Effect of the Different Dietary Supplements on the Average Surface Roughness and Color Stability of Direct Restorative Materials Used in Pediatric Dentistry.

Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children's oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [Dyract®XTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors (p < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time.

Assessment of the biointeractivity of a novel vital pulp therapy agent derived from eggshell biowaste: An in vitro study.

This study aimed to assess the calcium (Ca2+) and hydroxyl (OH-) ion-releasing ability, namely the biointeractivity of eggshell-derived hydroxyapatite (ESDHA) in comparison with mineral trioxide aggregate (MTA) and calcium hydroxide (CH). ESDHA, MTA and CH samples (n = 10; 8 × 1.6 mm) were immersed in 10 mL of deionised water (37°C, pH 6.8). Ca2+ and OH- ion releases were detected in 1, 7 and 21 days. Scanning electron microscopy and Fourier transform infrared spectroscopy analyses were also conducted. IBM SPSS 20.0 was used for statistical analyses. The cumulative Ca2+ ions (56.22 ± 11.28 ppm) were detected as most significant in ESDHA (day 21; p < 0.05). The OH- ion values of the ESDHA group were statistically higher than MTA and CH (days 1 and 7; p < 0.05). ESDHA and CH showed a similar pattern with sharp peaks in Ca2+, oxygen and carbon elements. ESDHA being a sustainable material with a high ion-releasing ability may be a preferable alternative to the commercial vital pulp therapy agents.

In vitro caries-preventive effect of a mineralization-promoting peptide combined with fluoride gel on sound primary teeth.

BACKGROUND: Mineralization-promoting peptide-3 (MPP3) is a new biomimetic remineralization agent. AIM: To assess the remineralization efficiency of MPP3, either alone or in combination with fluoride gel. DESIGN: The samples were divided into four groups: control, 1.23% fluoride gel, 10% MPP3 gel, and 1.23% fluoride gel + 10% MPP3. Following the application of remineralization agents (4 min), the samples remained in a pH-cycling model (37°C, 4 weeks). Microhardness, microcomputed tomography (micro-CT), polarized light microscopy (PLM), and field emission scanning electron microscopy (FE-SEM) analysis were conducted. RM-ANOVA, one-way ANOVA, and intraclass correlation coefficient (ICC) were used for statistical analysis, and a significance level of p < .05 was employed. RESULTS: Mineralization-promoting peptide 3 and fluoride gel + MPP3 increased the microhardness of the enamel compared with initial values in each group (p < .05). Mineralization-promoting peptide 3 successfully maintained the mineral density of enamel, although the cariogenic pH-cycling and PLM results indicated that the lesion depth (µm) was significantly lower in the fluoride gel + MPP3 group (27.0336 ± 12.53650) than in the control group (37.3907 ± 12.76002, p < .05). CONCLUSION: The combined use of MPP3 with fluoride gel enhanced the caries-protective and mineralization-promoting effects of fluoride. Mineralization-promoting peptide 3 may be a potential agent that can be employed to improve the physical properties of enamel.

Evaluation of the knowledge level of pediatricians on dental trauma and their awareness of the ToothSOS mobile application: A cross sectional study.

BACKGROUND/AIM: Pediatricians play an essential role in managing pediatric oral emergencies; hence, they should have accurate information on dental injuries. This study aimed to assess the knowledge level of pediatricians regarding traumatic dental injuries (TDI) and their awareness of the ToothSOS mobile application. MATERIALS AND METHODS: A survey comprising 10 questions was created on Google forms, and the links were sent to the participants via electronic mail and a mobile application. The demographic characteristics and the knowledge level of pediatricians about TDI and their awareness of the ToothSOS mobile application were evaluated. The questions were prepared by following similar studies and the current guidelines of the International Association of Dental Traumatology. RESULTS: A total of 229 pediatricians (74.2% female) participated in this study. The correct answer rates revealed statistical differences in terms of profession and experience on the following issues: the most frequently traumatized tooth, the preference of the antibiotic agent, and the management of avulsed primary tooth (p < .05). The decision to consult a dentist revealed statistical differences in the profession (p = .001). The correct answers on the correlation between the age group and dental trauma accompanied by soft tissue injuries showed statistical differences in experience (p = .005). Although none of the participants knew the ToothSOS application, 91.7% of them preferred using this tool in future practices. This rate was statistically higher in participants with an experience of more than 10 years (p = .013). CONCLUSIONS: The knowledge level of pediatricians regarding dental trauma was found to be sufficient, except for the questions on avulsion injuries. However, the fact that the participants were unaware of the ToothSOS mobile application was the most considerable result of the study, and this finding highlighted the importance of informing pediatricians dealing with oral injuries regarding the latest updates on dental traumatology.

Comparing the physical and mechanical properties of different biocompatible three-dimensional resin materials in possible use of dental appliances: An in vitro study.

OBJECTIVE: This study aimed to assess the colour stability, water sorption, microhardness and water contact angle of two different 3D printing systems (SLA and DLP) in a possible use of producing paediatric and orthodontic dental appliances. MATERIALS AND METHODS: SLA and DLP printer systems produced a total of 160 disk samples with a diameter of 15.00 mm and a height of 2.00 mm. Colour changes of 64 samples were assessed in distilled water, coffee, coke and cherry juice and Vicker's microhardness tests were also conducted. Solubility and water sorption were held following the water contact angle assessment. Statistical analyses were performed using the SPSS software. Mann-Whitney-U test, Friedman test and Bonferroni post hoc Multiple Comparison Test were performed. RESULTS: In DLP and SLA groups, coffee had a statistically significant colouring effect regarding the assessment periods (P = .001, 20.09 ± 2.96, 22.09 ± 3.51, respectively), and the discolouration effect of coffee was higher in the SLA group at all endpoints (P < .05). At the same time, DLP was more affected by coke solution in T0-T1 and T0-T7 (P < .05). The values of water sorption showed statistically significant differences in the group of DLP compared to the SLA (P = .01, 121.11 ± 10.54, 92.78 ± 8.70, respectively). No statistical significance was detected between the solubility values and water contact angle of SLA and DLP groups. The SLA printer's microhardness values revealed statistically significantly higher values than the DLP group (P = .001) and a decrease was detected following the immersion period in the microhardness values of the SLA group (P = .022). CONCLUSION: The compared groups exposed to staining solutions revealed colour changes above the clinically acceptable values at all periods (ΔE00 = 2.25).

Effects of a mineralization-promoting peptide on the physical and chemical properties of mineral trioxide aggregate.

Mineral trioxide aggregate (MTA) has been used widely in dentistry due to its sealing ability and biocompatibility. Delayed setting time is one of the major limitations of MTA. Various additives have been studied to further improve the properties of MTA with varied degrees of success. In this study, we have investigated the effect of a calcium phosphate mineralization promoting-peptide (MPP3) on the physical and chemical properties of MTA in comparison with Na2HPO4. Based on the reported effects of MPP3 on calcium-phosphate mineralization reaction, our hypothesis was that MPP3 may also show beneficial effects on the calcium-silicate mineralization system of MTA. Na2HPO4 was used for comparison since its setting accelerant effect on MTA has been well documented. The cements were prepared by mixing with distilled water, 0.40 mM MPP3 solution, 15% Na2HPO4 solution, and a combination of MPP3 and Na2HPO4 solution. Initial and final setting times were measured via Vicat needle. Microhardness values were measured via Vickers indenter at 1,3,7, and 28 days after hydration. Compressive strength after setting was measured via universal testing machine. Morphological and compositional analyses were performed via FESEM imaging, XRD and Raman spectroscopy. The microhardness data was evaluated via repeated-measures ANOVA. Setting time and compressive strength data were evasluated via one-way ANOVA. Initial setting time was reduced to ∼3 min in the Na2HPO4 containing groups but remained at ∼5 min in the control and MPP3 groups. Final setting times were significantly reduced in all groups compared to the control group. The reduction in the final setting times in the Na2HPO4 containing groups were significantly higher compared to the MPP3 group. Microhardness was significantly higher in the MPP3 group at all time points. No statistically significant difference in compressive strength was observed among the groups. FESEM analysis showed presence of ettringite crystals in the MPP3 group, and NaBiO3 crystals in the Na2HPO4 containing groups. XRD analysis showed a broadening of peaks at 2θ = 32° in the Na2HPO4 containing groups, possibly due to presence of NaBiO3. Raman spectroscopy showed statistically higher ettringite content in the MPP3 containing groups. Our findings indicate that MPP3 is a beneficial additive to eliminate some of the drawbacks associated with MTA with no detrimental effects on mechanical properties and without resulting in phases that potentially cause discoloration, such as NaBiO3. We propose that the reduced final setting time and increased microhardness by MPP3 may be associated with the increased ettringite content. Future studies, where wider range of MPP3 concentrations are studied may help elucidate and optimize the beneficial effects of MPP3 observed in this study.

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.

Immunolocalization of fibronectin during reparative dentinogenesis in rat molor teeth after pulp capping with mineral trioxide aggregate or calcium hydroxide.

The aim of this study was to evaluate the immunolocalization of fibronectin during reparative dentinogenesis in rat teeth after pulp capping with mineral trioxide aggregate (MTA) or calcium hydroxide (Ca(OH)2). The pulps of 72 upper and lower first molar teeth from 18 male Wistar rats were experimentally exposed. The pulps were capped with MTA or (Ca(OH)2); final restoration followed with zinc oxide and eugenol cement. The animals were euthanized at, respectively, one, three, seven and fourteen days postoperatively. At day one, all groups showed varying degrees of inflammation, from mild to severe. There was no positive reaction for fibronectin at day one. After three days, a partial acute pulpitis was observed in the Ca(OH)2 group. There was less inflammation in the MTA group (p<0.05), and a layer of fibrin barrier was observed along the pulp walls of the MTA material. The layer of fibrodentin formation showed positive reaction for fibronectin. At seven days, the Ca(OH)2 group showed mild inflammation and demonstrated more immunostaining for fibronectin than the Ca(OH)2 group (p<0.05) at three days. Pulps capped with MTA at seven days showed thicker fibrin barrier formation than the MTA group at three days and more immunostaining for fibronectin in whole groups (p<0.05). At fourteen days, there was no positive reaction for fibronectin in either the MTA or Ca(OH)2 group. It seems MTA showed better biocompability properties with the dental pulp tissue, inducing the expression of reparative molecule fibronectin compared with Ca(OH)2. Therefore, MTA may be a better choice for pulp capping procedures.

Two-year study of alternative conservative treatment modalities for early anterior permanent tooth loss.

Premature tooth loss in children may consist of single or multiple, primary or permanent, and anterior or posterior units of the dentition. This tooth loss may be due to either trauma or caries and, in some cases, to congenital or genetic defects. With anterior tooth loss cases, there are several problems the dental practitioner must consider. These are space maintenance, masticatory function, speech and esthetic appearance.

Treatment considerations for a patient with hypohidrotic ectodermal dysplasia: a case report.

AIM: This clinical report describes the oral rehabilitation of a 6-year-old male ectodermal dysplasia (ED) patient diagnosed with hypodontia. BACKGROUND: ED is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures and their accessory appendages. Common manifestations include defective hair follicles and eyebrows, frontal bossing with prominent supraorbital ridges, nasal bridge depression, and protuberant lips. Intraorally, most common findings are anadontia or hypodontia, conical teeth, and generalize spaces. The patient may suffer from dry skin, hyperthermia, and unexplained high fever as a result of deficiency of sweat glands. REPORT: A six-year-old boy who exhibited many of the manifestations of ED as well as behavioral problems and a severe gag reflex. The treatment was designed to improve his appearance and oral functions and included the fabrication of several removable prostheses and acid-etched composite resin restorations during his growth and development. SUMMARY: Young patients with ED need to be evaluated early by a dental professional to determine the oral ramifications of the condition. When indicated, appropriate care needs to be rendered throughout the child's growth cycle to maintain oral functions as well as to address the esthetic needs of the patient. This clinical report demonstrates that removable partial dentures associated with direct composite restorations can be a reversible and inexpensive method of treatment for young ED patients.