The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis.

Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 µm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

Localization of mental and mandibular foramens on the conventional and digital panoramic images.

The purpose of this study was to compare the efficiency of conventional and digital panoramic images for localization of mental and mandibular foramens. Six dry edentulous human mandibles were used in the study. Conventional and digital panoramic images were obtained and the vertical and horizontal measurements were performed for localization of mental and mandibular foramens on the images. The correlations between radiographic (conventional and digital) and direct measurements were compared. A measurement error between the radiographic and direct measurements was determined at the level of 1 mm. The measurement errors were generally less in conventional panoramic radiography than digital one. There was statistically strong positive correlation between direct and radiographic measurements. Statistically significant difference was found between radiographic and direct measurements for bone height of mandible in ramus region. According to the results of this study, diagnostic performance of conventional and digital panoramic images seems to be equal for the localization of mental and mandibular foramens. The vertical radiographic measurements are generally reliable and correlated with direct measurements in mandible for conventional and digital panoramic radiography, but the evaluation of bone height in ramus region may not be sufficiently reliable.

Reproducibility and agreement of clinical diagnosis of occlusal caries using unaided visual examination and operating microscope.

AIM: To assess the reproducibility of clinical diagnosis of occlusal caries using unaided visual examination and examination with an operating microscope (16 x magnification) and to determine the agreement between these 2 methods. MATERIALS AND METHODS: Three experienced dentists used unaided visual examination and an operating microscope to grade, according to a standard caries rating scale, a total of 299 occlusal surfaces in 112 subjects (mean age 28.3 years, standard deviation 0.5 years), during several examination sessions. Intraobserver and interobserver reproducibility was calculated, and agreement in diagnosis of the same teeth by different methods was also determined. RESULTS: The level of intraobserver agreement for the 2 modes of clinical diagnosis was substantial, as indicated by kappa values; however, there was substantial interobserver variability with both techniques. Agreement in clinical diagnosis between the 2 techniques was 62.5% for observer 1 (kappa = 0.483), 65.4% for observer 2 (kappa = 0.531) and 63.5% for observer 3 (kappa = 0.508) (p = 0.001). CONCLUSIONS: Intraobserver agreement with the operating microscope and with unaided visual examination was roughly the same, but interobserver agreement was low with both techniques. For some surfaces, the diagnosis made by a particular observer with unaided visual examination differed from that made with microscopic examination. The diagnoses differed most frequently for surfaces that were scored as sound with unaided visual examination.

Efficacy of 3 techniques in removing root canal filling material.

OBJECTIVE: Retreatment of a root canal in the case of infection requires complete removal of previous filling material. This study evaluated the efficacy of 3 techniques in removing laterally compacted Resilon/Epiphany and gutta-percha/AH Plus from straight and curved canals during retreatment. MATERIALS AND METHODS: Extracted human teeth (90 maxillary anterior teeth with single,straight root canals and 90 mandibular molars with mesial canal root curvatures of 20 degrees to 35 degrees ) were divided into 6 groups each consisting of 15 straight and 15 curved root canals. Three groups were obturated using gutta-percha/AH Plus and 3 were obturated with Resilon/Epiphany. After 3 weeks storage at 37 degrees C and 100% humidity, all root canal fillings were removed using a Gates Glidden drill, a Gates Glidden drill plus chloroform or a System B device. RESULTS: For all removal techniques, specimens obturated with gutta-percha/AH Plus showed significantly more remnants of obturation material than specimens filled with Resilon/Epiphany for both straight and curved canals (p < 0.05). Removal time was shorter for Resilon/Epiphany than gutta-percha/AH Plus filling for all techniques and for both curved and straight canals. The Gates Glidden drill and Gates Glidden drill plus chloroform removal techniques were significantly faster than the System B technique for both straight and curved canals. The Gates Glidden drill technique was best for straight canals, whereas the Gates Glidden drill plus chloroform was the best technique for curved canals when removing Resilon/Epiphany sealer. CONCLUSIONS: Removal of Resilon/Epiphany filling resulted in fewer remnants and was faster than gutta-percha/AH Plus removal using a Gates Glidden drill with or without chloroform in both straight and curved canals.

The antimicrobial and antifungal efficacy of tetracycline-integrated gutta-percha.

The purpose of this study was in vitro evaluation of the antimicrobial and antifungal efficacy of commercially available gutta-percha containing tetracycline on some potential endodontic pathogens. The test microorganisms were Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, Porphyromonas endodontalis, and Candida albicans . Tetracycline-integrated gutta-percha (TGP) cones, tetracycline disc, and conventional gutta-percha cones of the same size were placed on the inoculated plates. The plates were incubated at 37 degrees C aerobically or anaerobically. Growth inhibition zones on each plate were inspected at 24, 48, and 72 h. Tetracycline disc and TGP cones inhibited all the tested bacterial strains, however the greatest antimicrobial effect was seen on S. aureus. Tetracycline disc and TGP seemed less effective on E. faecalis and P. aeruginosa. However, all tested treatments were unable to affect C. albicans . Based on the results of this study, it seems that TGP offers an antimicrobial advantage over conventional gutta-percha.

Effect of disinfection on the dimensional stability of polyether impression materials.

PURPOSE: Difficulties in sterilizing impressions have led to chemical disinfection solutions as an alternative; however, some impression materials are more sensitive to humidity. For example, polyether impression materials are more hydrophilic. This study investigated the effect of three disinfecting methods on the dimensional stability of three polyether impression materials. MATERIALS AND METHODS: Three polyether impression materials (P2, Impregum Penta Soft, and Impregum Penta) were submitted to the following treatments: spray disinfectant (Mikrozid Liquid), immersion in 2% glutaraldehyde solution (Super-On), immersion in 0.525% sodium hypochlorite solution for 10 minutes, and a control group (not disinfected). Each group included five samples. After treatment, dimensional change was evaluated according to ISO 4823. The data were analyzed by 2-way analysis of variance at alpha= 0.05. RESULTS: The mean percentages of linear dimensional change of materials P2, Penta Soft, and Penta were -0.040%, 0.098%, and 0.100%, respectively. The dimensional change associated with different disinfectant agents mikrozid liquid, 2% glutaraldehyde, room air (control), and 0.525% sodium hypochlorite was 0.013%, 0.024%, 0.077%, and 0.096%, respectively. The interaction between the impression materials and the disinfectant treatment was not significant. The disinfectant agents can be classified in two groups as low- and high-effected. The control group did not significantly differ from either group. CONCLUSION: From the standpoint of dimensional change, the disinfectants tested for 10 minutes caused no significant linear dimensional change in the polyether impression materials, compared with the control group.

The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure.

OBJECTIVE: To evaluate the convenience and utility of optic nerve ultrasonography (ONUS) in the evaluation of emergency patients with elevated intracranial pressure (EICP) due to traumatic or non-traumatic causes. METHODS: This study was conducted between May 2005 and December 2005 in the emergency department of Meram Faculty of Medicine, Selcuk University. Patients with traumatic or non-traumatic EICP were included in the study. Among these, 28 patients with EICP determined on cranial computed tomography (CCT) and a control group of 26 patients with no disease had the vertical and horizontal diameters of the optic nerves (ONs) of both eyes measured by ultrasonography (US). The measurements were done by wetting the closed eyelids and using a 7.5-MHz linear probe. RESULTS: Horizontal and vertical diameters of both ONs of the 54 patients were measured and the averages calculated. The mean (SD) ON diameter for the group suspected of having EICP was found to be 6.4 (0.7) mm, and that for the control group to be 4.6 (0.3) mm. In the statistical analysis carried out between these two groups (t test), the difference was found to be significant at p<0.001. CONCLUSIONS: In detection and follow-up of EICP cases, such as cerebrovascular accident and trauma, ONUS is a practical, risk-free, inexpensive, convenient and, if performed by experts, reliable method. As a result, although CCT may be more useful in diagnosis, ONUS may be more efficient in detecting EICP. In those cases where CCT and other conventional imaging methods are not available, ONUS can facilitate the diagnosis and help in treatment.

Socio-demographic and economic factors affecting the acceptance of removable dentures.

OBJECTIVES: The aim of this study was to evaluate relationships between the socio-demographic and economic factors of patients and the reasons of admission, usage periods of the two types of clinics, frequencies of denture changes, satisfaction levels and preferences of prosthetic dental treatment. MATERIALS AND METHODS: 510 partially and/or totally edentulous patients were studied using a questionnaire. The questionnaire consisted of questions; age, gender, education level, income status, problems with dentures, necessity for new dentures. Also asked was the place that the subjects would prefer to get their denture treatment, irrespective of their income level. In this study, Z-test was used to analyze two-sample proportions, T-test was used to determine two-sample means and Chi-square test was used to determine relationship between two classified variables. RESULTS: The number of male patients with complete dentures was more than the number of females, with an opposing trend for partial dentures. Irrespective of gender, each patient had had nearly two dentures by the time of questioning. It was also observed that the university clinics were generally preferred by patients from higher income levels with a higher educational level (x2=25.206, P<.00). When patients were asked where they would prefer denture treatment, regardless of cost, private practice was the preferred-choice. CONCLUSIONS: With respect to dental condition and the acceptance of removable dentures, there were differences among gender, educational level and income status.

Antibacterial activity of a new endodontic sealer against Enterococcus faecalis.

AIM: The purpose of this study was to test a new root canal sealer (Epiphany) and 5 other root canal sealers (Diaket, Endomethasone, AH 26, Sealapex, Sultan) for their antimicrobial effect on Enterococcus faecalis. MATERIALS AND METHODS: The antimicrobial effect of 6 root canal sealers was tested by the agar diffusion method. The freshly mixed sealers were placed in prepared wells of agar plates inoculated with E. faecalis. All plates were incubated for 72 hours at 37 degrees C under aerobic conditions, and zones of inhibition were measured at 24, 48 and 72 hours. RESULTS: All of the sealers caused bacterial growth inhibition. Their effectiveness, in descending order of antimicrobial activity, was as follows: Endomethasone, Sultan, Sealapex, Diaket, Epiphany and AH 26. Epiphany sealer had little effect on the tested microorganism. The effectiveness of the root canal sealers decreased marginally with greater duration of incubation. CONCLUSIONS: The Epiphany root canal sealer offered no antibacterial advantage over the other sealers tested.

Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope.

This study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra-oral camera and operating microscope, respectively. There was a statistically significant difference between the intraoral camera and the other two methods (p<0.05), while there was no significant difference between the unaided visual examination and operating microscope (p>0.05). As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.

A radiographic study of location of mental foramen in a selected Turkish population on panoramic radiograph.

Purpose of this study was to investigate the most common position of the mental foramen in a selected Turkish population. The study sample included three hundred and sixty one panoramic radiographs of selected Turkish population taken in Faculty of Dentistry, University of Gazi. The most common position of the mental foramen was between the first premolar and the second premolar (71.5%). The mental foramen was symmetrical in 90.4% of patients. In this study, the difference of the location of the mental foramen in different ethnics groups was discussed. Clinicians and anthropologists should expect to find the position of the mental foramen to be symmetrical and between the first premolar and the second premolar teeth.

Color stability of a dental composite after immersion in various media.

The purpose of this study was to determine the effects of staining solutions on the different shades of a dental composite, and to compare these effects with that of distilled water. Two shades of effect (ET1 and ET2), two shades of enamel (EL and EM), and two shades of dentin (DA1 and DA2) were used. Specimens were immersed in three staining solutions (chlorhexidine gluconate, filtered coffee, and orange juice) and distilled water. Color changes were characterized using the CIELAB color space. Since significant interactions occurred, the staining effect of each solution on each shade was determined using one-way ANOVA and the levels of factor in one-way ANOVA were compared using Tukey's method (p < or = 0.05). The staining solutions were found to be more chromogenic than distilled water, and EM and DA2 shades were found to be more color-stable. Based on the color change results in this study, chlorhexidine gluconate (1.45), filtered coffee (1.43), and orange juice (1.02) were determined as having "slight" staining effects on the tested shades. As for the tested shades in this study, they revealed acceptable color change results.

Approximal carious lesion depth assessment with insight and ultraspeed films.

This study evaluated the efficiency of a new E/F-speed film, Insight, at the determination of approximal carious lesion depths compared with Ultraspeed. Radiographs of 80 extracted human molars and premolars were taken with both films under standardized conditions. The presence or absence of caries and depth of lesions was determined by three observers using a predetermined scale. The actual status of each surface was determined histologically. Observer responses were assessed with the Gamma measure of association test. Differences between the observers' agreement levels were not significant. The efficiency of Insight and Ultraspeed at true depth diagnosis was found to be 54.9%; 55.8% and Gamma values were found to be 0.883 and 0.922, respectively, at p<0.001. The difference between the two films was not statistically significant (p=0.852). This study suggested that there was no statistically significant difference between the two films at detecting the depths of approximal carious lesions.