The effect of fluoride varnish application on colour change due to paediatric drug usage in polyacid-modified composite resin: an in vitro study.

OBJECTIVE: Colour stability is important in the long-term aesthetic success of restorative materials and is affected by both internal and external factors. Internal discolourations are due to the properties of the restorative materials. External discolourations can be associated with frequent consumption of food and beverages and the use of suspensions or syrups containing colourants/additives. Fluoride varnish application has an important place in preventive dentistry. The purpose of the research was to examine the protective effect of fluoride varnish application on the colour change on polyacid-modified composite resin restorative materials caused by the use of various paediatric drugs. METHODS: Two hundred ten discs were prepared from polyacid-modified composite resin material and divided into two groups: flouride varnish was applied to one group and flouride varnish was not applied to the other group. The groups were further divided into seven subgroups and the samples were kept in artificial saliva, amoxicillin + clavulanic acid, cefuroxime axetil, clarithromycin, paracetamol, ibuprofen, and iron supplement drug solutions. The colour change values of the discs were measured using a spectrophotometer device before immersion in the drug solutions and on the 7th, 14th, 21st, and 28th days after the immersion. The obtained data were calculated and statistically evaluated using IBM SPSS V23 software. RESULTS: It was found that the application of fluoride varnish in the iron supplement drug group prevented the colour change of the polyacid-modified composite resins for 28 days. In the amoxicillin + clavulanic acid, cefuroxime axetil, and paracetamol groups, the fluoride varnish did not prevent colour change in the polyacid-modified composite resin restorative materials at the end of the 14th day. CONCLUSION: It is thought that fluoride varnish application may be beneficial as a preservative in the colour change of polyacid-modified composite resins due to the use of various paediatric drugs, and this protective feature may be effective for a specific period of time.

Effect of radiotherapy on the coronal-sealing ability of two different root canal sealing materials.

OBJECTIVE: This study aimed to assess the coronal-sealing ability of two different root canal obturation materials: gutta-percha with AH Plus and Resilon with Epiphany SE between radiated and nonirradiated groups. MATERIALS AND METHODS: Fifty-six extracted premolar teeth were randomly divided into two main groups according to the presence or absence of radiotherapy. Specimens were divided into two equal groups. In the radiotherapy group, a total dose of 60 Gy was delivered with 1.8 Gy/d fractions, 5 days a week, for 35 days. The root canals were obturated with either gutta-percha/AH Plus or Resilon/Epiphany SE canal sealer. The samples were then evaluated for the coronal-sealing ability using a centrifuging dye penetration test at 3000 rpm for 5 min in a 2% Rhodamine B solution. The degree of dye penetration was evaluated with a stereomicroscope. RESULTS: Although the sealing ability of both groups was not affected in radiotherapy, the coronal leakage values of Resilon/Epiphany SE slightly increased when radiation was applied (P > 0.05). CONCLUSION: Radiotherapy does not significantly affect the coronal-sealing ability of root canal obturation materials, gutta-percha/AH Plus and Resilon/Epiphany SE.

Relationship between Severe Early Childhood Caries and dental development.

AIM: Severe early childhood caries (sECC) is a public health problem that continues to affect infants and preschool children worldwide. Knowledge of the changes in dental development is important for paediatric dentists in order to determine a treatment plan. The aim of this study was to investigate dental development in children with sECC, compared to age and gender-matched controls, by calculating the dental age (DA). MATERIALS AND METHODS: A total of 300 children (144 females, 156 males) with sECC aged 5 years were studied and compared with 300 control subjects (caries-free), case-matched for gender and age. The dental development was assessed using the DA estimation method of Demirjian et al. [1973], and data were statistically analysed using a 2-sided t test and chi-squared test. RESULTS: The mean differences between the DA and chronological age (CA) in the sECC females and males were 0.67±0.6 years and 0.98±0.6 years, respectively, whereas the results of the case controls were 1.44±0.8 years for the females and 1.57±0.6 years for the males. The differences between the sECC and case control groups were significant for both genders (p<0.001). CONCLUSION: Children with severe early childhood caries have lower rates of dental development when compared to normal children.

Evaluation of root canal morphology of human primary mandibular second molars by using cone beam computed tomography.

OBJECTIVES: The aim of the present study was to investigate the root canal configurations of primary mandibular second molars (PMSMs) using Vertucci classification. Materials and Methods: The root canal types of 228 PMSMs (228 mesial and 228 distal roots) were evaluated. In addition, the relationship between external root morphology and Vertucci classification was investigated. The Chi-square test or Fisher Exact Chi-square test was used for the evaluations, and P < 0.05 was considered statistically significant for all tests. Results: The most commonly observed root canal type, which was observed in 228 roots (50%), was Type 4 followed by Type 8 (15.79%), Type 5 (14.47%), Type 1 (9.21%), and Type 3 (6.57%). In 150 mesial roots, the root canal Type 4 was observed whereas the same type was observed in 78 distal roots, and the difference was significant (P < 0.001). In flat roots (82.9%), the most frequently observed root canal type was Type 4 (50.8%) (P < 0.001). CONCLUSION: Various root canal types were observed in both mesial and distal roots although Type 4 was the most commonly observed. Root canal types showed a consistent relationship with separated and conical root shapes whereas the flat roots showed different root canal types.

Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey.

INTRODUCTION: Child abuse is a serious public problem. Signs of abuse are often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to investigate dental students' knowledge about and attitudes towards child abuse. MATERIAL AND METHODS: This study was performed at the Faculty of Dentistry of the Ondokuz Mayis University. The data were collected through a self-report questionnaire administered to dental students (137 female/111 male) in three different dental classes (third, fourth and fifth study years) and grouped by considering those students who have been training in the school year of 2013. The definition of physical and social indicators of abuse, awareness regarding legal and ethical responsibilities, students' experience and requests made by students were evaluated by the students' response to questions put in the questionnaire. Descriptive statistics and chi-square tests were performed to analyse the questionnaire data. RESULTS: The questionnaire completion rate was 100%. About 67.74% of the third year, 40.71% of the fourth year and 16.67% of the fifth year believed that they could detect child abuse cases. However, results indicated a major lack of knowledge of social indicators, signs of physical abuse and reporting procedure amongst all respondents. The assessment of the total correct answers exhibited significant differences amongst third-, fourth- and fifth-year students' answers. Fifth-year students had the highest rate of correct responses (P < 0.05). Most students wanted to receive more knowledge about this topic. CONCLUSION: Dental students in Turkey are not sufficiently prepared for their role in diagnosing suspected cases of child abuse.

Clinical and radiological evaluation of calcium sulfate as direct pulp capping material in primary teeth.

AIM: To evaluate the clinical and radiological response of primary molars to direct pulp capping with calcium sulfate hemihydrate. MATERIALS AND METHODS: Forty primary molar teeth in 40 healthy children aged 5-9 years were treated by direct pulp capping. Teeth were randomly assigned to two groups (n=20) according to material used for capping, as follows: Group 1: calcium hydroxide cement (Dycal); Group 2: calcium sulfate hemihydrate (Dentogen). All teeth were restored with a conventional glass ionomer base (Fuji IX) and amalgam. RESULTS: After 12 months, the overall success rate of direct pulp capping was approximately 75% (24/32 teeth, excluding exfoliations). The success rate did not differ significantly between calcium hydroxide and calcium sulfate hemihydrate treatment. CONCLUSION: Calcium sulfate hemihydrate was found to be as successful as calcium hydroxide for direct pulp capping of primary molars with Class I cavities. Further histological studies are needed to support these findings.

Comparison of hardness of three temporary filling materials cured by two light-curing devices.

AIM: Polymerization ability of light-curing devices can affect the light-cured material hardness. The purpose of the present study was to evaluate and compare the hardness of three temporary filling materials that had been light-cured by either a light emitting diode (LED) or a halogen light-curing unit. METHODS: The temporary filling materials, First Fill, Voco Clip and Bioplic, were placed in wells in a Teflon plate. The 24 specimens of each material were divided into two groups (N.=12/group) for photo-activation by either of the two light-curing units. The LED or halogen device was applied for 40s to the top surface of each specimen. A Knoop hardness test was performed on the top and bottom surface of each specimen, with five measurements per specimen. RESULTS: The highest hardness values for both the LED and halogen treated groups were observed for First Fill and the lowest values were for Voco Clip in top and bottom surfaces. The hardness obtained for the three materials with the halogen unit were significantly higher than the values obtained with the LED unit in both surfaces (P<0.05). CONCLUSION: First Fill light-cured temporary material exhibited the highest hardness values on the top and bottom surfaces than Voco Clip and Bioplic temporary materials. The hardness of light-cured temporary filling materials can be affected by the type of light-curing unit.

Association of passive smoking with dental development in young children.

AIM: To assess dental development in young children who have been exposed to passive smoking by comparing dental ages with the corresponding features in a healthy control group. MATERIALS AND METHODS: A total of 90 passive smokers (PS) with a mean age of 5.49 years and 90 healthy age-matched controls were included in this study. The children were investigated for stimulated salivary cotinine level. Three categories were formed with respect to the number of cigarettes smoked. Dental development was analysed using panoramic radiographs. RESULTS: The dose-response relationship between the cotinine levels of the PS subjects and the number of cigarettes smoked per day was found to be significantly different for the three exposure categories. A significant difference was found between the chronological and dental ages of PS subjects when compared with those of the control group, but there were no significant differences in dental ages related to gender in both groups. CONCLUSION: We could clearly conclude that young children who were PS subjects had delayed dental development.

Comparison of halogen versus LED light-cured temporary endodontic filling materials for sealing.

AIM: The purpose of this study was to compare the sealing ability of the three light-cured temporary restorative materials curing with two different light curing devices; halogen and LED. METHODS: After the preparation of standard endodontic access cavities, the canal systems were instrumented by using a step-back technique irrigated with sodium hypochlorite and EDTA. Light-cured temporary restorative materials; First fill, Bioplic, and Diatemp were applied and polymerized with either of the LED or Halogen light-curing devices. The specimens were immersed in 2% methylene blue solution for four days in an incubator for the leakage assessment. RESULTS: The first fill presented the least microleakage values for both the LED (2.54±0.53) and halogen (2.84±0.48) treated groups whereas; Diatemp presented the highest microleakage values for both the LED (2.83±0.59) and halogen (3.28±0.56) groups. The leakage values of all light-cured temporary filling materials for the LED-treated groups were lower than the halogen treated ones. However, there were statistically no significant differences among the three groups (P>0.05). CONCLUSION: It is concluded that light curing temporary filling materials can achieve a good and comparable sealing capacity when cured by both LED and halogen LCUs.

The effects of calcium hydroxide removal methods on bond strength of Epiphany SE with two irrigation protocols.

OBJECTIVE: The purpose of this study was to compare the effects of five calcium hydroxide removal methods on the bond strength of Epiphany SE sealer after canal irrigation with NaOCl+EDTA or NaOCl+MTAD. MATERIALS AND METHODS: The 120 roots were instrumented by using the ProTaper rotary system under irrigation with 2.5% sodium hypochlorite and randomly divided into two major groups according to the final irrigation: 1.3% NaOCl + MTAD and 5% NaOCl + 17% EDTA. For controls, 10 roots from each of the final irrigations with NaOCl + MTAD and NaOCl + EDTA (20 roots) were not filled with Ca(OH)2. The intra-canal paste, Ca(OH)2 was applied to each of the 100 remaining roots and stored at 37°C for 7 days. Each group was sub-divided into five sub-groups (n = 10) according to the removal technique for the intra-canal dressing: Group-1: recapitulation with size 30 K file + 3 ml of saline solution, Group-2: recapitulation with size 30 K file + 3 ml of 5% NaOCl, Group-3: using 5% NaOCl + 17% EDTA, Group-4: using 5%NaOCl + 15% citric acid, and Group-5: using 1.3% NaOCl + 5 ml MTAD. The root canals were filled with Resilon and Epiphany SE sealer. The bond strength was measured. RESULTS: The mean bond strength of Epiphany SE to root dentine irrigated with NaOCl + MTAD was lower than that of NaOCl + EDTA. The highest bond strengths were 3.31 ± 0.057 and 2.60 ± 0.054 in the NaOCl + citric acid group when Ca(OH)2 was applied to roots treated with NaOCl + EDTA and NaOCl + MTAD, respectively (p < 0.05). CONCLUSION: For root canals treated with NaOCl + EDTA or NaOCl + MTAD, the use of NaOCl + chelating agent for Ca(OH)2 removal does not adversely affect the bond strength of Epiphany SE to dentin.

Bacterial survival in the radiographic processes.

AIM: The purpose of this study was to investigate the microbial contamination in hand-operated and automatic radiographic solutions and on contact surfaces during radiographic procedures such as X-ray cone and button and surface of hand-operated and automatic radiographic solution tanks in dental clinics. METHODS: A 10 mL liquid solution was taken with syringe at 5, 10, 24, and 48 hour time intervals from freshly prepared hand-operated and automatic processing solution. The swab samples were taken from the surfaces of radiographic solution tanks, X-ray cone and its button. The specimens were inoculated into blood agar and Eosin Methylene-Blue (EMB) agar. The plates were incubated in an incubator for 48 hours at 37 °C. Becton Dickinson Phoenix Automated Microbiology System was used for determining the microorganisms. RESULTS: Although the microbiologic analyses of the samples revealed no microbial growth in the hand-operated and automatic radiographic solutions in all observation periods, the microbial growth on the contact surfaces was observed. Staphylococcus epidermidis, metisillin resistant from the surface of radiographic solution tanks, X-ray cone and switch. Streptococcus mitis was found on the X-ray switch. CONCLUSION: Radiographic procedures can cause cross contamination; clinicians should therefore apply disinfection protocols in all radiographic procedures.

Legionella in the dental office.

OBJECTIVE: This study aimed to assess the microbiology of dental unit water and municipal water in terms of Legionella species and total bacteria levels. METHODS: The presence of Legionella species was investigated using the culture method, direct fluorescent antibody and polymerase chain reaction techniques in collected dental unit water and municipal water samples from 71 dental offices in Ankara, Turkey. In addition, total bacterial counts were assessed using the culture method. RESULTS: In 27% of the dental unit water samples and in 13% of municipal water samples, the number of colony-forming units (cfu ml(-1)) significantly exceeded acceptable values for high-risk group patients. No Legionella spp. was found in the dental unit water samples. Legionella SG3 was found in only one municipal water sample. CONCLUSION: The dental unit water systems examined in this study did not include Legionella spp., but other bacteria at high numbers were determined. This is a potential threat, especially for elderly people, the medically compromised patients receiving regular dental treatment and the dental clinic staff.