Metabolic control and periodontal treatment decreases elevated oxidative stress in the early phases of type 1 diabetes onset.

OBJECTIVE: Recently, increasing concern has been focused on the contribution of oxidative stress in the pathology of periodontal disease and diabetes mellitus. Firstly, the present study aimed to analyze gingival crevicular fluid (GCF), salivary, and serum oxidative status in children with type 1 diabetes mellitus (T1DM) at diagnosis and systemically healthy children with and without gingivitis. Additionally, the diabetic patients were reevaluated after diabetes and periodontal treatment. DESIGN: The study groups were composed of 32 T1DM patients at diagnosis, and age- and gender-matched thirty-six systemically healthy children with (G) and without (H) gingivitis. The diabetic patients who took insulin therapy (1.5 units/kg/day totally) and periodontal treatment (oral hygiene education with professional scaling) were reevaluated after 3 months. The levels of total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were recorded. RESULTS: GCF, salivary, and serum OSI were elevated in group T1DM compared to the other groups at baseline (p<0.05), and decreased in group T1DM at reevaluation compared to baseline (p<0.05). GCF OSI was positively correlated with periodontal clinical parameters (p<0.05). Glycated hemoglobin was positively correlated with GCF TOS (r=0.302, p=0.007), GCF OSI (r=0.346, p=0.002), salivary TOS (r=0.326, p=0.046), and serum TOS (r=0.239, p=0.044). CONCLUSION: The instability in the oxidative status that accompanies diabetes may be considered a significant pathogenic factor of diabetes-related periodontal inflammation.

Effectiveness of different irrigation solutions on triple antibiotic paste removal from simulated immature root canal.

To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of irrigation solutions on removal of triple antibiotic paste (TAP) from root canals of the simulated immature teeth. Fifty single-rooted teeth were used. TAP was placed into each root canal, and specimens were stored in distilled water for 4 weeks at 37°C. After 4 weeks, the temporary coronal seal was removed and the samples were randomly divided into five groups as follows: (i) saline; (ii) ultrasonic activation of saline; (iii) NaOCl; (iv) ultrasonic activation of NaOCl; (v) chlorhexidine digluconate (CHX). The amount of remaining TAP on the canal walls was measured under stereomicroscope with 30× magnification. The data were analyzed using a one-way ANOVA and post-hoc Tukey test at a significance level of 0.05. There were statistically differences among CHX and ultrasonic activation of NaOCl and other groups (p < 0.05). There were no significant differences among the ultrasonic activation of saline, NaOCl, and saline groups (p > 0.05). Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove the triple antibiotic paste from simulated immature root canals. Ultrasonic activation of the NaOCl gave the best and CHX was the worst results.

Fracture strength of roots instrumented with three different single file systems in curved root canals.

OBJECTIVE: The aim of this study was to compare the fracture strength of roots instrumented with three different single file rotary systems in curved mesial root canals of maxillary molars. MATERIALS AND METHODS: Curvatures of 25°-35° on mesial roots of 60 maxillary molar teeth were sectioned below the cementoenamel junction to obtain roots 11 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameter and weight. They were distributed into three experimental groups and one control group (no instrumentation) (n = 15): Reciproc rotary file (R25, VDW, Munich, Germany), WaveOne Primary rotary file (Dentsply Tulsa Dental Specialties, Tulsa, UK) and OneShape (Micro-Mega, Besancon, France) rotary file. Vertical load was applied until fracture occurred. Data were statistically analyzed using one-way analysis of variance test (P < 0.05). RESULTS: The mean fracture load was 412 ± 72 Newton (N) for the control group, 395 ± 69 N for the Reciproc group, 373 ± 63 N for the WaveOne group and 332 ± 68 N for the OneShape group. The fracture load differences among three experimental groups were not statistically significant (P > 0.05.) Whereas, the fracture loads of control and OneShape groups were significantly different (P = 0.012). CONCLUSIONS: Fracture resistance of the roots instrumented with WaveOne and Reciproc file systems were similar to the control group whereas it was observed that OneShape rotary file systems enhance the fracture strength of standardized curved roots when compared with the control group.

Applicability of the Demirjian method for dental age estimation in western Turkish children.

OBJECTIVE: The aim of this study was to examine whether the Demirjian method would be appropriate for estimation of the dental age of western Turkish children. MATERIALS AND METHODS: This study comprised 635 Turkish children (age = 7-16 years) from the western Aegean region who were chosen on the basis of radiological evidence from digital orthopantomograms. Their dental maturity was evaluated according to the stages proposed by Demirjian. A paired t-test was used for statistical analysis. RESULTS: The mean difference between the chronological and dental ages ranged from 0.10-0.76 years for males and from 0.28-0.87 years for females. CONCLUSION: The applicability of the Demirjian method is not suitable for western Turkish children and western Turkish children have a lower degree of dental maturity than that observed in the eastern, northeastern and northern Turkish subjects.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. .

A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population.

OBJECTIVE: The aim of this study was to determine the root and canal morphology of the maxillary and mandibular anterior teeth in a Turkish population by analyzing cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT images of 417 females and 410 males with a mean age of ranging from 14 to 70 years were examined in this study. A total of 1453 maxillary central incisors, 1504 maxillary lateral incisors, 1523 maxillary canines, 1582 mandibular central incisors, 1603 mandibular lateral incisors, and 1604 mandibular canines were analyzed. The number of root canals and the canal configurations were investigated and then were classified according to Vertucci's classification. The data were analyzed with the Pearson Chi-square test. RESULTS: The Type 1 canal configuration was most prevalent in the maxillary anterior teeth (96.8-99.7%). The Types 2, 3, 4, and 5 canal configurations were observed within the range of 0-1.3%, 0-0.8%, 0-0.7%, and 0-1.8%, respectively. In the mandibular anterior teeth, the Type 1 canal configuration was most prevalent (77-95%). The Types 2, 3, 4, and 5 canal configurations were observed within a range of 0.2-2.7%, 0.2-1.6%, 0.9-5.9%, and 1.8-14.4%, respectively. The prevalence of two canals was higher in males than in females both in the maxillary and mandibular anterior teeth (P < 0.05). CONCLUSIONS: Type 1 was the most prevalent canal configuration of maxillary and mandibular anterior teeth in the Turkish population. Type 5 was the most frequently observed canal configuration of the two canalled teeth. The incidence of root canal numbers and configurations differed with sex.

Evaluation of the root and canal morphology of mandibular permanent molars in a south-eastern Turkish population using cone-beam computed tomography.

OBJECTIVE: The aim of this retrospective study was to determine the root and canal morphology of the mandibular first and second permanent molars in a Turkish population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of mandibular first (n = 966) and second molar (n = 1165) teeth from 850 Turkish patients were evaluated. The root canal configurations were classified according to the method of Vertucci. The data were analyzed by Pearson's Chi-square test. RESULTS: The majority of mandibular molars were two rooted with three canals; however, three roots were identified in 0.05% of the first molars and 0.01% of the second molars, and 100% of the additional root canals were of type I configuration. Mesial roots had more complex canal systems with more than one canal, whereas most distal roots had a type I configuration. CONCLUSIONS: Within the limitations of this study, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a Turkish population. This study may help clinicians in the root canal treatment of mandibular molars.

Evaluation of the relationship between the maxillary posterior teeth and the sinus floor using cone-beam computed tomography.

AIM: The aim of this study was to evaluate the relationship between each root of maxillary premolars and molars and the maxillary sinus floor according to sex, sinus position, and age by decade in a Turkish population by using cone-beam computed tomography (CBCT) scanning. METHODOLOGY: We evaluated a database of 5,166 (2,680 maxillary premolars and 2,486 maxillary molars) CBCT scans obtained from 849 patients. The vertical relationship between each root of the molar and premolar teeth to the sinus floor was classified into three types: type 1, the roots penetrated into the sinus floor; type 2, the roots contacted the sinus floor; and type 3, the roots extended below the sinus floor. RESULTS: The results of the classification of each root in relationship to the sinus floor were as follows: type 3 occurred most frequently in the first (92.4 %) and second (71.6 %) premolar teeth, type 1 (34.2 %) occurred most frequently in the palatinal roots of the first molar teeth, type 3 occurred most frequently in the mesiobuccal (39.9 %) and distobuccal (39.7 %) roots of the first molar teeth, and type 2 (36.7 %) occurred most frequently in the mesiobuccal roots of the second molar teeth. No significant differences were found between the left and right sides, but several differences were found between males and females. The relationship between the posterior teeth and the sinus floor differed according to the age decade interval (p < 0.05). CONCLUSIONS: The maxillary first premolars have no relationship with the maxillary sinus floor, but the maxillary second molars are closer to the sinus floor. Also the second decade and males were most susceptible to undesirable results.

A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population.

AIM: The aim of this study was to evaluate the root canal number and configuration of maxillary and mandibular premolar teeth by gender, intervals for decades, tooth position and unilateral or bilateral occurrence in a Turkish population using Cone Beam Computed Tomography(CBCT) scanning. METHODOLOGY: CBCT images of 5496 maxillary and mandibular premolars from 849 patients were evaluated. The following was evaluated in all the images: numbers of roots and root canals, the morphology of the root canal configuration according to the Vertucci classification, male-female differences in the tooth position and male-female differences in unilateral or bilateral occurrence. The reliability data were analyzed with a chi-square test. RESULTS: The most prevalent root canal frequency was the two canals (86.2%) and type IV (76.9%) configuration for maxillary first premolar, one canal (59.7%) and type I (54.5%) canal configuration for second premolar. The incidence of one canal was higher in females and the occurrence of two or three canals was more common in males. The incidence of one canal was higher on the left side of maxillary premolars and the incidence of two canals was higher on the right side. Most mandibular first (93.5%) and second (98.5%) premolars had one canal. In general, females had one root canal of the mandibular premolar, whereas males had two or three canals. The type I configuration was most common and the incidence was higher on the right side. There were some differences found in the frequency distribution of the number of root canals and configuration of maxillary and mandibular premolar teeth according to intervals for decades. CONCLUSION: CBCT scanning provides comprehensive information about the root canal morphology of maxillary and mandibular premolar teeth. These data may help clinicians in root canal treatment of premolar teeth.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT.

OBJECTIVE: This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. MATERIAL AND METHODS: The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. RESULTS: The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. CONCLUSIONS: The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

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.

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.