Could bulk fill glass hybrid restorative materials replace composite resins in treating permanent teeth? A randomized controlled clinical trial.

OBJECTIVE: This study aims to compare the clinical and radiographic efficacy of Equia system bulk fill glass hybrid material with composite resins in the permanent restoration of pediatric patients' permanent teeth. MATERIALS AND METHODS: The study included 44 pediatric patients aged 8-16 who applied to Necmettin Erbakan University Pediatric Dentistry Department. The groups were formed as symmetrical teeth in the same patient using the split-mouth design. The study included class I caries lesions of 144 permanent teeth. Group 1 was restored with the Equia system bulk fill glass hybrid material (Equia Forte HT + Equia Forte Coat [GC, Co, Tokyo, Japan]) (n = 72) and Group 2 with the Charisma Smart universal composite resin (Kulzer, Gmbh, Hanau, Germany) + Clearfil SE Bond (Kuraray, Noritake, Sakazu, Okayama) (n = 72). Evaluations were performed clinically and radiographically by two physicians in 2nd week, 3rd month, 6th month, and 12th month and the results were recorded. Clinical evaluation was carried out using modified-USPHS criteria. Obtained data were statistically analyzed using Kendall's W test and Cochran's Q test for the comparison within the group, and the Chi-square test for the comparison between groups. RESULTS: Among the materials utilized in the study, there was no statistically significant difference in marginal adaptation, marginal discoloration, retention, anatomical form, postoperative sensitivity, and secondary caries according (p > 0.05). Group 2 outperformed statistically significant Group 1 in terms of color match in all periods (p < 0.05). While there was no statistically significant difference in surface structure between the groups in 2nd week and 3rd month (p > 0.05), there was a statistically substantial difference in 6th, and 12th months (p < 0.05). No secondary caries or periapical lesions were found in any restorations during radiographic evaluation. CONCLUSION: After a year, the clinical performance of both Equia and composite resins was equivalent and successful in the majority of the measures against which they were evaluated. CLINICAL SIGNIFICANCE: Based on the results of the research, Equia system bulk fill glass hybrid restorations are considered a viable alternative to composite resins in class I permanent teeth restorations.

Effect of low-level laser therapy in wound healing of primary molar teeth extraction.

INTRODUCTION: Tooth extraction in children requires attention to wound healing and pain management, which are influenced by patient-related factors and behavioral guidance. AIM OF THE STUDY: The study aimed to evaluate the effect of LLLT on healing sockets in pediatric patients with bilateral primary molar teeth extraction and determine its impact on pain management. METHODS: 6-10 years of age, systemically healthy, and with atraumatic extraction indications of bilateral primary molar teeth were included in the study (n = 40). In the first session, randomly selected teeth were extracted under local anesthesia. In the control group, only clot formation in the socket was observed and photographed. The other group extractions were performed 2 weeks later. The low-level laser therapy (LLLT) group was treated with a 980 nm wavelength, in a continuous emission mode, 0.5 W power, 300 J of energy, 400 µm tip, 60 s diode laser and photographed. Nonepithelialized surface measurements were performed using ImageJ. Pain assessment was performed using the Wong-Baker Pain Scale. Statistical analyses were performed using SPSS software. RESULTS: There was a statistically significant difference between the groups in the Wong-Baker values in 3rd day (p < 0.05). In soft tissue healing on the 3rd and 7th day, the nonepithelialized surface of the laser socket was smaller than that of the control group, and the measurement results were found to be statistically significant (p < 0.05). CONCLUSION: Although LLLT was not found to be very effective in reducing postoperative discomfort after extraction of primary molars, it provided better wound healing in extraction sockets.

The effects of gastric acid on pediatric restorative materials: SEM analysis.

In this study, we aimed to demonstrate changes in the surface roughness and microhardness of three different restorative materials routinely used in pediatric dentistry (composite, compomer and resin-modified glass ionomer cement (RMCIS)) in response to continuous daily exposure to gastric acid. Twelve samples of each of type of restorative material were prepared. Eleven of the specimens were included in the gastric acid cycle. The microhardness and surface roughness of ten samples were measured before and after the cycle. Another sample included in the cycle was compared with the sample not included in the cycle by scanning electron microscopy (SEM). There was a significant difference between the groups in terms of roughness scores following gastric acid cycle (p = 0.039). RMCIS material possessed the highest roughness value. A significant difference was identified in terms of microhardness levels before and after the gastric acid cycle (p = 0.001). The most significant change was observed in the compomer material. SEM analysis, performed after the gastric acid cycle, revealed that most cracks were identified in RMCIS material; this was followed by compomer and composite materials, respectively. Our analysis indicates that the restorative materials used frequently in pediatric dental procedures, show increased surface roughness and reduced microhardness when exposed to gastric acid.

Unraveling the impact of primary immunodeficiency disorders on the microbiota of dental caries in children through 16S rRNA gene-based metagenomic analysis.

Background/aim: Dental caries is a frequently occurring and multifactorial chronic disease in children resulting from the interaction of cariogenic bacteria and host susceptibility. The aim of this study was to elucidate the impacts of primary immunodeficiency disorders (PIDs) on microbiota of dental caries in children by 16S rRNA gene-based metagenomic analysis. Materials and methods: Enrolled in this study were 15 children with primary PID with caries (PID group) and 15 healthy children with caries as a control (CG). The DMFT index, saliva flow rate, and buffering capacity of each participant were assessed before the metagenomic analyses were conducted. For taxonomic profiling, the reads were obtained by high-throughput sequencing of the V3-V4 hypervariable region of 16S rRNA. Results: The DMFT score, saliva flow rate, and buffering capacity of the groups were similar. The flow rate and buffering capacity had no correlation with the number of species with 95% confidence. The metagenomic analysis resulted in the identification of 2440 bacterial species in all of the samples. Among the 50 most prevalent species present at ≥1% relative abundance, Prevotella melaninogenica and Prevotella salivae were differentially more abundant in the PID group. The PID group and CG showed similar species richness and evenness, but 4 of the 5 samples with the highest Shannon-Weiner and Inverse Simpson indices belonged to the PID group. The Spearman test results for correlation of the species in the PID subgroups showed that Prevotella oris had a positively correlated relationship with both Scardovia wiggsiae and Saccharibacteria genera incertae sedis. Conclusion: This study provided insight into the caries microbiota of children with immunodeficiency diseases. Differentially abundant species, novel bacterial associations, and unique bacterial species were disclosed in the PID samples, indicating the role of the immune system in altering the caries microbiota. The prominent bacterial species and associations in the PID group should be suspected in regard to their link with present or future diseases.

Knowledge and experience of pediatricians and pedodontists in identifying and managing child abuse and neglect cases.

Child abuse, by definition parents and other family members, caregivers, or any adult he does not know culturally inappropriate, harmful to the child described, inhibiting growth and development, or exposure to a restrictive behavior. This study aims to evaluate the capabilities of pediatricians and pedodontists in identifying and managing child abuse and neglect within healthcare settings, a crucial responsibility for professionals across various medical disciplines. Questionnaire was performed on 53 pediatricians and 89 pedodontists. Utilizing a 28-item expert-designed electronic questionnaire, the study solicited responses from pediatricians and pedodontists to assess their demographic characteristics, professional experience, and self-perceived competence in this critical area. The results indicate that 42% of the participating healthcare providers have encountered at least one case of child abuse and neglect. Notably, pedodontists displayed a higher level of uncertainty in identifying abuse and neglect cases compared to pediatricians. Furthermore, participants who had a higher level of self-perceived competence were significantly more willing to identify and manage cases, although this self-assessment did not correlate with their actual skills or level of willingness to intervene effectively. The study concludes that there is a pressing need for specialized training programs tailored to enhance the skill sets of healthcare providers in identifying and managing child abuse and neglect. These programs should encompass not only academic knowledge but also practical applications and psychosocial support techniques to ensure a holistic approach to combating this serious issue.

Antibacterial and Smear Layer Removal Efficacy of Er:YAG Laser Irradiation by Photon-Induced Photoacoustic Streaming in Primary Molar Root Canals: A Preliminary Study.

OBJECTIVE: The objective of this study was to compare antibacterial and smear layer removal efficacy of the erbium:yttrium-aluminium-garnet (Er:YAG) laser irradiation by photon-induced photoacoustic streaming (PIPS), neodymium:yttrium-aluminium-garnet (Nd:YAG), and diode lasers and conventional irrigation agent in primary molar root canals. BACKGROUND: The selection, application, and activation of the irrigant are important factors affecting the success of the endodontic treatment. MATERIALS AND METHODS: Distal root canals of human primary mandibular molar teeth used for antimicrobial efficacy evaluation were first inoculated with Enterococcus faecalis (n = 25). Smear layer removal efficacy was evaluated on the noninoculated specimens (n = 20). The root canals in the first treatment groups were irrigated with a conventional technique using 5% sodium hypochlorite (NaOCl). In the laser groups, the root canals were irradiated with either Nd:YAG (1064 nm) or diode lasers (940 nm) followed by NaOCl irrigation agent. In the fourth groups, the NaOCl irrigation agent was activated with an Er:YAG laser (2940 nm) by PIPS tip using nonablative settings. Antibacterial efficacy was determined by viable counts of E. faecalis after treatments. The treated root canals were examined by scanning electron microscopy to determine the smear layer removal efficacy of treatments. RESULTS: Statistically significant (p < 0.05) reductions in the number of E. faecalis were achieved in Nd:YAG and diode laser groups and Er:YAG laser by PIPS-activated irrigation groups compared to the NaOCl group. Er:YAG laser by PIPS-activated irrigation resulted in more cleaning of the root canal walls and a higher quantity of open tubules. CONCLUSIONS: These findings suggest that Er:YAG laser by PIPS-activated irrigation can be considered as an effective irrigant agitation technique in pediatric endodontics.

Antibacterial effect of bioactive glass incorporated in acrylic resins against Streptococcus mutans and Lactobacillus acidophilus activity in biofilm / Efeito antibacteriano do vidro bioativo incorporado em resinas acrílicas sobre a atividade de Streptococcus mutans e Lactobacillus acidophilus em biofilme

Objective: The rough surfaces of removable appliances used in pediatric dentistry or orthodontics, may result in an environment for biofilm accumulation, yielding to enamel demineralization. This study aimed to assess the effects of adding nanoparticles of bioactive glass to polymethylmethacrylate to promote the antibacterial activity in acrylic resins. Material and Methods: Acrylic resin specimens (20x20x1mm3) were prepared by adding 2% or 5% bioactive glass. The specimens in the control group without bioactive glass were prepared from the mixture of acrylic powder containing nanoparticles and liquid monomer (n=10 per group). The antibacterial activity of the specimens against Streptococcus mutans and Lactobacillus acidophilus activity in biofilm was investigated through counting colony forming units (CFU). Data were analyzed using a one-way analysis of variance and Tukey's post hoc tests at the significance level of 0.05. Results: The incorporation of 2% (p=0.001) and 5% (p<0.001) bioactive glass in acrylic resin reduced the metabolic activity and CFU of L. acidophilus. For S.mutans, antimicrobial activity was observed only with the 5% concentration of bioactive glass, and this group was statistically different from the control (p<0.001). When L. acidophilus was exposed to polymethyl methacrylate with 5% bioactive glass, significant decrease was observed compared to the control group (p<0.05). Conclusion: Adding bioactive glass nanoparticles into the acrylic resins used for fabricating removable appliances revealed a greater antibacterial effect against cariogenic bacteria tested (AU)

Objetivo: As superfícies rugosas dos aparelhos removíveis utilizados em Odontopediatria ou Ortodontia, podem resultar em um ambiente para acúmulo de biofilme, cedendo à desmineralização do esmalte. Este estudo teve como objetivo avaliar os efeitos da adição de nanopartículas de vidro bioativo ao polimetilmetacrilato para promover a atividade antibacteriana em resinas acrílicas. Material e Métodos: Amostras de resina acrílica (20x20x1 mm3) foram preparadas pela adição de 2% ou 5% de vidro bioativo. Os corpos de prova do grupo controle sem vidro bioativo foram preparados a partir da mistura de pó acrílico contendo nanopartículas e monômero líquido (n=10 por grupo). A atividade antibacteriana dos espécimes sobre a atividade de Streptococcus mutans e Lactobacillus acidophilus em biofilme foi investigada através da contagem de unidades formadoras de colônias (UFC). Os dados foram analisados por meio de análise de variância unidirecional e testes post hoc de Tukey com nível de significância de 0,05. Resultados: A incorporação de 2% (p=0,001) e 5% (p<0,001) de vidro bioativo em resina acrílica reduziu a atividade metabólica e UFC de L. acidophilus. Para S. mutans, a atividade antimicrobiana foi observada apenas com a concentração de 5% de vidro bioativo, sendo este grupo estatisticamente diferente do controle (p<0,001). Quando L. acidophilus foi exposto ao polimetilmetacrilato com 5% de vidro bioativo, foi observada diminuição significativa em relação ao grupo controle (p<0,05). Conclusão: A adição de nanopartículas de vidro bioativo nas resinas acrílicas utilizadas na fabricação de aparelhos removíveis revelou um maior efeito antibacteriano contra as bactérias cariogênicas testadas(AU)

Evaluation of wettability characteristics and adhesion of resin composite to photo-polymerized pulp-capping materials with and without bioactive glass / Avaliação das características de molhabilidade e adesão da resina composta aos materiais fotopolimerizáveis com e sem vidro bioativo

Objective: This study evaluated the wettability and adhesive properties of three different photopolymerized resin-based pulp-capping materials with or without bioactive glass (BAG). Material and Methods: Cylindrical specimens (5 per group) were prepared from photo-polymerized pulp-capping materials (TER-TheraCal LC, BIN-Biner LC, and CAL-CalciPlus LC containing BAG). After surface finishing, contact angle measurements were made (θ)using the sessile drop method and surface free energy was calculated. For shear test, cylindrical acrylic blocks (N = 30) (diameter: 6 mm; height: 1 m) in the center were filled with the pulp-capping materials (N = 10 per group) flattened using a metal spatula and photo-polymerized. The specimens were stored at 37 °C in 100% humidity for 24 h prior to the bonding procedures. An adhesive system (CLEARFIL SE BOND, Kuraray) was applied on the material surfaces and photo-polymerized for 20 s. Then, resin composite material (Filtek Z250, 3M ESPE) was bonded on the substrate materials using translucent plastic molds (internal diameter: 2 mm; height: 2 mm). The specimens were photopolymerized with an LED photo-polymerization unit for 20 s. After polymerization, the specimens were stored at 37 °C, at 100% humidity for 24 h. Shear force was applied at the pulp-capping material and the resin composite interface In a universal testing machine (1 mm/min).Data were analyzed using 1-way ANOVA and Tukey`s tests at the significance level of 0.05. Results: Contact angle values showed significant difference between the 3 materials with group CAL presenting the lowest (35.35 ± 12.89) and group BIN the highest values (74.77 ± 13.56) (p < 0.05). Significantly lower surface energy was observed with BIN (36.22) (p 0.05). Group BIN (9.12 ± 3.45) showed significantly lower (p < 0.05) mean bond strength than those of TER (11.56 ± 5.67) and CAL (12.66 ± 4.34) (p > 0.05). Most of the observed modes of failures in all groups were of mixed type of failures. Conclusion: The bioglass used in Calciplus LC did not adversely affect the wettability, surface energy and adhesive properties. (AU)

Objetivo: Este estudo avaliou as propriedades de molhabilidade e adesivas de três diferentes materiais capeadores pulpares fotopolimerizaveis à base de resina, com ou sem vidro bioativo (BAG). Material e Métodos: Amostras cilíndricas (5 por grupo) foram preparadas a partir de materiais capeadores pulpares fotopolimerizáveis (TER-TheraCal LC, BIN-Biner LC e CAL-CalciPlus LC contendo BAG). Após o acabamento da superfície, as medidas do ângulo de contato foram feitas (θ) usando o método de gota séssil e a energia livre da superfície foi calculada. Para o ensaio de cisalhamento, blocos de acrílico cilíndricos (N = 30) (diâmetro: 6 mm; altura: 1 m) foram preenchidos no centro com os materiais de capeamento pulpar (N = 10 por grupo) achatados usando uma espátula metálica e fotopolimerizados. Os espécimes foram armazenados a 37 ° C em 100% de umidade por 24 h antes dos procedimentos de colagem. Um sistema adesivo (CLEARFIL SE BOND, Kuraray) foi aplicado nas superfícies do material e fotopolimerizado por 20 segundos. Em seguida, o material de resina composta (Filtek Z250, 3M ESPE) foi colado nos materiais do substrato utilizando moldes de plástico translúcido (diâmetro interno: 2 mm; altura: 2 mm). Os espécimes foram fotopolimerizados com um dispositivo de fotopolimerização de LED por 20 s. Após a polimerização, os espécimes foram armazenados a 37 °C, a 100% de umidade por 24 h. A força de cisalhamento foi aplicada no material capeador e na interface da resina composta em uma máquina universal de ensaios (1 mm / min). Os dados foram analisados por meio do teste de ANOVA e teste de Tukey ao nível de significância de 0,05. Resultados: Os valores do ângulo de contato mostraram diferença significativa entre os 3 materiais com o grupo CAL apresentando os menores valores (35,35 ± 12,89) e o grupo BIN os maiores valores (74,77 ± 13,56) (p < 0,05). Uma energia de superfície significativamente menor foi observada com o BIN (36,22) (p 0,05). O grupo BIN (9,12 ± 3,45) apresentou resistência de união média significativamente menor (p 0,05). A maioria dos modos de falhas observados em todos os grupos eram de tipo misto de falhas. Conclusão: O biovidro utilizado no Calciplus LC não afetou negativamente a molhabilidade, energia superficial e propriedades adesivas. (AU)