An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

OBJECTIVES: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. METHOD AND MATERIALS: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. RESULTS: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). CONCLUSIONS: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

Advancing dentistry: fractal assessment of bone health in pediatric patients with celiac disease using dental images.

OBJECTIVES: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. METHOD AND MATERIALS: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. RESULTS: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. CONCLUSIONS: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effectiveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease.

Comparison of fit accuracy between conventional and CAD/CAM-fabricated band-loop space maintainers.

AIM: The aim of this in vitro study was to evaluate the band fit of metallic band-loop space maintainers fabricated by conventional and 3D printing technologies for clinical applications. DESIGN: Sixteen digital intraoral impressions were selected, and resin models were printed with a 3D printer. Forty band-loop space maintainers were fabricated (20 each for both the conventional and digital groups). To evaluate the band fit of conventional and CAD/CAM-fabricated space maintainers, cement space was visualized with low-viscosity condensation silicone material on resin models. Digital evaluation was carried out using dual scan method by superimposing two scans of resin models covered with or without a silicone layer on the abutment tooth. The mean quadratic deviation (root mean square, RMS) was calculated. The RMS values between the groups were evaluated with Student's t test. Statistical significance was set at p < .05. RESULTS: No statistical significance was found between the conventional and digital groups (p = .56). CONCLUSIONS: Within the limitations of this study, the band fit of conventional and CAD/CAM-fabricated space maintainers had no difference. Future research into CAD/CAM-fabricated appliances from different perspectives such as fracture strength and patient comfort is warranted.

Evaluation of anxiety-provoking situations related to clinical training in dental education.

INTRODUCTION: The aims of this study were to evaluate the situations that cause anxiety in clinical training and to discuss the precautions that can be taken to reduce clinical anxiety in dental education. MATERIALS AND METHODS: This multi-centred survey-based study was created through Google Docs, and 3rd, 4th and 5th grade dental students were included. The students were asked to rate their reactions on a 4-point Likert scale "not anxious" to "very anxious" for 27 questions related to academics, communication and interaction, diagnosis, dental treatments, deficiencies and mistakes in the treatments. RESULTS: 1332 students were reached, and 1320 students completed the questionnaire. Whilst extracting wrong tooth (3.53 ± 0.83), getting infected by patient (3.39 ± 0.85) and getting diagnosis wrong (3.31 ± 0.83) were identified as the 3 most anxiety-provoking situations, taking panoramic radiograph (1.48 ± 0.71) and communication with patients and dental assistants/nurses (1.76 ± 0.87; 1.64 ± 0.76) were identified as 3 situations that cause the least anxiety. Female students reported higher anxiety levels than male students in most of the questions (p < .05). A statistically significant difference was observed between the grades of the students (p < .05). 3rd grade students showed statistically higher anxiety levels than higher grades in 16 out of 27 questions. No statistical significance was observed according to the status of the university (p > .05). CONCLUSION: Questions related to diagnosis, delivery of the dental treatments, deficiencies and mistakes in the treatments caused higher anxiety levels amongst dentistry students. As experience and time in the clinical training increase, the anxiety level of the students decreases. Orientation programmes and establishing an effective communication between grades are recommended. Also, gender-based solutions must be taken into consideration.

Evaluation of the Trabecular Structure of Mandibular Condyles in Children Using Fractal Analysis.

OBJECTIVE: To evaluate the trabecular internal structure of the mandibular condyle with fractal analysis on panoramic radiography in children. STUDY DESIGN: 159 panoramic radiographs were separated into 8 groups according to age and gender. The radiographs were standardized as 8-bit images. Regions of interest, located on both mandibular condyles, were selected as 64x64 pixel squares. Image J v1.50i software was used to obtain the fractal dimension (FD) values by the box-counting method. RESULTS: The data obtained from the right and left condyles were analyzed in terms of gender and age groups. No statistically significant difference was observed between the genders in respect of the mean FD values for both condyles (p>0.05). Mean, standard deviations and the 95% confidence intervals for the FD values of the left and right condyles were obtained according to age. A statistically significant difference was observed in the mean FD values for both left (p= 0.019) and right (p= 0.000) condyles when all groups were compared and no statistically significant difference was found between all groups except the 6-year-old group for both condyles. In both condyles, the significantly lowest mean FD values were determined in the 6 years age group. CONCLUSIONS: The FD values of the mandibular condyle trabecular structure changed with age. It will be possible to evaluate these changes from panoramic radiographs by making calculations using the fractal analysis method.

The effect of pre-anesthesia with a needle-free system versus topical anesthesia on injection pain of the inferior alveolar nerve block: a randomized clinical trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of pain control between a needle-free system and topical anesthesia applied prior to inferior alveolar nerve block (IANB). MATERIALS AND METHODS: The present study was designed as a randomized controlled cross-over clinical study on 60 children (aged 6 to 12 years) requiring dental treatment with IANB in bilateral mandibular molars. As pre-anesthesia, topical anesthesia (TA) was applied on one side and the Comfort-in™ injection system (CIS) on the other side in two separate sessions before IANB. The injection pain during IANB, at both the needle insertion and solution deposition phases, was analyzed using the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability Scale (FLACC). The data were analyzed using the Wilcoxon signed-rank test, Spearman correlation, and Mann-Whitney U test. RESULTS: There were statistically significant differences between TA and CIS in subjective and objective pain evaluations during both the needle insertion and solution deposition. The use of a needle-free system in pre-anesthesia yielded a significant decrease in subjective and objective pain scores (p < 0.001). No statistical difference was found between TA and CIS in terms of patient preference, but patient preference for CIS was significantly higher in older patients (p < 0.01). CONCLUSIONS: It was determined that the use of a needle-free system in pre-anesthesia yielded a decrease in injection pain of IANB. CLINICAL RELEVANCE: Pediatric dentists should be aware of the new injection system in order to decrease the level of injection pain.

Bactericidal Effect of 2780 nm Er,Cr:YSGG Laser Combined with 940 nm Diode Laser in Enterococcus faecalis Elimination: A Comparative Study.

Objective: This study aims to compare the bactericidal efficacy of different Er,Cr:YSGG disinfection methods, particularly combined application of Er,Cr:YSGG and Diode laser. Background: Root canal disinfection is important for long-term endodontic success. Different laser systems are proposed as alternatives to conventional techniques in bacterial elimination. Materials and methods: Ninety-five straight, single-rooted premolars with similar canal dimensions were selected. After the mechanical preparation, the samples were sterilized, and root canals were infected with Enterococcus faecalis. The samples were randomly divided into five groups (n = 15): 5% NaOCl, Er,Cr:YSGG, Er,Cr:YSGG +5% NaOCl, Er,Cr:YSGG + Diode, and control group. Results: The maximal bacterial elimination was observed in Er,Cr:YSGG + NaOCl group (p < 0.005). More bacteria were found in Er,Cr:YSGG and Er,Cr:YSGG + Diode groups compared with 5% NaOCl group (p < 0.005). Marginal significance was detected between the Er,Cr:YSGG group and the Er,Cr:YSGG + Diode group (p = 0.091). Conclusions: The most successful E. faecalis elimination was obtained from laser-activated irrigation group. As combined application of Er,Cr:YSGG and Diode laser gives suggestive results, further studies with larger sample sizes are needed to clarify the outcome.