Comparative evaluation of fluoride-free remineralization agents with and without Er,Cr:YSGG laser on artificial enamel remineralization.

This study aimed to evaluate the efficacy of fluoride-free remineralizing agents in initial enamel caries, with and without combined Er,Cr:YSGG laser application. The remineralization effect of various agents and their combinations on artificial initial caries was investigated using 10 experimental groups (n = 7): NC, negative control; PC, positive control; TM, calcium-phosphate compounds (CPP-ACP); TD, theobromine-containing toothpaste; RG, ROCS® remineralizing gel; L, Er,Cr:YSGG laser (2780 nm; 0.25 W; repetition rate, 20 Hz; pulse duration, 140 µs; tip diameter, 600 µm; without air/water cooling); L + fluoride toothpaste; L + TM; L + TD; and L + RG. The demineralized bovine enamel specimens were subjected to an 8-day pH cycle by daily application of the remineralizing agents and laser therapy once prior to the pH cycle and paste application. The enamel samples underwent the Vickers surface microhardness test, and one sample per group was analyzed with scanning electron microscopy. The Kruskal Wallis test was used to compare the microhardness recovery percentage (SMHR%) for each group, and multiple comparisons were made with the Dunn test. Groups L (p = 0.003), RG (p = 0.019), L + TM (p < 0.001), L + fluoride toothpaste (p = 0.001),and L + RG (p = 0.036) exhibited significant increase in SMHR%. The tested remineralizing agents exhibited no statistically significant difference in effect when used alone and in combination with Er,Cr:YSGG laser. Combined application of Er,Cr:YSGG laser and ROCS® remineralization gel effectively promoted enamel remineralization, while use of CPP-ACP and fluoride toothpaste alone was ineffective. Theobromine-containing toothpaste exhibited the least SMHR%. Long-term evaluation of these agents is recommended.

Bioactivity evaluation of calcium silicate-based endodontic materials used for apexification.

This study aims to compare the bioactivity of Biodentine, ProRoot MTA and NeoMTA Plus with regard to their element uptake (Ca, Si and Ca/P) by root canal dentine in a simulated apex (n = 30 each) and evaluate the correlation between the dentine fracture resistance (n = 30 each) and interfacial layer thickness. Specimens immersed in a corrected simulated body solution (c-SBF) for 1, 30 and 90 days were used. In all test materials, the Ca and Si concentrations in the root dentine were found to be significantly higher, whereas the Ca/P and Si concentrations increased over time (P < 0.05). The dentine fracture resistance showed a difference at only day 30. The dentine fracture resistance of Biodentine and ProRoot MTA was positively correlated with the Si and Ca/P values, and the mean interfacial layer thickness of all specimens. A high biomineralisation capacity of ProRoot MTA and Biodentine, and their positive effects on the dentine fracture resistance during the first 30 days suggest that they may present more advantages than NeoMTA Plus in apexification treatment.

Evaluation of Final-Year Turkish Dental Students' Knowledge, Attitude, and Self-Perceived Competency towards Preventive Dentistry.

BACKGROUND: Dental education plays an important role in providing students with the opportunity to develop their evidence-based knowledge and clinical skills regarding patient-specific preventive care and caries management strategies. The aims of this study were to examine the knowledge, attitude, and self-perceived competency towards preventive dentistry among final-year dental students and to investigate their preventive practice for high-caries-risk children. Methods. Data were collected from a convenience sample of 126 dental students using a questionnaire. The IBM SPSS Statistics version 21 was used for data analysis. RESULTS: A total of 126 students completed the questionnaire, and 63% of the respondents were female. Significant gender differences were found in the total Professional Preventive Knowledge Scale (PPKS) (p=0.016) and its subscales of the noncariogenic nutrition (p=0.015), dental hygiene/clinical examination (p < 0.001), caries-preventive practice (p=0.02), and the Hiroshima University-Dental Behavioral Inventory (HU-DBI) (p=0.028). Significant differences were observed in the total PPKS (p=0.003) and its subscales of the noncariogenic nutrition (p=0.043) and caries risk management (p=0.006) in terms of self-perceived need to receive education and training. Caries-preventive practice was correlated with the self-perceived competency (r = 0.279; p=0.002), the attitudes (r = 0.394; p < 0.001), the total PPKS (r = 0.457; p < 0.001) and its all subscales of dental hygiene and clinical examination (r = 0.425; p < 0.001), noncariogenic nutrition (r = 0.410; p < 0.001), and caries risk management (r = 0.184; p=0.039). The self-perceived competency was positively correlated with the total PPKS (r = 0.192; p=0.031) and its subscale of noncariogenic nutrition (r = 0.259; p=0.003). Greater self-perceived competence, more positive attitudes, and good knowledge regarding preventive dentistry were found to be important predictors of the caries-preventive practice of dental students, explaining 31% of the variance (adjusted R 2 = 0.312, p < 0.001). CONCLUSION: 40% of dental students reported educational and training needs regarding the diagnosis, caries-preventive agents, and risk-based treatment plan. These results should be taken into account by the stakeholders in developing the national core curriculum for undergraduate Turkish dental education.

Evaluation of Crossbites in Relation with Dental Arch Widths, Occlusion Type, Nutritive and Non-nutritive Sucking Habits and Respiratory Factors in the Early Mixed Dentition.

PURPOSE: The purpose of this study was to analyse the connection between dental arch widths, malocclusion type, nutritive sucking habits and non-nutritive sucking habits, and respiratory factors with the presence of crossbites (CB) in the early mixed dentition. MATERIALS AND METHODS: Data were collected from 72 children with and without CB. A questionnaire was applied to parents/carers to obtain information about nutritive and non-nutritive sucking habits. The posterior and anterior crossbites were diagnosed in a centric relationship. Dental arch widths were measured directly from the models by two calibrated examiners. The data were analysed statistically using chi-square and Fisher's exact tests. RESULTS: The incidence of Class III malocclusion and the presence of ear, nose and throat problems in the study group were significantly higher than in the control subjects (p = 0.01, p = 0.047). The mean breastfeeding duration for children in the CB group was found significantly shorter than in the control subjects (p = 0.043). The number of children with mouth breathing in sleep was significantly higher in the CB group than the control subjects (p = 0.046). The children with CB demonstrated a statistically significant increase in mandibular intercanine width (ICW) than the control group (p = 0.044). CONCLUSION: The results demonstrated that an insufficient duration of breastfeeding, mouth breathing, ear-nose-throat problems and Class III malocclusion were associated with the presence of CB in the early mixed dentition.

Knowledge of sports participants about dental emergency procedures and the use of mouthguards.

AIM: The aim of this study was to evaluate the knowledge of sports participants regarding emergency management of dental trauma and the awareness about mouthguards. METHODS: A specific questionnaire regarding knowledge, experiences and behaviours after dental trauma and the use of mouthguard was distributed to 359 sports participants up to 18 years of age. The sports involved were basketball, swimming, volleyball, soccer, tennis, badminton, handball, athleticism, golf, gymnastics, water polo and karate. The questions were focused on personal experience, awareness of first aid and dental emergency procedures and knowledge about mouthguards. RESULTS: The results showed that 10.9% had experienced a kind of dental trauma, and 12.5% would look for a dentist for treatment in emergency. 34.5% would re-implant the avulsed tooth, 33.4% would maintain the avulsed tooth in handkerchief and 25.3% would maintain it in saline solution. 41.1% were aware of the possibility of oral injuries during sports practice, and 55.4% knew about mouthguards, but only 11.2% of the participants reported to use them. There was a statistically significant difference between the experienced participants (>5 years) and less-experienced group (<5 years) in knowledge about dental emergency procedures and mouthguards. Reasons given for not wearing mouthguards include 'lack of aesthetic' was significantly high in experienced participants. The less-experienced participants significantly stated that they had never heard about mouthguards before. CONCLUSION: Our results showed a lack of knowledge of sports participants about management and prevention of traumatic dental injuries. Educational programs should be organized to give information about emergency treatment and promote the use of mouthguards to sport participants.

Predominant causes and types of orofacial injury in children seen in the emergency department.

BACKGROUND: The aim of this study is to determine the type and cause of traumatic orofacial injuries in children up to 18 years of age. METHODS: This retrospective study involved data collected from 12055 patients that came to Istanbul University, Medical Faculty, Department of Emergency in 2011. The patients' data were evaluated with regard to age, gender, etiologic factor of the trauma, type and localization of the injury, and time interval between injury and treatment. RESULTS: A total of 1296 children in 12055 patients with orofacial trauma were evaluated. Trauma incidence was higher in boys (65%). The major etiologic factor of injury was falls (56%) and primary localization was in the frontal region (41%). The most frequent types of injury were laceration (30.1%) and hematoma (18.6%). 4% of the injuries were found in the orodental region including lips, teeth, tongue and oral mucosa of the mouth. 38% of the patients came to the emergency department within 30-60 minutes after the injury and 68% were sent home with symptomatic treatment. CONCLUSION: Considering the high percentage of orofacial traumas, effective education is necessary regarding the appropriate diagnostic approach, emergency management and prevention of traumatic dental injuries.

Effects of two fluoride varnishes and one fluoride/chlorhexidine varnish on Streptococcus mutans and Streptococcus sobrinus biofilm formation in vitro.

AIMS: The aim of this study was to evaluate and to compare the effect of two fluoride varnishes and one fluoride/chlorhexidine varnish on Streptococcus mutans and Streptococcus sobrinus biofilm formation, in vitro. STUDY DESIGN: Standard acrylic discs were prepared and divided into groups based on the varnish applied to the disc surface: Fluor Protector, Bifluoride 12, and Fluor Protector + Cervitec (1:1). Untreated discs served as controls. In the study groups, biofilms of S. mutans and S. sobrinus were formed over 24 h, 48 h, and 5 days. The fluoride concentrations in the monospecies biofilms and viable counts of S. mutans and S. sobrinus were investigated. RESULTS: In all study groups, a statistically significant increase in the viable number of S. mutans and S. sobrinus cells was observed between 24 h and 5 days. In both monospecies biofilms, the greatest antibacterial efficacy was detected in the Fluor Protector and Fluor Protector + Cervitec groups at 24 h. For all groups, the amount of fluoride released was highest during the first 24 h, followed by a significant decrease over the next 4 days. A negative correlation was detected between fluoride concentration and antibacterial effect in those groups with biofilms containing both species. Despite the release of high levels of fluoride, the greatest number of viable S. mutans and S. sobrinus cells was detected in the Bifluoride 12 group. STATISTICS: The data were analyzed using GraphPad Prism software (ver. 3). CONCLUSIONS: The Fluor Protector + Cervitec varnish exerted prolonged antibacterial effects on S. mutans and S. sobrinus biofilms compared to the other varnishes tested.