Caries prevalence, oral health practices/behaviours and dental anxiety levels amongst dental hygiene students: A cross-sectional study.

OBJECTIVE: This study aimed to determine caries prevalence, oral health practices/behaviours and dental anxiety levels amongst dental hygiene students. MATERIALS AND METHODS: A self-administered questionnaire was used to determine students' oral hygiene practices/behaviours. The students were subjected to oral examinations to determine their decayed, missing, filled teeth (DMFT) scores according to the WHO criteria. In addition, the Corah's Dental Anxiety Scale (CDAS) was used to measure the students' dental anxiety levels. RESULTS: A total of 280 students (mean age: 20.8 years) participated in this study. Amongst the students, 52.8% brush their teeth twice a day, and 17.48% and 15.17% use floss and mouthwash daily, respectively. Moreover, the defined smoking rate was 22.85%. The mean DMFT scores of the preclinical and clinical students were 3.39 ± 3.22 and 3.55 ± 3.19, respectively. Most of the students (82.6%) preferred fluoride toothpaste, and the DMFT scores of those who use and do not use fluoride toothpaste significantly differed (p = 0.031). Furthermore, junk-food consumption affected the scores for decayed teeth (p = 0.048) and missing teeth (p = 0.039). Most students had low or moderate CDAS scores (CDAS <13), and anxiety scores were lower amongst the clinical students than amongst the preclinical students. CONCLUSIONS: Although the students demonstrated favourable oral health behaviours/practices and low caries prevalence, their adherence to oral hygiene instructions and to healthy dietary and lifestyle habits should improve. The importance of this topic should be strongly emphasized in the undergraduate curriculum. For this purpose, professional behavioural control methods that suit students' individual capacities, motivations and therapeutic needs may be employed. The principal findings of similar studies should be evaluated by lecturers to help students adopt optimal oral health practices/behaviours, reducing their dental anxiety levels and improving their professional competencies.

Educational concerns and awareness level among dental hygiene students during the COVID-19 pandemic.

OBJECTIVE: This study aimed to evaluate the educational concerns and awareness level among dental hygiene students during the COVID-19 pandemic. MATERIALS AND METHODS: A questionnaire, created via Google Forms, was sent electronically to 240 dental hygiene students from Turkey, of which 223 replied to the survey. The questionnaire was divided into 4 parts and consisted of 24 close-ended questions. RESULTS: The main symptoms of COVID-19 were correctly recognized by 71% of the students, and 40.2% of the students were aware of the transmission routes. Of all, 77.1% of the students expressed fear of getting infected, 96.9% believed that they would more likely get infected while performing dental procedures, and 91% believed that dental hygienists' cross-contamination risk was high. Furthermore, 69.5% of the students stated that their undergraduate education process was negatively affected, 59.6% appreciated ongoing online education, and 31.8% wanted face-to-face clinical internships. CONCLUSIONS: Although most of the students were aware of the transmission routes and preventive measures of COVID-19, concerns regarding disease transmission among them remain. Students appreciated the ongoing online education and believed that face-to-face education is risky during this current pandemic. However, they believe that this process can adversely affect their professional knowledge and especially practical skills. A balance must be struck between sustaining an effective dental hygiene education process and containing the spread of COVID-19.

Characterisation of the calcium silicate-based cement-composite interface and the bonding strength with total-etch or single/two-stage self-etch adhesive systems.

Due to favourable biological and physical properties, calcium silicate-based cements (CSCs) are biocompatible materials used widely for vital pulp therapies. Sealing efficacy between the adhesive system and CSC determines the clinical success of treatment. This study aimed to evaluate the shear bond strength (SBS) of CSC to composite resin with different adhesive systems and to analyse the CSC-composite interface. Mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (Septodont, Saint-Maur-des-Fossés, France) and NeoMTA Plus (Avalon Biomed Inc., Bradenton, FL) samples (n = 90) were placed in the cavities and divided into three subgroups according to the adhesive family (n = 10). SBSs were measured using a universal testing machine. The interfaces were examined using a scanning electron microscope (SEM) (×1000). NeoMTA Plus showed significantly higher SBS values than MTA and Biodentine (P < 0.0001). The application of total-etch adhesive system over Biodentine and NeoMTA Plus provided the statistically highest bond strength (P < 0.05). However, when the SBS values of MTA subgroups were compared, different adhesive families applied over MTA did not make a significant difference in SBS values (P > 0.05). Based on SEM analyses, the specimens exhibit no gaps, cracks or delamination within the adhesive layer, which indicates a good adhesion between the CSC-composite interface in all subgroups. In conclusion, the different adhesive families used over CSC did not influence interfacial gap formation.

Effect of work environment and specialty degree of dentists on cross-infection control in COVID-19 pandemic.

OBJECTIVES: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree  of dentists on their behavior, awareness, and  attitudes regarding cross-infection control during the COVID-19 pandemic. DESIGN: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10th and 20th of November 2020, 2,400 surveys were e-mailed to dentists. RESULTS: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160) , applied strict cross-infection control methods during the COVID-19  pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010). CONCLUSIONS: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection.

Effect of work environment and specialty degree of dentists on cross-infection control in COVID-19 pandemic

ABSTRACT Objectives: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree of dentists on their behavior, awareness, and attitudes regarding cross-infection control during the COVID-19 pandemic. Design: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10th and 20th of November 2020, 2,400 surveys were e-mailed to dentists. Results: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160), applied strict cross-infection control methods during the COVID-19 pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010). Conclusions: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection.

The effectiveness of a caries preventive program in mothers and infants - An 18- month follow-up study.

BACKGROUND/PURPOSE: MS and LB, the primary bacteria groups responsible for dental caries, and high levels of these bacteria in the mother promote transmission from mother to infant. The aim of this study was prevention of maternal MS and LB transmission on infants by using different preventive strategies and inhibition of early childhood caries proggession. MATERIALS AND METHODS: This study was conducted with 50 mother-child pairs who were randomly allocated into either a study group or a control group (n = 25 each). Mothers in the study group were enrolled in a detailed preventive program that included elimination of dental caries with restorative and antibacterial procedures, whereas those in the control group received only a single episode of oral-health education. RESULTS: After 18 months, significant MS and LB inhibition was observed in the study group (p < 0.0001). In addition, caries prevalence in the infants in the study and control groups was 0% and 20% respectively, and the difference between the two groups was statistically significant (p = 0.020). CONCLUSION: These results indicate that primary preventive intervention and oral-health instruction can significantly inhibit the MS and LB levels of mothers and prevent caries in their children during the early years of life.

Effects of Different Disinfection Methods on Microleakage of Giomer Restorations.

OBJECTIVES: The purpose of this in vitro study was to investigate the effects of different disinfection methods on microleakage of Class V Giomer restorations. MATERIALS AND METHODS: Class V cavity preparation was performed on 40 sound permanent central incisors. Class V cavities (3 x 2 x 2 mm) were prepared on the buccal surfaces of the selected teeth. The teeth were randomly divided into four groups, each to be disinfected with a different method: Group 1-Disinfection with 2% chlorhexidine, Group 2-Disinfection with 6% sodium hypochlorite, Group 3-Disinfection with erbium, chromium: yttrium-scandium-gallium-garnet laser, Group 4-Control (distilled water). BeautiBond adhesive and Beautifil II Giomer restoration materials were applied to all surfaces of the cavities after the disinfection of all groups. The teeth were thermocycled 5,000 times (5-55°C), and then were immersed in 0.5% methylene blue for 24 hours. After rinsing, the teeth were longitudinally sectioned and dye penetration was assessed under a stereomicroscope (40x) to evaluate microleakage. STATISTICAL ANALYSIS: The results were statistically evaluated by using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: Statistically, no significant difference was found between all four groups (p > 0.05). There was no statistically significant difference in microleakage scores of study groups (p > 0.05). Also, the microleakage scores of the gingival margins were significantly higher than the incisal margins (p < 0.0001). CONCLUSIONS: Application of the different cavity disinfectants has no effect on the microleakage of Class V Giomer restorations.

The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth.

OBJECTIVE: This study examined the effects of MTA and Biodentine on the clinical and radiographic success rates of pulpotomies performed on primary teeth with carious pulp exposures. MATERIALS AND METHODS: This study was conducted with 44 mandibular primary molars requiring vital pulpotomy. Carious dentin surrounding the exposure site was used as the inclusion criteria for all teeth, which were randomly divided into two groups according to pulpotomy material [MTA group (n = 24), Biodentine group (n = 20)]. Treatment was followed up clinically and radiologically for 24 months. Pulp canal obliteration was not regarded as a failure. RESULTS: Clinical and radiographic success rates at the end of 24 months were 100% for the MTA group and 89.4% for the Biodentine group. Success rates did not vary significantly between the groups (p = 0.646). Pulp canal obliteration was observed in two teeth (8.3%) in the MTA group at 6 months, but the teeth were found to be stabilized by 24 months. CONCLUSION: The long-term clinical and radiographic success rates obtained in this study indicate that both MTA and Biodentine are appropriate options for pulpotomy treatment of primary teeth with carious exposure in patients whose teeth should be retained for long periods of time. CLINICAL RELEVANCE: The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposures. The carious exposure is presumed to be accompanied by severe inflammation, which makes the prognosis of treatment unpredictable. Biomaterials can be used especially in cases with carious pulp exposures.

Does Achievement of Hemostasis After Pulp Exposure Provide an Accurate Assessment of Pulp Inflammation?

PURPOSE: The purpose of this study was to determine in primary molars with carious exposures whether hemostasis at the exposure site and pulp orifice reflected inflammatory status of the pulp at the canal orifice based on cytokine levels. METHODS: Forty mandibular primary molars with deep caries were included in the study. Teeth were divided into two groups: group A had teeth where hemostasis at the exposure site was achieved within five minutes, and group B had teeth where hemostasis at the exposure site could not be achieved within five minutes. Blood samples were harvested from the exposure sites and canal orifices. Cytokine levels for IL-1ß, IL-2, IL-6, IL-8, IL-10, TNF-α, and PGE2 were measured using ELISA for all sample sites. RESULTS: The IL-6 levels at the exposure sites were found to be significantly higher in group A when compared to group B, but there was no statistically significant differences in any of the cytokine levels at the canal orifices between the two groups. CONCLUSIONS: Controlling bleeding at the exposure site or canal orifices does not provide accurate assessment of inflammation at the canal orifice and may be misleading for diagnosing vital pulp treatment in primary teeth with a carious pulp exposure.

Shear bond strength of different restorative materials to mineral trioxide aggregate and Biodentine.

SIGNIFICANCE OF STUDY: Mineral trioxide aggregate (MTA) and Biodentine (calcium silicate-based materials) have great importance in dentistry. There is no study comparing the bond strength of Biodentine and MTA for composite, compomer, and compomer or resin-modified glass ionomer (RMGIC). Although many advantages of Biodentine over MTA; in this study, MTA has shown better shear bond strength (SBS) to restorative materials. AIM: Recently, a variety of calcium silicate-based materials are often used for pulp capping, perforation repair, and endodontic therapies. After those treatment procedures, teeth are commonly restored with composite resin, (RMGIC materials in pediatric dentistry. The aim of this study was to evaluate the SBS of composite resin (Filtek™ Z250; 3M ESPE, USA), compomer (Dyract XP; LD Caulk/Dentsply, USA), and resin-modified glass ionomer (Photac-Fil Quick Aplicap; 3M ESPE, USA) to white MTA and Biodentine. MATERIALS AND METHODS: Ninety acrylic cylindrical blocks were prepared and divided into two groups (n = 45). The acrylic blocks were randomly allocated into 3 subgroups; Group-1A: MTA + composite (Filtek™ Z250), Group-1B: MTA + compomer (Dyract XP), Group-1C: MTA + RMGIC (Photac-Fil Quick Aplicap), Group-2A: Biodentine + composite, Group-2B: Biodentine + compomer, Group-2C: Biodentine + RMGIC. The specimens were mounted in Universal Testing Machine. A crosshead speed 1 mm/min was applied to each specimen using a knife-edge blade until the bond between the MTA/Biodentine and restorative material failed. Failure modes of each group were evaluated under polarized light microscope at ×40 magnification. RESULTS: There was no statistically significant difference between MTA + Composite resin with MTA + Compomer; and MTA + RMGIC with Biodentine + RMGIC (P > 0.05). There were statistically significant differences between other groups (P < 0.05). CONCLUSIONS: The results of the present study displayed that although many advantages of Biodentine over MTA; MTA has shown better SBS to compomer and composite resin materials than Biodentine.