Effectiveness of motivational interviewing on oral healthcare in pediatric patients.

The study aimed to evaluate the effectiveness of motivational interviewing, compared to using different traditional motivational techniques on early adolescents' knowledge, attitudes, behavior changes, and oral hygiene status about oral healthcare; 156 healthy early adolescents aged between 10-12 years were included in this interventional study. The participants were randomly assigned to four groups. Basic oral hygiene training (BOHT) (n = 39) group, video monitored (VIDEO) (n = 39) group, plaque disclosed method (PDM) (n = 39) group, and motivational interviewing (MI) (n = 39) group. The participants joined all the motivation sessions one-to-one, face-to-face, with the primary researcher. The data collection forms consist of questions measuring the levels of knowledge, attitude and behavior related to oral health. The participants were invited to the reminder sessions in the following 2 weeks and 1 month. The participant's plaque index was recorded and assessed by a blinded examiner at the reminder sessions. Data forms were re-filled after a 3-month end-point to evaluate participants' knowledge, attitude, behavior changes and oral hygiene status. After the follow-up period, while there was a slight increase in knowledge and attitude levels in the PDM and VIDEO groups, there was a higher increase in behavior and attitude levels in the MI group. Compared to the oral hygiene status, the Plaque Index score reduction was greater in the MI group than in the other groups (p < 0.05); Although positive changes were observed in all groups, the most significant improvement was observed in the MI group. It was concluded that MI could have a positive effect on improving the oral hygiene habits of pediatric patients.

The effect of a home-based orofacial exercise program on oral aperture of patients with systemic sclerosis: A single-blind prospective randomized controlled trial.

OBJECTIVES: This study aims to evaluate the effect of a home-based orofacial exercise program on the oral aperture (OA) of systemic sclerosis (SSc) patients. PATIENTS AND METHODS: This single-blind prospective randomized controlled study performed between March 2017 and January 2019 included 56 SSc patients (3 males, 53 females; mean age 52.9±10.6 years; range, 31 to 70 years) with an OA of <40 mm. Patients were divided into two groups. Group 1 (n=28, mean age 53.8±9.6 years) was given orofacial exercise program twice a day for one month in addition to oral hygiene care advices, followed by no activity for the next month. Group 2 (n=28, mean age 50.0±11 years) received oral hygiene care advices for the first month followed by the same exercise program for the next month. Patients' OA was measured at baseline, and at first and second months. RESULTS: After the first month, OA increased in Group 1 (p<0.001), whereas no change was observed in Group 2 (p=0.579). At the end of two months, there was no additional increase in Group 1 (p=0.352), while there was a significant increase in Group 2 (p<0.001). There was no difference between OAs of the groups at the end of the trial (p=0.564). CONCLUSION: Our results suggest that home-based orofacial exercise program improves OA of SSc patients.

The effects of chitosan addition to glass ionomer cement on microhardness and surface roughness.

OBJECTIVE: The aim of this study was to investigate the surface microhardness and roughness properties of a modified glass ionomer cement formed by adding different ratios of Chitosan, when exposed to saliva and acid erosive gastric acid cycle environments. METHODS: Chitosan was added to conventional glass ionomer liquid at volumes of 5% and 10%. The chitosan-modified glass ionomer was used for the experimental group, and traditional glass ionomer formed the control group. All the groups were separated into two subgroups. One of these subgroups was subjected to a gastric acid erosive cycle. The other subgroup was immersed in artificial saliva. Microhardness, surface roughness with optical profilometer and AFM measurements of all the samples were taken. Qualitative surface topographic evaluations were made using a SEM. The data were analyzed by Kruskal-Wallis and Mann Whitney U-test for pairwise comparisons of the groups at the 0.05 level of significance. RESULTS: The addition of chitosan to GIC had a positive effect on the microhardness values. The gastric acid erosive cycle application negatively affected the microhardness and surface roughness properties of the sample groups. CONCLUSION: The chitosan-modified glass ionomer cement samples showed clinically acceptable surface roughness values. Although the results of the addition of the biopolymer, chitosan, to GIC are promising, there is a need for further in-vivo studies.

Malnutrition, associated clinical factors, and depression in systemic sclerosis: a cross-sectional study.

INTRODUCTION: The aim of this study was to evaluate the associations between malnutrition and the clinical features of the disease and depression in patients with systemic sclerosis (SSc). METHOD: Patients with SSc who were followed up in our clinic were enrolled in the study. Malnutrition risk was assessed using the Malnutrition Universal Screening Tool (MUST). Skin involvement was assessed using the modified Rodnan skin score (mRSS) and interincisal distance (ID) measurements were used to assess the maximal mouth opening capacity. The Beck Depression Inventory (BDI) was used for measuring the severity of depression. RESULTS: Ninety-eight patients with SSc (84.7% women; mean age 52.67 ± 11.26 years) were included in the study. According to the MUST scores, 61.2%, 15.3%, and 23.5% of patients had low, medium, and high risk for malnutrition, respectively. The mRSS was significantly higher in the group with high malnutrition risk compared with low-risk group (p = 0.014). Malnutrition risk was associated with interstitial lung disease and bowel involvement (p = 0.044 and p = 0.021, respectively). Interincisal distance was lower in the group with high malnutrition risk compared with the low-risk group (p = 0.003). Malnutrition risk was higher in patients who had mild-to-severe depressive symptoms than in those without (p = 0.012). Interincisal distance and bowel involvement were the most relevant factors for malnutrition. CONCLUSIONS: The risk of malnutrition is increased in patients with SSc. In our study, microstomia and bowel involvement were the most relevantly associated factors with malnutrition. KEY POINTS: • The risk of malnutrition is increased in patients with systemic sclerosis (SSc). • Microstomia and bowel involvement are found to be the most important factors associated with malnutrition. • Depressive symptoms are seen frequently among patients with SSc, and depression seems to be one of the etiologic factors or the result of malnourishment in SSc. • Assessment of nutritional status and the presence of depression should be a part of routine clinical visits of patients with SSc.

The effect of gastric acid on chitosan modified glass ionomer cement: SEM-EDS.

This study aimed to use scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS) to examine the elements that passed into the gastric acid solution after the application of a gastric acid erosive cycle to chitosan modified glass ionomer cement (GIC). Chitosan modified GIC samples were obtained by adding chitosan (vol/vol) of 5 and 10% to GIC for the experimental groups. These two experimental groups and a control group were subjected to gastric acid erosive treatment for 60 s six times a day for 10 days. The sample surfaces were coated with approximately 1 nm of gold to increase conductivity with the Q 150R ES device (Quorum Technologies, East Sussex, England). Surface topography images were obtained with a SEM. Besides, EDS analysis was also determined the number of elements graphically in the region where the fast electron beam hit. In the samples examined, the amount of element was determined. After gastric acid application, cracks and voids were observed on the surfaces of the samples. In the EDS analysis of the 5 and 10% chitosan modified GIC and control groups, Si, Al, Na, and F was found. It is necessary to investigate the antibacterial properties and physical properties of chitosan modified glass ionomer-free elements and fluorine ions using advanced techniques.

Clinical evaluation of a self-adhering flowable composite as occlusal restorative material in primary molars: one-year results.

PURPOSE: The aim of this study was to evaluate and compare the 1 year clinical performances of a self-adhering flowable composite and a commercially available self-etch adhesive/composite system in occlusal restorations of primary second molars. MATERIALS AND METHODS: Thirty-one patients (10 male, 21 female) were recruited into the study. A total of 62 occlusal cavities were restored with either a universal composite or a self-adhering flowable composite according to manufacturers' instructions. The restorations were clinically evaluated 1 month after placement as baseline, and after 3, 6 months and 1 year post-operatively using modified USPHS criteria by two operators. RESULTS: Lack of retention was not observed in any of the restorations. With respect to color match, marginal adaptation, secondary caries and surface texture, no significant differences were found between two restorative materials tested after 1 year. None of the restorations had marginal discoloration and anatomic form loss on the 1 year follow-up. Restorations did not exhibit post-operative sensitivity at any evaluation period. CONCLUSION: The clinical assessment of self-adhering flowable composite exhibited good clinical results with predominating alpha scores after 1 year. Advantage of the application convenience for children is promising for self-adhered flowable composite materials in pediatric use.

Congenital erythropoietic porphyria with erythrodontia: A case report.

BACKGROUND: The causes for intrinsic tooth discoloration can be separated into two categories as systemic and local. Systemic causes are either genetic or drug-induced effects. The development of dentition can also be affected by a number of systemic factors and metabolic diseases such as porphyria. Congenital erythropoietic porphyria (CEP), also known as Gunther's disease, is a metabolic disease caused by a transformation in the gene that codifies uroporphyrinogen-3 synthesis, leading to porphyrin aggregation in urine, skin, bone, and dentin. CASE REPORT: A 21-month-old girl with erythrodontia was referred to Paediatric Dentistry Department in September 2017. A physical examination revealed blisters on her face, nose, hands, and feet. Laboratory findings showed highly elevated urine total uroporphyrin and total coproporphyrin I and III levels. Next-generation sequencing multigene panel testing for porphyria demonstrated a homozygous c.10C>T (p.L4F) mutation in the UROS gene. For curative therapy, the patient was admitted to the allogeneic bone marrow transplantation program. CONCLUSION: Congenital erythropoietic porphyria most commonly presents in the first few years of life. Manifestations can include reddish-colored urine, skin blistering, scarring, and erythrodontia. A timely diagnosis can prevent undesirable skin findings of the disease and death due to hematological involvement before a curative allogeneic bone marrow transplantation is performed.

Evaluation of Skeletal and Dental Effects of Lower Lingual Arches.

OBJECTIVE: A lower lingual arch is usually recommended as a holding device to maintain arch length and to prevent mesial migration of the mandibular first molars. Despite its widespread use, comparatively little is known about the effects of a lower lingual holding arch on preservation of lower arch dimensions and tooth position and the impact of the device on mandibular growth. The aim of this study is to evaluate the skeletal and dental effects of the lower lingual holding arch with regard to arch dimension, positions of mandibular molars and incisors, and usual mandibular growth. STUDY DESIGN: Thirty-four children (18 males and 16 females) who needed space maintainers were included in the present study. The patients were divided into two groups according to whether they were missing second primary molars on one or both sides. Group I comprised 16 children (8 males and 8 females, average age 8.8 ± 0.9 years) with a missing second primary molar on one side; Group II comprised 18 children (10 males and 8 females, average age 8 ± 0.7 years) with extractions on both sides. Lateral cephalograms, dental pantomograms, and study casts of the patients were taken at the beginning and the end of the study period. Average treatment time was 20.4 ± 4 months. RESULTS: Lower incisors moved forward and Incisor Mandibular Plane Angle (IMPA°) increased in both treatment groups. Statistically significant differences between the groups were found when comparing pre-treatment and post-treatment arch dimension and position of mandibular molars. Results were better for lingual arches with extraction on one side than with extraction on both sides Conclusions: A lingual arch seems to be an effective tool for maintaining arch length, and was not found to impair mandibular growth.

Comparison of the Shear Bond Strength of Silorane-Based Composite Resin and Methacrylate Based Composite Resin to MTA.

Background. Mineral trioxide aggregate (MTA) is a material that has recently gained popularity in the application of the vital pulp therapy. Along with the increasing use of MTA to this end, the permanent restoration material to be placed on MTA has become a significant issue. The aim of this in vitro study was to investigate the bond strength of the novel low-shrinkage silorane-based composite resin (SBC) to MTA. Methods. Twenty acrylic blocks filled with MTA were prepared for this study. SBC was the test group and methacrylate-based composite resin (MBC) was used as the control group. Shear bond strength test was performed to determine the bond strength. The surfaces of broken samples were evaluated under a stereomicroscope and grouped as adhesive, cohesive and mixed. Data were examined by statistical analysis. Results. Statistical analysis revealed that SBC exhibited higher shear bond strength than the control group. It was observed that most of the failures in the test group were of cohesive type within MTA. Conclusion. Based on the results, SBC showed higher shear bond strength than the control group; however, clinical follow-up is needed to evaluate the clinical success.

Dental anxiety in children with cleft lip and palate: a pilot study.

PURPOSE: To investigate the level of dental fear and anxiety of children who have cleft lip and palate (CLP). MATERIALS AND METHODS: The study was performed at Cukurova University, Faculty of Dentistry. A total of 32 7- to 12-yearold children, 17 of them with CLP (8 girls and 9 boys) and 15 of them without CLP (7 girls and 8 boys) participated in the study. The children were evaluated by using the Facial Image Scale (FIS) and Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) methods. The anxiety state of the children was assessed twice using FIS: first in the dental hospital waiting room (FIS-WR) and after, while sitting in the dental chair (FIS-DC). CFSS-DS was administered to all participants in order to assess the dental anxiety while they were sitting in the dental chair. RESULTS: According to the FIS results, there was no difference between CLP and control group in the waiting room (P = 0.682). However, the CLP group showed lower scores than the control group while they were sitting in the dental chair (P = 0.030). The FIS scores of the CLP group were significantly higher in the waiting room than while sitting in the dental chair (P = 0.007). In the control group, there was no significant difference between FIS-WR and FIS-DC values (P = 0.664). The total CFSS-DS scores of children with CLP were lower than those of the control group, but these differences were not statistically significant (P > 0.05). CONCLUSION: Children with CLP showed more anxiety in the FIS-WR than in the FIS-DC, but they showed lower scores than the control group in the FIS-DC. The positive previous experience of meetings with dentists of the CLP children could explain these results. Positive previous experiences with dentists and a short time in the waiting room could be key elements in the care of CLP children.

Adhesive tooth fragment reattachment with intentional replantation: 36-month follow-up.

Crown-root fracture is one of the most challenging fracture types in dental traumatology literature. Aesthetic and functional rehabilitation is the primary goal of the treatment of crown-root-fractured tooth. For this purpose, reattachment of the fragment to its original position is a good choice. This paper reports a case of an adhesive fragment reattachment of a complicated crown-root fracture with intentional replantation in a 9-year-old girl patient and 36-month follow-up.