Is Bioactive Glass an Effective Agent in Pulp-capping Treatments?: A Randomized Controlled Clinical Trial with One-year Follow-up.

AIMS: Indirect pulp-capping treatment is a procedure applied to teeth with deep and close-to-pulp caries lesions and without pulp degeneration symptoms. This study aimed to explore the use of a material containing bioactive glass for indirect pulp capping in primary and permanent teeth. MATERIALS AND METHODS: The study included 145 patients, aged 4-15 years, without any systemic disease and 100 primary second molars and 100 permanent first molars in total. Four material groups were determined: calcium hydroxide (Dycal-DC group), glass ionomer (Biner LC-BC group), calcium silicate (TheraCal LC-TC group), and Bioactive glass-containing ACTIVA BioACTIVE-AC group. Clinical and radiographic evaluations were made 1, 3, 6, 9, and 12 months after the treatment. The data obtained were statistically analyzed using the Chi-square test. RESULTS: During the 12-month follow-up period, the DC and TC groups were more successful clinically (94%), while the DC and AC groups were found to be more successful radiographically (94%). However, no statistically significant difference was found between the groups (p > 0.05). CONCLUSIONS: The results of this study supported the view that the success of indirect pulp-capping treatments was independent of the material used. CLINICAL SIGNIFICANCE: This study demonstrated that a material containing bioactive glass, ACTIVA BioACTIVE-Base/Liner, can be used safely in indirect pulp-capping processes.

Effect of different surface treatments on the shear and microtensile bond strength of resin-modified glass ionomer cement to dentin.

OBJECTIVE: The aim of this study was to evaluate the effect of different surface treatments on the microtensile bond strength (µTBS) and shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) to dentin. MATERIALS AND METHODS: Fifty-two extracted human molars were flattened to obtain dentin surfaces. For SBS assessment 40 teeth were divided into four groups according to their surface treatments (acid etching, Er:YAG laser QSP mode, Er:YAG laser MSP mode and control-SiC) (n = 10). A plastic cylinder was placed over the differently treated dentin surfaces and RMGIC was placed into the rings and polymerized. Twelve teeth were used for the µTBS test. The treated dentin surfaces described above were restored with 4 mm high RMGIC and light cured; then, the specimens were sectioned into serial sticks (n = 15) and µTBS and SBS were tested for failure in a testing machine with a 1 mm/min crosshead speed. The data were analyzed by one-way ANOVA and Tukey HSD tests (α = 0.05). RESULTS: Acid etching showed significantly higher SBS than the other groups (p < 0.05). Er:YAG QSP and MSP-treated groups showed higher SBS values than the control group, but the difference was not statistically significant (p > 0.05). Er:YAG MSP showed the highest µTBS value followed by acid etching, whereas the control group exhibited the lowest value (p < 0.05) and the differences between the control group and Er:YAG QSP were not significant (p > 0.05). CONCLUSIONS: The application of Er:YAG MSP mode and acid etching to dentin can be used for improving the bond strength of RMGIC.

Retrospective evaluation of the effectiveness of teledentistry approach during COVID-19 in pediatric dentistry: A parental perspective.

Objective: Dentistry necessarily requires close face-to-face contact with patients, so it was largely halted during the COVID-19 pandemic. During this pandemic, teledentistry (TD) could be a novel way to resume dental practice. It was aimed to investigate the satisfaction of the parents who received teledentistry (TD) service in a pediatric dentistry clinic during the COVID-19 pandemic, as well as other factors that may have contributed to this satisfaction. Methods: It was conducted using a telephone survey to interview the parents who used the TD system between June and December 2020. The survey includes participant demographics, COVID-19 anxiety, TD system, reasons for using TD, and Internet use in the field of health. Five-point Likert scale was used. A Chi-squared test was used and p < 0.05 was accepted as significant. Results: Most of the participants stated that they had no trouble connecting to the TD system (82.5%), and 119 participants reported that the system helped them to solve their health problems. Significant relationships (p < 0.05) were found between overall satisfaction and parental job, level of education, anxiety level (3 questions), and use of the Internet in healthcare (4 questions), whereas no associations were found regarding the other variables (p > 0.05). Conclusions: Parents benefited greatly from the TD system and would be open to using it after the pandemic. The education and parental job categories of parents, anxiety level, and use of the Internet in healthcare seem to have relationships with overall satisfaction.

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.

Dental findings in marfan syndrome: a case report.

Marfan syndrome is an autosomal dominant disorder of connective tissue primarily characterized with anomalies affecting the musculoskeletal system, the cardiovascular system and the eyes. It has been suggested that early diagnosis of the syndrome is important, because of the risk of infective endocarditis. A 7-year-old female was referred to our clinic, with a chief complaint of dental crowding in the anterior region of mandible. It was observed that the patient needed multiple treatments based on detailed clinical and radiographic examinations. The treatment was carried out with antibiotic prophylaxis an hour prior to her appointment considering her profound caries. The patient was advised to visit regularly for follow up and she was referred for orthodontic evaluation.

Biofilm formation by Staphylococcus aureus isolates from a dental clinic in Konya, Turkey.

The ability of Staphylococcus aureus to form biofilm is considered to be a major virulence factor influencing its survival and persistence in both the environment and the host. Biofilm formation in S. aureus is most frequently associated with production of polysaccharide intercellular adhesion by ica operon-encoded enzymes. The present work aimed at evaluating the in vitro biofilm production and presence of the icaA and icaD genes in S. aureus isolates from a dental clinic in Konya, Turkey. The surfaces of inanimate objects were sampled over a period of six months. S. aureus isolates were subjected to Congo Red Agar (CRA) and crystal violet (CV) staining assays to evaluate their ability of biofilm production, while the presence of the icaA and icaD genes was determined by polymerase chain reaction. S. aureus contamination was detected in 13.2% of the environmental samples. All the 32 isolates were observed to be positive for both the icaA and icaD genes. Phenotypic evaluations revealed that CV staining assay is a more reliable alternative to CRA assay to determine biofilm formation ability. A high percentage of agreement (91%) was observed between the results from CV staining and ica genes' detection assays. Phenotypic and genotypic evaluations should be combined to detect biofilm formation in S. aureus. Our findings indicate that dental clinic environments should be considered as potential reservoir for biofilm-producing S. aureus and thus cross contamination.

Antimicrobial and mechanical properties of dental resin composite containing bioactive glass.

BACKGROUND: The aim of this study was to evaluate the antimicrobial efficacy and mechanical properties of dental resin composites containing different amounts of microparticulate bioactive glass (BAG). METHODS: Experimental resin composites were prepared by mixing resin matrix (70% BisGMA and 30% TEGDMA) and inorganic filler with various fractions of BAG to achieve final BAG concentrations of 5, 10 and 30 wt%. Antimicrobial efficacy was assessed in aqueous suspension against Escherichia coli, Staphylococcus aureus and Streptococcus mutans and in biofilm against S. mutans. The effect of incorporation of BAG on the mechanical properties of resin composite was evaluated by measuring the surface roughness, compressive strength and flexural strength. RESULTS: Under the dynamic contact condition, viable counts of E. coli, S. aureus and S. mutans in suspensions were reduced up to 78%, 57% and 50%, respectively, after 90 minutes of exposure to disc-shaped composite specimens, depending on the BAG contents. In 2-day-old S. mutans biofilm, incorporation of BAG into composite at ratios of 10% and 30% resulted in 0.8 and 1.4 log reductions in the viable cell counts compared with the BAG-free composite, respectively. The surface roughness values of composite specimens did not show any significant difference (p>0.05) at any concentration of BAG. However, compressive and flexural strengths of composite were decreased significantly with addition of 30% BAG (p<0.05). CONCLUSIONS: The results demonstrated the successful utilization of BAG as a promising biomaterial in resin composites to provide antimicrobial function.

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)