Evaluation of the biocompatibility of experimentally manufactured portland cement: An animal study.

OBJECTIVES: The purpose of this study was to evaluate the biocompatibility of MTA and the experimentally manufactured portland cement (EMPC). STUDY DESIGN: Twenty one Sprague Dawley (SD) rats were allocated to testing of three groups. Group I and Group II included ProRoot MTA and the EMPC. The materials were mixed with distilled water and placed in polyethylene tubes. The tubes were implanted subcutaneously in the dorsal region of the animals. Group III served as control; the implanted polyethylene tubes remained empty. At 7, 14, and 28 days after the implantation, the animals were sacrificed and the implants were removed with the surrounding tissues. The specimens were prepared for histological examination to evaluate the inflammatory response. RESULTS: No significant difference was found between tissue reactions against the tested materials (p>0.05). Also, control group showed similar results (p>0.05). CONCLUSIONS: Results suggest that the EMPC has the potential to be used in clinical conditions in which ProRoot MTA is indicated. MTA and the EMPC show comparable biocompatibility when evaluated in vivo. Although the results are supportive for the EMPC, more studies are required before the safe clinical use of the EMPC. Key words:Mineral trioxide aggregate, portland cement, subcutanous implantation.

Evaluation of caries dentin using light-induced fluorescence: a case report.

Minimal invasive therapy has been becoming more important day by day in dentistry. In minimally invasive dentistry, only the infected dentin is removed and the affected dentin is left behind while preparing to repair a cavity. Healthy enamel and dentin have particular fluorescence properties, compared to demineralized dental tissues, which absorb less light and thereby have a lower level of fluorescence properties. It helps clinicians detect caries and apply the most appropriate treatment strategy during cavity preparation. This study investigated the efficacy of the SoproLife camera system which is a novel light-induced fluorescence camera system.

Dental restoration dislodgment and fracture during scuba diving: a case of barotrauma.

BACKGROUND: The term "barotrauma" is used to describe a physical injury caused by a rapid or extreme change in air pressure. Enclosed areas within the body are particularly affected by barotrauma. CASE DESCRIPTION: A 40-year-old man had complaints of restorations in three teeth fracturing and dislodging while he was scuba diving at a depth of 35 meters. The affected teeth contained carious dentin. The caries was removed, and the affected teeth underwent endodontic, restorative and prosthetic rehabilitation. CLINICAL IMPLICATIONS: Inadequate restorations and selection of dental materials in some cases predispose patients to barotrauma. To prevent barotrauma-related damages on the teeth, it is important to maintain good-quality restorations and avoid trapping air beneath them. Dentists and patients who are exposed to barometric stress as part of their jobs or hobbies should know the causes of barotrauma and be aware of the importance of routine dental checkups to avoid barotrauma-related dental problems.

Reproducibility and agreement of clinical diagnosis of occlusal caries using unaided visual examination and operating microscope.

AIM: To assess the reproducibility of clinical diagnosis of occlusal caries using unaided visual examination and examination with an operating microscope (16 x magnification) and to determine the agreement between these 2 methods. MATERIALS AND METHODS: Three experienced dentists used unaided visual examination and an operating microscope to grade, according to a standard caries rating scale, a total of 299 occlusal surfaces in 112 subjects (mean age 28.3 years, standard deviation 0.5 years), during several examination sessions. Intraobserver and interobserver reproducibility was calculated, and agreement in diagnosis of the same teeth by different methods was also determined. RESULTS: The level of intraobserver agreement for the 2 modes of clinical diagnosis was substantial, as indicated by kappa values; however, there was substantial interobserver variability with both techniques. Agreement in clinical diagnosis between the 2 techniques was 62.5% for observer 1 (kappa = 0.483), 65.4% for observer 2 (kappa = 0.531) and 63.5% for observer 3 (kappa = 0.508) (p = 0.001). CONCLUSIONS: Intraobserver agreement with the operating microscope and with unaided visual examination was roughly the same, but interobserver agreement was low with both techniques. For some surfaces, the diagnosis made by a particular observer with unaided visual examination differed from that made with microscopic examination. The diagnoses differed most frequently for surfaces that were scored as sound with unaided visual examination.

Comparison of the efficacy of three different mouthrinse solutions in decreasing the level of streptococcus mutans in saliva.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of three different antiseptic mouthrinse solutions on the saliva samples obtained from the individuals, who had high caries activity rate. METHODS: The efficacy of three antiseptic mouthrinses were evaluated in a study with healthy volunteers. The three antiseptic solutions used in this study were 0.1% octenidine dihydrochloride (Octenisept, Schülke&Mayr, UK), 0.12% chlorhexidine digluconate (Kloroben, Drogsan, Turkey) and an antimicrobial enzymatic rinse (Biotene, Laclede, Inc, USA). A total of 27 adult volunteer subjects were participated in the study. The subjects were stratified into three balanced group. Then the mouth rinses were used by each group according to the manufacturer's directions. The subjects were restricted for 60 minutes for food intake after using the prescribed mouthrinse. The saliva samples were collected from the volunteers at 1, 10 and 60 minutes after their usage in tubes. The tubes were kept in +4 degrees C in a fridge till the evaluation. 10(-3) and 10(-5) dilutions were prepared for each solution and S. mutans were evaluated according to total number of colony forming unit (CFU) per ml. The dilutions were spreaded on the surface of Brucella agar plates for anaerobic incubation for 48 hours. The dilutions were 100, 10(-3) and 10(-5) of the solutions Kloroben, Biotene, Octenisept, and the time factor were 0, 1, 10 and 60 minutes. The statistical analyses were performed by Duncan and Bonferroni tests. RESULTS: Octenisept was found to be more effective over S. mutans than the other mouthrinse solutions (P<.05). CONCLUSIONS: All mouthrinse solutions except Biotene were effective on oral microorganisms.

The use of a microscope for restorative treatment decision-making on occlusal surfaces.

Using an operating microscope, this study assessed the effect of 16x magnification on the restorative treatment of posterior teeth and compared the results against an unaided visual examination in vitro. Three dentists examined 300 premolars and molars at different times using an unaided visual examination and an operating microscope at 16x magnification. The observers examined the occlusal surfaces of teeth according to a patient model and selected a treatment protocol based on the following scale: 0: No Active Care (NC); 1: Preventive Care (PC) and 2: Operative Care and Preventive Care (OC+PC) advised. According to the results, there was good intra-observer agreement and moderate interobserver agreement with both techniques. No significant difference was found between the treatment using an unaided visual examination and that using an operating microscope. The use of a microscope at 16x magnification did not aid in the restorative treatment decision-making on occlusal surfaces.

The resistance of collagen-associated, planktonic cells of Enterococcus faecalis to calcium hydroxide.

This study examined whether collagen association by an endodontic isolate of Enterococcus faecalis conferred resistance to the bacterium against calcium hydroxide. E. faecalis A197A was grown at 46 degrees C until early stationary phase. Standardized bacterial suspensions were pretreated for 1 hour either with acid-soluble collagen or acidified phosphate-buffered saline (ac-PBS) and cultured to determine the baseline viable bacterial numbers. The bacterial suspensions were challenged with calcium hydroxide solution. Samples were removed at 6, 12, and 24 hours and cultured on tryptone soy agar plates. An adherence assay was performed to confirm that the collagen in the pretreatment medium was bound by the bacteria. Significantly more bacteria were cultivated at 12 hours in the collagen-pretreated group than the ac-PBS-pretreated group (p < 0.01). No bacteria could be cultivated at 24 hours in either group. Collagen association by E. faecalis A197A was found to increase the tolerance of the bacterium to calcium hydroxide.

Dietary habits and oral health related behaviors in relation to DMFT indexes of a group of young adult patients attending a dental school.

OBJECTIVES: The aim of the present study was to investigate the dietary habits and oral health related behaviors in relation to the dental health status in terms of decayed, missing and filled teeth (DMFT index) of a group of young adults attending to a dental school located in a major city in Turkey. STUDY DESIGN: A total of 416 young adults (247 females and 169 males) with an age range of 18-25 (Mean 23.2 sd 0.97) attending the Oral Diagnosis department participated in the study. The patients completed a questionnaire including questions about demographic factors, dietary habits and oral health related behaviors. Subsequently, the DMFT index and plaque index was calculated. Descriptive statistics, Mann Whitney U/ Kruskal Wallis Variance analysis, Chi-square/Fisher's Exact tests and multiple linear regression analysis were used for statistical analysis of the data when applicable. RESULTS: According to the results of the study, approximately 70% of the patients had regular main meals and a very high snacking rate (76.9%) was present. Although not at a high rate, most of the patients brushed their teeth regularly twice a day (44.2%) and approximately half used other hygiene aids in addition to brushing (43.8%). The median of the DMFT index was 5 and a majority of the patients had moderate plaque accumulation which could be seen with the naked eye (45.0%). Dental plaque had the most significant effect on the DMFT index. CONCLUSION: In conclusion, advice, including importance of regularity of main meals, decrease in snacking frequency, regular brushing twice a day and the use of other oral hygiene aids for the elimination of dental plaque would be helpful to enhance the dietary habits and oral health related behaviors of young adult Turkish patients.

Dietary habits and oral health related behaviors in relation to DMFT indexesof a group of young adult patients attending a dental school

Objectives: The aim of the present study was to investigate the dietary habits and oral health related behaviors inrelation to the dental health status in terms of decayed, missing and filled teeth (DMFT index) of a group of youngadults attending to a dental school located in a major city in Turkey.Study Design: A total of 416 young adults (247 females and 169 males) with an age range of 18-25 (Mean 23.2 sd 0.97)attending the Oral Diagnosis department participated in the study. The patients completed a questionnaire includingquestions about demographic factors, dietary habits and oral health related behaviors. Subsequently, the DMFT indexand plaque index was calculated. Descriptive statistics, Mann Whitney U/ Kruskal Wallis Variance analysis, Chi-square/Fisher’s Exact tests and multiple linear regression analysis were used for statistical analysis of the data when applicable.Results: According to the results of the study, approximately 70% of the patients had regular main meals and a veryhigh snacking rate (76.9%) was present. Although not at a high rate, most of the patients brushed their teeth regularlytwice a day (44.2%) and approximately half used other hygiene aids in addition to brushing (43.8%). The median ofthe DMFT index was 5 and a majority of the patients had moderate plaque accumulation which could be seen withthe naked eye (45.0%). Dental plaque had the most significant effect on the DMFT index.Conclusion: In conclusion, advice, including importance of regularity of main meals, decrease in snacking frequency,regular brushing twice a day and the use of other oral hygiene aids for the elimination of dental plaque would behelpful to enhance the dietary habits and oral health related behaviors of young adult Turkish patients (AU)

Dental fear and anxiety levels of patients attending a dental clinic.

OBJECTIVE: The aim of this study was to evaluate the anxiety levels of patients attending a university oral diagnosis clinic. Avoidance, felt physiologic responses, and the most fear-producing stimuli of dental treatment were also evaluated. METHOD AND MATERIALS: A total of 1,437 patients were asked to complete a questionnaire consisting of the Dental Anxiety Scale (DAS), Dental Fear Scale (DFS), and questions about age, gender, education level, and frequency of dental visits. The patients were grouped according to gender and divided into 5 age categories. Statistical analysis was made by descriptive statistics, two-proportion z test, analysis of variance, Tukey's Honestly Significant Difference test, and Scheffé test. RESULTS: The mean DAS score was 9.52 (SD 4.08) for females, 7.96 (SD 3.30) for males, and 8.76 (SD 3.80) for the total sample. There was no statistically significant difference between the mean DAS scores of age groups. Patients with a primary school education and those who had never visited the dentist had the highest anxiety scores. According to the DFS, the most felt autonomic response was increased heart rate, and the most fear-producing stimuli were the sight of the needle (25.1%) and sensation of the injection (24.1%). Of the patients 10.5% avoided calling for an appointment, and 4.9% canceled or did not appear for appointment. CONCLUSION: Some patients are afraid of some of the stimuli involved with dental treatment. This could affect the patient-dentist relationship and the dental treatment plan; therefore, before dental treatment, patients' anxiety and fear levels should be assessed.

Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope.

This study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra-oral camera and operating microscope, respectively. There was a statistically significant difference between the intraoral camera and the other two methods (p<0.05), while there was no significant difference between the unaided visual examination and operating microscope (p>0.05). As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.

The assessment of unaided visual examination, intraoral camera and operating microscope for the detection of occlusal caries lesions.

This study compared the efficiency of unaided visual examination, intraoral camera and operating microscope according to a visual scoring system (ERK) at occlusal caries detection. A total of 84 extracted human molars were mounted to create mouth models with a premolar in contact on both sides. The models were examined in a phantom head simulating clinical conditions by four observers using the three techniques: unaided visual examination, an intraoral camera and on operating microscope according to the ERK scale. The teeth were than sectioned in a mesio-distal direction and examined under a stereomicroscope with 10x magnification for histological validation. The sensitivity, specificity, positive predictive and negative predictive values were calculated for the four observers with three techniques and statistical analyses were performed using Friedman and DUNN tests, while strength of agreement was determined by calculating Kappa values. From the data, mean sensitivity values were cal. culated as 0.26, 0.43, 0.49 and mean specificity values as 0.87, 0.80 and 0.73 for unaided visual examination, intraoral camera and operating micro scope, respectively. The Kappa values ranged between 0.187 and 0.301 for visual examination, 0.328 and 0.459 for intraoral camera and 0.363 and 0.516 for operating microscope. As a result, the use of an intraoral camera and operating microscope improved occlusal caries detection according to the ERK scale.

Approximal carious lesion depth assessment with insight and ultraspeed films.

This study evaluated the efficiency of a new E/F-speed film, Insight, at the determination of approximal carious lesion depths compared with Ultraspeed. Radiographs of 80 extracted human molars and premolars were taken with both films under standardized conditions. The presence or absence of caries and depth of lesions was determined by three observers using a predetermined scale. The actual status of each surface was determined histologically. Observer responses were assessed with the Gamma measure of association test. Differences between the observers' agreement levels were not significant. The efficiency of Insight and Ultraspeed at true depth diagnosis was found to be 54.9%; 55.8% and Gamma values were found to be 0.883 and 0.922, respectively, at p<0.001. The difference between the two films was not statistically significant (p=0.852). This study suggested that there was no statistically significant difference between the two films at detecting the depths of approximal carious lesions.

The efficiency of three different films and radiovisiography in detecting approximal carious lesions.

OBJECTIVE: The aim of this study was to evaluate the efficiency of Ultraspeed, Ektaspeed Plus, and Insight radiographic films, and radiovisiography in detecting approximal carious lesions. METHOD AND MATERIALS: Eighty approximal surfaces of 40 extracted human molars and premolars were evaluated. Radiographs of teeth blocks were taken with three different films and radiovisiography under standard conditions. The presence or absence of approximal caries was evaluated by three observers according to a five-point confidence scale. The actual status of each surface of the teeth was histologically determined from the teeth sections. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios of the imaging modalities were calculated, and observer responses were assessed with Kendall's tau and Spearman's rho tests. RESULT: The sensitivity values for Ultraspeed, Ektaspeed Plus, Insight, and radiovisiography were 0.39, 0.48, 0.45, and 0.49, respectively, while the specificity values were 0.91, 0.88, 0.84, and 0.90, respectively. The difference in detecting approximal carious lesions between the systems was not statistically significant. CONCLUSION: This study suggests that there is no significant difference between the four imaging modalities in detecting approximal carious lesions.

Common errors on panoramic radiographs taken in a dental school.

The aim of this study is to evaluate the frequency of common errors seen on panoramic radiographs taken in the Radiology Department of a dental school by trained assistants. Four hundred and sixty radiographs were evaluated for 20 categories of common errors. Out of the evaluated radiographs, 37.61% were found to be error-free. The most common errors were found to be the palatoglossal airspace shadow of air above the tongue due to the patient not raising the tongue against the palate (46.30%) and the superimposition of hyoid bone with the mandible (26.30%) respectively. The least common error was found to be dirty or bent films (0.21%). The quality of panoramic radiographs could be enhanced by improving radiographic technique.