Determining treatibility of primary teeth with pulpal exposure.

OBJECTIVES: To determine rates of pulpal exposure during caries removal with an excavator or a bur, to assess success rates of vital pulp therapies in both cases, to analyze pulpal bleeding as an indicator of primary teeth treatability. STUDY DESIGN: Of the 352 primary mandibular molars with deep carious lesions, 141 with pulp exposed during the removal of caries were grouped according to type of instrument causing pulpal exposure and existence of bleeding at the exposure site. Teeth suitable for direct pulp capping or formocresol pulpotomy were treated and followed up for two years. RESULTS: The difference between the rates of pulpal exposure with an excavator (52.5%) or a bur (47.5%) was insignificant. The treatment success rate of teeth with pulp exposed by an excavator (15.8%) was significantly lower than teeth with pulp exposed by a bur (48.8%), regardless of whether bleeding existed at the exposure site or not; however when bleeding existed, this difference was insignificant (15.8% and 40.6%, respectively). CONCLUSIONS: Pulpal exposure possibility during caries removal caused by an excavator and a bur was similar the treatment success rate was lower when the exposure was caused by an excavator the existence of pulpal bleeding resulted in mistakes in diagnoses.

Clinical evaluation of DIAGNOdent in detection of occlusal caries in newly erupted noncavitated first permanent molars in caries-active children.

OBJECTIVE: The aim of this study was to compare the in vivo diagnostic ability of a laser fluorescence system (DIAGNOdent, KaVo, Biberac, Germany) with that of visual inspection in the early detection of occlusal caries in newly erupted noncavitated first permanent molars among caries-active children. MATERIALS AND METHODS: A total of 505 mandibular first permanent molar teeth in 307 children aged 6 to 7 years with decayed, missing, and filled tooth surfaces (DMFS)>8 were examined. Visual examination and DIAGNOdent measurement of caries were compared for teeth with intact occlusal surfaces or varying degrees of fissure discoloration, but with no radiologic evidence of enamel or dentin caries. Teeth were classified according to caries status as sound, enamel caries, or dentin caries using visual examination and DIAGNOdent scoring systems corresponding to histologic definitions of caries depth. Analysis of the results was performed using Cohen's unweighted kappa statistic. RESULTS: Statistical analysis revealed "poor" agreement between the two diagnostic methods (κ=0.231). CONCLUSION: Clinical results suggest that the DIAGNOdent device does not seem to be suitable for accurate diagnosis of early caries lesions in newly erupted first permanent molars.

Success rate of calcium hydroxide pulpotomy in primary molars restored with amalgam and stainless steel crowns.

OBJECTIVES: To compare the success rate of calcium hydroxide (Ca(OH)(2)) pulpotomies in primary molars restored with a stainless steel crown (SSC) to that of teeth restored with amalgam and to evaluate the role of restoration failure in treatment outcome. STUDY DESIGN: Pulpotomies were performed in 154 primary molars. Teeth were grouped according to pulpal exposure type as either mechanically or cariously exposed, with cariously exposed teeth further divided according to size of exposure site (pinpoint or larger than pinpoint). Seventy teeth were restored with amalgam and 84 with a SSC. Teeth were followed up for 12 months. RESULTS: Pulpotomy success rates were 79.9% for teeth restored with a SSC and 60% for those restored with amalgam. The difference between these rates was statistically significant (p <0.01). Restoration failure rates were 14.3% for amalgams and 2.4% for SSCs. The difference between these rates was also statistically significant (p <0.01). Among the 12 failed restorations, treatment was found to be successful in five cases (41.7%) and unsuccessful in seven cases (58.3%). This difference was not statistically significant (p >0.05). CONCLUSIONS: The pulpotomy success rate for teeth restored with a SSC was higher than for those restored with amalgam. Restoration failure did not appear to have an effect on treatment prognosis.

[Conservative applications on treatment of teeth with esthetic problem]. / Estetik problemli dislerin tedavisinde konservatif yaklasimlar.

Today with the development of new restorative materials, the esthetic problems of the anterior teeth because of hypoplazies, fluorizes, fractures shape, form or color irregularities can be treated with conservative preventive and esthetic techniques such as bleaching, surface coating, cosmetic contouring and composite laminate veneering. These procedures are usefull adjuncts and economic alternatives to more extensive procedures such as crown applications. In this study, the young patients who have esthetic and psychologic problems due to color, form, shape, surface texture abnormalities and fractures of their anterior teeth were treated with bleaching, composite laminate veneer and cosmetic contouring techniques.

[Effect of dowel space preparation on the integrity of the apical seal]. / Post-core yapiminda apikal sizdirmazligin korunmasi.

Fifty-six single-rooted maxiller teeth obturated with amalgam, N2 and AH26 were tested in vitro to determine if dowel space preparation had an effect on apical seal. Dye penetration was evaluated using 210 UV Spectrophotometer and it was observed that the use of AH26 with or without gutta-percha to seal the root was the most suitable technique on apical seal and dowel space preparation did not influence the sealing ability of it.