Comparison of bispectral index values and depth of sedation during deep sedation using sevoflurane anesthesia in healthy children versus children with cerebral palsy.

BACKGROUND: Patients with cerebral palsy (CP) are at significant risk by means of periodontal disease and tooth decay. Pharmacological techniques that require intensive care such as sedation and general anesthesia are generally used for dental treatment of this patient group. AIM: The purpose of this retrospective study was to compare bispectral index (BIS) values and depth of sedation recorded during deep sedation protocols performed for healthy children and children with CP in the Department of Pediatric Dentistry, Faculty of Dentistry, Gazi University. MATERIALS AND METHODS: The measurements of BIS and hemodynamic variables recorded during treatment of 26 healthy children and 26 children with CP between 3 and 10 years of age who were treated under sevoflurane and 50% N2O-50% O2 mixture deep sedation method were investigated retrospectively. RESULTS: The mean BIS values in the CP group was statistically lower at all the time points when compared with the control group (P < 0.001). While there was no statistically significant difference between groups in terms of duration of treatment (P = 0.657), the median recovery time in the CP group was significantly longer than that recorded in the control group (P < 0.001). Significant correlation was found between modified Ramsay Sedation Scale (mRSS) scores and BIS levels at 5th, 10th, and 20th min in the control group (P < 0.001). Similar correlation was found in the CP group at 15th and 20th min. CONCLUSION: We concluded that it is necessary to consider the dosage and effect mechanisms of drugs used in children with CP to prevent overuse of anesthetics and emergence of anesthesia-related complications.

Remineralization Capacity of Three Fissure Sealants with and without Gaseous Ozone on Non-Cavitated Incipient Pit and Fissure Caries.

OBJECTIVE: The purpose of this study was to investigate the remineralization activation of the application of three fissure sealants (FSs), alone or with gaseous ozone (GO), on non-cavitated initial caries and evaluate the clinical success of FS. STUDY DESIGN: Sixty children who had DIAGNOdent scores between 10-30 on bilateral symmetric mandibular first permanent molars were included in study. In a split-mouth design, teeth were assigned to experimental (with GO) and control (without GO) groups. GO was applied to teeth on one side and then the same brand of randomly selected FSs was applied to the teeth on both sides. Children were divided into 3 groups based on type of FS (Group 1: Aegis {Bosworth Co, North Hamlin Avenue Skokie, Illinois, USA}, Group 2: Fuji Triage {GC, Tokyo, Japan}, Group 3: Helioseal {Ivoclar Vivadent, Liechtenstein, Germany}). All FSs were then examined for retention rates at 1, 3, 6, 9, and 12 months; at the end of 12 months, all FSs were removed with an air-abrasion device and DIAGNOdent scores noted to compare with the initial values. RESULTS: The application of GO with either Fuji Triage or Aegis FS was effective on remineralization (p<0.05); however, the application of Helioseal FSs was not effective (p>0.05). The 1(st) and 12(th) months' full retention rates of Fuji Triage FSs was a significant difference (p<0.05) from other FSs (Aegis and Helioseal) (p>0.05). CONCLUSIONS: GO+Aegis FS showed the highest remineralization; and, at the end of 12 months, its clinical success was higher than other FSs.

Comparison of the resin-dentin interface in primary and permanent teeth.

The purpose of the present study was to compare primary and permanent teeth in terms of the thickness of the hybrid layer developed with two bonding systems: Syntac (multi step) and Syntac Single Component. Fourteen sound primary first molars and 14 sound permanent first bicuspids, were removed for orthodontic reasons, and divided into 4 groups: 7 primary and 7 permanent teeth were restored with Syntac adhesive resin system (multi step); and 7 primary and 7 permanent teeth were restored with Syntac Single Component adhesive resin system. Measurements of hybrid layer thickness were performed by means of SEM and two teeth in each group were evaluated on TEM for further confirmation of resin-dentin interface. The result of this study indicated that the hybrid layer was significantly thicker in primary than in permanent teeth (p < 0.05). No difference was observed in the hybrid layers produced by two dentin bonding systems (p < 0.05).

A histopathologic study of direct pulp-capping with adhesive resins.

OBJECTIVE: The purpose of this study was to evaluate the histologic pulp responses of Optibond and Syntac adhesive resin systems placed directly on exposed pulp tissues. STUDY DESIGN: Class V facial cavities with pulpal exposures were prepared in dogs. After acid etching of enamel margins, the cavities were restored with a composite resin after pulp-capping with one of the dentin bonding agents. The remaining exposures were capped with calcium hydroxide and amalgam as controls. The animals were killed after 7, 21, and 90 days and the pulps were evaluated histologically. Statistical analysis was carried out with the chi-square test. RESULTS: There was no statistically significant difference with respect to inflammatory cell response, fibrosis, bleeding, or bacterial staining criteria over the time intervals of evaluation among the Optibond, Syntac, and calcium hydroxide groups. New dentin formation was also observed for all of the groups at the end of 90 days. CONCLUSION: The results of direct pulp-capping with a dentinal adhesive and composite resin appear promising but further in vivo studies are recommended.

Microleakage of resin composite restorations with glass-ceramic inserts.

OBJECTIVE: The purpose of this study was to evaluate the effects of glass-ceramic inserts and different application techniques of resin composites on marginal leakage. METHOD AND MATERIALS: Three groups of 10 standardized, round, Class V cavities were prepared on the buccal surface of 30 extracted human molar teeth. Group 1 received resin composite restorations, placed in one increment (bulk). Group 2 received resin composite restorations that were placed in two increments, and group 3 received resin composite restorations with beta-quartz ceramic inserts. After the teeth were thermocycled and placed in 0.5% basic fuchsin for 24 hours, they were sectioned and examined for microleakage. RESULTS: On the occlusal margins, there was no statistically significant difference between the restorations placed with the incremental technique and the restorations with beta-quartz inserts. The restorations placed with the bulk technique had significantly more microleakage than did the others. On the gingival margins, the restorations with beta-quartz inserts exhibited significantly less microleakage than did the other groups. The restorations placed with the bulk technique showed significantly more dye penetration than did the others. CONCLUSION: The use of a glass-ceramic insert reduced the marginal leakage of Class V resin composite restorations.

Clinical evaluation of transcutaneous electronic nerve stimulation for pain control during tooth preparation.

The purpose of this study was to evaluate the effectiveness of a transcutaneous electrical nerve stimulation unit. The effects of electronic dental anesthesia and local anesthesia for deep cavity preparations in primary molars were compared in children aged 7 to 9 years by using the Eland Color Scale. The patients had symmetric teeth requiring Class I cavity preparation. One of the teeth was treated with electronic anesthesia and the other with local anesthesia. The tooth and method were selected randomly. Both restorations were finished at the same visit. There was no statistically significant difference between the groups in the perception of pain. Fifty-six percent of the children preferred transcutaneous electrical nerve stimulation, while 36% of them preferred local anesthesia.

Salivary and urinary fluoride levels after 1-month use of fluoride-releasing removable appliances.

Forty children aged 8-10 years participated in this study. Half (n =20) of them used orthodontic appliances which contained fluoride-releasing devices embedded in the lingual surface of the appliance and the other half used orthodontic appliances prepared from a fluoride-releasing acrylic polymer. Prior to the adjustment of appliances and after 1, 7, 14, 21 and 30 days salivary and urinary samples were collected and the fluoride concentrations were determined. The mean fluoride release was highest during the first week. However, the values decreased considerably after that and the curves for the two groups became parallel. The results indicate that fluoride-releasing removable appliances could be useful for a prolonged release of low concentrations of fluoride without any systemic effect.

Comparison of the effect of insertion techniques of a resin composite on dentinal adaptation of two visible light-cured bases: direct evaluation versus a replica technique.

This scanning electron microscopic study evaluated the adaptation of two visible light-cured bases, Calcimol LC and Ionoseal, to the dentinal surface after the use of various techniques to insert the resin composite material. Twenty-eight Class I cavities were prepared and restored in four groups: seven Calcimol LC and resin composite placed with a bulk or an incremental technique; and Ionoseal and resin composite placed with a bulk or an incremental technique. The specimens were sectioned longitudinally through the center of the restoration and an impression was made with a poly(vinyl siloxane) impression material. When the tooth surfaces and the impressions made from these surfaces were compared in the scanning electron microscope, extra gaps on tooth surfaces were observed that were not apparent in the impressions. These extra gaps probably resulted from desiccation of tissues; thus, the observation of replicas was useful to eliminate the inclusion of "false" gaps in the analysis. The results indicated that there was no substantial difference between Calcimol LC and Ionoseal base materials placed under resin composite inserted with an incremental technique.

Comparison of electrosurgery and formocresol as pulpotomy techniques in dog primary teeth.

The primary teeth of four dogs were treated using either a conventional formocresol or electrosurgical technique following pulpotomy. Pulps of the treated teeth were evaluated histologically for the presence of inflammation, fibrosis, necrosis, resorption, and reparative dentin formation. Results indicated that conventional formocresol pulpotomy technique is histopathologically superior to electrosurgery pulpotomy technique.