The contribution of genetics to dental caries, oral habits and occlusal traits in Turkish twins: A comparative study.

OBJECTIVE: The aims of this study were to investigate and compare the prevalence of dental caries and the frequency of oral habits, molar relationships and occlusal traits between children of multiple births, and singletons, and to determine the relative contributions of genetics and environmental factors to these parameters by using twin study design. METHODS: The study group consisted of 345 multiple births (34 monozygotic and 122 dizygotic twin pairs, 11 sets of triplets) and 345 singletons between the ages of 2 and 17. The prevalence of dental caries, and the frequency of tooth brushing, the children's oral habits, molar relationships, and occlusal traits were recorded. RESULTS: The percentage of children who brushed their teeth more than twice daily was statistically significantly higher in multiple births than in singletons. Higher correlation coefficients were found in dental caries index, except for decayed, filled (df) (2-5 age group) and filled (f) (6-11 age group), in the monozygotic twin pairs compared to those in the dizygotic twin pairs. In children between the ages of 6 and 11 years, mouth breathing, bruxism, lip biting, and pencil biting were higher in singletons than in children of multiple births. There were statistically significant differences between children of multiple births and singletons, with increased overjet in the 2-5 year age group being observed. CONCLUSION: When analyzing these parameters, environmental factors must also be investigated. Due to the low incidence of twin births, longitudinal follow-up studies with more twin pairs are necessary to determine whether these results are generalizable.

The clinical success of ART restorations and Hall technique in primary molars: a randomized 18-month follow-up study.

Objectives: The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars. Materials and Methods: This randomized clinical study observed 40 children (aged 5-6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis. Results: Thirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful. Conclusions: The 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.

Analyzing the psychological effects of the COVID-19 pandemic on Turkish dental professionals.

BACKGROUND: Due to the working conditions, while performing dental procedures, dental professionals may experience a sense fear and anxiety about coronavirus disease 2019 (COVID-19). OBJECTIVES: The aim of this study was to assess the levels of fear and anxiety about COVID-19 among dental professionals by using the Turkish version of the Fear of COVID-19 Scale (FCV-19S) and the Coronavirus Anxiety Scale (CAS), and to explore the risk factors associated with the intensity of fear and anxiety. MATERIAL AND METHODS: This cross-sectional study was conducted between October 16 and October 23, 2020, during the normalization process, by sending an online survey to 813 dental professionals working in public and university hospitals in Turkey. The questionnaire contained questions about socio-demographic characteristics as well as epidemic-related questions. The levels of fear and anxiety were assessed by means of FCV-19S and CAS, respectively. RESULTS: The sample's mean scores were 18.48 ±5.47 for FCV-19S and 2.17 ±3.08 for CAS. Female participants expressed higher levels of fear of COVID-19 than male participants (p < 0.05). CONCLUSIONS: The fear and anxiety levels in dentists during the COVID-19 pandemic were found to be high.

An Evaluation of Knowledge, Awareness, Attitudes, and Behaviors Regarding COVID-19 Among Parents of Pediatric Dental Patients.

Children infected with COVID-19 have a critical part in community-based viral transmission. This study aimed to evaluate knowledge, awareness, attitudes, and behaviors of parents of pediatric dental patients on COVID-19 and to present required actions to prevent its spreading. A total of 524 parents took part in this cross-sectional study. A self-administered questionnaire was prepared for determining sociodemographic characteristics and socioeconomic status of parents, along with their COVID-19-related knowledge, awareness, attitudes, and behaviors. In total, 90.6% of parents were unaware that disease may show no symptoms; 61.1% and 32.6% did not know roles of "close contact with asymptomatic patients" and "dentistry practices" in transmission, respectively; 30.2% thought it could be transmitted to their children at dental clinics, and only 16.4% stated their children as carriers. Parents need to be informed on COVID-19 transmission through contact with asymptomatic individuals, risks associated with dentistry practices, and role of children in transmission.

One-year clinical evaluation of two high-viscosity glass-ionomer cements in class II restorations of primary molars.

BACKGROUND: Little information exists on the clinical performance of restorative materials on primary teeth of preschool children. This study aimed to evaluate clinical performance of compomer, glass-hybrid-added high-viscosity glass-ionomer cement and zinc-added high-viscosity glass-ionomer cement materials in class ΙΙ restorations of primary molars. METHODS: The study included 251 teeth of 57 patients aged 4-7 years with proximal caries in primary molars. The teeth were divided into three groups, and each restorative material was randomly distributed. Dyract XP, Equia Forte and ChemFil Rock materials were placed after cavity preparation and clinically evaluated at 3, 6, 9 and 12 months using modified United States Public Health Service criteria. Statistical analyses were performed using chi-square and z tests. RESULTS: At the end of 12 months, a total of three restorations in Dyract XP group, 22 in Equia Forte group and 11 in ChemFil Rock group failed in retention criteria. No statistically significant difference existed between retention, colour match and surface texture criteria of all groups at 3 and 6 months, but a statistically significant difference was found at 12 months (P < 0.05). CONCLUSION: For class ΙΙ restorations of primary molars, the success of compomer material was superior to high-viscosity glass-ionomer materials.

Emergence stages of permanent teeth in twins: A comparative study.

BACKGROUND: The relative effects of genetic factors on the timing of tooth eruption can be demonstrated through twin studies; however, twin studies on the eruption time of permanent teeth were limited. AIM: To compare the emergence stages of permanent teeth in twins and non-twin children. DESIGN: A total of 480 patients aged from 5.0 to 13.11 years who attended to the Department of Pediatric Dentistry for any dental reason were included in the study. Twins were compared with the control group in terms of the emergence stages for all permanent teeth. RESULTS: At the age of 5 years, girls in the control group showed statistically significant differences related to the central incisors, the first molars in the mandibular dentition and the first molars in the maxillary dentition, showing more advanced emergence stages. In the 6- to 8- and 12- to 13-year-old age groups, no gender-related differences in emergence stages were observed. Gestation age was found to have a statistically significant effect on the emergence stages of permanent teeth. There were no statistically significant differences between birthweights and tooth emergence stages in twins. CONCLUSION: Longitudinal studies are needed to determine whether there is a strong genetic effect on emergence stages of permanent teeth in twins.

Changes in the aetiological factors of dental trauma in children over time: An 18-year retrospective study.

BACKGROUND/AIM: Dental trauma causes significant aesthetic, functional and psychosocial problems that often require emergency attention in children. The aim of this retrospective study was to assess the factors related to dental injuries in children. A secondary aim was to better understand how to improve the education given to children, parents and teachers in schools regarding dental trauma. MATERIALS AND METHODS: Records of children who were referred to the Department of Pedodontics at Suleyman Demirel University were reviewed. A total of 1971 patients with a history of dental trauma who attended the clinic from 1999 to 2017 were evaluated. The following information was recorded: age, gender, year, aetiology, location, season and time elapsed after trauma. Results were evaluated using the Pearson chi-square test. RESULTS: The patients' average age was 8.56 ± 0.08. Dental injuries were frequent in the 7- to 12-year age group (55.9%). Children in the 0- to 6-year age group attended the clinic more frequently during the years 2013 and 2017 compared to previous years. Boys had a higher frequency of trauma than girls (P < 0.05). The most frequent cause of trauma was falls (46%). The accidents occurred predominantly in the street (41.8%). Trauma that took place at home increased in the later years of the study period, whereas the percentage of injuries occurring in schools decreased. The ratio of patients who attended the clinic within the first two days after trauma was 33.4% between 1999 and 2007, and this increased to 59.8% between 2013 and 2017. The majority of the injuries occurred during the summer. CONCLUSIONS: The aetiological factors related to trauma in children, and the number of patients who attended the clinic, have not changed over the 18-year period but the elapsed time to attend the clinic has changed. Education will increase the awareness regarding the importance of emergency intervention immediately following dental trauma.

Three-dimensional finite element analysis of the composite and compomer onlays in primary molars.

Resin onlay restoration is an esthetic alternative technique used for restoring extensively damaged primary molars. Understanding the behavior of materials under repeated functional stress and how the stress is transmitted to the remaining tooth structure is important. The aim of this study was to compare stresses in primary molars restored with indirect composite and compomer onlay. 3D frame models of the right mandibular and maxillary primary molars and the alveolar bone were created using computerized tomography images of a six-year-old girl. The enamel and dentine layers above the cement layer were unified to generate onlay restoration, and composite and compomer were used as restorative materials. The vertical occlusal load (100 N) was applied to the teeth in the occlusal contact areas. The von Mises stress distributions and normal stress distributions of the y-axis (parallel to the long axis of tooth) were evaluated. The occlusal stress is transmitted to the cervical part of healthy teeth by spreading it through the enamel layer. The composite and compomer restorative materials exhibited similar stress distribution patterns. An indirect technique creates a structure similar to the original morphological form, and it allows restorations to distribute high occlusal stresses and to minimize possible breakages.

Dental age estimation by different methods in patients with amelogenesis imperfecta.

Amelogenesis imperfecta (AI) is one of the developmental enamel defects. In patients with AI, as well as enamel defects, some dental anomalies are encountered and may affect tooth development. For children whose enamel structure is not normal, whether an accurate result can be obtained by dental age determination methods is not clear. The aims of this study are to determine the dental age for the assessment of tooth development in patients with AI by 3 different methods, to decide a method that will present the most accurate result to the chronological age, and to build a basis in terms of postmortem identification. The records of patients who were referred to the Department of Pediatric Dentistry between the years of 1999 and 2018, and diagnosed with AI were reviewed. At the age of 6-15 years, 58 patients (33 males-25 females) (Group I) with AI were determined. A total of 116 healthy individuals (66 males-50 females) (Group II) who were age and gender matched with the AI group were selected as the control group. Chronological age was calculated, and Nolla's, Demirjian's and Haavikko's methods were used to estimate dental age. Chronological and dental ages were compared according to the group and gender. The accuracy of three methods was also evaluated. There was no statistical significant differences for the tooth development in terms of group and gender. Dental age was over-estimated by Demirjian's method and under-estimated by Nolla's and Haavikko's methods. Haavikko's and Nolla's methods were more accurate in the dental age estimation. AI did not present an impact on the dental development. By using particularly Haavikko's method, the possible margin of error in evaluations of dental development can be reduced. Similar studies comprising other defects affecting the tooth structure and morphology are also necessary.

A comparison of the effectiveness of resin infiltration and microabrasion treatments applied to developmental enamel defects in color masking.

This study aimed to evaluate color masking effect from treatments with resin infiltrant and two different remineralization agents applied with microabrasion to anterior teeth with developmental enamel defects. The incisors of patients aged 8-17 were evaluated. The study involved two groups including fluorosis (Group 1) and hypomineralization (Group 2) cases. These two groups were further divided based on the treatment received: Group A: Icon®, Group B: Opalustre®+Clinpro White Varnish®, and Group C: Opalustre®+Tooth Mousse®. The spectrophotometric values were recorded. Furthermore, the L* and ΔE values were evaluated by repeated measures of ANOVA. The largest increase in L* values over time after treatment was in Group 1A, followed by Group 1C and Group 1B. The largest increase in ΔE values over time after treatment was in Group 1A. Clinically observable difference was achieved as a result of all treatment groups. Especially resin infiltration treatment has been found to be more effective in teeth with fluorosis.

Effects of Wi-Fi (2.45 GHz) and Lactic Acid Bacteria on Oral Pathogens and Caries Development in Rats.

PURPOSE: To evaluate the effects of Wi-Fi and lactic acid bacteria on salivary mutans streptococci and caries formation. MATERIALS AND METHODS: Wistar rats and their offspring were equally divided into two main groups and seven subgroups. Experimental groups were exposed to Wi-Fi during pregnancy and lactation. Subgroups were divided according the administration of the beneficial bacteria L. plantarum 167.P6.5 and L. rhamnosus M17-10.2. In the 8-week experimental period after weaning at 21 days, Mutans streptococci counts and the number of carious lesions were determined. RESULTS: The MS count ratios at the end of 8 weeks were statistically significantly lower than those at the end of 4 weeks in all groups given L. rhamnosus (p < 0.05). A strong correlation was found between the total MS count and sulcal caries scores (r = 0.507). No statistically significant difference was observed between groups exposed to Wi-Fi and other groups in terms of microorganism count and caries scores (p < 0.05). CONCLUSIONS: These results suggest that lactic acid bacteria, especially those originating from an oral source, may be of benefit as probiotics for the prevention of oral pathogens and dental caries. Perinatal and lactational exposure to Wi-Fi does not predispose to caries development in rats.

Oral-Facial-Digital Syndrome Type 1: Oral Findings in a 6-Year-Old Girl.

Oral-facial-digital syndrome (OFDS) is a group of congenital anomalies with 13 different forms. OFDS type 1 (OFDS1) is a developmental genetic anomaly related to the X chromosome, that is often seen in girls, and affects the face, oral cavity, and extremities. In this study, we discuss the oral findings of a 6-year-old girl with OFDS1 and her situation after 2.5 years.

Evaluation of dentin permeability of fluorotic permanent teeth.

OBJECTIVE: The in vitro permeability characteristics of dentin have been studied extensively and used to evaluate the efficacy of various preventative and restorative procedures. The aim of this in vitro study was to precisely determine the dentin permeability of fluorotic premolar teeth using an electronic hydraulic conductance measurement system with photosensors and to compare the data with healthy premolars. METHODS: In total, 40 fluorotic and healthy premolar teeth with complete root formation that were extracted for orthodontic purposes and had no caries, restoration, fractures, or cracks were selected for this study. Teeth were classified according to a modified form of the dental fluorosis index of Thylstrup and Fejerskov. The dentin discs were placed in an electronic hydraulic conductance measurement system equipped with photosensors, which was designed for measurements of dentin permeability. The amount of distilled water passed through each dentin disc (µL/min) under a constant pressure was determined. Dentin permeability data of the fluorotic and healthy teeth were recorded and analyzed statistically. RESULTS: The present study showed that fluorosis influenced the volume of fluid that passed through the dentin and the dentin permeability was decreased, whereas dental fluorosis severity was increased in permanent teeth. CONCLUSION: The number of teeth with fluorosis is increasing, depending on fluorine sources, so more appropriate treatments will need to be evaluated by standardizing the methods employed in related studies.

Fracture Resistance of Prefabricated Primary Zirconium Crowns Cemented with Different Luting Cements.

Purpose: The purpose of this study was to determine the retention of prefabricated primary zirconium crowns (PPZCs) and the fracture resistance of samples cemented with four different luting cements subjected to a chewing simulation test with thermocycling mechanical loading (CSTTML). Methods: A total of 120 extracted primary molar teeth were selected and allocated into four groups, according to luting cement materials (bioactive cement, resin cement, glass ionomer cements [GICs], resin-modified GICs). After half of each group was subjected to CSTTML, all the samples were subjected to fracture tests and the mean force required to fracture the PPZCs was recorded. Results: After the CSTTML test, corresponding to a simulated one-year aging, none of the sample materials were found to be cracked, fractured, chipped, or non-retained. Resin cements in all groups showed the highest fracture resistance, whereas bioactive cement, subjected to CSTTML and resin-modified GIC in all tests, showed the lowest values. However, no statistically significant differences were found. Conclusions: The prefabricated primary zirconium crowns were found to be successful after almost one year of simulated aging. The results of all of groups showed that the PPZCs cemented with resin and glass ionomer cements were more successful. However, further in vitro and in vivo studies are needed to determine their potential for clinical success.

In vitro evaluation of onlay restorations on primary teeth.

PURPOSE: Many novel materials have been developed such as composite resin, ceramic, zircon or metal-supported ceramic for use in aesthetic restoration of primary teeth and permanent teeth with extensive crown damage. The aim of the present study was to compare microtensile bond strengths on materials using the microtensile bond strength test. MATERIALS AND METHODS: The microtensile bond strength on the primary tooth dentin was measured on extracted primary teeth using an indirect method and fracture patterns were evaluated. RESULTS: The analysis of bond strengths using the Mann-Whitney U-test did not show significant difference between the rank averages of the compomer and composite resin (p = 0.741). The dentin sections, from which test samples were obtained, contributed to the bond strength; dentin samples obtained just above the pulp had lower bond strength, and the difference was statistically significant (p = 0.005). The adhesive type fracture was the most prevalent fracture type for both materials. CONCLUSIONS: When the chemical, physiological, and micromorphological differences between primary and permanent teeth are taken into consideration, the success of the materials used for restorations can be different between primary and permanent teeth. Therefore, materials used in the dentistry must be evaluated separately for primary teeth.

Effect of fluoride on salivary immunoglobulins and sialic acid.

OBJECTIVE:: The aim of our study was to evaluate the effect of fluoride on salivary immunoglobulin and sialic acid levels in children with dental fluorosis and healthy teeth who live in places with high fluoride concentration in drinking water. METHOD:: Fifty-one (51) healthy children between 6 and 12 years old with no caries were randomly selected from primary schools enrolled in the dental-care program operated by the Department of Pediatric Dentistry. The children were divided into two groups: group I comprised 26 children with dental fluorosis [Thylstrup-Fejerskov Dental Fluorosis Index (TFI) = 4] who lived in Isparta (2.7-2.8 ppm), and group II consisted of 25 children without dental fluorosis who were born in low-fluoride areas and had lived in Isparta for only the previous two years. Stimulated and unstimulated saliva were collected and analyzed for fluoride, salivary immunoglobulins and sialic acid levels. RESULTS:: Sialic acid level was correlated negatively with age. Levels of secretory immunoglobulin A (sIgA) and secretory immunoglobulin G (sIgG) were higher in children with dental fluorosis compared with those in group II, although these differences were not significant. CONCLUSION:: Increased sIgA and sIgG levels may arrest the progression of caries in subjects with dental fluorosis. Given the risks of dental fluorosis, further studies of the effects of different fluoride levels in drinking water on salivary composition of children with mixed dentition are needed to confirm the results of our study and to provide data for comparison.

16-Year follow-up of an avulsed maxillary central incisor after replantation following 10-h storage: An unusual case.

Tooth avulsion is a type of dental injury defined as the complete displacement of a tooth out of the alveolar socket, and the lack of prompt treatment measures can result in the loss of function, poor quality of life, and psychological and social problems. However, several factors may not permit the immediate replantation of an avulsed tooth; therefore, delayed replantation has emerged as an alternative to meet the esthetic, functional, and psychological demands of patients. Here it was described that the successful replantation of an avulsed maxillary central incisor in a 9-year-old boy who presented at the clinic with the tooth stored in unfavorable conditions as dry and then in olive oil-milk mixture almost 10 h after the event. The tooth has remained in its socket healthy for 16 years after treatment. The patient was satisfied with both esthetics and function.

Can onlay's be an alternative restoration for severely damaged primary teeth.

OBJECTIVE: The aim of this study was to evaluate indirect compomer and composite resin onlay restorations of severely damaged primary molars in vivo. MATERIALS AND METHODS: At the study, 48 restorations, in seven girls and ten boys totally 17 patients aged 4-8, was evaluated clinically with using USPHS criteria for 15 months. RESULTS: The study results revealed that the clinical success rate of compomer and composite onlay restorations was 79% and 96%, respectively. No significant differences were found statistically between the materials. CONCLUSIONS: In the children severely damaged primary molars, onlays are usually worked with an indirect technique in clinics. One of the advantages of indirect technique is being most similar to its original form morphologically.

Effect of fluoride on salivary immunoglobulins and sialic acid

Summary Objective: The aim of our study was to evaluate the effect of fluoride on salivary immunoglobulin and sialic acid levels in children with dental fluorosis and healthy teeth who live in places with high fluoride concentration in drinking water. Method: Fifty-one (51) healthy children between 6 and 12 years old with no caries were randomly selected from primary schools enrolled in the dental-care program operated by the Department of Pediatric Dentistry. The children were divided into two groups: group I comprised 26 children with dental fluorosis [Thylstrup-Fejerskov Dental Fluorosis Index (TFI) = 4] who lived in Isparta (2.7-2.8 ppm), and group II consisted of 25 children without dental fluorosis who were born in low-fluoride areas and had lived in Isparta for only the previous two years. Stimulated and unstimulated saliva were collected and analyzed for fluoride, salivary immunoglobulins and sialic acid levels. Results: Sialic acid level was correlated negatively with age. Levels of secretory immunoglobulin A (sIgA) and secretory immunoglobulin G (sIgG) were higher in children with dental fluorosis compared with those in group II, although these differences were not significant. Conclusion: Increased sIgA and sIgG levels may arrest the progression of caries in subjects with dental fluorosis. Given the risks of dental fluorosis, further studies of the effects of different fluoride levels in drinking water on salivary composition of children with mixed dentition are needed to confirm the results of our study and to provide data for comparison.

Clinical Success of Fiber-reinforced Composite Resin as a Space Maintainer.

INTRODUCTION: The early loss of deciduous molars is a frequently encountered problem in dentistry. Various space maintainer designs were developed to prevent the loss of the space. The aim of this study was to evaluate long-term clinical performance and survival rates of fiber-reinforced composite resin (FRCR) as a space maintainer clinically. MATERIALS AND METHODS: This study was designed on 44 children who had early missed deciduous molars. Space maintainers were prepared on plaster models of patients and fixed directly to the adjacent teeth. Survival rate and whether it causes any damage to adjacent teeth were examined clinically and radio-graphically for 24 months or until failure. Kaplan-Meier survival analysis was used for the statistical analyses. RESULTS: Overall, 16.2% of space maintainers were dislodged and accepted to be failed at the end of 12 months. At the 24-month control, 52.2% success was stated with the FRCR space maintainer and because of permanent tooth eruption, 31.8% of space maintainer were taken out. The mean duration of space maintainers was measured to be 14.8 ± 3.48 months. There was no statistical significance between survival time and gender, tooth number, localization, and measured space (p > 0.05). CONCLUSION: After all 24 months follow-up, as well as esthetic properties of FRCR space maintainer, their applicability in a single seance and strength against the forces are determined as the advantages of the technique. CLINICAL SIGNIFICANCE: The FRCR space maintainers can be thought of as alternatives to metal space maintainers.