Assessment of orofacial dysfunction using the NOT-S method in a group of Turkish children with cerebral palsy.

OBJECTIVES: A healthy determination of orofacial findings of children with cerebral palsy is important as this will lead us to utilize perfect multidisciplinary therapies of orofacial dysfunctions (OFD). Nordic Orofacial Test-Screening (NOT-S) is a comprehensive screening method of OFD which consists of a structured interview and clinical examination. The aim of our study was to evaluate the orofacial dysfunctions in a group of Turkish children with cerebral palsy using Nordic Orofacial Test-Screening (NOT-S) and find out the factors associated with OFD comparatively with a healthy group. MATERIALS AND METHODS: NOT-S was applied to 84 children aged 3-16 years. Forty-two children with cerebral palsy were included in the study group and 42 healthy children were randomly selected for the control group. Two trained and calibrated examiners who were experienced on NOT-S interview and examination of the validity and reliability of the Turkish version performed screening and interpreted the results. RESULTS: NOT-S interview and clinical examination subscale scores of children with cerebral palsy were higher and found to be statistically significant (Mann-Whitney U test; p < 0.001). The total scale score of the cerebral palsy group was also statistically significant (p < 0.001). The most common dysfunctions were in the facial expression area (55.9%) and in the chewing and swallowing area (52.4%) following in sensory function area (47.6%). CONCLUSIONS: The results of this study indicated that the NOT-S protocol was an effective and valuable tool for the comprehensive screening of orofacial dysfunctions in a group of Turkish children with cerebral palsy.

Corrigendum to "A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish".

[This corrects the article DOI: 10.1155/2016/8357621.].

How Does Dental Trauma Affect the Quality of Life in Turkish Families?

PURPOSE: To assess the responsiveness of the Family Impact Scale (FIS) to describe changes in quality of life (QoL) after traumatic dental injury (TDI), and compare the efficacy of subscales. MATERIALS AND METHODS: Parents of 110 children aged 7-15 admitted to the Gazi University Faculty of Dentistry Department of Paediatric Dentistry for dental trauma were included in this study. A three-part questionnaire was distributed to the participants: questions regarding personal information, TDI and QoL. The types of TDI were classified according to Andreasen et al.3 Quality of life was measured using the FIS. The questionnaires were translation into Turkish, and QoL was measured using the Turkish Family Impact Scale (T-FIS) total score and scores for subscales. The Kolmogorov-Smirnov test was used to assess normal distribution of the data. After this procedure, the nonparametric Kruskal-Wallis test was used. RESULTS: Traumatic dental injuries exhibited a negative impact on parents' QoL, as shown by the total T-FIS score and subscales (p < 0.001). In this study, the determined values for parental emotions > parental/family activity > financial burden > family conflict had a negative impact on the parents' QoL. Parental emotional values were statistically different from those of parental/family activity, financial burden and family conflict values (p < 0.001). CONCLUSION: Traumatic dental injuries in children present a negative impact on Turkish parents' QoL. Parental emotions were the most affected subscale.

A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish.

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.

A retrospective study of traumatic dental injuries.

AIM: The prognosis of dental trauma cases varies depending on the time elapsed after the trauma before treatment started. The aim of this study was to examine epidemiological and dental data from traumatic injuries to primary and permanent teeth during the period from 2005 to 2010. MATERIAL AND METHODS: The examinations aimed to determine the age and sex distributions of patients, the causes of tooth injury, the type of teeth injured, the monthly distribution of the trauma, the time elapsed between injury and treatment, and the classification of the traumatized teeth and their treatments. RESULTS: The dental trauma records of patients with an average age of 9 years, including 120 girls (35.3%) and 220 boys (64.7%), were evaluated. The most commonly affected teeth were the maxillary central incisors (66.24%). The main cause was falls (70.1%). In primary dentition, subluxation (36.4%) was observed in the highest percentage of injured teeth, and in permanent dentition, the most common observation was uncomplicated crown fractures (44.9%). Only 18 patients (2.9%) were referred to the clinic within 1 h following the injury. The most frequent treatment for primary teeth was examination and follow up (63.9%). Restoration with composite resin (26.3%) and root canal treatment (28.6%) were the most common procedures for permanent teeth. CONCLUSION: It was revealed that although the most frequent type of injury in permanent dentition was uncomplicated crown fracture, the root canal treatment was the most common treatment in permanent dentition. This finding suggests that when the checkup time after the injury was delayed, the pulp could lose vitality. This finding reveals that it is important to inform the parents about dental trauma and the importance of bringing their children fast to a dentist in trauma cases.

The effect of temperature on bisphenol: an elution from dental resins.

AIM: Bisphenol A (BPA) elution from baby bottles into content has been of great public interest and debate in recent year. Uncontrolled BPA elution due to temperature increase may create a risk factor for human health. However, dental resins that are used in pediatric dentistry also have BPA derivatives. The aim of this study is to evaluate BPA elution from dental resins and to determine the effect of temperature increase on this elution. MATERIALS AND METHODS: Four dental resins containing BPA derivatives (Filtek Z250, Filtek Supreme XT, Fissurit FX, and Admira) and a control group (BPA free G-aenial) were used in this study. Each specimen was stored in 2 ml of 75% ethanol-water solution at 37°C. Water at a temperature of 59°C ± 1°C (preferred temperature of hot drinks) was added to the study samples at certain time intervals (1, 6, 24 hours and 2, 3, 4, 5 and 6 days). The methanol samples were analyzed using high-performance liquid chromatography (HPLC). Data was analyzed using multivariate and repeated measures analysis of variance (p < 0.05). RESULTS: The study samples generally eluted more BPA than the control samples (p < 0.05). The greatest amount of BPA for an individual time period was measured after 6 hours for the groups A to D; the same was found after 24 hours for group E. CONCLUSION: While the BPA elution levels evaluated in the study samples were more than control samples, all measured values were under the reference levels and the amounts do not constitute a risk. CLINICAL SIGNIFICANCE: Resin-based dental materials can act as a source of BPA (within safety margins), especially when they react with hot water.

Knowledge of dentists in the management of traumatic dental injuries in Ankara, Turkey.

PURPOSE: This study was designed to assess dentists' knowledge of emergency treatment of traumatic dental injuries (TDIs) in Ankara, Turkey. MATERIALS AND METHODS: A total of 154 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part was composed of 12 closed-ended questions related to knowledge of how to manage different types of TDIs in children. The questionnaires were answered by 133 general dental practitioners (GDPs) and 21 specialists. The survey data were statistically analysed using the chi-square test and ttest to assess dentists' knowledge. RESULTS: The results show that when the answers were compared, lower numbers of correct answers were noted for questions related to splinting time for avulsed teeth and appropriate treatment for complicated crown-fractured deciduous incisors with large pulp exposure. Greater numbers of correct answers were observed for questions related to the storage medium, systemic antibiotic usage for avulsed teeth and appropriate treatment for intruded primary teeth. The mean number of correct answers from specialists was not significantly greater than that from GDPs (P > 0.05). CONCLUSION: In conclusion, this survey showed a low level of knowledge of TDI management among the participants and highlights the need to improve dentists' knowledge of TDI treatment protocols.

Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double-blind study.

PURPOSE: The purpose of this study was to evaluate and compare the reaction to pain during local injection and duration of numbness of soft tissue with 4% articaine or 3% mepivacaine in children. METHODS: A randomized, double-blind, split-mouth study was used with a sample of 50 7- to 13-year-old children (25 boys and 25 girls; mean age=11.3 years old) that had similar operative procedure needs in symmetric primary teeth. The modified behavioral pain scale was used for objective evaluation of the children. The sensation after injection and treatment was evaluated using the Wong-Baker FACES pain rating scale. Parents were instructed to ask the child and to record the time when feeling of numbness disappeared. RESULTS: The duration of soft tissue was longer for articaine (140.69 ± 49.76 minutes) than for mepivacaine (117.52 ± 42.99 minutes). No difference regarding efficacy of the anesthesia was observed. No statistically significant difference was found in blood pressure, heart rate, or oxygen saturation in all evaluation periods for both solutions. The feeling after treatment was similar for the 2 solutions. CONCLUSION: Four percent articaine with 1:200,000 and 3% mepivacaine presented the same efficacy, and children displayed the same behavior during injection.

Effects of Antiseptics on Pulpal Healing under Calcium Hydroxide Pulp Capping: A Pilot Study.

OBJECTIVES: The objective of this pilot study was to evaluate the effects of three different antiseptic materials on healing processes of direct pulp therapies with Ca(OH)(2) histopathologically. METHODS: Twenty-eight upper and lower first molar teeth from 7 male Wistar rats were used in this study. Four cavities were prepared in each rat in four quadrants, and each quadrant represented different experimental groups. In Group I: 0.5% sodium hypochlorite (NaOCl); in Group II: 2% chlorhexidine digluconate (CHX); in Group III: 0.1% octenidine dihydrochloride (OCT); and in Group IV 0.9% sterile saline was applied to the exposure site with a sterile cotton pellet for 3 minutes. After hemorrhage control, the pulps were capped with hard setting Ca(OH)(2) and, finally, restored with IRM. The animals were euthanized at 21 days post-operatively. After sacrificing, routine histological procedures were performed and evaluated statistically with non-parametric Kruskal-Wallis test among the groups and two-by-two comparisons by using the Mann-Whitney U test for inflammatory response and tissue organization scores at the confidence interval of 95%. RESULTS: There were significant differences in inflammatory response and tissue organization scores between the groups (P<.05). Statistical evaluation of inflammatory response showed that Group IV was significantly different from Groups I, II and III separately with a higher inflammatory cell response (P<.05) whereas no significant differences were detected between the other groups in two-by-two comparisons (P>.05). Healthy coronal and radicular pulp tissue organization scores indicated that the Group I has better pulp tissue organization than Group IV and this was significantly different (P<.05) whereas no significant differences were observed between the other groups separately (P>.05). CONCLUSIONS: The antiseptic materials used in this study created an environment that, rather than saline solution, may affect clinical and histological success in a positive way.

Accuracy of an electronic apex locator: a clinical evaluation in primary molars with and without resorption.

OBJECTIVE: The aim of this study was to evaluate the accuracy of electronic apex locator (Root ZX) in primary teeth with and without apical root resorption in vivo. STUDY DESIGN: The electronic working length was determined in 28 primary teeth (A total of 46 primary molar root canals with 24 roots without resorption and 22 roots with resorption) from twenty-eight healthy children using Root ZX. The teeth were then extracted. The actual length of each root was measured placing a K-File until the tip was visible at the apical foramen or the apical resorption level and approved with digital microscopic evaluation under 20x magnification and then withdrawn 1 mm. The distances from the file tip to the base of the rubber stop were measured and compared with the measurement obtained from apex locator. The data were evaluated with t test using standard statistical software (SPSS 13.0). The critical value of statistical significance was 5%. RESULTS: For root canals without resorption, the accuracy of Root ZX was 79.16% and 95.82% within +/- 0.5 and +/- 1 mm, respectively. For root canals with resorption, the accuracy of Root ZX was 63.63% and 86.35% within +/- 0.5 and +/- 1 mm, respectively. No statistically significant differences were detect between the electronically determined lengths and the actual lengths regardless of whether or not resorption. CONCLUSION: Using a Root ZX Electronic Apex Locator in primary teeth with or without resorption is recommended for the determination of working length.

Clinical and radiographic outcomes of calcium hydroxide and formocresol pulpotomies performed by dental students.

OBJECTIVE: The aim of this study was to compare the clinical and radiographic success rates of 3 pulpotomy techniques: formocresol, calcium hydroxide, and calcium hydroxide/iodoform. STUDY DESIGN: The pulpotomies were performed by fifth-year undergraduate dental students. Members of senior staff at the clinics supervised all of the procedures. Informed consent was obtained from each child's parents. The teeth were randomly assigned to the experimental (calcium hydroxide and calcium hydroxide/iodoform) or control (formocresol) groups. After coronal pulp removal and hemostasis, remaining pulp tissue was covered with calcium hydroxide or calcium hydroxide/iodoform paste in the experimental groups. In the control group, formocresol was placed with a cotton pellet over the pulp tissue for 5 minutes and removed; the pulp tissue was then covered with zinc oxide-eugenol. All teeth were restored with stainless-steel crowns. Clinical and radiographic successes and failures were recorded at 1-, 3-, 6-, and 12-month follow-ups by the authors. Data were statistically analyzed using chi-squared tests. RESULTS: The follow-up evaluations revealed that the clinical success rates were 89.7% for formocresol, 33.3% for calcium hydroxide, and 17.2% for calcium hydroxide/iodoform. The radiographic success rates were 89.7% for formocresol, 33.3% for calcium hydroxide, and 13.8% for calcium hydroxide/iodoform. CONCLUSIONS: Formocresol was superior to calcium hydroxide and calcium hydroxide/iodoform pastes for primary molar pulpotomies. Internal resorption was the most common radiographic failure in all 3 pulpotomy techniques.

Mesiodens as a risk factor in treatment of trauma cases.

The presence of mesiodens often results in complications including retention of primary teeth and delayed eruption of permanent teeth, closure of eruption path, rotations, retention, root resorption, pulp necrosis, and diastema as well as nasal eruption and formation of dentigerous and primordial cysts. Less common complications involving the permanent incisors include dilaceration of the developing roots and loss of tooth vitality. Therefore, early diagnosis of mesiodens has particular importance in terms of preventing such complications. However, with respect to surgical removal of mesiodens, ideal timing of intervention - immediate or delayed intervention - remains to be a highly controversial issue. While predisposing factors of dental trauma such as open bite, increasing overjet with protrusion of upper incisors, and insufficient lip closure have been well documented in the literature, there is limited evidence indicating mesiodens as a risk factor in trauma. In this report of two cases, it is aimed to emphasize mesiodens as a risk factor in the treatment of dental trauma besides its effect on prognosis.

Clinical evaluation of the plaque-removing ability of three different toothbrushes in a mentally disabled group.

The aim of the study was to evaluate the efficacy of plaque removal of three different toothbrushes on mentally disabled children in two different age groups. A manual triple-headed brush (SuperBrush; Dento Co. AS [junior, regular]) compared with a new manual toothbrush (CrossAction; Oral-B [35 compact, 40 regular]) and an electric toothbrush with an oscillating rotating head (Braun Plaque Control 3D [Braun 3D]; Oral-B [D15525]). Fifteen children aged 6-12 (Group A) and 15 children aged 13-18 (Group B) with mild mental disabilities participated in the single-blind clinical study. To obtain a plaque-free condition at baseline, professional tooth-cleaning was performed on each participant. After instructions on how to use the toothbrushes, each group started the experiment. After 1 week of application, the Quikley Hein (QH) plaque index and the approximal plaque index (API) were used to assess the oral hygiene status of each participant. This was followed by a week of recess before each group switched to the next type of toothbrush. The study lasted for 5 weeks. Compared to the two other brushes, the Braun 3D was more effective in removing plaque (means of QHI: 1.54 (Braun 3D), 1.77 (SuperBrush), and 2.15 (CrossAction) in total; means of API 1.37 (Braun 3D), 1.52 (SuperBrush), 1.94 (CrossAction). The study indicated that the electric toothbrush is the most effective for removing dental plaque in mentally disabled children, whereas the SuperBrush is a good alternative.

The effect of air abrasion with two new bonding agents on composite repair.

This study evaluated the shear bond strength of repairs made with a composite (Herculite/Kerr) when two different surface treatment methods and two new generation bond materials were used. The bonding surfaces were prepared by sanding with 500-grit aluminum oxide sandpaper or air abrading with 25-micron aluminum oxide. Treated resin surfaces were acid etched, washed for one minute and air dried. Before adding the composite Herculite, either Optibond Solo (Kerr), Solobond M (Voco) bonding agent or no bonding agent (control group) was applied. The specimens were evaluated for shear bond strength after thermocycling. Fracture surfaces of some samples were also evaluated with SEM. Light microscope and SEM examination of fractured repair surfaces indicated mostly cohesive failure within the air-abraded group. The results showed that surface treatment with air abrasion plus Optibond Solo application had the highest shear bond strength.

Combined apexification and orthodontic intrusion of a traumatically extruded immature permanent incisor.

A patient with a traumatic extrusion of the maxillary right central incisor was referred to the Pedodontic Clinic of Gazi University Faculty of Dentistry after 15 days. Orthodontic repositioning of the tooth was planned in 6 months. At the beginning of orthodontic therapy it was observed that the tooth was necrotic and needed an apexification procedure. The apexification procedure and orthodontic intrusion were successfully performed at the same time. In addition, a "walking bleach" was performed after the orthodontic and endodontic procedures were completed. At the 3-year recall, the tooth appeared normal in all respects.