 40 first permanent mandibular molar teeth were participated in the study. Patients were randomly allocated to 2 experimental groups consisting of 20 subjects. In the first group, ozone was applied once for 40 seconds to the assigned test teeth of each pair. In the second group, ozone was applied once for 40 seconds to the assigned test teeth of each pair with the use of re-mineralizing solution. Progression or improvement of the caries was assessed at baseline, immediately after treatment and at 1-,2-,3-, and 6 month follow-up by comparing the DIAGNOdent values, Clinical Severity Indexes, Oral Hygiene Scores. The results were analyzed statistically by using the Wilcoxon-Test for dependent samples in each group. When comparing different test groups (control and experimental groups) the Friedman S test followed by the Mann-Whitney U test was used. RESULTS: A statistically significant difference was found between all of the control and experimental test lesions in each group (P<.001). However, there was no statistically significant difference between the ozone treated groups and those using the additional re-mineralizing solution (P>.001). CONCLUSIONS: Ozone treatment either alone or combined with a re-mineralizing solution was found to be effective for remineralization of initial fissure caries lesions.

The efficiency of a new polishing material: nanotechnology liquid polish.

INTRODUCTION: This study evaluated the efficiency of a nanotechnology liquid polish system on the surface roughness of two different types of nano resin composites. METHODS AND MATERIALS: The resin composite materials tested in this study were Ceram-X (Dentsply) and Clearfil Majesty Esthetic (Kuraray). Forty standard samples of each resin composite material were prepared and stored in artificial saliva at 37 degrees C for one week. The samples of each material were randomly assigned to one of four test groups (n = 10) and contoured with carbide burs, except for Group 1 (control). Group 2 was treated with aluminum oxide-impregnated polymer points (Enhance Finishing System, Dentsply), followed by diamond-impregnated micropolishing points (PoGo, Dentsply); whereas Group 3 was treated with only a nanotechnology liquid polish system (Lasting Touch, Dentsply) and Group 4 was treated with aluminum oxide-impregnated polymer points and diamond-impregnated micropolishing points, then the nanotechnology liquid polish system. Surface roughness values (Ra) of all samples were obtained with an optical pro-filometer. The difference between the groups was assessed with one-way analysis of variance and the Kruskal Wallis test. RESULTS: All finishing and polishing techniques created statistically rougher surfaces than the control group (p < 0.001). The lowest Ra values were detected in Group 4, although significant differences were not found between Groups 2 and 4 (p > 0.001) independent of the type of resin composites. CONCLUSION: With the combination of finishing and polishing procedures, a nanotechnology liquid polish application may provide a more glossy surface for resin composite restorations.