Ectopic eruption of maxillary permanent first molars: Predictive factors for self-corrected and impacted outcome.

OBJECTIVE: The aim of this study was to describe the occurrence, angulation and mesialisation ratio of the ectopic eruption of the maxillary permanent first molar (PFM) and its correlation with the pathological resorption of maxillary primary second molar (PSM). METHODS: This retrospective study was performed using the subsequent panoramic radiographs of 11.924 child patients aged 6-10 years. Ectopic eruption status is categorised as self-corrected and impacted types. To evaluate the differences between the two groups (self-corrected and impacted), the angulation of PFM, mesialisation ratio of PFM, and degree of adjacent PSM root resorption were also assessed. The data were statistically analysed using ANOVA and chi-square tests. Pearson correlation was used to analyse whether a quantitative relationship exists between PFM mesialisation ratio and PSM root resorption. RESULTS: Ectopic eruption frequency was determined as 0.83%. The distribution of ectopic eruption according to gender shows a higher prevalence in males than females. In most cases of ectopic eruption, the eruption status was impacted. The impacted PFMs showed more negative vertical and positive horizontal angle between the PSM and PFM. There was no significant difference between eruption status and angles. Mesialisation ratio of impacted PFMs was significantly higher than self-corrected PFMs. There was significant difference between the PFM mesialisation ratio and the degree of PSM root resorption. CONCLUSION: Even if eruption disturbances do not occur frequently, making an early diagnosis is important to begin treatment at an optimal time. Although the relationship between horizontal and vertical angles and the ectopic eruption pattern is controversial, it is one of the clinical determinants. The mesialisation ratio of the impacted type was significantly higher than the self-corrected type. Self-correction of PFM was reduced in PSM with grade III and IV root resorption.

A pilot study of a deep learning approach to submerged primary tooth classification and detection.

AIM: The aim of the study was to compare the success and reliability of an artificial intelligence (AI) application in the detection and classification of submerged teeth in panoramic radiographs. MATERIALS AND METHODS: Convolutional neural network (CNN) algorithms were used to detect and classify submerged molars. The detection module, based on the stateof- the-art Faster R-CNN architecture, processed a radiograph to define the boundaries of submerged molars. A separate testing set was used to evaluate the diagnostic performance of the system and compare it with that of experts in the field. RESULT: The success rate of the classification and identification of the system was high when evaluated according to the reference standard. The system was extremely accurate in its performance in comparison with observers. CONCLUSIONS: The performance of the proposed computeraided diagnosis solution is comparable to that of experts. It is useful to diagnose submerged molars with an AI application to prevent errors. In addition, this will facilitate the diagnoses of pediatric dentists.

Candidate gene sequencing reveals mutations causing hypoplastic amelogenesis imperfecta.

OBJECTIVE: Amelogenesis imperfecta (AI) is a rare hereditary disorder affecting the quality and quantity of the tooth enamel. The purpose of this study was to identify the genetic etiology of hypoplastic AI families based on the candidate gene approach. MATERIALS AND METHODS: We recruited three Turkish families with hypoplastic AI and performed a candidate gene screening based on the characteristic clinical feature to find the pathogenic genetic etiology. RESULTS: The candidate gene sequencing of the LAMB3 gene for family 1 revealed a heterozygous nonsense mutation in the last exon [c.3431C > A, p.(Ser1144*)]. FAM20A gene sequencing for families 2 and 3 identified a homozygous deletion [c.34_35delCT, p.(Leu12Alafs*67)] and a homozygous deletion-insertion (c.1109 + 3_1109 + 7delinsTGGTC) mutation, respectively. CONCLUSION: The candidate gene approach can be successfully used to identify the genetic etiology of the AI in some cases with characteristic clinical features. CLINICAL RELEVANCE: Identification of the genetic etiology of the AI will help both the family members and dentist understand the nature of the disorder. Characteristic clinical feature can suggest possible genetic causes.

Effectiveness of Different Cleaning Solutions in Removing Residual Caries-Detector Dyes.

OBJECTIVE: Caries-detector dyes (CDDs) have proven useful in the identification and removal of carious dentin. However, residues of these cleaning agents may remain in the oral cavity. This study conducted spectrophotomectric analyses to evaluate the effectiveness of different cleaning agents in removing residual CDDs from the oral cavity. MATERIAL AND METHOD: Ninety freshly extracted human third-molar teeth were used in the study. Tooth occlusal surfaces were ground to expose dentin. Specimens were randomly distributed into 3 groups according to CDD [Seek Caries Indicator (SCI), Caries Detector (CD), Caries Marker (CM)], and each group was further divided into 3 sub-groups according to cleaning solution [distilled water (DW), 3% NaOCl, and 3% H2 O2 )]. CDDs were applied to dentin surfaces according to the manufacturer's instructions and then rinsed with a cleansing solution. The effectiveness of cleaning solutions in removing CDD residues was determined according to color change by comparing spectrophotometric measurements of tooth color before CDD application and after cleaning. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's HSD test (α = 0.05). RESULT: For all CDDs groups, the smallest color differences were observed in the 3% NaOCl sub-groups (P < .05), and the largest in the distilled water sub-groups (P > .05). When compared to the other CDD groups, the SCI group yielded the greatest color differences for all cleaning-agent sub-groups. CONCLUSION: Cleaning solutions such as 3% NaOCl or 3% H2 O2 can be used to remove residual CDD from dentin surfaces. CLINICAL SIGNIFICANCE: This study compared the effectiveness of three different cleaning agents in caries removal process.

A Comparative Study of Oral Health Parameters in Molar Incisor Hypomineralization and High-Caries-Risk Children Aged 8-11 Years.

OBJECTIVE: To compare oral health parameters: decayed missing filled teeth (dmft, DMFT), gingival index and plaque index in high-caries-risk children and children with molar incisor hypomineralization (MIH). SUBJECTS AND METHODS: A study group of 81 children affected by MIH (49 girls, 32 boys) aged 8-11 years (mean 9.4 ± 1.1) was race-, age- and sex-matched with 81 high-caries-risk children not affected by MIH (controls). The MIH and control groups were divided into four subgroups according to age. The oral health parameters of both groups were recorded under clinical conditions. Mann-Whitney U and Kruskal-Wallis tests were used to compare the differences in the number of MIH-affected teeth between the groups. Other traits were evaluated with the ANOVA test, and Duncan's multiple comparison tests were used for comparing means. Linear and ordinal regression analyses were used to model the variables. RESULTS: The mean age of the participants was 9.4 ± 1.1 years, and the mean number of affected teeth was 7.7 (range 3-12) in the MIH group. The number of affected teeth and severity of MIH did not change significantly with age and sex (p > 0.05). A comparison of the oral health parameters of MIH-affected and control children according to groups did not show any statistically significant differences between the groups for all parameters for all groups (p > 0.05) with the exception of DMFT values at 10 years of age (p < 0.05). In a comparison of the total scores without taking age into account, the children with MIH showed a significantly higher DMFT value than the children without MIH (p < 0.05), but there were no significant differences between the dmft, GI and PI values of the study groups (p > 0.05). CONCLUSION: The children in the MIH group had higher DMFT than those without MIH. Hence, the presence of MIH could have a detrimental effect on oral health parameters, especially on DMFT values.

Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the acid resistance of the primary enamel.

BACKGROUND: This study aimed to investigate the effects of a fluoride varnish with added Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) treatments on acid resistance of primary teeth enamel. METHODS: Enamel specimens obtained from 40 primary incisors (for surface microhardness testing) and 40 primary molars (for demineralization depth measurement) were randomly divided into four groups (n = 10 incisors and 10 molars) each according to surface treatment: no treatment (control), MI varnish (1-8 % sodium fluoride and 1-5 % CPP-ACP), Clinpro White (1-5 % sodium fluoride and <5 % modified tricalcium phosphate), Duraphat (<5 % sodium fluoride). Specimens were stored for 24 h in a moist environment. After varnish residues were removed, specimens were subjected to pH cycling. The effects of fluoride varnishes were evaluated according to surface microhardness, lesion depth and structural changes. Results were analyzed by ANOVA and Tukey's tests. RESULTS: The lowest changes in surface microhardness and lesion depth occurred in MI varnish group, followed by the Clinpro White, Duraphat and no treatment (control) group (for percentage of loss surface microhardness -20.80, -34.60, -57.80 and -73.40; for lesion depth values 23.60 µm ± 3.36, 29.85 µm ± 3.27, 40.37 µm ± 3.41 and 54.56 µm ± 4.16, respectively). Statistically significant differences in both surface microhardness and lesion depth were observed among all groups (P < 0.05). CONCLUSIONS: Within the limitations of this in vitro study, fluoride varnish containing CPP-ACP was more effective in increasing the acid resistance of primary enamel than other fluoride varnishes. However, further clinical research is needed to confirm these in vitro results.

Partial Pulpotomy with BioAggregate in Complicated Crown Fractures: Three Case Reports.

This report describes three cases of complicated crown fractures treated with partial pulpotomy using BioAggregate. Three maxillary permanent central incisors with complicated crown fracture were treated by partial pulpotomy using BioAggregate and reviewed clinically and radiographically for 24 months. Throughout this period, there was no spontaneous pain, periapical radiolucency, and coronal discoloration; the pulp was observed to be vital. Based on these findings, it was concluded that BioAggregate can be used in partial pulpotomy treatment of complicated crown fracture.

Graphene-based biosensors in milk analysis: A review of recent developments.

Cow's milk, an excellent source of fat, protein, amino acids, vitamins and minerals, is currently one of the most consumed products worldwide. Contaminations originating from diverse sources, such as biological, chemical, and physical, cause dairy product quality problems and thus dairy-related disorders, raising public health issues. For this reason, legal authorities have deemed it necessary to classify certain contaminations in commercial milk and keep them within particular limitations; therefore, it is urgent to develop next-generation detection systems that can accurately identify just the contaminants of concern to human health. This review presents a detailed investigation of biosensors based on graphene and its derivatives, which offer superior sensitivity and selectivity, by classifying the contaminants under the headings biological, chemical, and physical, in cow's milk according to their sources. We reviewed the current status of graphene-based biosensor (GBs) technology for milk or dairy analysis, highlighting its strengths and weaknesses with the help of comparative studies, tables, and charts, and we put forward a novel perspective to handle future challenges.

Evaluation of elementary school teachers' knowledge and attitudes about immediate emergency management of traumatic dental injuries.

PURPOSE: To investigate teachers' knowledge and attitudes about emergency management of traumatic dental injuries (TDIs) in children. MATERIALS AND METHODS: A total of 764 teachers from 13 elementary schools were included in the study. Data were collected using a self-reporting questionnaire in which teachers were asked about demographic information, previous experience with dental trauma, first-aid training, knowledge of emergency management and how they would respond to two hypothetical TDI cases. RESULTS: Of the 764 participants, 550 (71.4%) returned the questionnaire; of these, 309 (56.2%) were female and 241 (43.8%) were male. While 297 teachers reported having had first-aid training, only 13 (4.4%) of them reported emergency management of TDIs being covered in this training. Less than half of respondents (47.5%, n = 261) correctly answered the question on the appropriate response to a TDI involving a fractured tooth and only one-quarter of respondents (25.4%, n=140) correctly answered the question on the appropriate response to a TDI involving an avulsed tooth. CONCLUSION: The results of this study demonstrated teachers' low level of knowledge about the emergency treatment of TDIs in schoolchildren, suggesting that educational programmes are needed to improve proper emergency management of TDIs by teachers.

Timing of permanent teeth eruption in Turkish children.

OBJECTIVE: To identify the mean time of permanent teeth eruption in children aged 5-15 years in Samsun, Turkey. STUDY DESIGN: A total of 1,491 children aged 5-15 years (Female: 773; Male: 718) were included in this study. Teeth were recorded as either "not erupted" or "erupted," which was defined as having at least one cusp visible in the oral cavity. Differences between eruption times for males and females and for maxillary and mandibular teeth were analysed using independent t-tests. RESULTS: Eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars (p < 0.05). For both females and males, the first teeth to erupt were the central incisors and first molars, and the last to erupt were the second premolars, molars and canines. Mandibular incisors and canines erupted significantly earlier than their maxillary counterparts in both females and males (p < 0.05). CONCLUSION: In comparison with other studies, eruption times ofpermanent first molars, central and lateral incisors were delayed by several months, whereas eruption times of other teeth were accelerated by several months. The findings regarding eruption times should be considered when planning dental treatment.

Translated Mutant DSPP mRNA Expression Level Impacts the Severity of Dentin Defects.

Hereditary dentin defects are conventionally classified into three types of dentinogenesis imperfecta (DGI) and two types of dentin dysplasia (DD). Mutations in the dentin sialophosphoprotein (DSPP) gene have been identified to cause DGI type II and III and DD type II; therefore, these are not three different conditions, but rather allelic disorders. In this study, we recruited three families with varying clinical phenotypes from DGI-III to DD-II and performed mutational analysis by candidate gene analysis or whole-exome sequencing. Three novel mutations including a silent mutation (NM_014208.3: c.52-2del, c.135+1G>C, and c.135G>A; p.(Gln45=)) were identified, all of which affected pre-mRNA splicing. Comparison of the splicing assay results revealed that the expression level of the DSPP exon 3 deletion transcript correlated with the severity of the dentin defects. This study did not only expand the mutational spectrum of DSPP gene, but also advanced our understanding of the molecular pathogenesis impacting the severity of hereditary dentin defects.

Relationship between caries and dental plaque composition.

PURPOSE: To evaluate the relationship between dental caries and the biochemical composition of dental plaque and to determine the effect of a 10% sucrose solution on the biochemical structure of dental plaque in children. METHODS: 60 children grouped according to caries status took part in this study [Caries-free (CF), DMFS=0, df-s = 0; Caries-positive (CP), DMFS > or =10, df-s > or =10]. Dental plaque samples were collected before (baseline) and at 3 and 30 minutes after a 1-minute rinse with 10% sucrose. Fluoride (F), calcium (Ca), and inorganic phosphorus (Pi) levels were determined using ion chromatography, and insoluble polysaccharide (IEPS) concentrations were determined using colorimetric analysis. RESULTS: Although the mean baseline Ca and Pi levels in plaque were higher in the CF group than in the CP group, these differences were not statistically significant. Baseline IEPS levels were significantly higher in the CP group than in the CF group. Following exposure to sucrose, plaque F, Ca and Pi concentrations decreased significantly in both groups. However, insoluble polysaccharide concentrations increased significantly in the CF group only.

Dental development in children with mild-to-moderate hypodontia.

INTRODUCTION: The aim of this study was to compare dental development in a group of children with mild-to-moderate hypodontia with a matched group. METHODS: A study group of 70 children (43 girls, 27 boys) with hypodontia, aged 5.3 to 12.5 years, was matched for race, age, and sex with 140 healthy, normal control subjects. The children's dental ages were calculated by using a modified dental-age estimation method. Differences between dental and chronologic ages were analyzed by t tests, and the correlations between differences in dental and chronologic ages and the numbers of missing teeth were analyzed with the Spearman correlation test. RESULTS: Dental development in children with mild-to-moderate hypodontia was significantly delayed compared with the control group (P <0.05); however, the mean difference did not exceed 0.3 years in either sex. No correlation was observed between the differences in dental and chronologic age and the severity of hypodontia. CONCLUSIONS: Children with mild-to-moderate hypodontia had delayed dental development of a few months; this was statistically significant. Because of individual variations, each patient should be carefully examined.

Effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on enamel microhardness after bleaching.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CCP-ACP) application on the microhardness of bleached enamel and compare it to that of fluoride application. METHODS: 10 extracted bovine incisors were cut into four sections (4 x 4 x 3 mm) that were randomly distributed among five groups (n = 8). All groups were bleached three times using 38% hydrogen peroxide (HP), with 5-day intervals between bleaching, according to the following treatment protocols: Group A: bleaching only; Group B: bleaching + daily CCP-ACP paste; Group C: bleaching + daily casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACPF) paste; Group D: bleaching + daily 250ppm NaF solution; Group E: bleaching + APF gel (once after final bleaching). Specimens were maintained in artificial saliva throughout the experiment. Baseline and post-treatment Vickers microhardness values were obtained for all specimens. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey tests. RESULTS: Groups B and C showed significant increases in enamel microhardness following treatment (P < 0.001), whereas no statistically significant changes were observed in Groups A, D, or E (P > 0.05). One-way ANOVA of delta Vickers microhardness numbers (deltaVHN) revealed significant differences among groups (P < 0.001), with Group B showing the highest deltaVHN and Group A the lowest.

Shear bond strengths of different adhesive systems to white mineral trioxide aggregate.

This study was conducted to compare the shear bond strengths of different adhesive systems to White Mineral Trioxide Aggregate (WMTA). To this end, 40 cylindrical acrylic blocks with a hole in the middle measuring 4 mm diameter x 2 mm height were prepared. The hole was filled with WMTA, and the specimens were allocated into four groups: Group 1--Prime & Bond NT; Group 2--AdheSE; Group 3--Xeno III; and Group 4--Adper Prompt L-Pop. In each group, a different adhesive system and a compomer (Dyract AP) were applied over WMTA. Shear bond strengths were measured using a universal testing machine, and then the data were subjected to one-way ANOVA and Scheffé's post hoc test (p<0.05). Significantly lowest shear bond strength value was obtained with Adper Prompt L-Pop, whereas Prime & Bond NT revealed higher shear bond strength than the others (p<0.05). In conclusion, an etch-and-rinse adhesive system--which exhibited significantly higher shear bond strength than self-etch adhesive systems--could be a preferred choice when placing compomer materials upon WMTA.

The effects of children's drinks on the color stability of various restorative materials.

OBJECTIVE: To evaluate the effects of exposure to various children's drinks on the color stability of different esthetic restorative material commonly used in pediatric dentistry. STUDY DESIGN: Cylindrical specimens (15 x 2mm) were prepared from four different restorative materials (Fuji IX, Fuji II LC, Dyract Extra, and Filtek Z250). For each material, 20 specimens were prepared and divided into four groups. Each group was stored in a different solution (distilled water chocolate milk, cola, grape juice) for 24 hours. A colorimeter was used to measure the color of each specimen both before and after staining. Color change (deltaE*) was calculated, and data was analyzed using two-way ANOVA and Tukey HSD tests. RESULTS: For all restorative materials, the lowest deltaE* values were recorded for specimens stored in distilled water (0.42), followed by chocolate milk (0.88), grape juice (3.45) and cola (3.97). Among the four restorative materials tested, Fuji II LC showed the most color change (3.71) and Fuji IX the least (1.33). There were statistically significant differences among above groups (p < 0.05). CONCLUSIONS: DeltaE* values were acceptable for all materials tested, with the exception of Fuji II LC. Therefore, the use of RMGIC should be avoided in anterior restorations in children due to esthetic reasons.

Effects of Deproteinization on Bond Strength of Composite to Primary Teeth Affected by Amelogenesis.

Purpose: The purpose of this study was to evaluate the effect of different dentin deproteinization treatments on the microtensile bond strength (µTBS) of composite resin to primary dentin affected by hypocalcified amelogenesis imperfecta (AI). Methods: Flat dentin surfaces were obtained from both extracted hypocalcified AI-affected and sound primary molars and then randomly allocated into three groups according to surface treatment (deproteinization with sodium hypochlorite [NaOCl], deproteinization with chlorine dioxide [ClO2], nontreated controls). µTBS of specimens were measured with a universal testing machine, and data were analyzed using one-way analysis of variance and Tukey's tests. Results: The µTBS values for all groups with sound primary teeth were significantly higher than those of the comparable groups of hypocalcified AI-affected primary teeth (P<0.05). There were no statistically significant differences between the µTBS values of the control and the NaOCl groups for either the hypocalcified AI-affected or sound primary teeth (P>0.05); however, the µTBS values for the ClO2 groups were significantly higher than those of both the control and NaOCl groups (P<0.05). Conclusions: Within the limitations of this in vitro study, deproteinization with ClO2 can be considered effective in enhancing dentin bonding of hypocalcified AI-affected primary teeth.

Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion.

This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n = 10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey's tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p < 0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.

Shear bond strength of self-adhering flowable composite on dentin with and without application of an adhesive system.

PURPOSE: The aim of this study was to evaluate the shear bond strength (SBS) of conventional and self-adhering flowable resin composites on the dentin surfaces of primary and permanent teeth and to evaluate the effect of the application of an adhesive system under self-adhering flowable resin composite on SBS. METHODS: Prepared permanent and primary tooth dentin surfaces were randomly distributed into 3 groups according to application protocols as follows: group 1: Vertise Flow; group 2: OptiBond + Filtek Ultimate; and group 3: OptiBond + Vertise Flow. A universal testing machine was used to measure SBS of prepared specimens, and data were analyzed using 1-way ANOVA and Tukey test. RESULTS: Statistically significant differences were observed among all groups for primary and permanent teeth (P<0.05). The highest values were observed in group 2, followed by group 3, in both permanent and primary teeth. SBSs of all groups were significantly higher for permanent teeth than for primary teeth (P<0.05). CONCLUSION: Although SBS values of Vertise Flow groups were lower than those for conventional flowable resin composite groups, with further developments in material technology, self-adhering materials could be promising materials especially for pediatric dentistry.