Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study.

This study evaluated the differences in dental conditions and treatment modalities between disabled and non-cooperative healthy children under general anaesthesia. The data were collected from paediatric patients between 3 and 15 years of age who received dental treatment under general anaesthesia. Patients with at least one mental/physical disturbance (group 1) and other healthy non-cooperative patients (group 2) were compared with regard to gender, age, weight, and treatment time-type. The statistical analyses were performed using Fisher's exact and Mann-Whitney U tests. No significant differences were observed between the groups with regard to gender, weight and treatment-time (p>0.05). The numbers of treated teeth (p<0.01) and extractions (p<0.001) were higher in group 1 than in group 2, whereas the frequency of advanced restorative procedures for group 1 was lower than that for group 2, including preventive-resin-restoration (p<0.001), glass-ionomer-cement (p<0.05), root-canal (p<0.001) and stainless-steel-crowns (p<0.001). This study supports the hypothesis that the general condition of the patients may alter the type of treatment provided and confirms the necessity of performing preventive procedures.

Management of root resorption with mineral trioxide aggregate complicated by a luxation injury: report of a case with six-year follow-up.

Trauma to the oral region occurs frequently, comprising 5% of all injuries. The most common dental injuries are lateral luxations which can be seen with a prevalence of up to 27% among dental injuries. Ectopic eruption of maxillary canines can lead to root resorption on maxillary lateral incisors especially on apical and middle thirds of the roots. Half of these resorbed lateral incisors show severe resorption, in which the pulp is exposed. This case report describes non-surgical treatment with mineral trioxide aggregate (MTA) and a six-year follow-up of a maxillary lateral incisor, resorbed by ectopic eruption of the canine and affected by lateral luxation injury. The tooth was asymptomatic, and radiographic examination showed that the resorbed region had been successfully repaired with new hard tissue deposition within the six-year follow-up. MTA can be considered an effective repair material in nonsurgical treatment of this type of root resorption.

Six-Year Survival of a Mini Dental Implant-Retained Overdenture in a Child with Ectodermal Dysplasia.

Patients with ectodermal dysplasia (ED) experience several problems caused by abnormal development and functioning of the head and neck region. In addition to developmental nasal cartilage abnormalities and absence of sweat glands, hair, and eyebrows, edentulism or developmental disorders of teeth (cone-shaped teeth) are commonly observed in these types of patients. ED is also characterized by underdeveloped alveolar ridges, a decreased occlusal vertical dimension, reduced salivary secretion, and dry oral mucosa, which make prosthetic rehabilitation difficult. Few studies of intraosseous dental implant-retained prostheses have described adverse effects on craniofacial growth and esthetic and functional disadvantages, while some researchers have described the advantages of this treatment option as an alternative option in these cases. Due to the associated alveolar bone deficiency, dental mini-implant therapy may be a treatment option for these patients; however, there are isolated cases in the literature regarding the rehabilitation of ED patients with mini-implant-supported overdentures. This clinical report describes the rehabilitation of a 6-year-old child with ED using a maxillary removable partial prosthesis and a mini-implant-retained mandibular overdenture. The clinical and radiographic findings of this prosthetic rehabilitation during the 6-year follow-up are also presented.

Effects of casein phosphopeptide-amorphous calcium phosphate application after interproximal stripping on enamel surface: An in-vivo study.

INTRODUCTION: The aim of this study was to investigate the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application after interproximal stripping on enamel surface structures in vivo. METHODS: Fifteen patients with a mean age of 15.8 years participated in this study. For each patient, the extraction of 4 first premolars was part of the orthodontic treatment plan. The patients were randomly divided into 5 groups of 3 patients. With the exception of group 1, the mesial and distal surfaces of all first premolars were stripped with a stripping disc (Komet; Gebr Brasseler, Lemgo, Germany) under air cooling and then polished with Sof-Lex polishing discs (3M Dental Products, St Paul, Minn). In group 1, no stripping was performed, and the teeth were removed immediately. In group 2, the teeth were removed immediately after the stripping. In group 3, the stripped teeth were extracted after exposure to oral conditions for 3 months. In groups 4 and 5, CPP-ACP (Recaldent Tooth Mousse; GC Europe, Leuven, Belgium) or fluoride varnish (Bifluoride 12; Voco, Cuxhaven, Germany) was applied to the stripped surfaces for 3 months, respectively, before the teeth were extracted. Surface roughness and microhardness values were evaluated with 1-way analysis of variance and Tukey HSD tests. RESULTS: The CPP-ACP and the fluoride varnish applications increased the surface roughness and microhardness values that had been decreased by stripping. No statistically significant differences were found between groups 3, 4, and 5 for microhardness or between groups 4 and 5 for surface roughness (P > 0.5). CONCLUSIONS: The saliva and saliva plus remineralizing agents (fluoride varnish and CPP-ACP) increased the microhardness and surface roughness values of stripped enamel surfaces that had been decreased by stripping.

Alveoler process fracture in mandibular immature permanent incisors region.

The presented case evaluates the treatment of an alveolar fracture associated with mandibular immature lower permanent incisors. An 8-year-old girl was referred to our clinic 3 hours after the trauma. The clinical and radiographic examination of the alveoler bone showed a fracture, along with the mandibular fracture and significant segment mobility and dislocation of several immature mandibular permanent incisors. These were moving together to the lingual side because of the direct trauma associated with falling from the school wall. After the application of the buccal and lingual infiltration of local anaesthesia, the dislodged bone including the lower permanent incisors, were carefully repositioned. The teeth were splinted using semi-rigid arch bars with orthodontic brackets keeping the teeth between primary molars.The splints were removed one month later and no abnormality was observed in the immature permanent incisors. After 24 months follow up, the mandibular permanent incisors were observed to have the apical closure. Treatment of alveolar fractures in growing children with immature teeth may provide beneficial healing pattern with careful semi-rigid splinting and follow up procedures.

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.

Residual HEMA and TEGDMA release and cytotoxicity evaluation of resin-modified glass ionomer cement and compomers cured with different light sources.

The purpose of this study was first to evaluate the elution of 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) monomers from resin-modified glass ionomer cement (RMGIC) and compomers cured with halogen and light-emitting diode (LED) light-curing units (LCUs). The effect of cured materials on the viability of L929 fibroblast cells was also evaluated. One RMGIC (Ketac N100) and two compomers (Dyract Extra and Twinkystar) were tested. Materials were prepared in teflon disks and light-cured with LED or halogen LCUs. The residual monomers of resin materials in solution were identified using high-performance liquid chromatography. The fibroblast cells' viability was analyzed using MTT assay. The type of LCU did not have a significant effect on the elution of HEMA and TEGDMA. A greater amount of HEMA than TEGMDA was eluted. The amount of TEGDMA eluted from Twinkystar was greater than Dyract Extra (P < 0.05) when cured with a halogen LCU. All material-LCU combinations decreased the fibroblast cells' viability more than the control group (P < 0.01), except for Dyract Extra cured with a halogen LCU (P > 0.05). Curing with the LED LCU decreased the cells' viability more than curing with the halogen LCU for compomers. For Ketac N100, the halogen LCU decreased the cells' viability more than the LED LCU.

Validity of demirjian and nolla methods for dental age estimation forNortheastern Turkish children aged 5-16 years old

Objective: To evaluate the applicability of Demirjian and Nolla methods for northeastern Turkish population. Material and Method: A retrospective study was performed on panoramic radiographs of 673 subjects aged 5-15.9 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA).Results: The mean CA of the study sample was 10.37±2.90 and 10.03±2.81 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 11.26±3.02 years for females and 10.87±2.96 years for males. For Nolla method, the mean estimated DA was 9.80±3.41 and 9.53±3.14 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian and Nolla methods were 0.86 and -0.54 years for total study sample.Conclusion: Nolla method was found to be a more accurate method for estimating DA in northeastern Turkish population (AU)

Validity of demirjian and nolla methods for dental age estimation for Northeastern Turkish children aged 5-16 years old.

OBJECTIVE: To evaluate the applicability of Demirjian and Nolla methods for northeastern Turkish population. MATERIAL AND METHOD: A retrospective study was performed on panoramic radiographs of 673 subjects aged 5-15.9 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA). RESULTS: The mean CA of the study sample was 10.37±2.90 and 10.03±2.81 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 11.26±3.02 years for females and 10.87±2.96 years for males. For Nolla method, the mean estimated DA was 9.80±3.41 and 9.53±3.14 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian and Nolla methods were 0.86 and -0.54 years for total study sample. CONCLUSION: Nolla method was found to be a more accurate method for estimating DA in northeastern Turkish population.

Silorane-based composite: depth of cure, surface hardness, degree of conversion, and cervical microleakage in Class II cavities.

OBJECTIVE: The purpose of this study was to determine the depth of cure, degree of conversion (DC), hardness, and cervical sealing ability of silorane-based composite (Filtek Silorane [FS; 3M, Seefeld, Germany]) and to compare with methacrylate-based composites (MBCs = Filtek Supreme XT [FSXT] and Filtek P60 [FP60]). MATERIALS AND METHODS: The DC and hardness of every material were evaluated after 1, 7, and 30 days. The depth of cure was determined using the ISO 4049:2000 standard. Microleakage was evaluated by measuring dye penetration across the gingival wall in cross-sectioned specimens. RESULTS: FS showed lower depth of cure than FSXT and FP60. The DC of FS was significantly lower when compared to FP60 and FSXT. FS exhibited lower hardness than both FSXT and FP60 after 1 day of storage. The hardness of FS remained unchanged during the storage period. FS showed reduced microleakage scores compared to FSXT and showed similar microleakage scores compared to FP60. CONCLUSIONS: In conclusion, the DC and cure depth of FS are lower than those of MBCs. However, FS revealed stable hardness in water that is comparable to MBCs. The sealing ability of FS is similar or even better than that of MBCs.

Comparison of pre-emptive ibuprofen, paracetamol, and placebo administration in reducing post-operative pain in primary tooth extraction.

BACKGROUND: This study investigates preliminary investigations that a pre-emptive analgesia administration may reduce post-extraction pain. AIM: This prospective, placebo-controlled, randomized, double-blind trial was planned to compare the efficacy of the pre-emptive administration of ibuprofen, paracetamol, and placebo in reducing post-extraction pain in children. DESIGN: Forty-five children, ages 6-12, who needed primary mandibular molar tooth extraction were treated in paediatric dental clinics, with treatment preceded by local anaesthesia and analgesic drugs during the preoperative period. A five-face scale was used to evaluate pain reaction during the injection, extraction, and post-operative period. Self-report scores were recorded when the local anaesthesia had been administered in soft tissues and both before and after the extraction was completed. The Kruskal-Wallis and Mann-Whitney U tests (with Bonferroni correction paired t-test as the post hoc test) were used at a confidence level of 95%. RESULTS: The use of pre-emptive analgesics showed lower scores compared to the placebo, irrespective of the age, weight, gender of the child, and the number of teeth extracted during the study period. Additionally, ibuprofen exhibited lower pain scores (P < 0.05) compared to paracetamol at the 15-min (P < 0.001) and 4-h (P < 0.009) periods. CONCLUSIONS: Preoperative use of ibuprofen and paracetamol may provide a pre-emptive analgesic effect in paediatric patients who receive adequate analgesia during mandibular primary tooth extraction.

Antibacterial activity and physical properties of conventional glass-ionomer cements containing chlorhexidine diacetate/cetrimide mixtures.

STATEMENT OF THE PROBLEM: Hand excavation instruments are not as efficient as that with rotary burs in atraumatic restorative treatment (ART). PURPOSE: To evaluate the antibacterial activity (ABA), microhardness numbers (VHN), and cumulative fluoride releasing (CFR) patterns of conventional GICs (Fuji IX (FX) and Ketac Molar (KM)) containing chlorhexidine diacetate/cetrimide mixtures (2.5%/2.5%) (AB). MATERIALS AND METHODS: The powders of ABs were added to powders of FX and KM selected as experimental groups (EXPs). FX and KM were assigned as controls (CNTs). ABA against S.mutans (MS) and L.casei (LB) were examined between 1-90 days. VHN were calculated after 24 hours and CFR patterns measured between 1-30 days. Analysis of variance was used for comparison (p<0.05) RESULTS: Differences were found between EXPs regarding MS levels at days 1, 7 and 60 as well as for LB at all time periods (p<0.05). VHN decreased in EXPs compared to CNTs (p<0.05), and no differences were found between EXPs (p>0.05). CFR patterns tended to decrease in EXPs compared to the CNTs, but no differences were found between EXPs (p>0.05) CLINICAL SIGNIFICANCE These mixtures could be recommended for ART procedures to provide beneficial antibacterial effects without seriously deteriorating the physical properties of selected GICs.

Shear bond strength of orthodontic brackets to aged resin composite surfaces: effect of surface conditioning.

The aim of this study was to investigate the effects of surface conditioning protocols on the shear bond strength (SBS) of metal brackets to aged composite resin surfaces in vitro. Ninety composite resin discs, 6 mm in diameter and 2 mm in height, were prepared and treated with an ageing procedure. After ageing, the specimens were randomly assigned to one of the following groups: (1) control with no surface treatment, (2) 38 per cent phosphoric acid gel, (3) 9.6 per cent hydrofluoric acid gel, (4) airborne aluminium trioxide particle abrasion, (5) sodium bicarbonate particle abrasion, and (6) diamond bur. The metal brackets were bonded to composite surfaces by means of an orthodontic adhesive (Transbond XT). All specimens were stored in water for 1 week at 37°C and then thermocycled (1000 cycles, 5-55°C) prior to SBS testing. SBS values and residual adhesive on the composite surface were evaluated. Analysis of variance showed a significant difference (P = 0.000) between the groups. Group 6 had the highest mean SBS (10.61 MPa), followed by group 4 (10.29 MPa). The results of this study suggest that a clinically acceptable bond strength can be achieved by surface conditioning of aged resin composite via the application of hydrofluoric acid, aluminium trioxide particle abrasion, sodium bicarbonate particle abrasion, or a diamond bur.

Conversion degree, microhardness, microleakage and fluoride release of different fissure sealants.

The purpose of this study was to determine the degree of conversion (DC), microhardness, microleakage and fluoride release of a nano-filled resin based fissure sealant (Grandio Seal, GS) and compare it with an un-filled resin based fissure sealant (Clinpro, CL) and a glass-ionomer based fissure sealant (Fuji Triage, FT). Disk shaped specimens were prepared from tested fissure sealants to determine the DC, Vicker hardness (VHN) and fluoride release (FR). The DC and VHN of each material was evaluated after 24 h. The cumulative fluoride concentrations were evaluated at 1 h, 6 h, 12 h, 1, 7, 15 and 30 days. For microleakage evaluation, fissure sealants were applied to the etched and dried enamel surfaces of sound third molar teeth according to the manufacturer's instructions (n=10). After the thermocycling and mechanical loading procedures, microleakage assessments were carried out. Data were analyzed using one-way ANOVA followed by a post hoc Tukey test, the Kruskal Wallis and Mann-Whitney U test (p<0.05). Results revealed differences regarding DC between all groups: FT (89%) > GS (55.02%) > CL (%51.10) (p<0.05). The VHN values were significantly different among all groups in the following order: GS > FT > CL (p<0.05). FT exhibited significantly higher microleakage scores compared to the CL and GS sealants (p<0.05). The FR of FT was significantly greater than CL and GS (p<0.05). Nano-filled resin based sealant can be used as an alternative to other fissure sealant materials because of its superior hardness results and feasible sealing ability.

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.

Shear bond strength of conventional glass ionomer cements bound to mineral trioxide aggregate.

INTRODUCTION: This study measured the shear bond strength of conventional glass ionomer cements (GICs; Ketac Molar Easymix and Fuji IX) bonded to white mineral trioxide aggregate (WMTA) that had been allowed to set for 2 different time intervals. METHODS: Forty-eight WMTA specimens were prepared; half were stored for 45 minutes, and the remaining 24 specimens were stored for 72 hours at 37 degrees C and 100% humidity. Then each group was divided into 2 subgroups of 12 specimens, and each GIC was layered on each of the 2 WMTA preparations. The GIC-WMTA shear bond strengths were measured and were compared by using one-way analysis of variance. RESULTS: The shear bond strengths with the 45-minute and 72-hour WMTAs were 8.85 and 9.16 MPa, respectively, for Ketac Molar Easymix and 9.34 and 9.96 MPa, respectively, for Fuji IX. The GIC-WMTA bond strength was not different between GIC applications to WMTA that had set for 45 minutes versus 72 hours (P >.05). CONCLUSIONS: GICs might be used over MTA after the MTA has set for 45 minutes to allow single-visit procedures.

Initial repair bond strength of a nano-filled hybrid resin: effect of surface treatments and bonding agents.

BACKGROUND: The optimal surface treatment is an important factor in repairing failed restorations. PURPOSE: The aim of this study was to compare the effect of different surface treatments in combination with bonding agents on the repair of an aged nano-filled resin composite. MATERIALS AND METHODS: Resin composite disks (N = 180; Filtek Supreme XT, 3M ESPE, St. Paul, MO, USA), 6 mm in diameter and 2 mm in height, were prepared. After accelerated aging of 300 hours in a weathering tester, the specimens were randomly divided into six groups of 30 each, according to the following surface treatment methods: no surface treatment (control group, C), 38% phosphoric acid gel (PA), 9.6% hydrofluoric acid gel (HF), abrasion with sodium bicarbonate particles (SB), aluminum trioxide particle abrasion (AT), and diamond bur (DB). Fresh resin composite was bonded to the treated surfaces with one of two bonding agents (Prime&Bond NT, Dentsply/Caulk, Milford, DE, USA; Clearfil SE Bond, Kuraray Co./J., Morita, Japan). The effect of each surface treatment on the bond strength was determined by a shear bond test. Data were analyzed by two-way analysis of variance and Tukey's post hoc test (p = 0.05). RESULTS: Significant differences were found between the groups, for both surface treatment and bonding agent (p < 0.05). For all surface treatments, the shear bond strengths (SBSs) with Clearfil SE were higher than those with Prime&Bond (p < 0.05). The mean SBS values for the surface treatment groups were, from highest to lowest, 19.3 (DB), 18.7 (AT), 17.4 (SB), 15.2 (HF), 9.2 (C), and 8.8 MPa (PA). CONCLUSIONS: Surface treatment with DB or AT was more effective than with the other surface treatments tested for the repair of nano-filled composites. The adhesive used as an intermediate agent is also important in composite repair. CLINICAL SIGNIFICANCE: Surface treatment with a diamond bur plus a proper adhesive agent is a simple, efficient, and cost-effective procedure for enhancing the shear bond strength of a repaired nano-hybrid resin composite.

Effects of food-simulating liquids on the mechanical properties of a silorane-based dental composite.

The purpose of this study was to investigate the effects of food-simulating liquids (FSL) on the hardness and flexural strength (FS) of a new silorane-based composite and to compare it with methacrylate-based composites (MBCs). Four restorative materials (Filtek Silorane, P60, Z250, and Supreme XT) were used. Specimens for the FS and hardness measurements were fabricated in customized molds. Immediately after polymerization, the materials were stored in the following dietary simulating solvents at 37 degrees C for 1 week: distilled water, 0.02 N citric acid, heptane, and 75% aqueous ethanol solution. After conditioning, the FS and hardness values were measured. Data were subjected to ANOVA/Scheffé's test at a significance level of 0.05. The hardness and FS of Filtek Silorane were not significantly affected by FSL (p>0.05). Conversely, the hardness of MBCs significantly decreased after conditioning in water and ethanol (p<0.05). Similarly, the FS values of MBCs were significantly affected after conditioning in ethanol.

Temporary management of permanent central incisors loss caused by trauma in primary dentition with natural crowns: a case report.

Primary teeth injuries may cause developmental disturbances in the permanent dentition and loss of permanent incisors could be treated with different options. In this case report, an 11-year-old boy, with a history of trauma at the age of 4 years, is presented. Premature loss of permanent upper right central and upper left central teeth because of the mobility and arrest in root development were treated using patient's own natural crowns on a removable appliance. This treatment option could be considered as an esthetic and functional temporary management of permanent central incisors loss until the definitive treatment will be completed in the future.

Treatment of horizontal root fractures using MTA as apical plug: report of 3 cases.

Root fractures are rare occurrences through all dental injuries. They comprise only 0.5% to 7.0% of traumas affecting the permanent teeth. Generally the cervical and middle thirds of the roots are affected. The healing of these lesions depends on the health of the pulp, dentine, cementum, and alveolar bone. These case reports describe the management and 2-year follow-up of 3 maxillary central incisors with horizontal root fractures treated with mineral trioxide aggregate (MTA) as apical plug.