Comparison of remineralization ability of tricalcium silicate and of glass ionomer cement on residual dentin: an in vitro study.

OBJECTIVE: This study aimed to compare the remineralization effects of a calcium silicate-based cement (Biodentine) and of a glass ionomer cement (GIC: Fuji IX) on artificially demineralized dentin. METHODS: Four standard cavities were prepared in dentin discs prepared from 34 extracted sound human third molars. In each disc, one cavity was covered with an acid-resistant varnish before demineralization (Group 1). The specimens were soaked in a chemical demineralization solution for 96 h to induce artificial carious lesions. Thereafter, one cavity each was filled with Biodentine (Group 2) and GIC (Group 3), respectively, and one carious lesion was left unrestored as a negative control (Group 4). Next, specimens were immersed in simulated body fluid (SBF) for 21 days. After cross-sectioning the specimens, the Ca/P ratio was calculated in each specimen by using scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). Finally, data were analyzed using repeated-measures ANOVA with post-hoc Bonferroni correction. RESULTS: Both cement types induced dentin remineralization as compared to Group 4. The Ca/P ratio was significantly higher in Group 2 than in Group 3 (p < 0.05). CONCLUSION: The dentin lesion remineralization capability of Biodentine is higher than that of GIC, suggesting the usefulness of the former as a bioactive dentin replacement material. CLINICAL RELEVANCE: Biodentine has a higher remineralization ability than that of GIC for carious dentin, and its interfacial properties make it a promising bioactive dentin restorative material.

Assessment of MMP levels in reversible and irreversible pulpitis and a randomized controlled trial comparing clinical success of two different calcium-silicate cements in pulpotomy treatment of primary molars with an 18-month follow-up.

BACKGROUND: Matrix metalloproteinases (MMPs) are critical enzymes involved in the remodeling and defense mechanisms of dental pulp tissue. While their role in permanent teeth has been extensively studied, research focusing on MMPs in primary teeth remains limited. This gap highlights the need for further investigations to understand the specific contributions of MMPs to pulpal defense in primary teeth. Moreover, the clinical efficacy of Biodentine as a pulpotomy material in primary teeth warrants further exploration through well-designed studies to establish its success and long-term outcomes in pediatric dentistry. AIM: This study aims to compare the expression levels of MMP-2, MMP-8, and MMP-9 in cases of reversible and irreversible pulpitis. Additionally, it seeks to evaluate the clinical success of Mineral Trioxide Aggregate (MTA) and Biodentine when used as pulpotomy agents in primary molars. By analyzing the differential expression of these MMPs, the study will contribute to a better understanding of their role in pulpal inflammation and the potential therapeutic outcomes of MTA and Biodentine in primary molars. DESIGN: In this parallel randomized controlled trial, 63 mandibular primary second molars were assigned to two main groups: Group 1, consisting of 42 teeth diagnosed with reversible pulpitis, and Group 2, consisting of 21 teeth diagnosed with irreversible pulpitis. Group 1 was further divided into two randomized subgroups, each containing 21 teeth. The expression levels of MMP-2, MMP-8, and MMP-9 were evaluated in all samples. Pulpotomy treatments were performed using MTA and Biodentine in Group 1. Clinical and radiographic evaluations were conducted over an 18-month follow-up period. Statistical analyses were carried out using The Kolmogorov-Smirnov test, t-test and Fisher's exact test (p < 0.05). RESULTS: The study revealed that MMP-2 and MMP-9 expression levels were significantly elevated in specimens with irreversible pulpitis (p = 0.01), indicating a potential correlation between these matrix metalloproteinases and the severity of pulpal inflammation. However, no significant difference was observed in the clinical success rates of pulpotomies performed with MTA and Biodentine, suggesting that both materials are equally effective in the treatment of primary molars with reversible pulpitis. CONCLUSIONS: The expression of MMP-2 and MMP-9 in pulpal blood presents a promising biomarker for assessing the degree of pulpal inflammation in primary teeth, offering a potentially valuable diagnostic tool. Additionally, the clinical success of Biodentine in pulpotomy procedures supports its viability as an effective alternative to MTA, providing a reliable option. CLINICAL TRIAL REGISTRATION ID: The study protocol has been registered with an ID: NCT05145686. Registration Date: 9th November 2021.

The association between genetic polymorphisms in matrix metalloproteinases and caries experience.

OBJECTIVES: The variation in the caries susceptibility while environmental factors are similar indicates that the effect of individual factors such as genetics on caries process and tooth development should be revealed. The aim of this study was to evaluate the association between genetic polymorphisms in MMP13 (rs2252070) and MMP20 (rs1784418) with caries experience. MATERIALS AND METHODS: A cross-sectional study was conducted on 200 subjects aged 6 to 14 years. Demographic data, data on oral health habits were obtained through the statements of guardian of the individuals, caries data was collected by clinical examination. Unstimulated whole saliva was collected to extract the genomic DNA. Genotyping of the selected polymorphisms was carried out by real-time PCR. Allele and genotype frequencies were compared between different subgroups considering caries experience. Data were analyzed using SPSS 16.0 by chi-square test and logistic regression analysis. RESULTS: Allele distribution of MMP13 was different between caries-affected and caries-free subjects. MMP13 A allele increased the caries risk (p=0.005, OR=1.84, 95% CI 1.20-2.82). Allele and genotype distribution of the polymorphism in MMP20 were not associated with caries experience (p>0.05). CONCLUSIONS: It is concluded that the genetic variation in MMP13 was associated with the caries experience in selected subjects in Turkey. CLINICAL RELEVANCE: The knowledge regarding association between the MMP genes and caries experience, might benefit the clinical practice, improving caries-preventive and caries-therapeutic approaches.

The Role of Vitamin D Receptor Polymorphisms on Dental Caries.

OBJECTIVE: To determine the association between the ApaI, FokI, Cdx2 and TaqI polymorphisms of vitamin D receptor (VDR) gene in caries-active (high-moderate) and caries-free children. STUDY DESIGN: A hundred and fifty children (75 males, 75 females, mean age: 10.19 ± 1.61 years) were included in the study. The subjects were divided into three groups as high caries risk group (DMFT, dft>4)(n=55), moderate caries risk group (DMFT, dft=1-4)(n=57) and caries-free group (n=38). From each individual, blood samples were collected and DNA was extracted. The VDR gene was genotyped for the polymorphisms ApaI, FokI, Cdx2 and TaqI using polymerase chain reaction and restriction fragment length polymorphism methods. All data were analyzed by chi-square test, Fisher's exact test and t test. RESULTS: There was statistically significant difference in the frequency of TaqI genotypes (tt) between caries-active and caries-free children (p=0.029). No statistically significant differences were detected between ApaI, FokI, Cdx2 genotypes and dental caries. CONCLUSION: In the future, VDR gene polymorphisms may be used as a marker for the identification of patients with high caries risk.

Association of mutation in PTPN14 gene and gingival fibromatosis with distinctive facies: a novel finding in whole exome sequencing.

Gingival fibromatosis with distinctive facies presents a rare clinical picture. It is characterized by gingival fibromatosis in conjunction with some craniofacial dysmorphic features such as relative macrocephaly, bushy eyebrows, synophrys, hypertelorism, downslanting palpebral fissures, flattened nasal bridge, hypoplastic nares, cupid-bow mouth and a high palate. Autosomal recessive inheritance has been suggested. However, to date, no causative gene has been reported. Herein, we report a case presenting with the typical findings of this rare genetic syndrome. A homozygous c.1855C>T (p.Gln619Ter) mutation in the PTPN14 gene was identified.

Comparison of conventional versus colored compomers for class II restorations in primary molars: a 12-month clinical study.

OBJECTIVE: To evaluate the 12-month clinical performance of conventional (Compoglass F) and colored (Twinky Star) compomer restorative materials in class II restorations of primary molars. MATERIALS AND METHODS: A total of 196 restorations were placed in 98 children aged between 5 and 10 years (mean age: 7.43 +/- 1.31 years) who had bilateral matched pairs of carious posterior class II primary molars. A split-mouth design was used in which 2 materials (Compoglass F, Twinky Star) were randomly placed on contralateral sides by 3 dentists. At baseline, after 6 and after 12 months, the restorations were evaluated using modified US Public Health Service criteria for: secondary caries, marginal integrity, marginal discoloration, anatomic form and surface texture. The Alpha and Bravo scores were considered as clinical success. The data were subjected to statistical analysis by the Wilcoxon and McNemar tests (p < 0.05). The Kaplan-Meier survival method was applied to estimate survival percentages. RESULTS: No significant difference was found among the groups at all recalls regarding marginal integrity, marginal discoloration, anatomic form, secondary caries and surface texture. The 12-month mean cumulative survival rate of Compoglass F was 95.7%, while in the Twinky Star group, the survival rate was 93% in class II restorations with no significant difference between the groups for either material. CONCLUSION: Both conventional and colored compomer materials are suitable restorative materials for primary teeth for at least 12 months. Colored compomers could also be a good alternative to tooth-colored compomers in the restoration of primary molars.

Exclusion of candidate genes in seven Turkish families with autosomal recessive amelogenesis imperfecta.

Amelogenesis imperfectas (AI) are a group of inherited defects of dental enamel formation that show both clinical and genetic heterogeneity. Seven Turkish families segregating autosomal recessive AI (ARAI) were evaluated for evidence of a genetic etiology of AI for the seven major candidate gene loci (AMBN, AMELX, ENAM, FAM83H, KLK4, MMP20, and TUFT1). Dental and periodontal characteristics of the affected members of these families were also described. The mean scores of DMFS and dfs indices were 9.7 and 9.6, respectively. The mean PPD was 2.2 mm and the percentage of the sites with plaque and BOP were 87.8% and 72.4%, respectively. The exons and intron/exon junctions of the candidate genes were sequenced and no gene mutations were identified in any individuals. These findings support the existence of an additional gene(s) that are etiologic for ARAI in these families.

Oral rehabilitation of a patient with amelogenesis imperfecta.

Amelogenesis imperfecta is a hereditary disorder that causes defective enamel development in the primary and permanent teeth. Clinical treatment is important to address the esthetic appearance of affected teeth, reduce dentinal sensitivity, preserve tooth structure, and optimize masticatory function. The purpose of this case report was to describe the diagnosis, treatment planning, and dental rehabilitation of a patient with autosomal recessive amelogenesis imperfecta. The patient was followed for 5 years, and evaluation 3 years after restorations revealed no pathology associated with the rehabilitation. The patient's esthetic and functional expectations were satisfied.

A long-term effect of caries-related factors in initially caries-free children.

AIM: The aim of this study was to examine the rate and pattern of early childhood caries development in caries-free children based on their dental plaque accumulations, salivary Streptococcus mutans levels, maternal sharing, oral hygiene, and feeding attitudes at baseline and at 24-month follow-up period. DESIGN: A total of 92 children, aged between 15 to 35 months, comprised the study group. The children's dental examinations were first carried out at baseline, and 56 of them were re-examined 24 months later to determine the changes in dental status. The mothers were also interviewed at each examination based on a prepared questionnaire. RESULTS: The prevalence of caries incidence was 45% at 24-month evaluation period among initially caries-free children. The new caries formation was mostly observed on occlusal and aproximal surfaces of maxillary molars (28% and 26%) followed by mesial, distal and buccal surfaces of anterior teeth, respectively. Significant correlations between dental caries formation and maternal sharing, S. mutans levels, and plaque scores were found. CONCLUSION: The results indicated that early S. mutans colonization, high plaque accumulation, and maternal sharing were important factors on a child's caries development.

Multidisciplinary management and long-term follow-up of mesiodens: a case report.

Supernumerary teeth are relatively common in the oral cavity and are characterized by an excessive number of teeth. The term "mesiodens" refers to a supernumerary tooth located in the midline of the maxilla between the central incisors. Mesiodens may cause a variety of pathological complications such as impaction of the maxillary central incisors, tooth retention or delayed eruption of the permanent incisors, crowding, eruption within the nasal cavity, formation of diastema, intraoral infection, root anomaly, root resorption of adjacent teeth and cyst formation accompanied by bone destruction. Therefore it is recommended to follow-up with regular radiographic examination. Early diagnosis minimizes treatment needs and prevents associated complications. The present case, followed for 7 years, presented bilateral mesiodens resulting in delayed eruption of the permanent incisors and emphasizes the importance of multidisciplinary management and long-term follow-up.

The correlation between serum immunoglobulin A and immunoglobulin G levels and the presence of Treponema denticola in human periapical lesions.

The aim of this study was to compare the serum immunoglobulin A (IgA) and immunoglobulin G (IgG) levels and the presence of Treponema denticola in the root canals in a group of teeth with/without periapical lesion. A total of 66 children aged 8 to 13 years old were involved in this study. Five milliliters of blood samples were taken to detect the serum IgA and IgG levels. Sixty-six endodontic samplings were also obtained to determine the presence of T. denticola by polymerase chain reaction. The presence of T. denticola between the groups with/without periapical lesion was statistically significant (p = 0.026). A significant negative correlation was found between serum IgG and IgA levels and the presence of T. denticola (p = 0.023 and 0.038, respectively). This study may support the hypothesis that the presence of T. denticola in the root canals is mainly related to the periapical lesions, and the higher levels of serum IgG and IgA levels may protect against T. denticola.

Genotyping of Streptococcus mutans by using arbitrarily primed polymerase chain reaction in children with Down Syndrome.

OBJECTIVE: The aim of this study was to compare the caries prevalence between Down Syndrome (DS) and non-DS children and to investigate the difference between the genotypes of Streptococcus mutans (S. mutans) colonized in both DS and non-DS groups. DESIGN: Sixty children with DS and 64 non-DS children aged between 7 and 12 years old were included to this study. All erupted teeth were evaluated according to the criteria recommended by the World Health Organization. Unstimulated saliva samples were carried out from the children and cultivated on S. mutans selective Tryptone-yeast-cystine (TYC) agar with 0.2 U/ml bacitracin and 15% sucrose. Molecular typing of S. mutans strains was performed by using arbitrarily primed polymerase chain reaction (AP-PCR) with OPA-05 primer. All data were analysed by using SPSS (SPSS Inc., Chicago, IL, USA) 11.0 software program for windows. RESULTS: The caries index scores were found significantly lower in DS individuals than the non-DS group (p < 0.05). The salivary S. mutans levels between DS and non-DS groups did not show significant difference (p > 0.05). The difference between dental caries and salivary S. mutans levels also was not statistically significant (p > 0.05). According to the results of the AP-PCR typing, all profiles of S. mutans which colonized in DS group were different from the control group. The relationship between these different profiles and dental caries prevalence was statistically significant (p < 0.05). CONCLUSION: The profiles of S. mutans colonized in DS group might be a reason of low caries prevalence.

Evaluation of the relationship between caries indices and salivary secretory IgA, salivary pH, buffering capacity and flow rate in children with Down's syndrome.

The aim of this study was to compare the caries prevalence and salivary secretory IgA (sIgA), salivary pH, buffering capacity and flow rate between Down's syndrome (DS) and control subjects. Seventy-three institutionalised children with DS and 70 normal children aged 7-12 years old were included in this study. Tooth-brushing habits and daily dietary sugar exposures of the children, family income and education levels of the parents were recorded. DMFS and dfs scores were assessed according to the World Health Organisation's criteria and stimulated whole saliva samples were collected. Salivary sIgA levels were determined by radial immunodiffusion technique, the average salivary flow rate was measured from the total volume, and salivary pH and buffering capacity were determined using a pH micro-electrode. All data were analysed using SPSS version 11.0. The DMFS and dfs scores were significantly lower in the DS group than the control group (P < 0.05). Otherwise, the difference in plaque scores between the DS and control groups was not statistically significant (P > 0.05). There were no significant differences in tooth-brushing habits and daily dietary sugar exposures of the children, family income and education levels of the parents between the two groups (P > 0.05). Salivary sIgA levels were significantly higher in the DS group (P < 0.05). Salivary pH, buffering capacity and flow rate were quite similar in both the DS and control groups (P > 0.05). In conclusion, the patients with DS had a significantly lower prevalence of caries and significantly higher levels of salivary sIgA in this study. This finding tends to support the hypothesis that higher levels of salivary sIgA may protect against dental caries.

Management of a case with bilateral talon cusp in primary dentition.

The talon cusp is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. The alteration can cause clinical problems such as caries or occlusal interference. Management of the talon cusp varies according to the circumstances of the individual case and should be as conservative as possible. The purpose of this report was to present the case of bilateral talon cusp in primary maxillary central incisors that was successfully managed with conservative therapy.

Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts.

UNLABELLED: The aim of this study was to investigate the caries-related microorganisms in saliva and the prevalence of Early childhood caries (ECC) in 15- to 35-month-old Turkish children and their associations with the characteristics of the mothers, socioeconomic criteria, and feeding habits of the children. METHODS: Saliva samples of 101 children were studied to determine the numbers of Streptococcus mutans, lactobacilli, and Candida albicans. A questionnaire regarding the characteristics of the mothers, socioeconomic criteria, and feeding habits of the children was carried out before the dental examinations of the mother-child pairs. RESULTS: The regression analyses revealed DMFS scores of the mothers as an impact factor for the children's caries experience. The prolonged usage of feeding bottle with sweetened milk, pacifier use, and maternal sharing were strongly associated with the colonization of S. mutans, lactobacilli, and C. albicans, respectively. A significant correlation was also found between maternal education and S. mutans. CONCLUSION: Data indicated that the mother's DMFS scores, education, and feeding habits were strong risk indicators for the colonization of caries-related micro-organisms and ECC.

Efficacy of propolis as an intracanal medicament against Enterococcus faecalis.

This study sought to compare the antibacterial efficacy of three commonly used intracanal medicaments with propolis against Enterococcus faecalis. This study utilized 180 freshly extracted single-rooted intact human permanent teeth with a single root canal. After root canal preparations and sterilization, canals were contaminated with E. faecalis and incubated at 37 degrees C (+/- 1.0 degrees C) for seven days. The teeth were divided randomly into six groups. To determine bacterial growth on blood agar, microbiological samples were carried out with sterile paper points to evaluate results at 48 hours and at ten days. All data were analyzed statistically with t-test, Mann Whitney, Kruskal Wallis, and one-way ANOVA tests. This study revealed that propolis had good in vitro antibacterial activity against E. faecalis in the root canals, suggesting that it could be used as an alternative intracanal medicament.

Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study.

The aim of this study was to evaluate the in vivo efficacy of three intracanal medicaments (Ca(OH)2, 1% chlorhexidine gel and 1% chlorhexidine gel with Ca(OH)2 against Enterococcus faecalis in necrotic primary teeth. As a conclusion, chlorhexidine gel with or without Ca(OH)2 was more effective than Ca(OH)2 alone against Enterococcus faecalis.

Dental findings and treatment in consanguinity associated congenital chronic familial neutropenia.

The purpose of this report is to describe dental findings and treatment of an 11-year old male patient and a 5-year old female patient, children of first cousins, suffering from severe benign congenital chronic familial neutropenia. This case report emphazises the importance of differential diagnosis of immunodeficiencies including congenital chronic familial neutropenia in the background of severe periodontal diseases and/or diffuse carious lesions in children.

Chemical compositions and antimicrobial activities of four different Anatolian propolis samples.

Propolis means a gum that is gathered by bees from various plants. It is known for its biological properties, having antibacterial, antifungal and healing properties. The aims of this study were to evaluate the antimicrobial activity of four different Anatolian propolis samples on different groups of microorganisms including some oral pathogens and comparison between their chemical compositions. Ethanol extracts of propolis (EEP) were prepared from four different Anatolian propolis samples and examined whether EEP inhibit the growth of the test microorganisms or not. For the antimicrobial activity assays, minimum inhibitory concentrations (MIC) were determined by using macrodilution method. The MIC values of the most effective propolis (TB) were 2 microg/ml for Streptococcus sobrinus and Enterococcus faecalis, 4 microg/ml for Micrococcus luteus, Candida albicans and C. krusei, 8 microg/ml for Streptococcus mutans, Staphylococcus aureus, Staphylococcus epidermidis and Enterobacter aerogenes, 16 microg/ml for Escherichia coli and C. tropicalis and 32 microg/ml for Salmonella typhimurium and Pseudomonas aeruginosa. The chemical compositions of EEP's were determined by high-temperature high-resolution gas chromatography coupled to mass spectrometry. The main compounds of four Anatolian propolis samples were flavonoids such as pinocembrin, pinostropin, isalpinin, pinobanksin, quercetin, naringenin, galangine and chrysin. Although propolis samples were collected from different regions of Anatolia all showed significant antimicrobial activity against the Gram positive bacteria and yeasts. Propolis can prevent dental caries since it demonstrated significant antimicrobial activity against the microorganisms such as Streptococcus mutans, Streptococcus sobrinus and C. albicans, which involves in oral diseases.

Associations of interleukin (IL)-1ß, IL-1 receptor antagonist, and IL-10 with dental caries.

Streptococcus mutans is important in dental caries. Although the role of cytokines in the pathogenesis of dental caries is not clear, components of S. mutans were found to stimulate production of pro-inflammatory cytokines. We examined the associations of interleukin (IL)-1ß, IL-1 receptor antagonist (IL-1ra), and IL-10 with dental caries. Unstimulated whole saliva and blood samples were obtained from 108 children aged 6-12 years with high caries (decayed, missing, or filled teeth [dmft/DMFT] index >4, n = 37), moderate caries (dmft/DMFT = 1-4, n = 37), or caries-free (dmft/DMFT = 0, n = 34). S. mutans level was classified as low (<10(5) colony-forming units [CFU]/mL) or high (≥10(5) CFU/mL). Saliva and serum concentrations of IL-1ß, IL-1ra, and IL-10 were determined by ELISA. IL-1ß, IL-1ra, and IL-10 gene polymorphisms were genotyped using PCR and restriction fragment length polymorphism analysis. The chi-square, Mann-Whitney U, one-way ANOVA, posthoc, Fisher's exact, and t tests were used in statistical analysis. Dental caries was not correlated with salivary or serum concentrations of the studied cytokines. S. mutans level positively correlated with saliva IL-1ß concentration and inversely correlated with saliva IL-1ra concentration. There was no correlation of IL-1ß, IL-1ra, or IL-10 gene polymorphisms with dental caries. S. mutans is important in stimulating saliva IL-1ß and inhibiting IL-1ra. Future studies of associations between cytokines and dental caries should investigate additional cytokines and enroll a larger number of participants.