Evaluation of gap formation for different adhesive agents in primary teeth with optical coherence tomography.

Purpose: This study aimed to evaluate gap formation between the tooth surface and restorative material in terms of microleakage by using optical coherence tomography (OCT) for self-etch and selective-etch applications of two different universal and one self-etch adhesives. Materials and methods: Sixty non-caries, primary molar teeth were divided into six groups; self-etch and selective-etch application ways of two different universal and one self-etch adhesive systems (n:10). After Class-V cavities were prepared, every tooth was distributed randomly in groups to apply adhesion procedure and then, all cavities were restored with polyacid-modified composite resin. Microleakage was evaluated by measuring the gap between the tooth surface and restoration by a blind researcher with Image J Software from OCT images. During statistical analysis, the significance level was accepted as p<0.05. Results: According to the statistical analysis of the measurements obtained by Image J Software, selective-etch groups showed less gap formation than self-etch groups for each tested adhesive (p<0.05), and self-etch adhesive without etching showed significantly highest gap formation among all groups (p<0.05). Conclusion: Universal adhesives with a selective-etching step might be preferred over self-etch adhesives for long-lasting polyacid-modified composite resin restorations in primary teeth. However, obtained results should be considered with another prospective clinical study for long-term prognosis.

Does MIH Affects Preoperative and Intraoperative Hypersensitivity?

OBJECTIVE: Hypersensitivity is an important problem that is encountered during the treatment of hypomineralized teeth. The aim of this prospective study was to compare responses to electrical pulp tests (EPTs) and cold tests among carious teeth with and without molar incisor hypomineralization (MIH) before and after the administration of local anesthesia for caries removal Results: The EPT results of anesthetized carious teeth without MIH were significantly higher than those of carious teeth with MIH (p = 0.011). The cold test results were significantly higher for anesthetized carious teeth with MIH than for those without MIH (p = 0.0001). Intraoperative pain was significantly higher for carious teeth with MIH (p = 0.003). CONCLUSIONS: The results of this study suggest that even after achieving sufficient anesthesia, hypersensitivity remains a clinical problem in MIH-affected carious molars. The results presented in this study indicate that this phenomenon is not related to achieving effective local anesthesia; therefore, behavior management in such cases is of the utmost importance compared to relying on adjacent anesthetic methods.

Assessment of dental pain in children with intellectual disability using the dental discomfort questionnaire.

OBJECTIVE: This study aimed to compare the Dental Discomfort Questionnaire (DDQ) scores in children with and without intellectual disability (ID) and to measure correlation between the total DDQ and the Decayed, Missing, and Filled Teeth (DMFT/dmft) scores, as well as the condition of the tooth causing pain. METHOD: This cross-sectional study included 81 children with normal intellectual development who attended the Departments of Pediatric Dentistry at two Turkish Universities and 80 children with different levels of intellectual disability who reported dental pain in special education centers. The 12-question DDQ (Turkish version) was applied to the parents of the patients with their consent. The relationship of the DDQ scores with tha of the DMFT/dmft, dental status, and demographic data was evaluated. RESULTS: When the DDQ scores of children with intellectual disabilities were evaluated, it was found that the majority of the answers given to the questions were statistically similar (p < 0.05) to those of children with normal cognitive level. In the questions in which "pain when eating and brushing teeth" was evaluated, a higher score was obtained, which led to an increase in the total DDQ score (p < 0.001). There was a statistically significant difference between the groups in terms of the distribution of dental conditions (p < 0.001). When compared to the normal cognitive group, patients with mild and severe intellectual disabilities had more deep dentin caries, thoughy, frequent periapical abscess was less common in those groups (p < 0.001 and p = 0.022). There was no statistically significant relationship between DMFTscores. CONCLUSION: The DDQ was found to be a descriptive, functional, and easy-to-use questionnaire for children with intellectual disabilitiesin terms of detecting the presence of dental pain. No correlation was found between DMFT/dmft, dental status and DDQ scores.

Effects of music on sedation depth and sedative use during pediatric dental procedures.

STUDY OBJECTIVE: The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. DESIGN: Prospective, randomized, and controlled study. SETTING: Tertiary, university hospital. PATIENTS: In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. INTERVENTIONS: Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound-isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. MEASUREMENTS AND MAIN RESULTS: Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). CONCLUSIONS: Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients.

Effect of new light curing units on microleakage and microhardness of resin sealants.

To determine new developed light curing units with shorter curing times effects on microleakage and microhardness values for resin fissure sealants. Resin filled sealant (UltraSeal-XT), resin unfilled sealant (Delton Type-II) and ormocer-based sealant (Admira-Seal) were light cured with a quartz-tungsten-halogen (QTH), two LED light and a high power LED. Two hundred and forty extracted human molars were randomly allocated into four groups according to used light-curing unit and three subgroups were formed for three different fissure sealant materials. Specimens were immersed in 0.5% basic fuchsin for 24 h, sectioned and examined under a stereomicroscope, and scored for marginal microleakage. Knoop hardness number (KHN) readings were measured after 48 h. Statistical analyses of test were found in significant difference both microleakage and microhardness values between the various light curing units. The time saving approaches in the curing light were determined higher microhardness, although it was found in higher microleakage.

Dental and dentofacial problems in a female child with Toriello-Carey -syndrome: changes in 3 years.

Toriello-Carey syndrome is a rare disease whose clinical manifestations are midline facial defects, laryngeal and pharyngeal hypoplasia, cardiac defect, and corpus callosum hypoplasia. Literature states that clinical manifestations are more evident in males. This is the second report in the literature which describes the dental and dentofacial -features in an 8-year-old female patient with Toriello-Carey syndrome.

Shear bond strengths of different adhesive systems to biodentine.

The aim of this study was to measure the shear bond strength of different adhesive systems to Biodentine with different time intervals. Eighty specimens of Biodentine were prepared and divided into 8 groups. After 12 minutes, 40 samples were randomly selected and divided into 4 groups of 10 each: group 1: (etch-and-rinse adhesive system) Prime & Bond NT; group 2: (2-step self-etch adhesive system) Clearfil SE Bond; group 3: (1-step self-etch adhesive systems) Clearfil S(3) Bond; group 4: control (no adhesive). After the application of adhesive systems, composite resin was applied over Biodentine. This procedure was repeated 24 hours after mixing additional 40 samples, respectively. Shear bond strengths were measured using a universal testing machine, and the data were subjected to 1-way analysis of variance and Scheffé post hoc test. No significant differences were found between all of the adhesive groups at the same time intervals (12 minutes and 24 hours) (P > .05). Among the two time intervals, the lowest value was obtained for group 1 (etch-and-rinse adhesive) at a 12-minute period, and the highest was obtained for group 2 (two-step self-etch adhesive) at a 24-hour period. The placement of composite resin used with self-etch adhesive systems over Biodentine showed better shear bond strength.

Antimicrobial efficacy of octenidine hydrochloride, MTAD and chlorhexidine gluconate mixed with calcium hydroxide.

OBJECTIVE: The aim of this in vitro study was to investigate whether mixing with calcium hydroxide [Ca(OH)2] affects the antimicrobial action of Octenidine hydrochloride (Octenisept), MTAD and chlorhexidine against Enterococcus faecalis and Candida albicans. MATERIALS AND METHODS: Freshly grown cultures of Enterococcus faecalis, Candida albicans and a mixture of both strains were incubated in agar plates containing brain-heart infusion broth (BHIB). Zones of inhibition were measured at 24 and 48 hours. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA, both p=0.05). RESULTS: Mixing with Ca(OH)2 significantly increased the antibacterial effect of Octenisept (p<0.05), but did not alter its antifungal activity. Only chlorhexidine showed more antibacterial and antifungal efficiency compared to its Ca(OH)2-mixed version (both p<0.05). Mixing with Ca(OH)2 decreased the antibacterial efficacy of MTAD, but increased its antifungal effect (both p<0.05). CONCLUSION: These results demonstrate the differential effects of Ca(OH)2 addition on the antimicrobial action of the tested endodontic medicaments in vitro. Ca(OH)2 was as effective as its combination with all of the tested medicaments.

In vitro antimicrobial activity of Sodium hypochlorite, Chlorhexidinegluconate and Octenidine Dihydrochloride in elimination of microorganisms within dentinal tubules of primary and permanent teeth

The aim of this study was to evaluate the effectiveness of different irrigation solutions at different time intervals for the elimination of E.faecalis and C.albicans penetrated into the dentine tubules of primary and permanent teeth in vitro.The 4mm primary and permanent teeth sections were sterilized and contaminated with a mixture of E.faecalis and C.albicans strains. After the apllication of different irrigation solutions (..) (AU)

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In vitro antimicrobial activity of sodium hypochlorite, chlorhexidine gluconate and octenidine dihydrochloride in elimination of microorganisms within dentinal tubules of primary and permanent teeth.

The aim of this study was to evaluate the effectiveness of different irrigation solutions at different time intervals for the elimination of E. faecalis and C. albicans penetrated into the dentine tubules of primary and permanent teeth in vitro. The 4 mm primary and permanent teeth sections were sterilized and contaminated with a mixture of E. faecalis and C. albicans strains. After the application of different irrigation solutions (Sodium hypochlorite, Chlorhexidine gluconate, Octenidine Dihydrochloride, saline) to the contaminated tooth sections according to study groups, neutralizers were applied for inactivation of the solutions after 30 sec, 1 min and 5 min. Dentine shavings were placed into TSB and 10 µL from each tube was inoculated on agar plates, followed by an incubation period of 24 h at 37°C. The colonies were counted macroscopically. The results were compared by using Kruskal-Wallis and Mann Whitney U tests, with a significance level at p<0.05. Among the irrigation solutions that were tested against E. faecalis on primary and permanent teeth, the most effective one was found as 5-minute application of 0.1% Octenidine Dihydrochloride. The antibacterial effects of the tested solutions on the same time periods against C. albicans revealed no significant difference. There were no statistically significant differences between primary and permanent teeth with respect to the antimicrobial activity of the tested solutions. Moreover, Octenidine Dihydrochloride may be used as an alternative endodontic irrigant.

Effects of Antiseptics on Pulpal Healing under Calcium Hydroxide Pulp Capping: A Pilot Study.

OBJECTIVES: The objective of this pilot study was to evaluate the effects of three different antiseptic materials on healing processes of direct pulp therapies with Ca(OH)(2) histopathologically. METHODS: Twenty-eight upper and lower first molar teeth from 7 male Wistar rats were used in this study. Four cavities were prepared in each rat in four quadrants, and each quadrant represented different experimental groups. In Group I: 0.5% sodium hypochlorite (NaOCl); in Group II: 2% chlorhexidine digluconate (CHX); in Group III: 0.1% octenidine dihydrochloride (OCT); and in Group IV 0.9% sterile saline was applied to the exposure site with a sterile cotton pellet for 3 minutes. After hemorrhage control, the pulps were capped with hard setting Ca(OH)(2) and, finally, restored with IRM. The animals were euthanized at 21 days post-operatively. After sacrificing, routine histological procedures were performed and evaluated statistically with non-parametric Kruskal-Wallis test among the groups and two-by-two comparisons by using the Mann-Whitney U test for inflammatory response and tissue organization scores at the confidence interval of 95%. RESULTS: There were significant differences in inflammatory response and tissue organization scores between the groups (P<.05). Statistical evaluation of inflammatory response showed that Group IV was significantly different from Groups I, II and III separately with a higher inflammatory cell response (P<.05) whereas no significant differences were detected between the other groups in two-by-two comparisons (P>.05). Healthy coronal and radicular pulp tissue organization scores indicated that the Group I has better pulp tissue organization than Group IV and this was significantly different (P<.05) whereas no significant differences were observed between the other groups separately (P>.05). CONCLUSIONS: The antiseptic materials used in this study created an environment that, rather than saline solution, may affect clinical and histological success in a positive way.

In vitro antimicrobial activity of several concentrations of NaOCl and Octenisept in elimination of endodontic pathogens.

OBJECTIVE: The objective of this study was to test and compare the in vitro effectiveness of sodium hypochlorite (NaOCl), and octenidine hydrochloride (Octenisept) at different concentrations in the elimination of resistant microorganisms including S. aureus, E. faecalis, and C. albicans over a range of time intervals. STUDY DESIGN: A broth dilution test was performed, and the timing for irrigants to kill microbial cells was recorded. Then the samples were compared by using Kruskal-Wallis test, with significance level at P less than .05. Also minimum inhibitory concentration (MIC) of Octenisept was evaluated. RESULTS: The in vitro antimicrobial effect of the most effective concentrations of the tested irrigants were ranked from strongest to weakest as follows: 100% Octenisept, 50% Octenisept, 5.25 % NaOCl, and 2.5 % NaOCl. CONCLUSIONS: The antimicrobial action is related to type and concentration of the irrigants as well as the microbial susceptibility.