Is serum BDNF level reliable parameter in detecting of dental anxiety before impacted third molar surgery?

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a factor that implicate in the pathophysiology and treatment of depression and anxiety. The aim of this study was to determine the relationship between dental anxiety and BDNF serum level through impacted third molar surgery. MATERIAL AND METHODS: In this randomized, double-blind, cross-sectional study, the sample included patients who had been admitted for the impacted third molar extraction under local anesthesia between January to November 2020. The primary predictor variable was serum BDNF level and the second predictor variable was dental anxiety scores before and after operation in patients. The primary outcome variable was the correlation between anxiety scores (APAIS, MDAS, STAI, VAS) and serum BDNF level. The sample included 55 patients (22 Male, 33 Female) aged 18 to 42 (24,2+5,55). RESULTS: Comparison of pre-operative scores (APAIS, MDAS, STAI, VAS and BDNF) and post-operative scores were statistically significant (P < .05). Post-operatively, MDAS and VAS scores decreased, while BDNF levels and STAI scores increased compared to the preoperative scores. BDNF was not correlated with APAIS, MDAS, STAI, and VAS preoperatively and postoperatively. CONCLUSIONS: There may be a relationship between serum BDNF level and dental anxiety scale, but, no correlation was found between them.

Determination of the effect of two different methods of dental anesthesia on pain level in pediatric patients: A cross-over, randomized trial.

Background: In dentistry, needles are the most feared and anxiety-causing tool, making anesthetic injection a worrying practice for patients. Aim: To evaluate the effect of intraosseous anesthesia (IOA) and needle-free dental anesthesia (NFA) on pain levels in systemically healthy 8-10-year-old patients. Patients and Methods: Twenty patients aged 8-10 years were included in this cross-over study. Specifically, the pain was measured by Wong Baker, pulse rate (PR), and salivary opiorphin levels (SOL). In addition, the Frankl Behavioral scale was used to measure behaviors and face, legs, activity, cry, consolability (FLACC) was utilized to measure pain and discomfort. To determine the patients' anxiety levels Spielberger State-Trait Anxiety Scale (SSAS-SAAS) was used. The Friedman and Wilcoxon signed-rank tests were used. P < 0.05 was considered significant. Results: According to FLACC scores, IOA and NFA exhibited significantly pain alteration patterns in during local and topical anesthesia, respectively (p = 0.004, 0.001; P < 0.01). Also, only NFA showed significantly decreased SOL values in 5- and 10-min after local anesthesia periods compared to the before levels (p = 0.004, P = 0.001; P < 0.01). Conclusion: Patients feel similar pain perceptions during local anesthesia application in both injection systems. According to the SOL values, NFA may provide more higher anesthetic efficiency than IOA.

Antibacterial characteristics of glass ionomer cements containing antibacterial agents: an in vitro study.

PURPOSE: The objective of this study was to evaluate the antibacterial activity (ABA), Vickers microhardness numbers (VHN) and cumulative fluoride-releasing (CFR) patterns of conventional glass ionomer cement (GIC) containing AB agents. METHODS: Chlorhexidine (CHX), Cetrimide (CT) and Cetylpyridinum Chloride (CPC) were added to the powder and Benzalkonium Chloride (BC) was added to liquid of GIC in concentrations of 1% and served as the experimental group (EG). Antibacterial-free GIC was used a control group (CG). RESULTS: Compared to the CG, a statistically significantly higher level of ABA was detected at the 1st and 7th day against Streptococcus mutans (SM) and on all days against Lactobacillus casei (LC). The CG had statistically significantly high microhardness values in all time periods compared to the EG. With regard to fluoride ion release, there was no statistical difference between CG and EG at all times. A statistically significant increase was observed in both CG and EG during the 1st day to the 30th day. CONCLUSION: The results of this in vitro investigation demonstrated that AB agents added to the GIC can exhibit AB effects against SM and LC without seriously damaging the physical and chemical properties of the material.

Effect of laser application on microtensile bond strength of an orthodontic adhesive to water-aged composite.

AIM: This study evaluated the microtensile bond strength (MTBS) of an orthodontic adhesive to water-aged composite surfaces using different surface treatments. SUBJECTS AND METHODS: Twelve composite blocks (10 mm × 10 mm × 5 mm) were fabricated and randomly divided into two groups. Half of the specimens were stored in distilled water for 1 day, and the other specimens were stored for 30 days. The specimens were randomly assigned to six groups according to surface treatments (n = 15): Group 1, control (no treatment); Group 2, phosphoric acid; Group 3, diamond bur; Group 4, diamond bur + phosphoric acid; Group 5, laser; and Group 6, laser + phosphoric acid. One coat of orthodontic adhesive was bonded to one surface of composite blocks, and a microhybrid composite resin was bonded to the surfaces via a Teflon mold. Bond strength was evaluated using an MTBS test. Surface topography was evaluated using scanning electron microscopy (SEM) analysis. The data were analyzed using one-way analysis of variance, Tamhane post-hoc test, and independent sample t-tests (P < 0.05). RESULTS: Bond strength values tended to decrease in all groups (with the exception of Group 2) after storage in water for 30 days (P < 0.05). Laser and diamond bur application (with or without phosphoric acid) enhanced the bond strength. CONCLUSIONS: An Er,Cr:YSGG laser application may be a feasible alternative to diamond bur for enhancing the bond strength of orthodontic adhesive to composite resin.

Antimicrobial activity and volatile constituent analysis of three commercial herbal toothpastes containing Aloe vera L. and Fragaria vesca L. extracts.

AIMS: This work was designed to evaluate the antimicrobial activity of three different commercial herbal (Aloe vera L. and Fragaria vesca L. extracts) toothpastes [LR Aloe vera (HTP1), ESI Aloe fresh (HTP2) and ROCS Teens (HTP3)] against two microorganisms that cause tooth infections. MATERIALS AND METHODS: An agar disk diffusion method was used to test the antimicrobial activity of three herbal gel toothpastes in the amount of 100 µL against Streptococcus mutans and Staphylococcus aureus. In the second part of the work, the volatile organic compounds of three different commercial herbal toothpastes (HTP1-3) were determined by solid-phase microextraction/gas chromatography-mass spectrometry-flame ionization detection (SPME/GC-MS-FID). RESULTS: The sensitivity of the tested herbal toothpastes toward each microorganism was expressed as the mean of the clear zone within the range of 6-16 mm diameters. HTP1 and HTP2 were found to be more effective against both bacteria compared with HTP3. Oxygenated monoterpenes (99.34%, 91.44%, and 83.48%) were the most abundant groups in the SPME of HTP1-3, respectively. Menthol (25.41%, 35.82%, and 31.15%) and anethole (52.01%, 23.62%, and 38.79%) were the major compounds identified in the SPME analysis of HTP1-3, respectively. Carvone was found only in HTP3 (0.49%) in a small quantity. CONCLUSION: The commercial herbal toothpastes could have advantages in decreasing bacterial accumulation on teeth with protection of the oral cavity.

Short-term antibacterial activity and compressive strength of biodentine containing chlorhexidine/cetirimide mixtures.

BACKGROUND AND PURPOSE: Aim is to evaluate the antibacterial activity and physical properties of Biodentine containing chlorhexidine (CHX)/cetrimide (CT) mixtures at 24 h. MATERIALS AND METHODS: Powder formulations of CHX (2.5%) and CT (2.5%) were added to the powder of Biodentine and served as experimental groups (EXP). Antibacterial free groups were designed as control (CNT). The antibacterial acitivity (AB) (n = 5; for each) of disc-shaped specimens against Streptococcus mutans and Lactobacillius casei and compressive strength (CS) (n = 10; for each) tests used both for groups after 24 h after polymerization. STATISTICAL ANALYSIS USED: Normality of data were tested with the Shapiro-Wilk test. Significant differences were analyzed with the Mann-Whintey U test for both the methods (agar disk diffusion and compressive strength) at a significance level of P < 0.05. RESULTS: Significantly higher antibacterial effects were obtained in EXP groups compared to the CNTs for both bacteria after 24 h, distinctly (P < 0.01). No differences were found between groups regarding the CS values (P > 0.05). CONCLUSION: Since the incorporation of 5% CHX/CT to the Biodentine exhibited acceptable antibacterial activity without hampering compressive strength values at 24 h, this combination could be a promising alternative for eliminating the residual bacteria for indirect pulp-capping therapies.

Metatarsal head resurfacing arthroplasty in the treatment of hallux rigidus: is it reliable treatment option?

BACKGROUND: This study looks at the failure and complications arising secondary to resurfacing and hemi-arthroplasty done at the metatarsal head in patients with hallux rigidus. Our report includes a review of the relevant literature to verify the validity of our techniques. MATERIALS AND METHODS: We performed metatarsal head resurfacing with hemi-arthroplasty using the HemiCap(®), on 12 patients with hallux rigidus between the dates of March 2010 and October 2013. The mean follow-up period was 22.3 months (range 12-54). All patients were clinically and radiologically evaluated according to the American Orthopedics Foot and Ankle Society (AOFAS) functional scale and the Coughlin and Shurnas classification. RESULTS: The recorded mean AOFAS score showed an increase from the preoperative score of 49.2 ± 13.1 to a postoperative follow-up score of 80.8 ± 13.1 (p < 0.001). Pain scores also showed an improvement from 16.5 ± 7.1 points preoperatively to 32.5 ± 6.9 points during the postoperative follow-up (p < 0.001). The mean function score improved from 17.7 ± 7.6 points preoperatively to 33.2 ± 7.6 points during the final postoperative follow-up (p < 0.001). Furthermore, the mean range of motion improved from 16.3 ± 4.8° preoperatively to 45.4 ± 13.2° postoperatively (p < 0.001). Three patients (25 %) reported pain at rest. Surgical revision was done on these patients who have significant pain that limited their range of motion. CONCLUSION: Favorable outcomes were achieved by performing minimal bone resection which also helps maintain metatarso-phalangeal joint function through metatarsal head resurfacing arthroplasty. We expect the failure rates to decrease with the advancements of surgical techniques. Selecting the appropriate patient populous in the application of the technique is crucial in attaining successful clinical results.

The impact of Er:YAG laser enamel conditioning on the microleakage of a new hydrophilic sealant--UltraSeal XT hydro.

UltraSeal XT hydro is a new hydrophilic, light-cured, methacrylate-based pit and fissure sealant which has been developed by Ultradent Products, USA. The sealant is highly filled with a 53 wt.% mixture of inorganic particles which confer both thixotropy and radiopacity. The principal purpose of this study was to investigate the microleakage of UltraSeal XT hydro as a function of different enamel etching techniques. The occlusal surfaces of sound, extracted human molars were either acid etched, Er:YAG laser irradiated or successively laser irradiated and acid etched. UltraSeal XT hydro was applied to each group of teeth (n = 10) which were subjected to a thermocycling process consisting of 2500 cycles between 5 and 50 °C with a dwell time of 30 s. Microleakage assessments were then carried out using 0.5% fuchsin dye and optical microscopy. The microleakage score data were analysed using the Kruskal-Wallis, Mann-Whitney U test with Bonferroni adjustment. No significant differences in microleakage were noted between the individually acid etched and laser-irradiated groups (p > 0.05); however, teeth treated with a combination of laser irradiation and acid etching demonstrated significantly lower microleakage scores (p < 0.001). Electron microscopy with energy-dispersive X-ray analysis revealed that the mineral filler component of UltraSeal XT hydro essentially comprises micrometre-sized particles of inorganic silicon-, aluminium- and barium-bearing phases. Laser etching increases the roughness of the enamel surface which causes a concentrated zoning of the filler particles at the enamel-sealant interface.

The reasons for extractions of primary teeth in Turkish children.

AIM: The aim of this study was to determine the current reasons for primary teeth extractions in Turkish children and their relative importance. STUDY DESIGN: retrospective evaluation of patients by analysing dental records of children aged 2-13 years, receiving treatment in different regions in Turkey over a period of five years (2007-2012). Patient's age, gender, any significant medical finding, type of tooth extracted and the reason for the extraction were the parameters evaluated. RESULTS: It resulted that 2,508 primary teeth belonging to 1,755 children aged of 2-13 years were extracted. Extraction due to caries (57,4%) was found to be the most common reason. STATISTICS: Chi-square tests were performed for statistical analysis. Although no differences in the types of teeth extracted were observed between genders, striking differences were noted in the different age groups. CONCLUSION: From this study it can be concluded that caries and subsequent pulpal pathology are the most common reasons for extraction of primary teeth in Turkey. Primary molars were the most common tooth type extracted. Preventive programmes for preschool children should be given importance.

Accuracy of three different apex locators and visual exam in primary teeth with and without root resorption in vitro.

AIM: The aim of this study was to evaluate the accuracy and reliability of three apex locators (EndoMaster, Raypex, DentaPort ZX) and visual assessment in primary molar teeth in vitro. MATERIALS AND METHODS: Twenty-four extracted human primary molar teeth with and without root resorption were used in this study. After endodontic access preparation, root canal length was visually measured by means of a K file; then the teeth were embedded into alginate and the roots were measured again by mans of the three apex locators. The results were collected in SPSS 15.0 and statistical evaluations were completed by one-way ANOVA and Kruksal-Wallis test. RESULTS: The measurements closest to the visually determined length were obtained with EndoMaster. No statistically significant differences were found between visual and apex locators lengths (p>0.05). CONCLUSION: Within the limitations of this study, the use of apex locators would be useful in the endodontic treatment of primary teeth.

Clinical and radiographic outcomes of direct pulp capping therapy in primary molar teeth following haemostasis with various antiseptics: a randomised controlled trial.

AIM: This was to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) therapy in primary molar teeth following haemostasis with various antiseptics for 12 months. MATERIALS AND METHODS: A total of 70 vital primary molar teeth with deep dentin caries were randomly allocated to different antiseptic groups. After observing the pinpoint exposure, 0.9% saline solution (SS, control), 0.5% sodium hypochlorite (SH), 2% chlorhexidine digluconate (CHX), or 0.1% octenidine dihydrochloride (OCT) was applied with sterile cotton pellets for 3 min before calcium hydroxide (CH) DPC therapy. Statistical evaluation: The intergroup radiographic success criteria were analysed using a Kruskal-Wallis test in each follow-up period at a confidence interval of 95%. RESULTS: After 12 months, all groups showed a clinical success rate of 100% (no clinical failures were observed at the time of pulpectomy or extraction), and the overall radiographic success rates were OCT (100%) > SH (94.74%) > CHX (93.3%) > SS (84.21%), respectively (p > 0.05). OCT did not exhibit any failures. The undesirable radiographic failure types (pulpectomy or extraction) were mostly observed in the SS group. CONCLUSION: Compared with SS, the success of conventional CH usage in DPC therapy of primary molar teeth could be enhanced by providing acceptable disinfection features with antiseptic solutions. OCT seems to have relative beneficial effects compared to SH and CHX.

The success rates of a glass ionomer cement and a resin-based fissure sealant placed by fifth-year undergraduate dental students.

AIM: To evaluate retention and caries prevention of a glass-ionomer cement (GIC) and a resin-based fissure sealant placed by fifth-year undergraduate dental students. METHODS: The study was conducted according to a split-mouth, randomised clinical trial. Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study. The children were selected from a population that had a high risk for dental caries. Sealant materials were applied by fifth-year undergraduate dental students on 346 fissures of the first permanent molars in 173 children. The ages of the children ranged from 7-15 years (mean 9.4). Two researchers at the clinics supervised all of the procedures. Intra-examiner reproducibility and inter-examiner reproducibility were 0.90 and 0.86, respectively, for the clinical assessment of sealant retention and caries evaluation. RESULTS: GIC sealants were completely lost in 31.9% and resin-based sealants in 16.6% (p<0.05). The total retention rates of GIC sealants and resin-based sealants were 13.8% and 20.8%, respectively. After 24 months, the caries increment was 3.4% for GIC sealants and 4.8% for resin-based sealants (p>0.05). CONCLUSIONS: The retention of GIC sealants was markedly inferior to the retention of resin-based sealants; however, GIC when used as a pit and fissure sealant was slightly more effective in preventing occlusal caries.

Can sarcoidosis cause autoamputation of a finger phalanx?

Sarcoidosis is a multisystemic granulomatous disease. In the case presented, autoamputation of the distal phalanx of a little finger of the left hand was observed. The possibility of autodigital amputation as a result of sarcoidosis is discussed.

In vivo evaluation of teicoplanin- and calcium sulfate-loaded PMMA bone cement in preventing implant-related osteomyelitis in rats.

The objective of this study was to evaluate the efficacy of teicoplanin- and calcium sulphate-loaded polymethylmethacrylate (PMMA) bone cements in preventing experimental implant-related osteomyelitis in rats. Four groups of antibiotic-loaded rods were prepared and were implanted into the lateral condylus of the rat femur after inoculation of Staphylococcus aureus. The effectiveness of these were assessed microbiologically, radiographically, and histopathologically. Radiographic evaluation revealed a significant reduction of periostal reaction and osteolysis in rats that received calcium sulphate- and teicoplanin-loaded rods. Histopathological evaluation confirmed these results. Acute infection and bone necrosis were found to be significantly lower in rats that had received calcium sulphate- and teicoplanin-loaded rods. The addition of calcium sulfate to teicoplanin-loaded PMMA bone cement appeared satisfactory as an antibiotic-carrying system for prophylaxis of experimental implant-related osteomyelitis, but further investigations are needed to reach definitive statements for clinical applications.

Penetrating type intraosseous ganglion cyst of the lunate bone / Ganglión intraóseo penetrante del semilunar

Intraosseous ganglion cysts of the carpal bones located in the lunate are one of the rarely seen pathologic conditions. Here we present a case of the penetrating type of intraosseous ganglion cyst located in the lunate as an uncommon cause of wrist pain. The patient was successfully treated by surgical intervention. Intraosseous ganglion cyst should be considered in the differential diagnosis of chronic dull wrist pain.

Los gangliones intraóseos de los huesos carpianos localizados en el semilunar, constituyen una de las condiciones patológicas más raras que puedan verse. Aquí presentamos un caso del tipo penetrante de ganglión intraóseo, localizado en el semilunar como causa poco común del dolor de muñeca. El paciente fue tratado exitosamente mediante una intervención quirúrgica. El quiste ganglionar intraóseo debe ser considerado en el diagnóstico diferencial de dolores de muñeca sordos que se han hecho sentir por mucho tiempo, y se han vuelto crónicos.

Penetrating type intraosseous ganglion cyst of the lunate bone.

Intraosseous ganglion cysts of the carpal bones located in the lunate are one of the rarely seen pathologic conditions. Here we present a case of the penetrating type of intraosseous ganglion cyst located in the lunate as an uncommon cause of wrist pain. The patient was successfully treated by surgical intervention. Intraosseous ganglion cyst should be considered in the differential diagnosis of chronic dull wrist pain.

Penetrating type intraosseous ganglion cyst of the lunate bone / Ganglión intraóseo penetrante del semilunar

Intraosseous ganglion cysts of the carpal bones located in the lunate are one of the rarely seen pathologic conditions. Here we present a case of the penetrating type of intraosseous ganglion cyst located in the lunate as an uncommon cause of wrist pain. The patient was successfully treated by surgical intervention. Intraosseous ganglion cyst should be considered in the differential diagnosis of chronic dull wrist pain.

Los gangliones intraóseos de los huesos carpianos localizados en el semilunar, constituyen una de las condiciones patológicas más raras que puedan verse. Aquí presentamos un caso del tipo penetrante de ganglión intraóseo, localizado en el semilunar como causa poco común del dolor de muñeca. El paciente fue tratado exitosamente mediante una intervención quirúrgica. El quiste ganglionar intraóseo debe ser considerado en el diagnóstico diferencial de dolores de muñeca sordos que se han hecho sentir por mucho tiempo, y se han vuelto crónicos.

In vitro bacterial adherence to teicoplanin and calcium sulfate-soaked bone cement.

The aim of this study was to assess in vitro the improvement in release kinetics for teicoplanin and the inhibition of bacterial adhesion on calcium sulfate-soaked PMMA discs. Calcium sulfate has been used in vivo and shown to be biocompatible, and prevention of bacterial adhesion may be expected with calcium sulfate-soaked polymethylmethacrylate (PMMA). Discs were made by adding teicoplanin and calcium sulfate in powder form to PMMA powder. The antibiotic concentration eluted from PMMA discs was assayed by agar diffusion assay. Nonadherent bacteria were removed by washing and adherent bacteria were detached by sonication. The suspension including nonadherent bacteria was seeded on sheep blood agar plate and incubated for 24 h at 37 degrees C for the growth of microorganisms. The teicoplanin released from discs containing calcium sulfate was higher than that released from discs which had not been soaked with calcium sulfate. The count of bacteria adhering to the calcium sulfate-soaked discs was lower than that from the discs without calcium sulfate. In conclusion, the addition of calcium sulfate to teicoplanin-loaded PMMA bone cement may provide local antibiotic concentrations higher than MIC values due to increased antibiotic release. Furthermore, calcium sulfate was found to be effective in reducing bacterial adherence to treated discs.

Penetrating type intraosseous ganglion cyst of the lunate bone.

Intraosseous ganglion cysts of the carpal bones located in the lunate are one of the rarely seen pathologic conditions. Here we present a case of the penetrating type of intraosseous ganglion cyst located in the lunate as an uncommon cause of wrist pain. The patient was successfully treated by surgical intervention. Intraosseous ganglion cyst should be considered in the differential diagnosis of chronic dull wrist pain.