Readiness for clinical practice: Self-perceived confidence of final year dental students in Turkey - A multi-institutional study.

Introduction: The primary aim of undergraduate dental education is to prepare dental students for independent dental practice and to enable them to provide safe and effective dental care. This study aimed to investigate the self-perceived preparedness of senior dental undergraduate students in Turkey. Methods: Purposive sampling was used to recruit final-year dental students from 10 dental institutions offering undergraduate dental programs in Turkey. Student preparedness was assessed using a previously validated dental preparedness assessment scale based on 50 items encompassing core clinical skills, cognitive attributes, and behavioral skills. The research instrument was then translated into Turkish. The R statistical environment for Windows was used for the data analysis. Results: Responses were provided by 272 students (156 women and 116 men; 57% and 43%, respectively) across 10 different universities. The mean score of the participants was 75.68 with slightly higher scores for men compared to women (77.35 vs. 74.46 respectively). However, independent t-tests showed that the scores did not differ significantly between women and men. Conclusions: This study evaluated the self-perceived preparedness for dental practice of final-year students from 10 universities in Turkey. Although the results showed several areas of weakness, the scores of self-perceived preparedness of Turkish students were comparable to those reported in Europe and Asia. These findings can be used to inform future curriculum development to support students in consolidating their learning in perceived areas of weakness.

Clinical evaluation of resin infiltration treatment masking effect on hypomineralised enamel surfaces.

BACKGROUND: Resin infiltration is a micro-invasive treatment for molar incisor hypomineralisation (MIH). In this study it was aimed to evaluate the masking effect of resin infiltration treatment (ICON) on hypomineralised enamel surface of permanent anterior teeth by using laser fluorescence, spectrophotometer, and cross-polarisation photography. METHODS: A total of 116 permanent central incisors in 37 patients were included in the study. The resin infiltration treatment (Icon®) was applied to the teeth with MIH; the healthy teeth received no treatment (control). Hypomineralised enamel lesions were evaluated by ICDAS II criteria. DIAGNOdent Pen was used to assess the lesions and healthy enamel surface quantitatively. Colour changes in enamel lesions were evaluated by using a spectrophotometer (VITA EasyShare). Each enamel lesion was imaged using a cross-polarization technique before and after treatment. All photos were assessed using Image J to evaluate the changes in lesion size. Enamel lesions were evaluated before; immediately after; 1; 3; and 6 months after treatment. Statistical significance was set as p < 0.05. RESULTS: After the resin infiltration, significant decreases were found in the mean DIAGNOdent values for the treatment group (p < 0.05). The colour differences before and after treatment significantly differed in all follow-ups (p < 0.05). In the treatment group, lesion areas decreased significantly after treatment (p < 0.05). CONCLUSIONS: The resin infiltration treatment has a masking effect on MIH lesions without cavities, with stable outcomes after six months. The cross-polarization photography technique may be use to evaluate the lesion size instead of photography with flash. TRIAL REGISTRATION: NCT04685889 (registered 28 December 2020).

Effect of the new needle-free injection system on pain perception and dental anxiety during anesthesia: randomized controlled split-mouth study.

Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-in™) and the classic needle method during treatment-required infiltration anesthesia in children. Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05. Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750). Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-in™ system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance.

Evaluation of bone changes on dental panoramic radiography using mandibular indexes and fractal dimension analysis in children with familial Mediterranean fever.

AIM: It was aimed to evaluate the bone microarchitecture of children with FMF in the city of Tokat, where the disease is highly prevalent, in Turkey, one of the countries where familial Mediterranean Fever (FMF) disease is the most common, using mandibular indexes and fractal dimension analysis on panoramic radiography. METHODS: In this retrospective study, the results were evaluated and compared using the mandibular cortical index (MCI), the mental index (MI), the panoramic mandibular index (PMI), and the fractal dimension analysis of six different regions (condyle, angulus, and interdental) on dental panoramic radiographs in 124 children with FMF and 124 healthy children. The data were analyzed using the IBM SPSS V23. RESULTS: The distribution of MCI in children with FMF was similar to the control group (p > 0.05). The mean MI (3.59) values in FMF patients were statistically higher than the control group (p = 0.016). No statistically significant difference was found in PMI between the patients with FMF and the control group (p > 0.05). No statistically significant difference was found between the mean fractal dimension (FD) values according to the groups (p > 0.05). CONCLUSION: Trabecular bone microarchitecture of children with FMF is similar to healthy children. There is no correlation between the duration of colchicine use and bone microarchitecture.

Comperative evaluation of Nolla, Willems and Cameriere methods for age estimation of Turkish children in the Central Black Sea Region: A preliminary study.

PURPOSE: Since dental age estimation methods' accuracy and reliability levels differ in each society, the method should be appropriate for societies. This study aims to evaluate the applicability of Nolla, Willems, and Cameriere methods to Turkish children in the Central Black Sea Region. MATERIAL AND METHOD: This study was conducted based on the panoramic radiographs of 400 children between the ages of 6-14 years admitted to Tokat Gaziosmanpasa University Faculty of Dentistry, Department of Pediatric Dentistry for examination between 2016 and 2020. Nolla, Willems, and Cameriere methods estimated dental age on the selected panoramic radiographs. While 14 teeth in the left mandible and maxilla were evaluated for Nolla method, seven teeth in the left mandible were evaluated for Willems and Cameriere methods. Data were analyzed using IBM SPSS V23. The Pearson correlation coefficient was used to analyze the relationship between the chronological age (CA) and dental age (DA), and the paired sample t-test was used to analyze the difference. RESULTS: A statistically significant difference was found between CA-Nolla dental age (p = 0.002), CA-Willems dental age (p < 0.001), and CA-Cameriere dental age (p = 0.033) in boys. The mean differences between dental age and chronological age in boys were -0.24 years in the Nolla method, +0.49 years in Willems method, and -0.17 years in the Cameriere method. A statistically significant difference was found between CA-Nolla dental age (p = 0.001) and CA-Willems dental age (p < 0.001) in girls. The mean differences between dental age and chronological age in girls were -0.27 years in the Nolla method, +0.76 years in the Willems method, and -0.1 years in the Cameriere method. CONCLUSION: In this study method providing closest estimation for chronological age among children aged 6-14.99 that were examined in Central Black Sea Region, was the Cameriere method in both girls (79.9%) and boys (80.6%), followed by Nolla method and Willems method, respectively.

Comparative evaluation of pain perception with a new needle-free system and dental needle method in children: a randomized clinical trial.

BACKGROUND: Pain control during dental procedures is one of the most important topics related to behavior management in children. This study aims to compare the pain perception associated with a needle-free system (Comfort-In™) and the dental needle method during filling and pulpotomy treatments in children. METHODS: The study included teeth that required treatment (pulpotomy or filling treatment) in 56 patients aged 4 to 11 years with no systemic problems or history of allergy. Patients were randomly divided into the needle-free system group (filling treatment, n = 13; pulpotomy, n = 15) and dental needle method group (filling treatment, n = 14; pulpotomy, n = 14). For pulpotomy and filling treatment performed with 0.3 mL anesthesia, the active ingredient of which is 2% lidocaine and 1/80000 epinephrine. The patients' behavior before the procedure was evaluated by a pediatric dentist using the Frankl Behavior Scale. The pain intensity was assessed Immediately after injection (induction), during treatment (treatment), and at the end of the treatment (post treatment) by the Wong-Baker Faces Pain Scale. RESULTS: The median (IQR-InterQuartile Range) induction pain value was 6[3-8] and 2[0-4] in dental needle method and needle-free system respectively, p < 0.001). In filling and pulpotomy treatment group, no difference between the needle and needle-free group for treatment and post-treatment pain values. CONCLUSIONS: For pulpotomy and filling treatment, needle-free system performed with 0.3 mL anesthesia was found as effective as infiltrative anesthesia with a dental needle method. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04653974 . Registered 4 December 2020 - Retrospectively registered.

Analysis of tweets on toothache during the COVID-19 pandemic using the CrystalFeel algorithm: a cross-sectional study.

BACKGROUND: Reasons such as the lack of information on the COVID-19 disease, lack of proven treatment for it, uncertainty about the duration of the pandemic, or social isolation affect people's mental health. This study aimed to analyze the emotional type and intensity in tweets on toothache posted during the COVID-19 pandemic. METHODS: Using the Twitter Search API, we collected tweets in English associated with the keywords "Corona, Toothache" "Corona, Tooth, Pain" "Corona, Dental Pain" "Covid-19, Toothache" "Covid-19, Tooth, Pain" and "Covid-19, Dental Pain" posted between March 11, 2020 and June 30, 2020 all around the world. After the relevant inclusion and exclusion criteria were applied, 426 posts were selected and analyzed using the CrystalFeel algorithm, a sensitivity analytical technology with proven accuracy. The chi-square test (SPSS v23, IBM) was used to compare emotions and emotional intensities according to the words used. RESULTS: It was determined that 80.3% of the participants experienced fear and 61.7% had a negative emotional intensity. There was no statistically significant difference between the distributions of emotions according to the words without time distinction (p = 0.136). There was a statistically significant difference between the distributions of emotional intensity according to the words without time distinction (p = 0.006). The keyword "Corona, Toothache" was used the most frequently by 30.8% of the participants. CONCLUSIONS: This study is the first to analyze the emotional reactions of individuals who experienced toothaches during the COVID-19 pandemic using the CrystalFeel algorithm. Monitoring the social media posts of individuals experiencing toothache during the pandemic will help reduce fear and anger emotions and design public information messages that are compatible with the target group's needs.

Surgical Extrusion of Anterior Teeth with Intrusion Traumatic Injury: A Report of two Cases.

Intrusion is the most severe luxation injury type, which results in both soft and hard tissue damage. In severe intrusions, the crown must be re-positioned in the arch to avoid periapical pathology and marginal bone loss. There is minimal information about the effect of treatment delay on pulpal and periodontal healing in intrusion trauma. The present paper reports on two cases of severe intrusive luxation applied late at different times treated with surgical extrusion. The first patient, an 11-year-old female, referred to Tokat GOP pediatric dentistry clinic three days after the intrusion tooth 21. The second patient, a 13-year-old male, referred to our clinic fifteen days after a traffic accident. The intruded teeth were positioned surgically and splinted. Surgical extrusion should be preferred as soon as possible to initiate root canal treatment in teeth, the crown of which is fully embedded in the alveolar bone.

The pain colour of children with toothache in Turkish population.

BACKGROUND: Toothache is a common consequence of untreated caries, predisposed by poor oral hygiene and high caries risk. Most children expressed their pain through their parents or carers. The aim of this study was to determine the colour of pain presence and absence. METHODS: Patients aged between 4 and 14 and referred to a dentist for the first time due to toothache had a short-term pain of 1 month caused by deep cavities. The children chose paintings from the box of 24 standard colours (Crayola, Spain) and the circles were painted. Pain was rated by children on the Visual Analoge Scale. Normality and variance were tested using the one-sample Kolmogorov-Smirnov test. Associations were performed by using the Pearson correlation coefficient. Analyses were completed by using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) version 20.0 program. RESULTS: A total of 147 patients including 78 girls (53.1%) and 69 boys (46.9%) were included in the study. The principal component analysis showed that red has the highest factor loading in children with pain, whereas yellow was the other highest one in children without pain. CONCLUSION: The presence of pain was mainly associated with red, and the absence of pain was associated with yellow in Turkish population. Description of pain with colour can be useful tool to recognize the children and to improve dentist-patient or dentist-parents communication.

Inhibition Effects of Different Toothpastes on Demineralisation of Incipient Enamel Lesions.

PURPOSE: To evaluate the inhibitory effects of different toothpastes on demineralisation of incipient enamel lesions using a toothbrush simulator. MATERIALS AND METHODS: Fifty enamel specimens were prepared from extracted human molars. The specimens were randomly assigned to the following groups (n = 10/group): 1. no treatment (control); 2. toothpaste containing arginine (ProRelief, Colgate;); 3. fluoride toothpaste (Pronamel, Sensodyne GlaxoSmithKlein); 4. tooth mousse containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (Recaldent, GC); 5. toothpaste (Restore, Dr. Collins) containing bioactive glass (NovaMin, GlaxoSmithKlein). All specimens were exposed to pH cycling. The remineralising agents were applied to the samples with a toothbrush simulator for 2 min twice a day for five days. The weight percentage of mineral changes for the elements calcium (Ca), phosphorus (P), sodium (Na) and silica (Si) were measured by SEM energy-dispersive x-ray spectroscopy (SEM-EDX). SEM revealed properties of treated enamel surfaces. The data were analysed using one-way ANOVA. RESULTS: Statistically significantly higher levels of Ca and P were found in all groups compared to the control (p < 0.05). CONCLUSIONS: The toothpastes' efficacy of inhibiting demineralisation depended on the active ingredients in the respective toothpaste. The demineralisation inhibition efficacy of the tested toothpastes depended on the active ingredients in the toothpaste.

Radiographic characteristics of mesiodens in a non-syndromic pediatric population in the Black Sea region.

AIM: A mesiodens is the most frequent type of supernumerary tooth. They can be related to several complications, such as ectopic eruption and midline diastema. The aim of the present study was to assess the radiographic properties of mesiodens by analyzing the associated age, sex distribution, number of mesiodens per patient, shape, direction of eruption, and their association with complications. METHODS: The present study was performed using panoramic radiographs of 14 400 pediatric patients (4-14 years old) who visited the Department of Pediatric Dentistry at Gaziosmanpasa University for a variety of dental complaints from 2015 to 2018. RESULTS: There were 82 mesiodens diagnosed in a total of 71 patients. Among the 82 mesiodens, 51 (62.1%) were conical in shape, which was the most commonly seen shape, followed by 14 supplemental (17.07%), and 12 (14.6%) tuberculate. Of the 82 mesiodens, 65 (79.2%) were aligned vertically, nine (10.9%) were inverted, and eight (9.7%) were horizontally placed. Clinical complications were observed in 76.8% of patients. CONCLUSION: The management of mesiodens can be performed using three methods: (a) spontaneous eruption; (b) early intervention; and (c) delayed intervention. However, the management of mesiodens should be evaluated on an individual basis to determine the best treatment method. Mesiodens-associated complications should be addressed prior to the lateral incisors erupting.

Effects of pain catastrophizing and anxiety on analgesic use after surgical removal of impacted mandibular third molars.

BACKGROUND: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. METHODS: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. RESULTS: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). CONCLUSION: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

Are Environmental Factors Effective in Congenitally Missing Teeth? A Multicenter Study

Abstract Objective: To examine the prevalence of congenital absence of permanent teeth other than third molar teeth in non-syndromic children in the Black Sea and Mediterranean Regions of Turkey, and the correlation between gender and distribution sites in the jaws. Material and Methods: Panoramic radiographs and clinical records of 9831 children (5025 girls, 4806 boys) in the Mediterranean Region and 11372 children (5540 girls, 5832 boys) in the Black Sea region were examined. All panoramic radiographs were evaluated by a dentist. The permanent tooth, which was not seen in radiography, was recorded as a congenitally missing tooth, and the fact that the tooth was not extracted was confirmed by treatment records. The data were statistically evaluated by Chi-Square and t-test Results: The prevalence of congenitally missing permanent teeth was 2.8% (3.52% in girls, 2.5% in boys) in the Mediterranean region and 1.63% (1.82% in girls and 1.45% in boys) in the Black Sea region. Congenitally missing permanent teeth were observed more in the maxilla compared to mandible. The teeth that most frequently have congenitally missing permanent teeth in the Mediterranean Region are mandibular second premolars, maxillary lateral incisors and maxillary second premolars, respectively. The teeth that most frequently have congenitally missing permanent teeth in the Black Sea region are mandibular second premolars, maxillary second premolars and maxillary lateral incisors, respectively. Most of the patients had one or two teeth missing, and the lack of three or more teeth was rare Conclusion: In this study, which is performed in different climatic characteristics of Black Sea and Mediterranean Regions, the frequency of congenitally missing teeth is similar.

Bulk-Fill Restorative Materials in Primary Tooth: An Intrapulpal Temperature Changes Study.

OBJECTIVES: It was aimed to investigate the temperature changes in primary teeth pulp chamber during the curing/setting of bulk-fill restorative materials with different nanoparticle contents. METHODS: Twenty-five extracted, primary mandibular second molars were prepared as a Class II cavity. Five bulk-fill restorative materials consisting of Equia Fil (HVGIC), glass carbomer (GC) cement, Sonic Fill (SF), X-tra Fil (XF), and Quix Fil (QF) were tested. The measurement of the pulp chamber temperature changes (starting temperature 37°C) during setting/curing was performed with a J type thermocouple. The data, differences between highest and initial temperature values, were recorded and analyzed by one-way ANOVA. RESULTS: The temperature changes in the pulp chamber were in EF (2.81°C), GC (7.92°C), SF (3.33°C), XF (3.43°C), and QF (3.02°C). There were statistically significant differences between temperature changes in groups (P < 0.05). CONCLUSION: The tested bulk-fill resin composites and high-viscosity glass ionomer cement do not increase the intrapulpal temperature in primary teeth during the curing/setting.

Comparative evaluation of apical sealing ability of different root canal sealers.

PURPOSE: The aim of this study was to compare the short and long term apical sealing ability of different root canal sealers. MATERIALS AND METHODS: Fifty-five extracted human anterior single-root teeth were used. The coronal part of each tooth was removed and the root canals were prepared with NiTi rotary instruments. Teeth were divided into 5 study groups; Group I: MTA Fillapex (Angelus, Brazil); Group II: Sealapex (Sybron-Kerr, Romulus, MI, USA) and Group III: AH Plus (Dentsply, Konstanz, Germany) (n=15) and negative and positive control groups (n=5). The quality of root canal sealing was assessed by a fluid filtration method performed at 24 h and 180-day time intervals. Kruskal Wallis and Mann Whitney U tests were used to compare the groups. RESULTS: At 24 h evaluation, MTA Fillapex presented significantly less microleakage than the Sealapex and AH Plus (p<0.05). At long term interval (180-day), Sealapex and AH Plus presented significantly less microleakage than the MTA Fillapex (p<0.05). CONCLUSION: Sealapex and AH Plus showed significantly better sealing abilities than MTA Fillapex in the long term.

The applicability of Willems' method for age estimation in southern Turkish children: A preliminary study.

The aims of the present study were to evaluate the applicability and accuracy of Willems' method for assessing southern Turkish children and to analyze the practicability of this method in different age groups for both genders. Panoramic radiographs of 756 children (378 females, 378 males) aged between 5 and 14.99 years were examined by one observer. This retrospective study involved a contemporary southern Turkish population. The chronological ages of the subjects were divided into 10 groups. These 10 groups consisted of children of the following ages 5 and 14.99. Relationships between continuous variables were examined using Pearson's correlation coefficient. The paired t-test was used to compare all data according to gender and age groups. A p-value of less than 0.05 was considered significant for all statistical data. According to the results, a very high correlation was found for both girls (r(2) = 0.946) and for boys (r(2) = 0.940). Dental age (DA) and chronological age (CA) were consistent for girls in the four age groups (5-5.99, 6-6.99, 12-12.99, and 14-14.99) and for boys in the three age groups (5-5.99,13-13.99, 14-14.99). The maturity score of Willems' Belgian samples of the DA was applicable to seven groups of the southern Turkish children. The present study reports that Willems' method is more accurate for girls than for boys.

The setting mechanism of mineral trioxide aggregate.

Mineral trioxide aggregate (MTA) is a powder containing calcium silicate composed of hydrophilic particles which harden at the presence of moisture. MTA was initially introduced as a root end filling material. Due its practical advantages that include superior biocompatility, effective sealing capability, and the ability to improve regeneration of the pulp and peripheral root tissues, it is used in different clinical applications such as pulp capping, apexification, pulpotomy and perforation. Despite being a promising material in endodontic treatment, MTA is not commonly used. Long setting time is the main clinical disadvantage of MTA. The aim of this review is to provide an overview of the current literature concerning the setting mechanism of MTA, accelerators and devices used to evaluate various steps of the hardening process.

Idiopathic Juvenile Osteoporosis: A Case Report.

Idiopathic Juvenile Osteoporosis (IJO) is a very rare disease, self restrictive and shows marked, spontaneous improvement during adolescence. The major clinical features were pain with difficulty walking, growth retardation, oral and dental abnormalities with radiographically porous bone structure. A 13-year-old male referred to paediatric dentistry clinic for toothache. The observations made with extra-intraoral clinic examination that one revealed short and skinny stature, diffuse caries in deciduous teeth, abraded lower incisor, deep bite and dysmorphic appearance in permanent incisor. This report emphasizes the recognized features of IJO as well as describes facio-dental findings that could aid in the diagnosis and management of these patients.