The effect of the use of the deproteinization agent hypochlorous acid and two different pit and fissure sealant self-adhesive flowable composites upon its bonding with the enamel.

This study evaluates the effect of the deproteinization agents hypochlorous acid and sodium hypochlorite upon the bonding of the two different pit and fissure sealant, self-adhesive flowable composites with the enamel. Thirty-six third molars were randomly divided into six different groups. The groups were formed as follows: Group 1: 37% phosphoric acid + VertiseTM Flow; Group 2: 200 ppm hypochlorous acid + 37% phosphoric acid VertiseTM Flow; Group 3: 5.25% sodium hypochlorite + 37% phosphoric acid + VertiseTM Flow; Group 4: 37% phosphoric acid + Constic; Group 5: 200 ppm hypochlorous acid + 37% phosphoric acid + Constic; Group 6: 5.25% sodium hypochlorite + 37% phosphoric acid + Constic. In each group, samples were obtained that were rectangular prisms in shape (n = 12). Groups to which a deproteinization agent was applied (Groups 2, 3 and 5, 6) showed statistically higher microtensile bonding strength than Group 1, Group 4. There was no statistically significant difference in terms of microtensile bonding strength values between the Groups 3 and the Group 6. The study found that the groups to which deproteinization agents were applied had statistically higher microtensile bonding strength values compared with those groups to which acid and fissure sealants were applied. In this study, it was concluded that the use of fissure-sealing self-adhesive flowable composites after acid application to permanent tooth enamel provides an acceptable bond strength given the limitations of in vitro studies. In line with the results obtained, it was observed that in addition to the removal of the inorganic structure with the application of acid, the removal of the organic structure with the use of deproteinization agent increased the bond strength to the enamel.

Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods.

OBJECTIVES: This study aimed to assess awareness of anesthesiologists and neonatologists about oral complications occurring during and after the orotracheal intubation (OTI) in premature infants and their knowledge and behavior regarding protection methods from these complications in clinical practice. METHODS: This study included 94 neonatologists and 137 anesthesiologist. The final version of the questionnaire included 15 items in three main parts: (i) personal information; (ii) awareness about oral complications occurring during and after the OTI in premature infants; (iii) knowledge and behavior regarding protection methods from these complications in clinical practice. RESULTS: A total of 95.7% of neonatologists and 83.2% of anesthesiologists were aware of oral complications related to OTI. The most common complications the anesthesiologists encountered were oral, laryngeal, or pharyngeal region injuries (60.7%) and palatal groove (52.2%) for the neonatologists. The most preferred method for stabilization of the orotracheal intubation tube (OTT) was bonding to the perioral region with an adhesive tape (98.3%). The primary determining factor in the choice of OTT stabilization method was the ease of use (28.2%). A total of 23.8% of the participants were aware of the palatal stabilization device (PSD), whereas only 1.3% used it in their routine and 57.1% of them believed it can prevent complications. CONCLUSIONS: The results showed that neonatologists were more aware of the OTI-related oral complications than anesthesiologists. The knowledge of the participants regarding prevention of these complications is insufficient. Study participants believe in the efficacy of PSD but do not use it in clinical practice for a number of reasons.

The Clinical and Radiographic Success of Primary Molar Pulpotomy Using Biodentine™ and Mineral Trioxide Aggregate: A 24-Month Randomized Clinical Trial.

PURPOSE: The purpose of this study was to compare the clinical and radiographic success of Biodentine™ and mineral trioxide aggregate (MTA) pulpotomy in primary molars. METHODS: Thirty-two four- to nine-year-olds were included in this study. The primary molars were randomly assigned to the Biodentine™ and MTA groups. After coronal pulp removal and hemostasis, the remaining pulp tissue was covered with Biodentine™ or MTA. All teeth were restored with stainless steel crowns. Clinical and radiographic successes and failures were recorded at six-, 12-, 18- and 24-month follow-ups. Data were statistically analyzed using Mann-Whitney U and Wilcoxon tests. RESULTS: The 24-month follow-up evaluations revealed that the clinical success rates were 96.8 percent (30 out of 31) for both Biodentine™ and MTA. The radiographic success rates at 24 months were 93.6 percent (29 out of 31) for Biodentine™ and 87.1 percent (27 out of 31) for MTA. No significant differences were found among the groups at all follow-up appointments (P>0.05) Conclusion: Biodentine™ and mineral trioxide aggregate did not differ significantly in combined clinical and radiographic success after 24 months.

How Does Dental Trauma Affect the Quality of Life in Turkish Families?

PURPOSE: To assess the responsiveness of the Family Impact Scale (FIS) to describe changes in quality of life (QoL) after traumatic dental injury (TDI), and compare the efficacy of subscales. MATERIALS AND METHODS: Parents of 110 children aged 7-15 admitted to the Gazi University Faculty of Dentistry Department of Paediatric Dentistry for dental trauma were included in this study. A three-part questionnaire was distributed to the participants: questions regarding personal information, TDI and QoL. The types of TDI were classified according to Andreasen et al.3 Quality of life was measured using the FIS. The questionnaires were translation into Turkish, and QoL was measured using the Turkish Family Impact Scale (T-FIS) total score and scores for subscales. The Kolmogorov-Smirnov test was used to assess normal distribution of the data. After this procedure, the nonparametric Kruskal-Wallis test was used. RESULTS: Traumatic dental injuries exhibited a negative impact on parents' QoL, as shown by the total T-FIS score and subscales (p < 0.001). In this study, the determined values for parental emotions > parental/family activity > financial burden > family conflict had a negative impact on the parents' QoL. Parental emotional values were statistically different from those of parental/family activity, financial burden and family conflict values (p < 0.001). CONCLUSION: Traumatic dental injuries in children present a negative impact on Turkish parents' QoL. Parental emotions were the most affected subscale.

Comparison of Topical 10 Percent Lidocaine and a Local Anesthetic System in Pediatric Dental Patients.

PURPOSE: The purpose of this study was to compare the effectiveness of a three-in-one injection comfort system (ICS) and 10 percent lidocaine pump spray in reducing injection pain in children. METHODS: Fifty eight- to 12-year-old children treated at a university pediatric dental clinic participated in this study. The Children's Fear Survey Schedule-Dental Subscale was used to select nonanxious children to participate. Contralateral tooth pairs were treated in two separate visits with random use of either ICS or lidocaine pump spray. The pain perception levels were assessed with heart rate changes, the Modified Behavioral Pain Scale (MBPS), and the Wong-Baker FACES Pain Rating Scale (WBFPRS). At the end of the second visit, children's preferences were noted. Kruskal-Wallis and Mann-Whitney U tests were performed to compare the results. RESULTS: No significant differences were found between the two groups in the MBPS and WBFPRS scores, and mean heart rate changes (P>.05). However, 68 percent of the children preferred ICS. CONCLUSIONS: Both ICS and 10 percent lidocaine pump spray presented the same efficacy in reducing injection pain.

The effects of incorporation of silver-zeolite on selected properties of mineral trioxide aggregate.

The purpose of this study was to evaluate some physical and chemical properties of MTA incorporated with antibacterial silver zeolite (SZ). 0%, 0.2% or 2% mass fraction of SZ was added to MTA powder. The amounts of calcium released from the specimen in deionized water were measured with an atomic absorption spectrophotometer. The setting times of the samples were evaluated using Gilmore-type needles. For solubility and water absorption tests, the samples were placed in a cylindrical polystyrene-sealed container. At 7 days, the samples were removed from solutions and blotted dry for solubility and water absorption test. The highest calcium release was detected in 2% SZ MTA at 24 h. The addition of 2% SZ to MTA reduced the setting time statistically (p<0.05). 2% SZ MTA was significantly more soluble than MTA and 0.2 % SZ MTA (p<0.05). Further research is needed prior to clinical use of MTA with incorporated SZ.

Comparison of laser fluorescence devices for detection of caries in primary teeth.

The aim of this in vivo study was to evaluate the performance of fluorescence-based devices in detecting occlusal caries lesions in primary molars compared with conventional methods. Two examiners assessed 44 occlusal surfaces of first and second primary molars in 20 patients using two fluorescence devices: DIAGNOdent (LF) and DIAGNOdent pen (LFpen). Teeth were also assessed by visual examination and bitewing radiograph. Histological examination served as the gold standard after extraction. By using the McNemar test, the sensitivity, specificity, accuracy, and area under the receiver operating curve were calculated as outer enamel (D1), inner enamel (D2) and dentine caries (D3) lesion thresholds. The intra- and inter-examiner reproducibility were calculated using the Cohen's unweighted kappa statistics. At the D1 threshold, the LFpen sensitivity was statistically higher than LF and radiographic examination (P < 0.001), whereas there was no statistically significant difference among the groups at the D2 and D3 thresholds (P > 0.05). All methods demonstrated the highest sensitivity values at D3. At the D1 and D2 thresholds, there were no significant differences between the LFpen specificity and the other methods. All methods presented similar performance in detecting all lesions considering the area under the receiver operating curve. The LFpen showed better performance than LF. Furthermore, visual examination and the LFpen device seem to be sufficient for detection of occlusal caries in primary molars.

Knowledge of dentists in the management of traumatic dental injuries in Ankara, Turkey.

PURPOSE: This study was designed to assess dentists' knowledge of emergency treatment of traumatic dental injuries (TDIs) in Ankara, Turkey. MATERIALS AND METHODS: A total of 154 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part was composed of 12 closed-ended questions related to knowledge of how to manage different types of TDIs in children. The questionnaires were answered by 133 general dental practitioners (GDPs) and 21 specialists. The survey data were statistically analysed using the chi-square test and ttest to assess dentists' knowledge. RESULTS: The results show that when the answers were compared, lower numbers of correct answers were noted for questions related to splinting time for avulsed teeth and appropriate treatment for complicated crown-fractured deciduous incisors with large pulp exposure. Greater numbers of correct answers were observed for questions related to the storage medium, systemic antibiotic usage for avulsed teeth and appropriate treatment for intruded primary teeth. The mean number of correct answers from specialists was not significantly greater than that from GDPs (P > 0.05). CONCLUSION: In conclusion, this survey showed a low level of knowledge of TDI management among the participants and highlights the need to improve dentists' knowledge of TDI treatment protocols.

Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double-blind study.

PURPOSE: The purpose of this study was to evaluate and compare the reaction to pain during local injection and duration of numbness of soft tissue with 4% articaine or 3% mepivacaine in children. METHODS: A randomized, double-blind, split-mouth study was used with a sample of 50 7- to 13-year-old children (25 boys and 25 girls; mean age=11.3 years old) that had similar operative procedure needs in symmetric primary teeth. The modified behavioral pain scale was used for objective evaluation of the children. The sensation after injection and treatment was evaluated using the Wong-Baker FACES pain rating scale. Parents were instructed to ask the child and to record the time when feeling of numbness disappeared. RESULTS: The duration of soft tissue was longer for articaine (140.69 ± 49.76 minutes) than for mepivacaine (117.52 ± 42.99 minutes). No difference regarding efficacy of the anesthesia was observed. No statistically significant difference was found in blood pressure, heart rate, or oxygen saturation in all evaluation periods for both solutions. The feeling after treatment was similar for the 2 solutions. CONCLUSION: Four percent articaine with 1:200,000 and 3% mepivacaine presented the same efficacy, and children displayed the same behavior during injection.

Antibacterial effect of a new haemostatic agent on oral microorganisms.

OBJECTIVE: The purpose of this study was to determine the antibacterial effect of a newly developed haemostatic agent Ankaferd Blood Stopper® (ABS) and Ferric Sulphate (FS) on various oral microorganisms. STUDY DESIGN: Bacterial strains were freshly incubated in their specific broth media. For each of the strains, 3 wells per each agent, with a 5 mm diameter were made under aseptic conditions in the specific agar media. Then they were filled with a test agents or 0.2% chlorhexidine digluconate (CHX) (control group). After 24h and 48h incubation periods, inhibition zones were measured. RESULTS: ABS showed antibacterial effect on all test microorganisms except Lactobacillus acidophilus and Lactobacillus salivarius. Ferric sulphate and CHX have antibacterial effect on all microorganisms. When the test agents compared, the inhibition zones of the ABS were found smaller than the ferric sulphate and CHX. CONCLUSIONS: Although ferric sulphate and ABS have antibacterial effect, ferric sulphate had better antibacterial activity than ABS on oral microorganisms under in vitro condition. FS and ABS not only exhibit the haemostatic activity but also antimicrobial activity. Key words:Ankaferd blood stopper, ferric sulphate, haemostatic agent, haemostasia, bleeding, bactericide.

Short-term antimicrobial properties of mineral trioxide aggregate with incorporated silver-zeolite.

The purpose of this in vitro study was to determine whether adding silver-zeolite (SZ) to mineral trioxide aggregate (MTA) would enhance the antimicrobial activity of MTA against Staphylococcus aureus (ATCC #25923), Enterococcus faecalis (ATCC #29212), Escherichia coli (ATCC#25922), Pseudomonas aeruginosa (ATCC #27853), Candida albicans (ATCC #90028), Porphyromonas gingivalis (ATCC #33277), Actinomyces israelii (ATCC #12102), and Prevotella intermedia (ATCC# 15032). SZ was added at 0.2% and 2% mass fraction concentration to MTA powder. The control group was MTA powder with no SZ. The antimicrobial effect test was accomplished by placing freshly mixed MTA specimens on agar plates inoculated with microorganisms and comparing the zones of inhibition at 24, 48, and 72 h. The amounts of silver ion release from MTA specimens were measured with atomic absorption spectrophotometry at 10-min, 24-, 48-, and 72-h periods. The pH of MTA specimens was measured with a pH meter at 10-min, 24-, 48-, and 72-h periods. MTA with 2% and 0.2% SZ specimens showed inhibitory effects on some microorganisms at all time periods, whereas no antimicrobial activity showed for P. intermedia and A. israelii. MTA without SZ inhibited C. albicans, E. Coli, and P. intermedia. The highest silver release was detected in 2% SZ MTA at 24 h. The incorporation of SZ may enhance the antimicrobial activity of MTA.

Cytotoxicity of a new hemostatic agent on human pulp fibroblasts in vitro.

OBJECTIVE: The objective of this study was to evaluate the cytotoxicity of the plant extract ankaferd blood stopper (ABS) in vitro. STUDY DESIGN: ABS was eluted with fresh Dulbecco's Modified Eagle's Medium (DMEM) without serum for 72 h, at 37 °C. The cells treated with various dilutions of ABS were seeded into 96-well microplate at 104/well in triplicates. Cells without treatment served as a control group. The number of viable cells after 48 h incubation was determined by a modified 3-(4, 5-dimethyl-thiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay. The relative viability of pulp cells was expressed as color intensity of the number in the experimental wells relative to that of the control group. Absorbances were read at 570 nm on a microplate reader with a background subtraction at 620 nm. RESULT: The results showed that ABS was cytotoxic to human pulp fibroblasts by MTT assay. CONCLUSIONS: The influence of cytotoxicity to human pulp fibroblasts depended on concentration of ABS. The more dilutions exhibited less cytotoxic characteristics compared to the more concentrated forms.

Endodontic treatment of immature maxillary lateral incisor with two canals: type 3 dens invaginatus.

Dens invaginatus is a developmental anomaly. The nonsurgical endodontic treatment of a type 3 dens invaginatus with a large periradicular lesion in a maxillary left lateral incisor of a 10-year-old girl is presented. In spite of difficult diagnosis and treatment of type 3 dens invaginatus, nonsurgical treatment was performed successfully. Resolution of the periradicular lesion and apical closure was observed after 1-year follow-up.

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.

Antibacterial effect of silver-zeolite containing root-canal filling material.

The aim of this study was to determine the in vitro antibacterial effect of two experimental glass ionomer cements (GICs) on Streptococcus milleri, Staphylococcus aureus, and Enterococcus faecalis after 24 and 48 h incubation by using the agar diffusion inhibitory test. Silver zeolite (SZ) was added at 0.2 and 2% mass fraction concentration to GIC (Endion). The control group was Endion with no SZ. Each of them were prepared to uniform size using a custom-made Teflon mold, and the GIC materials were prepared to form disks (n = 5 per group). The effect of these materials on the growth of three bacteria associated with endodontic infections was determined using the agar diffusion inhibitory test. The amounts of silver ion release from these materials were measured with atomic absorption spectrophotometry at 10 min, 24- and 48-h periods. The pH of samples was measured with a pH-meter at 10 min, 24- and 48-h periods. After the incubation period, the agar plates were evaluated and the degrees of bacterial inhibition were measured in millimeters. A comparison of the mean of the test materials was statistically different in each group of specimens (p < 0.05). Between the two tested materials 2% SZ containing GIC showed the largest zone of inhibition on the agar plates of all the tested strains (p < 0.05). The most inhibition in bacterial growth occurred in E. faecalis. Adding 2% SZ to GIC resulted in a significant increase in the silver release into deionized water. This study demonstrated that GIC had an inhibitory affect on Streptococcus milleri, Staphylococcus aureus, and Enterococcus faecalis and that adding SZ increases that affect proportional to its concentration.