Effect of Finishing-Polishing Procedures on Cytotoxicity of Resin-Based Restorative Materials via Real-Time Cell Analysis.

OBJECTIVE: The aim of this study was to evaluate the effect of finishing and polishing procedures of compomer and bulk-fill composite resins on cytotoxicity against human gingival fibroblasts by xCELLigence analysis. STUDY DESIGN: Filtek™ Bulk Fill composite and Dyract XP compomer were used. After curing, the specimens were randomly divided into two groups and finishing-polishing procedures were applied to one group; no finishing-polishing procedures were applied to the other group. For the first time in this study, pure gold samples were prepared with the same weight and base area as the test specimens and the wells containing the pure gold samples were determined as the control group. xCELLigence system was used to assess the response of the human gingival fibroblasts after exposure to test specimens. Measurements were recorded for 72 hours after adding specimens. RESULTS: Finishing and polishing procedures caused a significant increase in cell viability of Dyract XP compomer samples at all time periods; the percentage of cell viability reached above 70% after finishing and polishing procedures. However, significant effects were not observed in Filtek™ Bulk Fill composite samples at any time period. CONCLUSION: Finishing and polishing procedures play an essential role in increasing the biocompatibility of Dyract XP compomer. It is recommended to apply finishing and polishing procedures even though a smooth surface may be obtained in restorations with matrix strips.

Evaluation of Residual Monomers Eluted from Pediatric Dental Restorative Materials.

Unreacted monomers eluted from resin-based restorative materials have been considered a reason of local and systemic adverse reactions. This study was designed to determine the effect of finishing and polishing procedures on the elution of Bis-GMA, TEGDMA, UDMA, and HEMA monomers from compomer and bulk-fill composite resins. Bulk-fill composite (3M ESPE GmbH, Seefeld, Germany) and compomer (Dentsply DeTrey GmbH, Konstanz, Germany) specimens with 3 × 4 mm diameters were prepared. The specimens were randomly divided into two groups, and finishing-polishing procedures were applied only to the experimental groups. Release of residual monomers was analyzed by using High-Performance Liquid Chromatography (HPLC) after 24, 48, and 72 hours. Repeated measures ANOVA and Tukey post hoc tests were used for comparisons. Finishing and polishing procedures had a significant effect on reducing the quantity of UDMA release in the Filtek™ Bulk Fill composite and Bis-GMA, HEMA, and TEGDMA in the Dyract XP compomer (p < 0.05). The restorative materials investigated here are not chemically stable after polymerization, and concentrations of eluted monomers may reach critical toxicity levels even after one restoration placement. Finishing and polishing procedures are mandatory to reduce residual monomers.

Effects of Fixed and Removable Space Maintainers on Plaque Accumulation, Periodontal Health, Candidal and Enterococcus Faecalis Carriage.

OBJECTIVE: To evaluate the effects of space maintainers on plaque accumulation, periodontal health and oral microflora. SUBJECTS AND METHODS: The study participants comprised 38 patients aged 4-10 years requiring either fixed or removable space maintainers. Plaque index, gingival index, bleeding on probing index, candidal colonization and Enterococcus faecalis were recorded just before the application of space maintainers (T0) and during treatment at the 1st (T1), 3rd (T2) and 6th (T3) month. RESULTS: The gingival and bleeding on probing index scores increased significantly (gingival index from 0.20 ± 0254 to 0.54 ± 0417 and bleeding on probing index from 7.18 ± 9.946 to 18.07 ± 14.074) in the regions with fixed space maintainers at T3 (p < 0.01). The mean Candida counts also increased (for removable appliances from 1.90 ± 3.638 to 1.98 ± 3.318, p < 0.05, and for fixed appliances from 4.25 ± 4.587 to 4.52 ± 4.431, p < 0.001). The salivary E. faecalis counts at T3 also increased significantly with the use of fixed and removable appliances (for removable appliances from 5.93 ± 2.65 to 85.53 ± 34.1 and for fixed appliances from 4.95 ± 2.94 to 123.59 ± 29.51, p < 0.001). A positive correlation was found between the plaque (r = 0.67), gingival (r = 0.76) and bleeding on probing index scores (r = 0.76) and the candidal colonization for the fixed space maintainers (p < 0.01, p < 0.001). CONCLUSIONS: In this study, both fixed and removable space maintainers led to an increase in the number of microorganisms in the oral cavity as well as to increases in the periodontal index scores. Patients should be informed that space maintainers may serve as a source of infection and that special attention must be given to their oral hygiene.

Dental management of patients with epidermolysis bullosa.

Epidermolysis Bullosa (EB) is a group of rare, genetic skin disorders characterized by fragility and blistering to minimal trauma. All oral surfaces may be involved, including the tongue, buccal mucosa, palate, floor of the mouth and gingiva. Common oral findings of the disease include microstomia, intraoral ulcerations and bullae formation, ankyloglossia, tongue atrophy, elimination of buccal and vestibular sulci, lingual depapillation and atrophy of the palatal folds. In these case reports; systemic findings, oral manifestations and preventive measures are described for 3 patients with EB, all of whom required extensive oral management. Early dental management and preventive care to minimize caries development and improve oral health is very important for patients with EB. Pediatric dentists play an especially important role in early intervention. In describing the dental management of three EB cases, this article stresses the importance of an aggressive dental preventive programme with strict oral hygiene instructions for patients and parents along with frequent professional cleaning and fluoride therapy.

Comparative evaluation of Ca(OH)2 plus points and Ca(OH)2 paste in apexification.

AIM: The aim of this study was to compare calcium hydroxide plus points (CHPPs) with the conventional calcium hydroxide paste (CHP) clinically and radiographically as materials used in apexification treatment. MATERIAL AND METHODS: Sixteen children, each with at least one necrotic permanent central incisor requiring apexification treatment, were selected for this study. Twenty-two selected teeth were divided into two test groups (10 CHP and 12 CHPP). The children were recalled for clinical evaluations every 3 weeks, and their radiographical evaluations were carried out every 3 months. Mann-Whitney U and Fisher's exact tests were used to evaluate the differences between the groups. RESULTS: The follow-up evaluations revealed that the success rate was 100% for CHP and 92% for CHPP. No statistically significant difference between the groups was observed (P > 0.05). CONCLUSIONS: CHPP-treated central incisors requiring apexification demonstrated good success. CHPP can be used for cases in which traditional Ca(OH)(2) apexification is indicated as it has a similar outcome with CHP.

Peripheral giant cell granuloma and peripheral ossifying fibroma in children: two case reports.

OBJECTIVES: The aim of this study was to present the clinical and histopathological evaluation of reactive gingival lesions, such as peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma (POF), as exemplified in two cases. CLINICAL PRESENTATION AND INTERVENTION: A 12- and a 13-year-old girl were referred to the Department of Pedodontics, both complaining of a painless swelling mass. After histopathological evaluation, the lesions were diagnosed as PGCG and POF. These gingival enlargements were totally resected after adequate clinical and radiological examinations. No recurrence has occurred in the 1-year follow-up period. CONCLUSION: These cases show that without histopathological evaluation, these two lesions could have been misdiagnosed due to their similarity in appearance. Early detection and treatment of these lesions are important to reduce bone loss or displacement of dental germs or teeth.

The rapid sterilization of gutta-percha cones with sodium hypochlorite and glutaraldehyde.

The purpose of this in vitro study was to evaluate the effectiveness of sodium hypochlorite and glutaraldehyde for rapid sterilization of gutta-percha cones contaminated with Bacillus subtilis ATCC 6633. Cones were treated with either 2% glutaraldehyde or 2.5% sodium hypochlorite. The gutta-percha cones were sterilized with a 2.5% sodium hypochlorite solution throughout the test. Glutaraldehyde did not decontaminate the gutta-percha cones even after 15 minutes of contact. All positive controls showed positive results during the first 24 hours. Negative controls were followed up for 24 and 48 hours and demonstrated the efficiency of previous sterilization. No microbial growth was observed in the groups tested. Even though gutta-percha cones are usually sterile during storage, they can be easily contaminated if incorrectly manipulated. NaOCl at 2.5% concentration is an effective agent for decontamination of gutta-percha cones at no additional cost.

Effects of saliva contamination on shear bond strength of compomer to dentin in primary teeth.

PURPOSE: To investigate the effects of saliva contamination on the bond strengths of two compomers applied to primary teeth dentin during different bonding stages. METHODS: 30 extracted human non-carious primary molars were prepared for shear bond-strength testing. Specimens were randomly divided into three groups of 10. Prime & Bond NT (acetone-based) and Futura Bond A & B (water-based) adhesives were tested under the following conditions: (a) non-contaminated conditions; (b) after contamination of the dentin surface with fresh whole saliva for 20 seconds and removal of excess saliva before adhesive application; and (c) contamination of the dentin surface with fresh whole saliva for 20 seconds and removal of excess saliva after adhesive curing. Following adhesive application Dyract AP or Glasiosite was applied via a polytetrafluroethylene split mould and light-cured to the dentin surface. Shear bond strengths were measured using an Instron Universal testing machine running at a crosshead speed of 1 mm/minute. After measuring shear bond strengths, specimens were prepared for SEM evaluation and identification of failure type. Results were analyzed by two-factor experiment with repeated measures as one factor. RESULTS: No statistically significant differences were found among the shear bond strengths (P > 0.05) of the groups. The results revealed that saliva contamination of dentin surfaces before or after adhesive application did not affect the shear bond strength of either compomer.

Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study.

PURPOSE: To evaluate the clinical and radiographic success of zinc oxide-eugenol (ZOE), Calcicur, Sealapex and Vitapex in primary molar pulpectomies. METHODS: 80 primary molars, showing signs of pulpal and/or periapical involvement, with no abnormal mobility, were selected from 76 children aged between 4-9 years-old, free from systemic disease. Radiographic evaluation was done to exclude teeth showing internal or pathological external root resorption and/or inadequate bone support. The selected teeth (20 in each group) were randomly treated with ZOE, Sealapex, Calcicur and Vitapex. The procedure involved primarily a one-visit pulpectomy. The teeth were evaluated clinically and radiographically every 2 months for a period of 18 months. RESULTS: In the ZOE group, all pulpectomies were successful. In the Sealapex group, two pulpectomies and in the Calcicur group, four pulpectomies showed complete resorption of the material in the root canal. Although re-treatment was performed, those teeth had to be removed due to pathological root resorption. In the Vitapex group, although six pulpectomies showed resorption of the filling material within the canals, this had no effect on the clinical and radiographical success of the treatment.