Effects of design software program and manufacturing method on the marginal and internal adaptation of esthetic crowns for primary teeth: A microcomputed tomography evaluation.

STATEMENT OF PROBLEM: The adaptation of digitally produced crowns is affected by the design software program and manufacturing method. The effect of artificial intelligence (AI) software program design on the adaptation of the crowns is unclear and comparative evaluations should be documented. PURPOSE: The purpose of this study was to assess the marginal and internal gaps, the absolute marginal discrepancies, and the 3-dimensional (3D) discrepancy volumes of the resin-based milled and 3D printed crowns for primary teeth designed with computer-aided design (CAD) and AI software programs by using microcomputed tomography (µCT). MATERIAL AND METHODS: A total of 40 resin-based esthetic crowns were produced for a prepared typodont tooth (right mandibular primary second molar) according to the design software program (CAD and AI) and manufacturing method (milling and 3D printing) (n=10). Four experimental groups were generated as CAD-milled, CAD-3D printed, AI-milled, and AI-3D printed. The marginal, axial, and occlusal gap values, the absolute marginal discrepancies, and the 3D discrepancy volumes of the specimens were measured by using µCT. The data were analyzed by using 2-way ANOVA and the Tukey HSD tests (α=.05). RESULTS: The lowest value for the marginal gap (54 ±43 µm) was observed in the CAD-milled group and the marginal gap value of the AI-3D printed group was significantly lower than the AI-milled group (P<.05). The lowest value for the axial gap (63 ±7 µm) was observed in the AI-3D printed group, and the highest value (145 ±58 µm) was observed in the CAD-milled group; the result for the occlusal gap value was opposite. The highest absolute marginal discrepancy value was observed in the CAD-milled group. The 3D discrepancy volumes increased in the order of the CAD-3D printed, AI-milled, CAD-milled, and AI-3D printed groups. CONCLUSIONS: The marginal and internal gap values of the resin-based crowns were affected by the design software program and manufacturing method; however, tested groups showed clinically acceptable gap values.

Assessment of dental pain in children with intellectual disability using the dental discomfort questionnaire.

OBJECTIVE: This study aimed to compare the Dental Discomfort Questionnaire (DDQ) scores in children with and without intellectual disability (ID) and to measure correlation between the total DDQ and the Decayed, Missing, and Filled Teeth (DMFT/dmft) scores, as well as the condition of the tooth causing pain. METHOD: This cross-sectional study included 81 children with normal intellectual development who attended the Departments of Pediatric Dentistry at two Turkish Universities and 80 children with different levels of intellectual disability who reported dental pain in special education centers. The 12-question DDQ (Turkish version) was applied to the parents of the patients with their consent. The relationship of the DDQ scores with tha of the DMFT/dmft, dental status, and demographic data was evaluated. RESULTS: When the DDQ scores of children with intellectual disabilities were evaluated, it was found that the majority of the answers given to the questions were statistically similar (p < 0.05) to those of children with normal cognitive level. In the questions in which "pain when eating and brushing teeth" was evaluated, a higher score was obtained, which led to an increase in the total DDQ score (p < 0.001). There was a statistically significant difference between the groups in terms of the distribution of dental conditions (p < 0.001). When compared to the normal cognitive group, patients with mild and severe intellectual disabilities had more deep dentin caries, thoughy, frequent periapical abscess was less common in those groups (p < 0.001 and p = 0.022). There was no statistically significant relationship between DMFTscores. CONCLUSION: The DDQ was found to be a descriptive, functional, and easy-to-use questionnaire for children with intellectual disabilitiesin terms of detecting the presence of dental pain. No correlation was found between DMFT/dmft, dental status and DDQ scores.

The Clinical and Radiographic Success of Primary Molar Pulpotomy Using Biodentine™ and Mineral Trioxide Aggregate: A 24-Month Randomized Clinical Trial.

PURPOSE: The purpose of this study was to compare the clinical and radiographic success of Biodentine™ and mineral trioxide aggregate (MTA) pulpotomy in primary molars. METHODS: Thirty-two four- to nine-year-olds were included in this study. The primary molars were randomly assigned to the Biodentine™ and MTA groups. After coronal pulp removal and hemostasis, the remaining pulp tissue was covered with Biodentine™ or MTA. All teeth were restored with stainless steel crowns. Clinical and radiographic successes and failures were recorded at six-, 12-, 18- and 24-month follow-ups. Data were statistically analyzed using Mann-Whitney U and Wilcoxon tests. RESULTS: The 24-month follow-up evaluations revealed that the clinical success rates were 96.8 percent (30 out of 31) for both Biodentine™ and MTA. The radiographic success rates at 24 months were 93.6 percent (29 out of 31) for Biodentine™ and 87.1 percent (27 out of 31) for MTA. No significant differences were found among the groups at all follow-up appointments (P>0.05) Conclusion: Biodentine™ and mineral trioxide aggregate did not differ significantly in combined clinical and radiographic success after 24 months.

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.

How Does Dental Trauma Affect the Quality of Life in Turkish Families?

PURPOSE: To assess the responsiveness of the Family Impact Scale (FIS) to describe changes in quality of life (QoL) after traumatic dental injury (TDI), and compare the efficacy of subscales. MATERIALS AND METHODS: Parents of 110 children aged 7-15 admitted to the Gazi University Faculty of Dentistry Department of Paediatric Dentistry for dental trauma were included in this study. A three-part questionnaire was distributed to the participants: questions regarding personal information, TDI and QoL. The types of TDI were classified according to Andreasen et al.3 Quality of life was measured using the FIS. The questionnaires were translation into Turkish, and QoL was measured using the Turkish Family Impact Scale (T-FIS) total score and scores for subscales. The Kolmogorov-Smirnov test was used to assess normal distribution of the data. After this procedure, the nonparametric Kruskal-Wallis test was used. RESULTS: Traumatic dental injuries exhibited a negative impact on parents' QoL, as shown by the total T-FIS score and subscales (p < 0.001). In this study, the determined values for parental emotions > parental/family activity > financial burden > family conflict had a negative impact on the parents' QoL. Parental emotional values were statistically different from those of parental/family activity, financial burden and family conflict values (p < 0.001). CONCLUSION: Traumatic dental injuries in children present a negative impact on Turkish parents' QoL. Parental emotions were the most affected subscale.

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.

Effect of new light curing units on microleakage and microhardness of resin sealants.

To determine new developed light curing units with shorter curing times effects on microleakage and microhardness values for resin fissure sealants. Resin filled sealant (UltraSeal-XT), resin unfilled sealant (Delton Type-II) and ormocer-based sealant (Admira-Seal) were light cured with a quartz-tungsten-halogen (QTH), two LED light and a high power LED. Two hundred and forty extracted human molars were randomly allocated into four groups according to used light-curing unit and three subgroups were formed for three different fissure sealant materials. Specimens were immersed in 0.5% basic fuchsin for 24 h, sectioned and examined under a stereomicroscope, and scored for marginal microleakage. Knoop hardness number (KHN) readings were measured after 48 h. Statistical analyses of test were found in significant difference both microleakage and microhardness values between the various light curing units. The time saving approaches in the curing light were determined higher microhardness, although it was found in higher microleakage.

Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study.

The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany) 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1-4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p < 0.05). The apical sealing ability of Biodentine was comparable to MTA at any apical plug thickness.

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.

Shear bond strengths of different adhesive systems to biodentine.

The aim of this study was to measure the shear bond strength of different adhesive systems to Biodentine with different time intervals. Eighty specimens of Biodentine were prepared and divided into 8 groups. After 12 minutes, 40 samples were randomly selected and divided into 4 groups of 10 each: group 1: (etch-and-rinse adhesive system) Prime & Bond NT; group 2: (2-step self-etch adhesive system) Clearfil SE Bond; group 3: (1-step self-etch adhesive systems) Clearfil S(3) Bond; group 4: control (no adhesive). After the application of adhesive systems, composite resin was applied over Biodentine. This procedure was repeated 24 hours after mixing additional 40 samples, respectively. Shear bond strengths were measured using a universal testing machine, and the data were subjected to 1-way analysis of variance and Scheffé post hoc test. No significant differences were found between all of the adhesive groups at the same time intervals (12 minutes and 24 hours) (P > .05). Among the two time intervals, the lowest value was obtained for group 1 (etch-and-rinse adhesive) at a 12-minute period, and the highest was obtained for group 2 (two-step self-etch adhesive) at a 24-hour period. The placement of composite resin used with self-etch adhesive systems over Biodentine showed better shear bond strength.

Ectodermal dysplasia with anodontia: a report of two cases.

Ectodermal dysplasia is a hereditary disorder that occurs as a consequence of disturbances in the ectoderm of the developing embryo. The triad of nail dystrophy, alopecia or hypotrichosis and palmoplantar hyperkeratosis is usually accompanied by a lack of sweat glands and a partial or complete absence of primary and/or permanent dentition. Two case reports illustrating the prosthetic rehabilitation of 2 young boys with anhidrotic ectodermal dysplasia associated with severe anodontia are presented. Since the oral rehabilitation of these cases is often difficult; particularly in pediatric patients, treatment should be administered by a multidisciplinary team involving pediatric dentistry, orthodontics, prosthodontics and oral-maxillofacial surgery.

Mesiodens as a risk factor in treatment of trauma cases.

The presence of mesiodens often results in complications including retention of primary teeth and delayed eruption of permanent teeth, closure of eruption path, rotations, retention, root resorption, pulp necrosis, and diastema as well as nasal eruption and formation of dentigerous and primordial cysts. Less common complications involving the permanent incisors include dilaceration of the developing roots and loss of tooth vitality. Therefore, early diagnosis of mesiodens has particular importance in terms of preventing such complications. However, with respect to surgical removal of mesiodens, ideal timing of intervention - immediate or delayed intervention - remains to be a highly controversial issue. While predisposing factors of dental trauma such as open bite, increasing overjet with protrusion of upper incisors, and insufficient lip closure have been well documented in the literature, there is limited evidence indicating mesiodens as a risk factor in trauma. In this report of two cases, it is aimed to emphasize mesiodens as a risk factor in the treatment of dental trauma besides its effect on prognosis.