Robotic approach to the reduction of dental anxiety in children.

OBJECTIVE: We introduced a humanoid robot for the use of techno-psychological distraction techniques in children aged 4-10 to reduce their anxiety and improve their behaviour during dental treatment. MATERIALS AND METHODS: Two hundred children (98 boys, 102 girls; mean age: 6.5 ± 1.66 years) appointed for first time for dental caries were included and randomly divided into two groups [N = 100 for each group; RG: Robot Group (accompanied by the robot), CG: Control Group (without robot accompaniment)]. Half of the children were treated under local anaesthesia (infiltration anaesthesia) (n = 50 within each group) and half of the children were treated without any local anaesthesia (n = 50 within each group) within each group. The success rate of the new robotic distraction technique was evaluated by using Parental Corah Dental Anxiety Scale, Facial Image Scale (FIS), physiological pulse rate and Frankl Behaviour Rating Scale (FBRS). RESULT: Pulse rates, which measured during treatment and after treatment, were statistically higher in CG than in RG (p < .05). After dental treatment, the FIS score was significantly higher in CG than RG (p < .05). 88.3% of the children in RG stated that they wanted the robot to be with them at the next treatment session. CONCLUSIONS: Robotic technology can successfully help in coping with dental anxiety and stress, and helps children to behave better in dental office.

Recessive Mutations in ACPT, Encoding Testicular Acid Phosphatase, Cause Hypoplastic Amelogenesis Imperfecta.

Amelogenesis imperfecta (AI) is a heterogeneous group of genetic disorders affecting tooth enamel. The affected enamel can be hypoplastic and/or hypomineralized. In this study, we identified ACPT (testicular acid phosphatase) biallelic mutations causing non-syndromic, generalized hypoplastic autosomal-recessive amelogenesis imperfecta (AI) in individuals from six apparently unrelated Turkish families. Families 1, 4, and 5 were affected by the homozygous ACPT mutation c.713C>T (p.Ser238Leu), family 2 by the homozygous ACPT mutation c.331C>T (p.Arg111Cys), family 3 by the homozygous ACPT mutation c.226C>T (p.Arg76Cys), and family 6 by the compound heterozygous ACPT mutations c.382G>C (p.Ala128Pro) and 397G>A (p.Glu133Lys). Analysis of the ACPT crystal structure suggests that these mutations damaged the activity of ACPT by altering the sizes and charges of key amino acid side chains, limiting accessibility of the catalytic core, and interfering with homodimerization. Immunohistochemical analysis confirmed localization of ACPT in secretory-stage ameloblasts. The study results provide evidence for the crucial function of ACPT during amelogenesis.

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.

Effect of fibroblast growth factor and enamel matrix derivative treatment on root resorption after delayed replantation.

BACKGROUND: Periodontal ligament (PDL) healing and long term prognosis of replanted avulsed teeth should rely on several factors including length of extra-oral dry time and type of the storage medium. The status of periodontal ligament is critical for the healing of replanted teeth. Different substances have been used for root surface treatment to promote formation of PDL and increase the survival of avulsed teeth submitted to replantation. AIM: The purpose of this study was to assess the effect of recombinant basic fibroblast growth factor 2 (bFGF) and enamel matrix derivative (EMD) on root resorption after delayed replantation. DESIGN: 18 freshly extracted single-rooted incisor and premolar teeth were extracted from the beagle dogs and immersed in whole bovine milk for 45 and 60 min (n = 3 each). Following storage period, sockets washed and teeth were treated with bFGF and EMD and replanted into the sockets. After 8 weeks, dogs were sacrificed, specimens processed to 4-µm thick serial sections for histopathologic examination and morphometric assessments. Thus, the proportions of the roots that exhibited signs of surface resorption, inflammatory resorption, and replacement resorption, that is, ankylosis and normal PDL were noted. RESULTS: The percentage of root resorption was in the following order: EMD>milk>bFGF for 45 min and milk>EMD>bFGF for 60 min. For all groups, teeth stored 60 min showed significantly higher incidence of PDL resorption than those stored for 45 min (P < 0.01). The highest incidence of replacement resorption was observed in teeth treated with EMD for 60 min. After 8 weeks, the least resorption was found in bFGF-treated group (P < 0.01). CONCLUSIONS: The findings of this study suggest that use of bFGF favored the formation of new periodontal ligament; prevent ankylosis and resorption process following delayed replantation of teeth while EMD shows replacement resorption, which may turn to ankylosis.

Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) May Be an Alternative Preventive Therapy in Children with Cerebral Palsy.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the buffering capacity of saliva and plaque pH in individuals with cerebral palsy (CP). MATERIALS AND METHODS: A total of 15 3- to 8-year-old subjects with CP living in a governmental institution were included in this study. Dental plaque pH and the buffering capacity of saliva were measured at the first visit (baseline) and accepted as control values. CPP-ACP complex (GC Tooth Mousse) was applied to the children twice a day. Measurements were repeated after the 1st, 2nd, 3rd, 4th, 6th and 8th weeks. RESULTS: Plaque indicator data show decreased acidogenicity in the 8-week period. Although there were no significant differences between the baseline and the 1st, 2nd and 3rd weeks' pH scores, a statistically significant difference was observed between the initial and 4th, 6th and 8th weeks' plaque pH scores. Saliva buffer scores were found to statistically significant increase between baseline and the 3rd, 4th, 6th and 8th weeks. CONCLUSION: Daily application of 10% w/v CPP-ACP paste is effectively changes saliva buffering capacity and plaque pH, thus promoting caries prevention in the primary and mixed dentition of CP children.

Condylar asymmetry in different occlusion types.

AIMS: The purpose of this study was to investigate the relationship between vertical asymmetries of the mandibular condyle with different occlusion types, including Angle Cl I, Cl II, Cl III malocclusions and unilateral posterior crossbite (UPC) in adolescent patients. METHODOLOGY: A total number of 120 patients (60 girls, 60 boys with a mean age of 13.64 ± 1.58 years) with no signs and symptoms of temporomandibular disorders were included in the study [n = 30 for each group; Group I: normal occlusion, Group II: Angle Class II malocclusion, Group III: Angle Class III malocclusion and Group IV: UPC]. The asymmetry index for each patient was measured using panoramic radiographs. The results were analyzed using Kruskal-Wallis and Mann-Whitney U test at the 95% confidence level. RESULTS: The results of the analyses showed no statistically significant differences between the gender and the age of the patients for condylar height asymmetry (P>0.05). No statistically significant difference was found between the occlusion types, according to condylar asymmetry level. The patients with UPC showed a significantly different level of condylar height asymmetry compared to the Class I, II and III occlusion types (P<0.05; P<0.01). CONCLUSIONS: Patients with UPC have asymmetric condylar heights. These patients might be at risk for developing skeletal mandibular asymmetries in the future. Early correction of posterior crossbite can help practitioners prevent skeletal asymmetries.

Clinical and radiological evaluation of inverse impaction of supernumerary teeth.

OBJECTIVE: To describe the clinical and radiological features of children with inverted supernumerary teeth. STUDY DESIGN: Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical complications, management and radiography were assessed during 3-years period. RESULTS: Thirty eight patients with a mean age of 9.10 ± 1.97 years (range:6-13) and a strong male preponderance of 3.7:1 (male:30, female:8) had a total of 69 ST, of which 41 were in inverted position. Thirty five patients had one (92.1%) inverted tooth, whereas 3 patients had two inverted teeth per case (7.9%). All cases were located in the maxilla. Midline was the most frequent site for the single inverted supernumerary tooth in 18 (47.4%) patients, followed equally by the right and left premaxillary region in 10 patients each (26.3%). Regarding morphology, 30 patients had conical (78.9%) and 8 (21.1%) had incisiform ST. No tuberculate shaped ST was detected. There was no statistically significant difference between number of inverted teeth and delayed tooth eruption, diastema, local malocclusion, palatinal swelling (p>0.05). There was no statistically significant difference between complications and age (p>0.05). Surgical removal at the time of diagnosis with subsequent follow-up during completion of permanent dentition was the treatment approach in all cases. CONCLUSIONS: Thorough clinical examination followed by a comprehensive radiographic screening is the crucial determinant of an accurate diagnosis of an impacted ST. Early diagnosis and timely management are key factors to prevent or minimize the complications, which may influence function and esthetics of the teeth and even psychological condition of the growing child.

Influence of acrylic resin polymerization methods on residual monomer release.

AIM: The aim of this study was to quantify and compare the amount of methyl methacrylate (MMA) monomer released from three different denture base acrylic material processed by different polymerization methods and storage conditions. MATERIALS AND METHODS: Microwave-cured, conventional heat and injection-technique acrylic polymerized materials were stored in neutral (pH = 7) and acidic (pH = 4.5) artificial saliva for 24 hours at the room temperature, separately. The residual MMA content was determined by high performance liquid chromatography (HPLC). RESULTS: The MMA leaching from resins showed that microwave-cured material has lower residual MMA leach compared both conventional and injection-technique on neutral saliva storage conditions. CONCLUSION: The all data's exhibited higher MMA release into an acidic saliva environment than neutral artificial saliva and there were no significant differences between the materials groups on acidic saliva storage conditions. CLINICAL SIGNIFICANCE: Microwave polymerization method might has some advantages on reducing release of MMA concentration and may contributory effect upon polymerization reaction on neutral pH storage condition, therefore methods of polymerization should be considered as amount of monomer release.

Novel FAM20A mutations in hypoplastic amelogenesis imperfecta.

Amelogenesis imperfecta (AI) is a genetically and clinically heterogeneous group of inherited dental enamel defects without any other nonoral symptoms. Recently, a disease-causing nonsense mutation (c.406C>T) in a novel gene, FAM20A, was identified in a large consanguineous family affected by AI with gingival hyperplasia. We performed mutational analyses on nine AI families with similar phenotypes and identified three homozygous mutations (c.34_35delCT, c.813-2A>G, c.1175_1179delGGCTC) in three families and a compound heterozygous mutation (c.[590-2A>G] + [c.826C>T]) in one family. An in vitro splicing assay with a minigene confirmed the mutations located in the splicing acceptor site caused the deletion of exons 3 and 6, respectively. Taking into consideration the locations of the nonsense and frameshift mutations, the mutant transcripts are most likely degraded by nonsense-mediated mRNA degradation and it results in a loss of the FAM20A protein. This study confirms the importance of the FAM20A protein in enamel biomineralization as well as tooth eruption.

Craniofacial and dental characteristics of Kabuki syndrome: nine years cephalometric follow-up.

OBJECTIVE: Kabuki syndrome is a rare autosomal dominant trait with variable clinical expression. Common dental manifestations of Kabuki syndrome are high-arched palate, micrognathia, malocclusion, microdontia, small dental arches, hypodontia, severe maxillary recession and mid-facial hypoplasia. STUDY DESIGN: This report includes the oral manifestations of a Turkish patient with Kabuki syndrome with consideration of the long-term craniofacial prognosis for this patient based on the physical, clinical and radiological findings in 9 years follow-up period. General appearance of the patient was characterized by postnatal growth retardation, moderate mental retardation, peculiar face characterized by long palpebral fissures with eversion of the lateral third of the lower eyelids, prominent and cup-shaped ears, broad and depressed nasal tips, short fifth fingers, psychomotor retardation and dermatologic abnormalities. RESULTS AND CONCLUSION: Cephalometric analysis revealed skeletal open bite; periapical and panoramic radiographic examinations showed agenesis permanent teeth. A patient with Kabuki syndrome, who may lead to a better understanding of the abnormalities, playing an important role in clinical diagnosis, planning and dental management is presented.

Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide.

UNLABELLED: Abstract - Background: The aim of this in vitro study was to assess the long-term fracture resistance of human immature permanent teeth filled with BioAggregate (BA), mineral trioxide aggregate (MTA) and calcium hydroxide (CH). MATERIALS AND METHODS: The study consisted of single rooted premolar teeth with immature root formation extracted for orthodontic reasons. A total of 28 immature premolars with average root length of 10.7 mm and apical diameter of 3 mm were included in the study. The pulps were extirpated and the canals were prepared using an apical approach. The teeth were randomly assigned to four groups: Group I: DiaRoot(®) BA (DiaDent, Burnaby, BC, Canada), Group II: Angelus MTA (MTA-A; Angelus, Londrina, Brazil), Group III: ProRoot(®) MTA (MTA-PR; Dentsply, Tulsa, OK, USA), Group IV: CH (Sultan Chemists Inc., Englewood, NJ, USA). The teeth were placed in saline solution at 4°C for 1 year. The root of each tooth was then embedded in an acrylic resin block. All specimens were loaded at a crosshead speed of 1 mm min(-1) in an Instron testing machine and the peak loads up to fracture were recorded. Data were analysed statistically by Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: Mean (±SD) failure loads (MPa) were: 37.69 ± 14.43 for BA group, 32.94 ± 8.15 for MTA-A group, 28.74 ± 9.49 for MTA-PR group and 23.18 ± 8.48 for CH group. The BA group exhibited the highest fracture resistance and the CH group showed the lowest resistance to fracture. Significant differences (P < 0.05) in fracture resistance were found between the DiaRoot-BA and CH groups, and also between the MTA-A and CH groups. CONCLUSION: Within the limitations of this study, data suggest that DiaRoot-BA-filled immature teeth demonstrate higher fracture resistance than other groups at 1 year. Considering the long-term risk of cervical root fracture associated with immature teeth, the use of DiaRoot-BA as a root canal filling material appears to be the most advantageous of the materials tested.

Oral microbiota and dental caries data from monozygotic and dizygotic twin children.

There are recent studies which aimed to detect the inheritance on the etiology of dental caries exploring oral composition. We present data on the oral microbiota and its relation with dental caries and other factors in monozygotic (MZ) and dizygotic (DZ) twin children. Following clinical investigation, DNA samples were collected and isolated from saliva of 198 patients (49 MZ and 50 DZ twins) with an average age of 9.7 ± 2.7 years. Salivary bacterial microbiota analysis was performed using high throughput amplicon sequencing method targeting V3-V4 region of the 16S rRNA gene. A total of 8,297,859 raw reads corresponding to 41,908 reads per sample were obtained on average. The QIIME2-deblur workflow was used for 16S rRNA amplicon analysis. Microbiome similarity analyses between twins (based on Bray-Curtis dissimilarity, weighted and unweighted Unifrac distances) showed that monozygotic twins share more bacterial microbial content compared to dizygotic twins. This is a large microbial community dataset of MZ and DZ twins with or without dental findings which can be further used for children oral microbiome profile explorations.

Antimicrobial Effect of Newly Formulated Toothpastes and a Mouthrinse on Specific Microorganisms: An In Vitro Study.

OBJECTIVE: The aim of this in vitro study was to assess the antimicrobial properties of newly formulated toothpastes (four toothpastes for adults and two toothpastes for kids/babies) and a mouthrinse. MATERIALS AND METHODS: Newly formulated six different toothpastes and one mouthrinse of a single brand and commercially available five toothpastes and three mouthrinse were investigated for their antimicrobial activity against two oral pathogens, Streptococcus mutans and Candida albicans, by agar well diffusion assay. After incubation, the inhibition zone diameters were measured in millimeters and statistical analyses were performed. RESULTS: All experimental adult toothpastes exhibited good antimicrobial activity against S. mutans and C. albicans except the experimental toothpaste D. Experimental toothpaste B exhibited the highest antibacterial activity against C. albicans and S. mutans. Experimental toothpaste for kids showed the best antimicrobial activity against S. mutans when kids' toothpastes were compared. None of the tested toothpastes for kids/babies showed antibacterial effects for C. albicans. Among the mouthrinse tested, Sensodyne mouthrinse showed the best results. Experimental mouthrinse showed significantly lower antibacterial activity against S. mutans then Sensodyne, Eludril, and chlorhexidine mouthrinse. CONCLUSION: Although experimental toothpaste and mouthrinse formulations revealed good results in terms of antimicrobial activity to some specific microorganisms, further studies involving more bacterial species or analyzing the quality and efficacy of these products by other in vitro or in vivo tests are needed.

The inhibitory effects of polypyrrole on the biofilm formation of Streptococcus mutans.

Streptococcus mutans primary thrives on the biofilm formation on the tooth surface in sticky biofilms and under certain conditions can lead to carious lesions on the tooth surface. To search for a new preventive material for oral biofilm-associated diseases, including dental caries, we investigated the effects of polypyrrole, which contains an electrochemical polymer and causes protonation and incorporation of anion under low pH condition, on the biofilm formation of S. mutans and other streptococci. In this study, polypyrrole was applied in biofilm formation assays with the S. mutans strains UA159 and its gtfB and gtfC double mutant (gtfBC mutant), S. sanguinis, S. mitis and S. gordonii on human saliva and bovine serum albumin-coated 96-well microtiter plates in tryptic soy broth supplemented with 0.25% sucrose. The effects of polypyrrole on biofilm formation were quantitatively and qualitatively observed. High concentrations of polypyrrole significantly inhibited the biofilm formation of S. mutans UA159 and S. sanguinis. As an inhibition mechanism, polypyrrole attached to the surface of bacterial cells, increased chains and aggregates, and incorporated proteins involving GTF-I and GTF-SI produced by S. mutans. In contrast, the biofilm formation of gtfBC mutant, S. sanguinis, S. mitis and S. gordonii was temporarily induced by the addition of low polypyrrole concentrations on human saliva-coated plate but not on the uncoated and bovine serum albumin-coated plates. Moreover, biofilm formation depended on live cells and, likewise, specific interaction between cells and binding components in saliva. However, these biofilms were easily removed by increased frequency of water washing. In this regard, the physical and electrochemical properties in polypyrrole worked effectively in the removal of streptococci biofilms. Polypyrrole may have the potential to alter the development of biofilms associated with dental diseases.

Prevalence and etiology of molar-incisor hypomineralization (MIH) in the city of Istanbul.

BACKGROUND/PURPOSE: Molar-Incisor-Hypomineralisation (MIH) is the term used to depict a condition in which one or more of the permanent molar teeth and usually no less than one incisor tooth is hypomineralised and the prevalence rates vary from 2.4 to 40.2%. The aim of this study was to assess the prevalence and the risk factors of MIH in children in Istanbul, Turkey. MATERIALS AND METHODS: A total of 1511 (760 M, 751 F), 8- to 11-year-old children were examined who had their first permanent molar and incisors evaluated using the EAPD criteria for MIH. Hypomineralized molars and incisors were recorded based on developmental defects of enamel index. The potential aetiological factors were retrieved through personal interview and etiological questions were asked to the parents. Statistical analysis was performed with a chi-Square test. RESULTS: MIH was observed in 215 (14.2%; 102 male, 113 female) children. The sample (1511 children) comprised 71 (9.9%) 8 year-olds with MIH and 144 (18.2%) 11 year-olds with MIH. A significant difference was found between 8 (9.9%) and 11-year-old (18.2%) children with MIH (p ≤ 0.001). Complications during the mother's pregnancy, birth prematurity, average breast feeding period, diarrhea frequency, digestive system diseases, asthma, frequent high fever, ear infection, renal failure, rubeola, chickenpox and parotitis were found to be significantly associated with MIH (p < 0.001). CONCLUSION: There are many events that can cause MIH which we cannot control or predict. Therefore, longitudinal studies with large sample size are needed so as to determine how various likely etiological factors described affect the etiological role.

Nephrocalcinosis in Amelogenesis Imperfecta Caused by the FAM20A Mutation.

BACKGROUND/AIMS: Enamel-renal syndrome is characterized by nephrocalcinosis, enamel defects, gingival hyperplasia and eruption failures. It has been recently identified that recessive mutations in the FAM20A gene result in amelogenesis imperfecta (AI)-gingival fibromatosis. The aim of this research to determine whether AI patients with known -FAM20A mutations also have nephrocalcinosis. METHODS: Complete oral and radiological examinations were performed for all participating family members. Renal examinations were performed using ultrasound. RESULTS: The teeth were evaluated for severe loss, and multiple eruption failures were evident from the clinical and radiological examinations. Unexpected extensive and fast crown resorption was found by radiological examination. Renal ultrasound revealed bilateral nephrocalcinosis in both affected individuals. Recessive FAM20A mutations can cause nephrocalcinosis in addition to the oral phenotype. CONCLUSION: AI patients with similar clinical phenotypes and FAM20A mutations should be examined for nephropathy even if they lack pertinent symptoms. Nephrology referral is warranted for patients who have clinical phenotypes related to AI-gingival fibromatosis even if they are not symptomatic.

Investigation of the Er: YAG laser and diamond bur cavity preparation on the marginal microleakage of Class V cavities restored with different flowable composites.

The purpose of this study was to evaluate the efficiency of the Er:YAG laser and diamond bur cavity preparation on the marginal microleakage of Class V cavities. Group 1: bur preparation (bp) + Vertise Flow (VF); Group 2: laser preparation (lp) + VF; Group 3: bp + Adper Easy One (AEO) + Filtek Ultimate Flowable Composite (FUFC); Group 4: lp + AEO + FUFC; Group 5: bp + Clearfil S3 Bond (CSB) + Clearfil Majesty Flow (CMF); Group 6: lp + CSB + CMF. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < .05). More microleakage was observed in cervical regions compared to occlusal regions in all groups (p < .05). No significant difference was observed among all groups in terms of occlusal and cervical surfaces, respectively (p > .05). The use of the Er:YAG laser for cavity preparation with different adhesive systems and flowable composites did not influence microleakage.

Effects of Different Pediatric Drugs on the Color Stability of Various Restorative Materials Applicable in Pediatric Dentistry.

Background. The chronic recommendation of pediatric drugs could exhibit erosive and cariogenic problems. Objective. To evaluate the effects of different pediatric drugs on the color stability of various restorative materials. Methods. Five specimens (1 mm × 3 mm) were prepared and immersed in ten different pediatric drugs and agitated every 8 hours daily for 2 min up to 1 week. Between immersion periods, the samples were stored in artificial saliva. After 1-week period, ΔE⁎ values were calculated. Two-way ANOVA and Fisher's LSD test were used for statistical analysis at a level of p < 0.05. Results. ΔE⁎ values were only significantly influenced by restorative material factor (p < 0.001) and varied in the range of 2.08 and 6.55 units for all drugs/restorative materials. The highest ΔE⁎ was found in Ferrosanol B-composite (6.55 ± 1.38) and the lowest one was found in Dolven-glass ionomer (2.08 ± 0.40) pairwise. The most prominent ΔE⁎ value elevations were obtained in composite material compared to the compomer and/or glass ionomers in Macrol, Ferrosanol B, and Ventolin (p < 0.001; for all) and also for other drugs (p < 0.05). Dolven exhibited significantly higher values compared to Augmentin (p = 0.021), Macrol (p = 0.018), and Ventolin (p = 0.013) in compomer group. Conclusion. The clinically perceptible color changes for tested composite/pediatric drug pairwise can be more problematic than compomer and glass ionomers in pediatric dentistry.

Success Rates of Pulpotomies in Primary Molars Using Calcium Silicate-Based Materials: A Randomized Control Trial.

OBJECTIVE: The aim of this study was to evaluate and compare, both clinically and radiographically, the effects of calcium silicate-based materials (i.e., ProRoot MTA [PR-MTA], MTA-Plus [MTA-P], and Biodentine [BD]) and ferric sulfate [FS] in pulpotomy of primary molars. MATERIALS AND METHODS: In this randomized clinical trial, 29 healthy 5- to 7-year-old children with at least four carious primary molars with no clinical or radiographic evidence of pulp degeneration were enrolled. The pulpotomy agents were assigned as follows: Group 1: BD; Group 2: MTA-P; Group 3: PR-MTA; and Group 4: FS. Clinical and radiographic evaluations were performed at 6, 12, and 24 months. Data were analyzed using chi-square tests. RESULTS: Total success rates at 24 months were 82.75%, 86.2%, 93.1%, and 75.86%, respectively. No statistically significant differences in total success rates were observed among the groups at 6-, 12-, and 24-month follow-ups. When the groups were compared according to follow-up times, the success rates in each group did not vary significantly among the 6-12-month, 6-24-month, or 12-24-month periods (p > 0.05). CONCLUSION: Although the success rates of BD, MTA-P, MTA-PR, and FS did not differ significantly, calcium silicate-based materials appeared to be more appropriate than FS in clinical practice.

Teratogenicity of Antiepileptic Drugs.

OBJECTIVE: Antiepileptic drugs (AED) have chronic teratogenic effects, the most common of which are congenital heart disease, cleft lip/palate, urogenital and neural tube defects. The aim of our study is to examine teratogenic effects of AED and the correlation between these malformations and AED in single or multiple pregnancies. METHODS: This is a retrospective study of malformations in children born to mothers currently followed up by our outpatient clinics who used or discontinued AED during their pregnancy. Their children were then investigated using echocardiography, urinary ultrasound, cranial magnetic resonance image, and examined by geneticists and pediatric dentists. RESULTS: One hundred and seventeen children were included in the study. Ninety one of these children were exposed to AED during pregnancy. The most commonly used AED were valproic acid and carbamazepine in monotherapy. The percentage of major anomaly was 6.8% in all children. Dysmorphic features and dental anomalies were observed more in children exposed especially to valproic acid. There were 26 mothers with two and four mothers with three pregnancies from the same fathers. No correlation was found between the distribution of malformations in recurring pregnancies and AED usage. CONCLUSION: Our study has the highest number of dysmorphism examined in literature, found in all the children exposed to valproic acid, which may account for the higher rate of facial dysmorphism and dental anomalies. On lower doses of valproic acid, major malformations are not seen, although the risk increases with polytherapy. Our data also indicate possible effects of genetic and environmental factors on malformations.