Pulp tissue dissolution capacities of different irrigation agitation techniques in artificial internal resorption cavities.

Purpose: The aim of this in vitro study was to compare the organic tissue dissolution capacities of 3 different irrigation agitation techniques (IATs) in artificial internal root resorption cavities (IRCs). Materials and methods: Ninety freshly extracted maxillary human incisors were selected. After decoronation procedure, the roots were split longitudinally, and a standard IRC were prepared in the canals on each half of the roots. Then, the bovine pulp samples (~2,3 mg) were previously weighed and placed into the cavities. The root fragments were reassembled and cemented to create a circular IRC within the canal. Teeth samples were randomly divided into 6 groups (n=15); sodium chlorur (NaCl) and sonic irrigation (SI), sodium hypochlorite (NaOCl) and SI, NaCl and passive ultrasonic irrigation (PUI), NaOCl and PUI, NaCl and laser activated irrigation (LAI), NaOCl and LAI. After that, the teeth were decemented and the tissue samples inside the cavities were weighed again. The percentage of weight loss was calculated and statistically analyzed. Results: SI has significantly more successful results than PUI and LAI in groups which the irrigant was NaCl. There was also a significant difference between LAI and PUI in groups which the irrigant was NaOCl (Group 6 ˃ Group 4, p=0.003). There was no significant difference between LAI and SI with NaOCl. Conclusion: Complete dissolution of bovine pulp tissue from IRCs was not achieved by any tested techniques. However, the LAI with NaOCl was more effective than other IATs. In addition, there is no significant difference between the LAI and SI with NaOCl.

Assessment of severity and mineral composition of saliva in schoolchildren with molar-incisor hypomineralization (MIH).

The aim of the study was to evaluate the severity of molar incisor hypomineralisation (MIH), related oral health and investigate salivary mineral composition. The study was conducted with 50 participants aged between 6-15 years who were effected with MIH and 50 without MIH. The International Caries Detection and Assessment System (ICDAS) scores, Decayed, Missing, Filled Teeth/Surface (DMFT/S), dft/s and gingival/plaque indices were evaluated. The pH, flow rate, buffering capacity and mineral composition of saliva was measured. "Student t" test, one-way analysis of variance in repeated measurements of groups, and Tukey multiplex in subgroup comparisons was used. Kruskal-Wallis, Mann-Whitney U, Wilcoxon and chi-square tests were used to analyze qualitative data and compare groups. A total of 100 children (57 females 43 males, mean age 10.12 ± 1.85) participated in the study. There was no difference between ICDAS, DMFT/S scores, but dft/s index values were statistically significant (p = 0.001). The simplified oral hygiene index of MIH patients were statistically higher, but no significant differences were found in modified gingival indices (p = 0.52). Although the salivary pH and flow rate of the patients in the study group were lower, the buffering capacity was higher than those in the control group, but no significant difference was observed (p = 0.64). The mean values of phosphorus, carbon and calcium content in the saliva samples of MIH patients were higher than those of patients without MIH, and this difference was low for phosphorus (p = 0.76) and carbon (p = 0.74), but significantly higher for calcium. To the best of our knowledge, this is the first study to evaluate the association between calcium, phosphate and carbon levels in saliva of children with MIH. The significantly high amount of calcium in the saliva of patients with MIH suggests that further investigations are needed.

Comparative evaluation of the clinical success of 3D-printed space maintainers and band-loop space maintainers.

BACKGROUND: Exploring the integration of 3D-printing technology in space maintainer (SM) manufacturing could offer innovative solutions and insights for enhancing SMs. AIM: To compare the clinical success, retention, and periodontal effect of traditional band-loop (TBL) SMs with 3D-printed SMs. DESIGN: Seventy children (mean age: 6.99 ± 1.18) were divided into two groups. Laser sintering (LS) group (n = 34): Patients were scanned with an intraoral scanner. SMs were produced with LS 3D-printing method from a titanium-based metal powder. T group (n = 36): Impressions were taken with alginate. SMs were produced by adjusting the bands and soldering the wires on the model. The retention and effects on oral hygiene of the SMs were evaluated at the sixth month. Preference for impression technique was assessed by a five-question survey. RESULTS: Thirty-eight percent of T SMs and 66% of LS SMs failed (p = .007). The mean survival time was significantly higher in the T group (p = .035). No difference was found between the initial and control full-mouth Gingival Index (GI) and Plaque Index (PI) values of the two groups. Both groups had increased GI/PI values in abutment teeth. Patients in the LS group interpreted their impression experience more positively. CONCLUSION: It is important to provide oral hygiene education before applying fixed SMs and utilize more digital workflow in paediatric dentistry.

Comparative evaluation of the fracture resistance of newly developed prefabricated fibreglass crowns and zirconium crowns.

BACKGROUND: Prefabricated fibreglass crowns (PFCs) require less tooth structure reduction than prefabricated zirconium crowns (PZCs) for restoring primary molars. Little is known, however, about their mechanical properties. AIM: To investigate the fatigue survival and fracture resistance of PZCs and PFCs cemented with two different types of luting cement [glass-ionomer cement (GIC) and resin-modified GIC (RMGIC)]. DESIGN: One hundred and twenty extracted human primary molars were randomly divided into subgroups (n = 15) according to the crown type (PFCs/PZCs), the luting cement (GIC/RMGIC) and crowns subjected to the chewing simulation test with thermocycling mechanical loading (CSTTML). The surfaces of the teeth were reduced by approximately 2 mm in the PZC group and 1 mm in the PFC group. All the samples were subjected to fracture tests. RESULTS: None of the samples subjected to CSTTML exhibited signs of surface damage, fracture or premature debonding. The forces required to fracture PFCs were higher than those required for PZCs in all groups (p = .001). The highest mean fracture resistance values were obtained from the group of PFCs cemented with GIC that were subjected to the CSTTML (2515.8 N ± 619.2 N). CONCLUSIONS: PFCs presented high fatigue survival and could be used as alternatives to PZCs as they require less tooth structure reduction. Crowns cemented with GIC had a similar fracture resistance value when compared with RMGIC.

Alterations of panoramic radiomorphometric indices in children and adolescents with beta-thalassemia major: A fractal analysis study

Background: Beta-thalassemia major is an inherited disorder that can cause bone deformity and loss of bone mineral density. The objective of this study is to evaluate the cortical and trabecular mandibular bone morphology of children and adolescents who have beta-thalassemia major (ß-TM) using a fractal dimension (FD) analysis and different panoramic radiomorphometric indices with digital panoramic radiographic images (DPRIs).Material and Methods: The study included 80 patients (with 40 patients each of ß-TM and control). The mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and simple visual estimation (SVE) were evaluated, and an FD analysis of five regions of interest (ROIs) (ROI 1: in basal cortical bone; ROI 2: in premolar region; ROI 3: in molar region; ROI 4: in angulus mandible and ROI 5: in condyle region) was obtained in all DPRIs. Quantitative variables were analyzed using the student’s t-test , Kruskal–Wallis and Mann-Whitney U tests.Results: When the ß-TM groups were compared with controls, there were no statistically significant differences found in the mean FD values, the ROIs of the trabecular bone, or the SVE. There was a significant correlation in the mean MCW, PMI, ROI of cortical bone (ROI 1), and MCI between ß-TM and control groups (p < 0.001, p < 0.001, p = 0.047, and p = 0.046, respectively). The mean MCW values correlated with the SVE in both the ß-TM and control groups (p = 0.031 and p < 0.001, respectively). While the mean MCW values correlated with the MCI (p = 0.04) in the control group, the mean MCW values were not correlated with the MCI (p = 0.493) in ß-TM group.Conclusions: The current study revealed lower MCW and PMI values in the ß-TM group. While the mean FD values of trabecular bone is similar to the control groups, the mean FD value is lower in cortical bone in the ß-TM group. MCW, PMI, FD of cortical bone and MCI may be key indicators in individuals with beta-thalassemia major.(AU)

Fracture Resistance of Prefabricated Primary Zirconium Crowns Cemented with Different Luting Cements.

Purpose: The purpose of this study was to determine the retention of prefabricated primary zirconium crowns (PPZCs) and the fracture resistance of samples cemented with four different luting cements subjected to a chewing simulation test with thermocycling mechanical loading (CSTTML). Methods: A total of 120 extracted primary molar teeth were selected and allocated into four groups, according to luting cement materials (bioactive cement, resin cement, glass ionomer cements [GICs], resin-modified GICs). After half of each group was subjected to CSTTML, all the samples were subjected to fracture tests and the mean force required to fracture the PPZCs was recorded. Results: After the CSTTML test, corresponding to a simulated one-year aging, none of the sample materials were found to be cracked, fractured, chipped, or non-retained. Resin cements in all groups showed the highest fracture resistance, whereas bioactive cement, subjected to CSTTML and resin-modified GIC in all tests, showed the lowest values. However, no statistically significant differences were found. Conclusions: The prefabricated primary zirconium crowns were found to be successful after almost one year of simulated aging. The results of all of groups showed that the PPZCs cemented with resin and glass ionomer cements were more successful. However, further in vitro and in vivo studies are needed to determine their potential for clinical success.

Aetiology, treatment patterns and long-term outcomes of tooth avulsion in children and adolescents.

OBJECTIVE: Tooth avulsion constituting an emergency for children and adolescents necessitates management approaches ensuring the survival of avulsed teeth. The aim of this study was to determine the causes of tooth avulsion and to examine some factors affecting the clinical & radiographic assessment of their prognosis after replantation. METHODOLOGY: The study sample was created by using archival records of patients who were referred to the Suleyman Demirel University, Faculty of Dentistry, Department of Pedodontics, with complaint of traumatic injuries, between December 1999 and 2008. The information about age, gender, time and cause of the injury, number of affected teeth, the root maturation level (mature/immature), vitality of the affected teeth, condition of supporting tissues, extra-oral time of avulsed teeth, storage media, time of replantation, type and duration of splinting, and healing process was obtained from the patients' records. RESULTS: The sample consisted of 66 traumatized children who had a total of 93 avulsed anterior permanent teeth. The age of these patients ranged from 6 to 16 years and the 9- and 10-year-old group had the highest incidence (n=25). The most frequent causes were falls (n=24; 36.4%). Thirty-three out of a total of 93 avulsed teeth (35.5%) were replanted. Of the 33 replanted teeth, 3 (9.1%) were stored in milk and 25 were stored in dry media (n=25; 75.8%). Fifteen teeth (45.5%) were replanted within 30 minutes after the injury. After clinical and radiographic evaluation a total of 12 replanted teeth (36.4%) were considered as failed. Ten of the replanted teeth had to be extracted due to progressive root resorption. Statistical analysis showed no significant relationship between the successes of replanted teeth with extra-oral period, storage media, root formation stage, and additional traumas to the supporting tissues (p>0.05). CONCLUSION: In this study, during the 9-year period, it was determined that 5.87% of all traumatic dental consisted of avulsion injuries. Thirty-three avulsed teeth in 26 patients were replanted, and 12 replanted teeth were revealed as failures. A high rate of success can be obtained when the avulsed teeth are kept under wet conditions and brought to a dental clinic as soon as possible.

Evaluation of pulpal blood flow changes in primary molars with physiological root resorption by laser Doppler flowmetry and pulse oximetry.

AIM: The aim of this study was to undertake a comprehensive quantitative investigation ofpulpal bloodflow (PBF) changes in human non-carious primary molar teeth with variable degrees of root resorption by Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) methods. MATERIALS AND METHODS: Data was collected from clinically and radiographically healthy 86 mandibular primary molars which have different physiological root resorption levels (PRRLs). PRRLs for each of the teeth were assessed using periapical radiographs and teeth were subdivided into three groups. RESULTS: The LDF values demonstrated a significant diference (p = 0.0001) between all groups although PO did not demonstrate any difference (p = 0.109). Statistical analysis of LDF values demonstrated significant differences between Groups A and C (p = 0.0001) and Groups B and C (p = 0.008). Furthermore, positive correlations were determined between LDF values and PRRL groups (p = 0.0001) and patients' ages (p = 0.0001). CONCLUSIONS: In our study, it was observed that the PBF values of human primary molars measured by LDF tended to increase with the progress of physiological root resorption and age. LDF was found to be a more effective method than PO to assess the pulpal vascularity changes of human primary molars.

Repositioning of a completely intruded permanent incisor with surgical extrusion: a 4-year follow-up case.

Intrusive luxation is a serious dental injury in the permanent dentition that has a poor prognosis. There is a lock of consensus concerning the management of intruded permanent teeth because of a small number of published studies and the injury's complicated nature. The purpose of this report was to present the successful outcome of a completely intruded permanent maxillary right central incisor with a concomitant uncomplicated enamel fracture in a 9-year-old boy. The intruded tooth was repositioned via surgical extrusion and splinted with a semirigid splint for three weeks. Clinical and radiographic examination 48 months often the surgical extrusion revealed no signs of progressive root resorption, marginal bone loss, or periopical disease. Also the percussion sound was normal and the tooth was functionally acceptable and oesthetically pleasing.

Surgical extrusion of a crown-root fractured immature permanent incisor: 36 month follow-up.

Crown-root fracture is defined as a fracture involving enamel, dentin and pulp and can be classified as either complicated or uncomplicated. The tooth with crown-root fracture presents a lot of problems during coronal restorations and extraction was formerly used in many cases. But loss of a permanent incisor in a young patient may create severe emotional problems and alternative treatment approaches must be considered. This report presents the successful results of a surgical extrusion of a complicated crown-root fractured, immature permanent incisor in a 9-year-old boy. Examination 36 months after the trauma indicated that the treatment had provided functional and esthetic results.

Value of Computed Tomography (CT) in Imaging the Morbidity of Submerged Molars: A Case Report.

Submerged primary molars can be difficult to manage due to the developing dentition. Rarely in some severe cases, may the surgical interventions be required while ensuring the vital structures are protected. Therefore these cases require sophisticated imaging techniques in order to locate the vital structures.In this case report, a 17 year old girl who had a retained and submerged deciduous molar which caused impaction of the second premolar and tipping of the first molar was presented. In addition, value of computed tomography (CT) for locating the vital anatomic structures was discussed.In our case, CT has been supplied effective information about localization of the vital structures and amount of bone volume during the diagnosis and treatment planning period in addition to the routine dental radiographies.

Epidemiology of traumatised primary teeth in the west-Mediterranean region of Turkey.

AIM: To investigate the incidence, aetiological factors and results of dental trauma on primary dentition of the children referred to the Süleyman Demirel University, Department of Paedodontics in a two year period. DESIGN: A retrospective study. PARTICIPANTS: Eighty four children (50 boys and 34 girls) with 159 affected deciduous teeth. RESULTS: The incidence of trauma was slightly higher in boys (59.5%). The age of the children ranged from 9 months to 6 years and the peak ages for trauma were 3 years and 5 years of age in respective genders. Falls were the most frequent cause of traumatic dental injuries (29.7%) and luxations were the most common type of trauma with 135 cases (84.9%). The most frequently performed treatment options were examination and follow up only (37.7%). Half of the cases (51.1%) were referred to our clinic in the first week after the trauma occurred. CONCLUSION: The results of this study suggest that a preventive educational programme should be instituted, directed at parents and teachers at nursery schools, in order to inform them about what to do in dental trauma cases and the importance of immediate attendance for dental care.