Children's drawing as a measurement of dental anxiety in paediatric dentistry.

BACKGROUND: Drawings can be used as a method of communication that represents an individual's self-concept, anxiety, attitude or conflict. AIM: The purpose of this study was to evaluate children's drawing as a measure of dental anxiety in a dental setting. DESIGN: Seventy-eight children, aged 6-12 years, were enrolled in this study. Pulp therapy and/or restorative treatment was performed during the first therapeutic session for all participants. Sound, Eye and Motor (SEM) and Frankl scales were used as an objective assessment of behaviour during treatment. After the treatment session, the children were instructed to draw a picture of a person at a dental clinic. Children's drawings were scored by a paediatric dentist and a psychologist using Child Drawing: Hospital (CD: H) scale and emotional indicators of Human Figure Drawings (HFD). The findings were compared with Frankl and SEM scores. RESULTS: There was a significant negative correlation between Frankl and CD: H scores (P = .017), and a significant negative correlation was found between HFD and Frankl scores (P = .048). CONCLUSION: Drawings can reveal a considerable amount of information about children's emotional status, and children's drawing can be a useful non-verbal self-report measure to evaluate anxiety in a paediatric dental setting.

Effect of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of newly developed restorative materials.

OBJECTIVES: To evaluate the effects of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of five restorative materials MATERIALS AND METHODS: The study groups were comprised of five different restorative materials, Beautifil II (B); GCP Glass Fill (G); Amalgomer CR (A); Dyract XP (D); Fuji IX GP (F) and 21 specimens were prepared from each material. Each group was divided into three subgroups according to the polishing system: Mylar (control) (C), Sof-lex (S), and Enhance-Pogo (EP). The amount of fluoride release was measured using a fluoride ion-selective electrode and surface roughness was investigated with a profilometer. Bacterial adhesion on the materials was evaluated by optical density readouts for S.mutans on a spectrophotometer. RESULTS: The highest amount of fluoride was released from specimens in the S subgroup of group G during all measurement days. Surface roughness values were significantly lower in subgroup C than the other polishing systems in all study groups except group G (P < .05). Group A displayed significantly higher surface roughness values than the other material groups in both subgroups (S and EP) (P < .01). Highest bacterial adhesion was observed in the EP subgroup of group A. CONCLUSIONS: Polishing promoted a significant increase of fluoride release on restorative materials especially in glass ionomer-based materials. CLINICAL SIGNIFICANCE: This article stated that polishing promoted a significant increase of fluoride release on restorative materials especially in glass ionomer-based materials. Further, proper polishing systems must be chosen according to the structure and composition of materials to provide the best clinical benefits in terms of fluoride release, surface roughness and bacterial adhesion.

Evaluation of Surface Roughness Characteristics Using Atomic Force Microscopy and Inspection of Microhardness Following Resin Infiltration with Icon®.

OBJECTIVE: The aim of this study was to evaluate the surface roughness via atomic force microscopy (AFM) as well as to evaluate the microhardness values of Icon® in comparison with sound and demineralized enamel in a large subject group. MATERIALS AND METHODS: Enamel samples were prepared from sound bovine incisors and randomly allocated into either AFM (n = 60) or microhardness (n = 60) groups. The AFM group was divided into control (n = 30) and Icon® (n = 30) subgroups. The microhardness group was also divided into three subgroups: control (n = 20), demineralization (n = 20) and Icon® (n = 20) groups. The demineralization and Icon® subgroups were subjected to a demineralizing solution (pH: 4, 2 hours). Following the formation of shallow white spot lesions and application of the infiltrant, each sample was examined according to its parameter. RESULTS: AFM images suggested that Icon® had a significantly rougher surface than the control group. When the AFM results were evaluated numerically, it was evident that the Icon® group possessed statistically higher Sa, Sq, mean height, and maximum deviation values compared to the control group. The mean Vickers hardness values of all groups were determined to be significantly different from one another. Hardness values in the demineralization group were determined to be significantly lower than the control and Icon® groups. No statistically significant difference was observed between mean Vickers hardness values for the contol and Icon® groups. CONCLUSIONS: The present in vitro study shows that more studies are required to improve the surface quality of this infiltrant material. CLINICAL SIGNIFICANCE: The present in vitro study shows that the resin infiltration technique results in increased microhardness of demineralized enamel. However, it was observed that the infiltrant material creates a significantly rougher surface compared to healthy, untreated enamel. (J Esthet Restor Dent 29:201-208, 2017).

Antibacterial surface properties of various fluoride-releasing restorative materials in vitro.

PURPOSE: The aim of this study was to investigate the antibacterial surface properties of high-viscosity glass ionomers (Fuji IX GP, Ketac Molar), a resin-modified nano-ionomer (Ketac N100), resin-modified glass ionomers (Fuji II LC, Vitremer), a compomer (Compoglass F) and a resin-based composite (Filtek Z250). METHODS: ISO-standardized specimens 6 mm in diameter were prepared for each restorative material. The antibacterial properties of the materials were tested in an agar diffusion assay using Streptococcus mutans (ATCC 25175) for 24 and 48 hours. An inhibition zone greater than 6 mm was defined as diffuse inhibition, whereas zones ≤6 mm were described as contact inhibition. RESULTS: All tested materials exhibited a contact antibacterial effect against S. mutans. Vitremer showed the most remarkable antibacterial diffuse inhibition. CONCLUSIONS: These materials might cause antibacterial effects against S. mutans when placed on cavity surfaces in both enamel and dentine, thereby preventing secondary caries formation.

Transalveolar repositioning of an impacted immature permanent mandibular canine.

The purpose of this case report is to discuss the four-year follow-up of a transalveolar transplantation of an impacted immature permanent mandibular left canine. A nine year-old-boy was referred to the dental school because of a mandibular swelling associated with the impacted canine. Under local anesthesia, the tooth was extracted and transplanted in its own space, followed by a two-week orthodontic fixation. The radiographic examination two months later revealed the presence of external inflammatory root resorption, which was treated with an apexification. The overall status of the transplanted tooth and the surrounding hard and soft tissues four years post-treatment indicates a successful outcome.

In vitro effects of two topical varnish materials and Er:YAG laser irradiation on enamel demineralization around orthodontic brackets.

The aim of this in vitro was to evaluate the effects of tricalcium phosphate (TCP) and amorphous calcium phosphate (ACP) containing varnish materials and Er:YAG laser irradiation on enamel demineralization around orthodontic brackets. Forty extracted human premolar teeth were randomly divided into four treatment groups (i.e., 10 in each group): (1) 5% NaF-ACP varnish, (2) 5% NaF-TCP varnish, (3) Er:YAG laser, and (4) control (no treatment). Er:YAG laser was operated at a wavelength of 2.94 µm and the energy output was 80 mJ per pulse; a pulse duration of 200 µsec and and a frequency of 2 Hz were used with water cooling. All samples were then put into pH cycles. Surface microhardness values and representative SEM images were assessed. Surface microhardness values were evaluated using Kruskal-Wallis and Mann-Whitney U tests. The results revealed that demineralization was significantly lower in the TCP and ACP varnish groups, whereas mean surface microhardness values of the TCP varnish were found higher than the ACP (P < 0.05). TCP and ACP varnish materials were found effective for reducing enamel demineralization around orthodontic brackets. Use of Er:YAG laser irradiation as described in this study for inhibition of demineralization was found not satisfactory.

Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort.

AIM: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate. METHODS: A placebo-controlled, randomised, double-blind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked "No pain" and "Unbearable pain". RESULTS: There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline) however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively). CONCLUSION: Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate.

Association of amoxicillin use and molar incisor hypomineralization in piglets: visual and mineral density evaluation.

AIM: The aim of the present study was to determine the prevalence of MIH both visually and quantitatively, and describes the range of mineral densities of enamel specimens from three groups of piglets where two groups were given different doses of amoxicillin in infancy. METHODS: In this blind randomized clinical study, 20 piglets were randomly divided into three groups. Group A received a standard dose (50mg/kg/day) and Group B received a high dose (90mg/kg/day) of amoxicillin in selected days of the month (20 working days) they were born. Group K did not receive any medication and served as control. Thirteen right mandibular permanent first molars (PFMs) were randomly collected from 3 groups of piglets at age 10 months for evaluation under X-ray micro-tomography. Tomographic data were obtained using a Skyscan 1174 compact micro-CT in the Department of Anatomy. RESULTS: Prevalence of MIH was 0% in all groups. MD values were quantified after enamel grey level (0-255) measurements on horizontal cross-sectional slices. After MD measurements, the effects of amoxicillin use on MIH are presented. CONCLUSIONS: While MIH is a multifactorial disturbance, the present study attempted to highlight the clinical findings of a possible relationship between amoxicillin use and MIH with the aid of X-ray micro-tomography.

A novel delivery system of probiotic drop and its effect on dental caries risk factors in cleft lip/palate children.

OBJECTIVE: The aim of the present study was to investigate the effect of the probiotic bacterium Lactobacillus reuteri on the levels of salivary mutans streptococci and lactobacilli in children with cleft lip/palate who used the novel drop containing L. reuteri. MATERIAL AND METHODS: The study group consisted of 19 operated cleft lip/palate children aged 4 to 12 years. The study had a double-blind, randomized crossover design, and the experimental period consisted of four consecutive time periods. During periods 2 and 4, consisting of 25 days each, parents were instructed that their children should consume 5 drops per day (0.15 to 0.20 g) of probiotic or placebo drops produced by the same manufacturer. The probiotic drop, BioGaia Reuteri drops, contained L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289 (≥1 × 10(8) CFU/5 drops). The counts of salivary mutans streptococci and lactobacilli were evaluated using the CRT tests. The data were processed with NCSS 2007 software using chi-square and McNemar tests. RESULTS: There was no statistically significant (p > .05) reduction of salivary mutans streptococci and lactobacilli after 25 days of consumption of both drops. CONCLUSIONS: The novel drop containing L. reuteri may not reduce the levels of salivary mutans streptococci and lactobacilli in cleft lip/palate children.

Orthodontic treatment of a transmigrated mandibular canine: a case report.

BACKGROUND: Intraosseous migration of a lower canine across the midline is a rare dental anomaly. The treatment options include: forced eruption of the unerupted tooth using orthodontic traction, autotransplantation, extraction followed by prosthetic replacement. AIM: To report the management of a transmigrated lower right canine. METHOD: The treatment involved surgical, orthodontic and cosmetic dental treatment. No permanent teeth were extracted. RESULTS: The transmigrated canine was placed between the left central and lateral incisors and the crown recontoured to simulate a lateral incisor. An acceptable aesthetic and functional outcome was gained. CONCLUSION: Transmigration is a rare dental condition that can be treated successfully with a collaborative effort from several dental disciplines.

Orofacial and dental injuries of snowboarders in Turkey.

BACKGROUND/AIMS: Snowboard riding has increased in popularity during the last decade and is also remarkable for its dramatic rise in association with serious injuries. The aim of this study was to evaluate the nature of dental or orofacial trauma in snowboard riders in Turkey, as well as to investigate if adolescent and young adult snowboard riders were aware of any protective measures. METHODS: An epidemiological survey was carried out through interviews with 86 snowboard riders in Turkey. RESULTS AND CONCLUSIONS: Seventeen snowboard riders had been affected by orofacial trauma. Results revealed that all snowboarders were aware of helmet protection whereas 50 out of 86 (58%) reported that they used them. It should be concluded that from the moment a youngster begins to practice snowboard riding, (s)he should be encouraged to wear a helmet and a properly fitted mouthguard as part of the necessary protection for them to safely enjoy their sport.

Antibacterial efficacy of diode and Er:YAG laser irradiation in experimentally contaminated primary molar root canals.

OBJECTIVE: In vitro comparison of the antibacterial efficacy of Diode and Er:YAG laser irradiation with that of NaOCl irrigation in contaminated primary molar root canals. STUDY DESIGN: 96 root canals prepared from 32 extracted primary molar teeth were mechanically enlarged and the teeth were randomly divided into 4 subgroups. The roots were inoculated with an overnight culture of Enterococcus faecalis in tryptic soy broth for 24 hours. The root canals irradiated with diode and Er:YAG laser and irrigated with NaOCl (5.25%) were experimental groups and untreated canals served as positive control group. Bacterial growth was analysed by counting viable E. faecalis on tryptic soy agar plates. RESULTS: The number of bacteria was significantly reduced in experimental groups in comparison with the control group. Diode laser was determined to be more effective in reducing the number of bacteria when compared to Er:YAG laser NaOCl irrigation was found significantly most effective. CONCLUSIONS: Diode laser irradiation and 5.25% NaOCl application provided a significant antibacterial effect in vitro, in contaminated primary molar root canals.

Oral colonization by Lactobacillus reuteri ATCC 55730 after exposure to probiotics.

OBJECTIVE: The aim of this study was to investigate whether Lactobacillus reuteri ATCC 55730 can be detected in the oral cavity after discontinuation of administration of a product prepared with this bacterium. MATERIALS AND METHODS: The study consisted of three 2-week periods: clearance period, intervention period, and post-treatment period. Twenty-five volunteers consumed a chewable tablet of L. reuteri ATCC 55730 (10(8) cfu/tablet) during a 14-day trial period. Saliva samples were collected and cultured onto MRS agar after a clearance period of 2 weeks and then daily after a 2-week intervention period for as long as L. reuteri was found. Lactobacillus reuteri colonies were analysed in saliva samples. The analysis was performed using selective media for L. reuteri followed by confirmation using the specific detection of reuterin produced by L. reuteri. RESULTS: The number of L. reuteri carriers decreased gradually, and after 1 week only 8% of the subjects harboured the bacterium. After 5 weeks, L. reuteri was not detected in any of the subjects. CONCLUSION: Consuming L. reuteri for 2 weeks does not seem to be sufficient for permanent colonization of L. reuteri in the oral cavity.

Do American football players in Turkey protect themselves from dental or orofacial trauma?

BACKGROUND/AIMS: Dental and orofacial trauma in contact sports differs from other sources, as it is possible to prevent it and reduce the dental and orofacial trauma by using protection devices. The aim of this study was to evaluate the occurrence of dental or orofacial trauma in American football players of Turkey National League as well as to investigate if the players were aware of mouthguards (MGs) and had used any. MATERIAL AND METHODS: An epidemiological survey was carried out through interviews with 78 American football players in four clubs competing in Turkey National League. Thirteen players had already been affected by orofacial trauma. RESULTS AND CONCLUSIONS: Results revealed that 67 of 78 Turkish-American football players were aware of MG, while 46 of 78 players also demonstrated its use. It should be concluded that from the moment a youngster starts practising football, he should be encouraged to wear an MG to get used to the sensation and, would automatically consider it as a part of the game. A great responsibility lies on dentists, to inform their patients about the importance of wearing MG and the consequences, if it is not worn.

Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria.

Previous studies have suggested that probiotic supplements in dairy products may affect the oral microbial ecology, but the effect in orthodontic patients has not previously been reported. The aim of the present study was to examine whether short-term consumption of fruit yogurt containing probiotic bifidobacteria would affect the levels of salivary mutans streptococci and lactobacilli in patients with fixed orthodontic appliances. A double-blind, randomized crossover study was performed and 24 healthy adolescents (12-16 years) undergoing orthodontic treatment were followed over four periods. During periods 2 and 4 (2 weeks each), the subjects ingested 200 g fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 (2 x 10(8) colony forming units/g) once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and wash-out periods of 1 and 6 weeks, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits before and after the yogurt consumption periods. Pre- and post-treatment values within each regimen were compared with a two-tailed marginal homogeneity test for categorical data. A statistically significant reduction of salivary mutans streptococci was recorded after probiotic yogurt consumption (P < 0.05), which was in contrast to the control yogurt. No significant alterations of the salivary lactobacilli counts were observed. Short-term daily consumption of fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 may reduce the levels of mutans streptococci in saliva during orthodontic treatment with fixed appliances.

The prevalence of molar incisor hypomineralization (MIH) in a group of children in a highly polluted urban region and a windfarm-green energy island.

BACKGROUND: Children's developing teeth may be sensitive to environmental pollutants such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans. The term molar incisor hypomineralization (MIH) was introduced to describe the clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars (PFMs) that are associated frequently with affected incisors. AIM: The aim of this study was to determine the prevalance of MIH in children from the most industrialized and polluted region and the most green-energy island of Turkey. DESIGN: In September 2007, a retrospective study was initiated in two elementary schools: one, a group of children (N = 153) who fitted the criteria from Tavsancil, Kocaeli (N = 109) and the other from Bozcaada island, Canakkale (N = 44). The soil samples were collected from selected regions in order to determine the contamination levels in a heavily industrialized area and a non-industrialized area. RESULTS: Prevalance of MIH in children in Bozcaada island was 9.1%, while prevalance of MIH was 9.2% in Tavsancil. The PCDD/F levels in soil samples collected from Bozcaada and Tavsancil were determined as 1,12 and 8,4 I-TEQ ng/kg dry soil, respectively (P < 0.001). CONCLUSIONS: In this preliminary study with a small study population, prevalence of MIH did not seem to be associated with the levels of PCDD/Fs in the environment.

The erosive potential of different malt drinks: an in vitro and in situ study.

OBJECTIVES: Whereas the potential effect of acidic drinks in the etiology of dental erosion is well recognized the role of malt drinks is unclear. The primary aim of the present study was to compare the in vitro erosive effect on enamel produced by different aromated malt drinks. A secondary objective was to compare their erosive effects in situ with those determined in vitro. MATERIALS AND METHODS: To select the malt drink for the study in situ, six commercially available malt drinks were examined for erosive potential in vitro. The study in situ was a single centre, 2-period, 2-treatment crossover study to compare the erosive effect of a commercially available malt drink (Test), with that of natural spring water (Control), over 10 day periods on 10 healthy volunteers. Subjects wore upper removable appliances containing two human enamel specimens from 9 a.m. to 4 p.m. The regimen of intake of the drinks was 250 ml at midday. Measurements of enamel loss were made on samples after 5 and 10 days by profilometry. RESULTS: The in situ study showed a statistically significant difference in erosive potential between the test and control beverages. No specimen exposed to the control beverage displayed appreciable erosion. Erosion occurred with the test drink, but to a variable degree between subjects. CONCLUSIONS: Malt drinks should be considered as potentially erosive as the results for enamel specimens exposed to the test beverage in the clinical study showed a degree of erosion that varied greatly between different participants. It is likely that under these conditions an increase in the degree of erosion would be observed in children and young people who consume malt drinks.

Short-term effect of ice-cream containing Bifidobacterium lactis Bb-12 on the number of salivary mutans streptococci and lactobacilli.

OBJECTIVE: Probiotic bacteria are thought to reduce the risk of some infectious diseases. The aim of the present study was to examine whether or not short-term consumption of ice-cream containing bifidobacteria can affect the salivary levels of mutans streptococci and lactobacilli in young adults. MATERIAL AND METHODS: A double-blind, randomized crossover study was performed and 24 healthy subjects (mean age 20 years) were followed over 4 periods. During periods 2 and 4 (10 days each), they ingested 100 ml (53 g) ice-cream containing Bifidobacterium lactis Bb-12 once daily or a control ice-cream without viable bacteria. Periods 1 and 3 were run-in and washout periods, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits at baseline and immediately after the intervention period. RESULTS: A statistically significant reduction (p<0.05) of salivary mutans streptococci was recorded after consumption of the probiotic ice-cream. A decline of high mutans streptococci counts was also seen after intake of the control ice-cream, but the difference compared to baseline was not statistically significant. The salivary lactobacilli levels were unaltered after both regimes. CONCLUSIONS: Daily consumtion of ice-cream containing probiotic bifidobacteria may reduce the salivary levels of mutans streptococci in young adults.

A probiotic lozenge administered medical device and its effect on salivary mutans streptococci and lactobacilli.

BACKGROUND: Previous studies have suggested that lactobacilli-derived probiotics in dairy products may affect oral ecology, but the effects of different delivery methods have received little attention. AIM: The aim of the present study was to investigate the effect of the probiotic Lactobacillus reuteri, delivered by a new medical device, on the levels of salivary mutans streptococci and lactobacilli in young women with high Streptococcus mutans counts. DESIGN: This is a randomized, double-blind, placebo-controlled study involving 20 healthy young women (aged 20 years): 10 as subjects and 10 as controls. The study subjects (Group A) sucked the medical device containing the probiotic lozenge with L. reuteri ATCC 55730/L. reuteri ATCC PTA 5289 (1.1 x 10(8) CFU) once daily for 10 days, while the control subjects (Group B) received placebo medical devices without bacteria. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits at baseline and 1 day after the final ingestion. RESULTS: Salivary S. mutans levels in the probiotic test group were significantly reduced, with statistical significance of reduction (P < 0.05). CONCLUSIONS: A short-term daily ingestion of lactobacilli-derived probiotics delivered via medical device containing probiotic lozenge reduced the levels of salivary mutans.

Compressive strength, surface roughness, fluoride release and recharge of four new fluoride-releasing fissure sealants.

The aim of this study was to investigate the compressive strength and surface roughness of two glass ionomer cements and two resin-based fissure sealants before and after fluoride release and recharge. Twenty-one specimens were prepared and divided into three groups for each material. First group was loaded in compression until failure. Fluoride released was measured from the remaining specimens, and then the second group of seven specimens was loaded at 28th day. The remaining seven specimens were exposed to 0.05% NaF solution and 1.23% APF gel. Fluoride amount was measured, and the last group was loaded at 70th day. Surface roughness measurement of five more disk-shaped specimens from each material was also carried out. After exposure to APF gel, all materials were recharged. At the end of experimental period, it was found that surface roughness increased, whereas compressive strength decreased, over time. In conclusion, fluoride-releasing fissure sealants could act as show, rechargeable fluoride release systems. However, if a fissure sealant exhibited high fluoride release, it had inferior mechanical properties.