Assessment of the oral health status of children with chronic kidney disease.

BACKGROUND: There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children. METHODS: A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices. RESULTS: The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00-4.00) in children with stage 1-3 CKD, 0.00 (IQR: 0.00-2.50) in stage 4-5 children, 0.00 (IQR: 1.00-3.00) in KTR, and 8.00 (IQR: 1.00-13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1-3, and 11.4% in stage 4-5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4-5, and 66.7% in stage 1-3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4-5 children (2.10 ± 1.08), followed by KTR (1.46 ± 1.19), stage 1-3 (1.27 ± 0.61), and healthy children (0.45 ± 0.44), respectively. CONCLUSIONS: Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries. A higher resolution version of the Graphical abstract is available as Supplementary information.

Association between serum biomarkers and oral health status in children with chronic kidney disease: A cross-sectional study.

OBJECTIVES: The aim of this study was to investigate the association between serum biomarkers and oral health parameters in children with chronic kidney disease (CKD). MATERIALS AND METHODS: Serum hemoglobin, blood urea nitrogen, serum creatinine, calcium, parathormone, magnesium, and phosphorus levels were measured in 62 children with CKD aged between 4 and 17 years. Intraoral examinations of the patients were performed by two different pediatric dentists. Dental caries was assessed using the decayed-missing-filled-teeth (DMFT/dmft) indexes, and oral hygiene was assessed using the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indexes. Spearman's rho coefficient and generalized linear modeling were used to examine the association between serum biomarkers and oral health parameters. RESULTS: The results of the study showed that there were negative and statistically significant correlations between serum hemoglobin and creatinine levels and dmft scores in pediatric patients with CKD (p = 0.021 and p = 0.019, respectively). Furthermore, blood urea nitrogen levels and DI and OHI-S scores (p = 0.047 and p = 0.050, respectively); serum creatinine levels and DI, CI, and OHI-S scores (p = 0.005, p = 0.047, p = 0.043, respectively); and parathormone levels and CI and OHI-S scores (p = 0.001 and p = 0.017, respectively) were found to be positively and statistically significantly related. CONCLUSIONS: There are associations between various serum biomarker levels and dental caries and oral hygiene parameters in pediatric patients with CKD. CLINICAL RELEVANCE: The impact of changes in serum biomarkers on oral and dental health is important for dentists' and medical professionals' approaches to patients' oral and systemic health.

Is there an association between molar incisor hypomineralization and developmental dental anomalies? A case-control study.

BACKGROUND: The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies. METHODS: Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies. RESULTS: No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively). CONCLUSIONS: While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.

Association between work-related musculoskeletal symptoms and quality of life among dental students: a cross-sectional study.

BACKGROUND: Dental students are frequently affected by work-related musculoskeletal symptoms (WMSs) due to reasons such as working conditions, difficult education process and long work periods. The aim of the study was to investigate the frequency and anatomical distribution of WMSs, and its effect on the quality of life (QoL) in dental students. METHODS: Sociodemographic and health-related characteristics of one-hundred and five dental students were recorded. WMSs were scored by the participants with the Nordic Musculoskeletal Questionnaire. Then, participants were asked to evaluate their QoL by scoring the World Health Organization Quality of Life-Brief Form. Differences between independent groups for continuous variables were evaluated by Student's t-test and ANOVA as appropriate. Linear regression analysis was performed to determine the effect of demographic and health-related parameters in predicting the QoL subscales. RESULTS: The most common painful region in the last 12 months was the neck (66.7%). The body region with the most WMSs in the last 7 days was the upper back (43.8%). Physical health-related QoL of those with diagnosed musculoskeletal symptoms, and general health-related QoL of those using medicine due to any musculoskeletal symptoms were found to be statistically significantly lower (p = 0.018, p = 0.041, respectively). It was observed that the general and physical health, psychological well-being, and social relationship of the participants who reported the presence of neck pain in the last 7 days were statistically significantly lower (p = 0.003, p < 0.001, p = 0.004, p = 0.012; respectively). According to multiple regression analyses, pain occurrence in the body in the last 12 months and/or in the last 7 days had a negative impact on the participants' general and physical health, psychological well-being, social relationship, and environmental status and related QoL (p = 0.026, p = 0.047, p = 0.021, p = 0.001, p = 0.027, respectively). CONCLUSIONS: The results of this study show that dental students' body regions, especially the neck and the back, are affected by WMSs. These negative changes observed in the body had a negative effect on the QoL of the dental students.

Relationship between erosive tooth wear and possible etiological factors among dental students.

OBJECTIVES: The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students. MATERIALS AND METHODS: A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables. RESULTS: Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001). CONCLUSIONS: Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times. CLINICAL RELEVANCE: The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.

Motivations, attitudes for choosing dental profession and preferred dental specialties amongst Turkish dental students.

AIM: The aim of the study was to investigate the influential factors for choosing dentistry, their thoughts about the profession, their expectations for the future and their thoughts about the specialisation of dental students from all grades in the School of Dentistry, Marmara University. MATERIALS AND METHODS: Socio-demographic information, influential factors the choice of profession, thoughts and expectations about dentistry, and thoughts about the specialisation were evaluated in the questionnaire that included different question types in four separate sections. Chi-square test was used to assess the relationship between categorical variables, and multiple linear regression was performed to examine the combined effects of variables that influence the always dream of becoming a dentist. RESULTS: 462 of the 471 participants from all grades who agreed to participate in the study completed the questionnaire with a response rate of 98.1%. It was seen that the students' clinical experience made differences in almost half of their motivational sources for choosing dentistry and their views on future opinions and expectations (p < .05). In addition to clinical experience, gender also made a statistically significant differences in almost all answers in the students' opinions about specialisation (p < .05). CONCLUSION: From the results of the study, the majority of Turkish dental students were self-motivated compared to familial and environmental factors for choosing dentistry as a career. The career motivations of them seemed to be associated with the socioeconomic aspects of dentistry, whereas the perceptions regarding the future of dentistry seemed to be associated with the need for postgraduate education.

The effect of a novel toothpaste in children with white spot lesions.

OBJECTIVE: To investigate the effect of a novel mineral containing toothpaste in comparison to a fluoride toothpaste in children with white spot lesions. METHODS: The clinical study was conducted from 2016 to 2018 at Marmara University Department of Pediatric Dentistry Clinic after approval from the ethics review committee of Yeditepe University, Istanbul, Turkey and comprised children of either gender aged 4-5 years having white spot lesions. They were randomly allocated into two groups. The FT (Fluoridated Toothpaste) group was given a 500ppm fluoridated toothpaste, while the Mineral Containing Toothpaste (MCT) group was given toothpaste containing calcium glycerophosphate, magnesium chloride, and 12% xylitol. The white spot lesions were examined using Laser Fluorescence (LF) at baseline and after a month of usage. The two readings were compared. Stimulated saliva was collected for measuring the salivary potential of hydrogen, buffering capacity, and streptococcus mutans. Data was analysed using SPSS 19. RESULTS: Of the 26 children, 10(38%) were girls and 16(62%) were boys. The overall mean age was 4.77±0.54 years. There were 13(50%) subjects in each of the two groups. Of the 381 measurements done, 198(52%) were in the MCT group and 183(48%) in the FT group. LF scores decreased in both the groups (p=0.001). The remineralising potential was not significantly different (p=0.866), while salivary buffering capacity and potential of hydrogen increased in both the groups but the change was not significant (p>0.05). The number of children positive for streptococcus mutans decreased in both the groups (p>0.05). CONCLUSIONS: The toothpaste containing calcium glycerophosphate, magnesium chloride and 12% xylitol had the remineralization properties needed for the prevention of gwhite spot lesions in children.

Changes in oral health-related quality of life after treatment of molar incisor hypomineralisation using Glass Hybrid Restorations.

OBJECTIVE: To assess the changes in children's oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. METHODS: The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry, Istanbul, Turkey.. Children aged 11-14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children's MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ11?14) prior to their dental treatment and 6 months after the treatment. RESULTS: Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 ±1.02 years. The overall CPQ score ranged from 3-83 (average 33.27 ± 16.46) at baseline and 0-61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. CONCLUSIONS: Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation.

Effect of Remineralization Agents on Molar-Incisor Hypomineralization-Affected Incisors: A Randomized Controlled Clinical Trial.

OBJECTIVE: The objective of this study was to evaluate the remineralization effect of two different mineral containing agents on white/creamy and yellow/brown demarcated opacities in incisors in children with molar-incisor hypomineralization (MIH) by using laser fluoresence (LF). STUDY DESIGN: Fifty-three children (n=401 lesions) with MIH were randomly divided into three groups: (1)calcium glycerophosphate (CaGP), (2)casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and, (3)control (1450 ppm fluoride toothpaste). Remineralization was evaluated by means of LF, at baseline, after one and threemonths. Anova Test for Repeated Measurements in intra-group comparisons in evaluating the effectiveness of remineralization agents. One-way Variance Analysis (ANOVA) and Tukey-Kramer Multiple Comparison test were used in the comparisons between groups and, Student Newman Keuls Multpile Comparison Test was used to determine the differences between the measurement averages in case of p<0.05. RESULTS: There was a significant improvement in MIH-lesions over time in all groups (p<0.001), with no differences between groups. The highest percentage of change was observed in CPP-ACFP in lesions LF≤20 scores and the mean percentage of change LF>20 scores, the highest percentage changes in CaGP. There was no significant difference between the groups over the time for all the used outcome measures (p>0.05). CONCLUSION: The additional use of both mineral containing agents in MIH-affected teeth improved these hypomineralized lesions with mineral deposition. Even if both agents could be used in the hypomineralized teeth with demarcated opacities, future studies are recommended the long-term effect of these mineral containing agents with longer observation and a larger sample size.

Two-Year Survival of High-Viscosity Glass Ionomer in Children with Molar Incisor Hypomineralization.

OBJECTIVE: We assessed the clinical survival of a high-viscosity glass ionomer (HVGI) at the 2-year follow-up to restore molar incisors severely affected by hypomineralization after selective carious tissue removal (SCR). The null hypothesis tested was that there are no differences in the overall survival times in the categories of the variables of interest. METHODS: A total of 134 fully erupted first molar incisors with hypomineralization, cavitated and with moderate-to-deep carious lesions without hypersensitivity or pain (MIH treatment need index 2a-c), were included in the study. HVGI (Equia Forte®; GC, Tokyo, Japan) restorations were applied after SCR to soft carious dentin. The follow-up lasted 2 years. The end point was defined as the absence of endodontic and restorative complications. Two-year, and 18-, 12-, and 6-month survival probabilities and standard errors were calculated using the Kaplan-Meier method. Survival probabilities according to patient gender, jaw, and lesion severity groups were compared using the log-rank test. Restorations were evaluated using the modified US Public Health Service criteria. RESULTS: HVGI restorations showed cumulative survival probabilities of 95.5% at 6 months, 94% at 12 months, 87.5% at 18 months, and 87.5% at 24 months. Survival probabilities according to patient gender, jaw, and lesion severity groups were not statistically significantly different (p > 0.05). Therefore, the null hypothesis was accepted. CONCLUSION: Following SCR, HVGI restoration provided moderate survival probabilities, suggesting that the SCR technique is effective.

Attitudes and knowledge of paediatric dentists' on digital radiography and cone beam computed tomography.

OBJECTIVE: To determine the frequency and reasons of digital radiography and cone-beam computed tomography usage among paediatric dental practitioners, and to assess their knowledge and need for specific education.. METHODS: The cross-sectional study was conducted from January to July 2017 and comprised paediatric dentists present at the European Academy of Paediatric Dentistry Interim Seminar in Turin, Italy, and members of the Turkish Society of Paediatric Dentistry who did not attend the event. Data about sociodemographics and their attitude towards, use of, and knowledge of digital radiography and cone beam computed tomography was collected by means of a 20-item questionnaire that was mailed to all the subjects. SPSS 22 was used to evaluate data. RESULTS: Of the 435 questionnaires distributed, 245(56%) were returned, while 194 (45%) were deemed usable. The mean age of the responding paediatric dentists was 35.84±9.10 (range: 24-67 years) and 126(64.9%) were female. Users of digital radiography identified its advantages, such as lower radiation dose 166(85.7%), ease of image storage 150(77.3%), and the possibility to change image settings and to carry out measurements 106(54.5%). Overall, 70(36%) paediatric dentists had no knowledge of cone beam computed tomography. Dental trauma was cited as the reason for using cone beam computed tomography by 70(61.3%) subjects, dental development issues by 138(71%) and pathology in the jaws by 147(75.8%). CONCLUSIONS: Digital radiography and cone beam computed tomography users are increasing in the world.

The Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate on Molar-Incisor Hypomineralisation: A Pilot Study.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) application on noncarious MIH (molar-incisor hypomineralisation) lesions using a DIAGNOdent device (KaVo), which measures laser fluorescence within the mineral structure of the tooth. MATERIALS AND METHODS: A total of 461 subjects age 7-12 (mean ±â€¯SD was 9.9 ±â€¯1.6) years were examined. Fifty- four children were diagnosed with MIH and divided into 2 groups. A total of 38 teeth met the inclusion criteria and were included in the study. Group 1 subjects (n = 15) used a paste containing 10% CPP-ACP, and group 2 subjects (n = 23) used a paste containing 10% CPP-ACP with 0.2% NaF (CPP-ACFP) for one month. RESULTS: After the application of the pastes for one month, significant decreases were found in the mean DIAGNOdent readings for both groups (CPP-ACP p = 0.0015 and CPP-ACFP p = 0.0001). However, the percentage decreases in both groups were not significantly different from each other (60.4% and 45.5% in CPP-ACP and CPP-ACFP groups, respectively). CONCLUSION: This pilot study shows that using CPP-ACP and CPP-ACFP had a positive effect in reducing hypomineralisation on enamel surfaces of MIH-diagnosed teeth for a one month period. It is important to diagnose molar-incisor hypomineralisation at an early stage to prevent excessive caries develeopment. Therefore, further clinical studies are necessary on the long-term application of these kinds of nanocomplexes.

Clinical Evaluation of a Fissure Sealant Placed by Acid Etching or Er:YAG Laser Combined with Acid Etching.

PURPOSE: To evaluate the efficacy of conventional acid etching alone (acid etching) and Er:YAG laser combined with acid etching (laser + acid etching) on fissure sealant (FS) retention of first permanent molars (FPMs) after 18 months. MATERIALS AND METHODS: Using a split-mouth design in 51 children, a total of 204 FPMs were sealed with acid etching alone or laser plus acid etching (laser+acid). The retention of sealants and occurrence of caries were evaluated at 3, 6, 12, and 18 months. Statistical analysis was performed using Pearson's chi-squared tests. RESULTS: The retention rate for FS in the laser+acid group was significantly higher than that of the acid-etch group at 12 (p = 0.0161) and 18 (p = 0.0227) months. Six FSs in the acid group and five FSs in the laser+acid group were completely lost after 18 months. The incidence of caries in the acid-etch group was 22% (n = 18) vs 10% (n = 8) in the laser+acid group at 18 months. The difference in caries development between the groups was not significant (p > 0.05). CONCLUSIONS: As enamel pretreatment, Er:YAG laser combined with acid etching significantly improves FS retention over conventional acid etching alone.

Efficacy of Dentaq® Oral and ENT Health Probiotic Complex on Clinical Parameters of Gingivitis in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study.

OBJECTIVES: Probiotics act as a unique approach to maintaining oral health by supplementing the endogenous oral bacteria with additional naturally occurring beneficial microbes to provide defense against pathogens harmful to teeth and gingiva. The aim of this pilot study was to clinically evaluate the effects of probiotics on plaque accumulation and gingival inflammation in subjects with fixed orthodontics. METHODS: The pilot study was comprised of 15 healthy patients, aged 11 to 18 years, undergoing fixed orthodontic treatment. Patients used an all-natural, dissolving lozenge containing six proprietary probiotic strains (Dentaq® Oral and ENT Health Probiotic Complex)for 28 days. Gingival Index (GI) according to Löe-Silness and Plaque Index (PI) according to Quigley-Hein for all teeth were measured at baseline (Day Zero) and at the end of the probiotic regimen (Day 28). RESULTS: The mean baseline GI and PI scores within each patient decreased by 28.4% and 35.8%, respectively, by Day 28. Patients reported decreased tooth and gingival pain, decreased oral bleeding, and increased motivation to maintain proper oral hygiene over the course of the study. CONCLUSIONS: This pilot study provided preliminary support for the use of Dentaq Oral and ENT Health Probiotic Complex as a safe and effective natural health product for the reduction of plaque accumulation and gingival inflammation. The results demonstrate its potential therapeutic value and open the door for larger scale placebo-controlled clinical studies to verify these findings.

Clinical performance of short fiber reinforced composite and glass hybrid on hypomineralized molars: A 36-month randomized split-mouth study.

OBJECTIVES: This study aimed to assess the clinical performance outcome at 36 months of molars with molar incisor hypomineralization and carious lesions, treated with two different restorative approaches following selective caries removal. METHODS: The children aged 6 to 12 years (18 female, 13 male) included in the study had at least two carious permanent first molars diagnosed with molar incisor hypomineralization. Sixty-two molars were restored in a split-mouth design. In all subjects, selective caries removal was performed so that caries was completely removed from the cavosurface walls and only soft dentin was left above the pulp chamber. Short fiber reinforced composite (SFRC; EverX Flow™) covered by micro-hybrid composite (G-Aenial® posterior composite) and Glass Hybrid (GH; Equia Forte® HT) were used as restorative materials. The restorations were evaluated according to modified United States Public Health Service (USPHS) criteria at baseline, 6, 12, 18, 24, and 36 month follow-ups. RESULTS: During the 36-month follow-up, eight GH and four SFRC restorations failed. The clinical success of both restorations decreased statistically over time (p < 0.001 for both). When variables such as restoration type, sex, age, tooth type, and time were included in the model, the risk of failure of the restorations of the left lower first molar was statistically significantly higher than that of the left upper first molar (p < 0.002). CONCLUSION: Direct composite restorations with SFRC and GH restorations perform similar clinical success with selective caries removal in the management of permanent molars affected by molar incisor hypomineralization. CLINICAL SIGNIFICANCE: SFRC or GH restorations with similar clinical success might be preferred for the management of MIH-affected molars.

Evaluation of different remineralization agents in the treatment of natural caries-affected dentin in permanent teeth.

BACKGROUND: In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. OBJECTIVE: In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. METHODS: Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS 2) (Code 3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5% NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. RESULTS: LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. CONCLUSION: The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.

A Randomized Clinical Trial of Short Fiber Reinforced Composite and Glass Hybrid Restoration for Molars Affected by Molar Hypomineralization.

Purpose: The purpose of this split-mouth design study was to evaluate the clinical success and survival of glass hybrid (GH) and direct composite with short fiber-reinforced composite (SFRC) after selective caries removal in restorations of permanent first molars that were affected by molar hypomineralization (MH). Methods: Thirty-one children aged six to 12 years with severe MH were randomly assigned as follows: group one equals GH (Equia Forte® HT) and group two equals SFRC (EverX Flow TM ) covered by micro-hybrid composite (G-Aenial® posterior composite). For selective caries removal, only disorganized dentin in the pulpal and the axial wall was removed using low-speed tungsten carbide burs and hand instruments. The restoration longevity was evaluated at baseline and six, 12, and 24 months after treatment according to modified US Public Health Service (USPHS) criteria. Results: Seven GH and two SFRC restorations failed within two years of the follow-up period. The clinical success of all restorations decreased statistically over time for retention and marginal adaptation criteria of USPHS criteria (P<0.001 for both criteria). The direct composite with SFRC was 3.32 times (confidence interval equals 1.26 to 8.79) more successful than GH restorations in terms of retention according to the USPHS criteria (P=0.016). However, survival at 24 months was 93.5 percent (±4.4 standard error [SE]) and 77.4 percent (±7.5 SE) for SFRC and GH restorations, respectively. Conclusion: The retention of the direct composite with short fiber-reinforced composite was superior to glass hybrid restorations at 24 months in the management of molar hypomineralization-affected molars.

Parent's report on oral health-related quality of life of children with cystic fibrosis.

BACKGROUND: Health-related quality of life (HRQoL) scales are now widely used in children with cystic fibrosis (cwCF) which reflects the course of the disease. In this cross-sectional study, our primary aim was to compare the Pediatric Oral Health-Related Quality of Life (POQL) and Oral Health Score (OHS) between cwCF and healthy group. Our secondary aim was to evaluate the association between Pseudomonas aeruginosa (PA) colonization, pulmonary function test, OHS and POQL in cwCF. METHODS: The study population (age ranging 6-14) included 55 cwCF followed at the Marmara University Division of Pediatric Pulmonology compared with 50 healthy peers. A survey consisted of general questions (age, sex, etc.) and the POQL instrument were filled by parents. The decayed, missing, and filled teeth for both primary (dft) and permanent dentition (DMFT) was detected according to WHO criteria. Data like current body mass index (BMI z score), colonization status with PA, predicted value for forced expiratory volume in 1 second (FEV1pp), and any hospitalizations during the previous year were obtained from their medical. Differences between the groups were evaluated using Chi-square and Mann-Whitney U test with a significance level set at 0.05. RESULTS: There was no significant difference between PA-colonized cwCF and healthy controls in DMFT (p = 0.916). For all domains of POQL (emotional function, social function, role function), scores of cwCF were significantly better than healthy controls (p < 0.05). There were no statistically significant differences between all domains of POQL scores in PA colonized and non-PA colonized cwCF' POQL scores (p > 0.05). CONCLUSION: Although POQL scores of cwCF were encouraging, dental caries prevention and regular follow-ups should be taken into consideration.

Assessment of Relationship between Intelligence Quotient and Orthodontic Treatment Need.

Objective: Low cognitive ability may reduce the ability to understand the importance of oral health and to perform the necessary practices to maintain proper oral hygiene. Early loss of primary teeth following high caries risk may lead to malocclusion of permanent dentition. This study aimed to evaluate the relationship between the cognitive levels of adolescents and their orthodontic treatment needs. Material and Methods: Between January 2018 and May 2018, 200 adolescents aged 10 - 15 who applied to the Pediatric Dentistry Clinic of Marmara University and sought orthodontic treatment were invited to participate in the study. The orthodontic treatment needs of 150 adolescents who agreed to participate were evaluated with the Index of Orthodontic Treatment Need - Aesthetic Component and their cognitive levels were evaluated with the Raven Standard Progressive Matrices (SPM) Test. P-value < 0.05 was considered statistically significant. Results: The mean age (± standard deviation) of 126 adolescents (77 females and 49 males) who completed the SPM test was 11.8 (± 1.3). There was no consistency between the intellectual level and the need for orthodontic treatment (Kappa value = 0.071, p-value = 0.081). There was no correlation between malocclusion severity and intelligence quotient scores of adolescents (ρ [rho] = -0.089, p = 0.322). According to Multiple logistic regression results, there was no difference between 'borderline need' (p = 0.059) and 'great need' (p = 0.881) from 'no need' for orthodontic treatment in adolescents with different intelligence quotients. Conclusions: The results showed no evidence for an association between malocclusion and intelligence quotient.

Caries experience and oral hygiene status of a group of visually impaired children in Istanbul, Turkey.

PURPOSE: To evaluate the caries experience, oral hygiene status and oral health knowledge of a group of visually impaired students. MATERIALS AND METHODS: The study was conducted at one of the largest visually impaired children's schools among students aged between 7 and 16 years (n = 178) in Istanbul, Turkey. A 16-item questionnaire was asked in addition to a clinical tooth examination. The 16-item verbal questionnaire was developed to record the students' general health, impairment, the socioeconomic profile and education level of their parents, oral health knowledge, sources of information about oral health and oral hygiene habits. Oral hygiene was assessed according to Greene and Vermillion's Simplified Oral Hygiene Index (OHI-S). To measure the oral hygiene status, OHI-S index scores were recorded. Additionally, DMFT and dft indices were documented. RESULTS: Only 26.40% of children were caries free, and only 2.2% of students had good oral hygiene. A total of 3.3% of these students were mildly retarded and 2.8% of them had a developmental disability. Visually impaired children exhibited a fair-to-poor level of oral hygiene. CONCLUSION: Maintenance of oral hygiene remains the greatest challenge in the care of visually impaired children.