Assessment of dental anxiety levels among dental emergency patients during the COVID­19 pandemic through the Modified Dental Anxiety Scale.

BACKGROUND: Coronavirus disease 2019 (COVID­19) continues to affect dental emergency services worldwide. Dental anxiety (DA) is described as a common and distressing problem in terms of oral health maintenance. OBJECTIVES: The present study aimed to evaluate DA levels as well as the COVID­19 fear and perception of control (COVID­19 FPC) in patients attending dental emergency clinics during the COVID­19 pandemic. MATERIAL AND METHODS: Sociodemographic, dental and medical data was obtained from the participants. A face-to-face questionnaire with questions referring to the reasons for the emergency dental visit, the visual pain scale, the Modified Dental Anxiety Scale (MDAS), and the COVID­19 Fear and Perception of Control Scale (COVID­19 FPCS) as well as additional questions concerning bruxism and a previous diagnosis of anxiety/panic attacks or depression was administered. The χ2 test was used to analyze the data. RESULTS: A total of 1,439 patients were included in the study. The most common reason for the dental visit was pain (47.5%). The prevalence of DA was 5.1% (74/1,439). A significant association was found between DA and gender (p = 0.020). The incidence of severe pain was higher in patients with DA than in those without DA (p = 0.002). No significant differences in the MDAS scores were found between patients with and without a chronic disease (p = 0.804), with regard to the educational status (p = 0.364), or between the age groups (p = 0.600). The prevalence of a 'strongly agree' response to all questions in COVID­19 FPCS was higher in patients with DA as compared to those without DA. CONCLUSIONS: Females and patients with severe pain were more likely to exhibit DA. In general, patients with DA strongly agreed with the statements of COVID­19 FPCS, which may indicate a correlation between the 2 scales.

The influence of voxel size and artifact reduction on the detection of vertical root fracture in endodontically treated teeth.

OBJECTIVE: The aim of this study was to evaluate the effect of voxel size and artefact reduction (AR) on the identification of vertical root fractures (VRFs) in endodontically treated teeth. METHODS: A total of a hundred sound, extracted human mandibular single-rooted premolars were decoronated, after which root canal preparation was performed, canals were filled with gutta percha by single cone technique. Randomly selected fifty specimens were fractured, repositioned and glued together. The teeth were examined with cone beam computed tomography (CBCT) in five different voxel sizes (0.125, 0.200, 0.250, 0.300, and 0.400 voxels). Two scans were performed for each tooth, one with AR and one without AR. Two radiologists evaluated the CBCT scans. RESULTS: All voxel dimensions were successful in detecting VRFs in CBCT scans. But as the voxel size increased, the percentage of detecting VRFs decreased. High accuracy, sensitivity, specificity and predictive values were found for VRF detection on CBCT scans. Accuracy and sensitivity values decreased (from 100 to 82) while voxel dimensions increased (from 0.125 to 0.400). High-resolution images (0.125, 0.200, and 0.250 voxels) caused an increase in sensitivity for detection of VRFs. AR did not affect the accuracy, sensitivity, specificity and predictive values for VRF detection on CBCT scans. CONCLUSIONS: High-resolution CBCT images resulted in an increase in sensitivity and specificity for detection of VRFs compared with lower-resolution CBCT images. The use of AR did not further improve its diagnostic potential.

CBCT assessment of gubernacular canals in relation to eruption disturbance and pathologic condition associated with impacted/unerupted teeth.

OBJECTIVES: The aim of this study was to demonstrate the imaging characteristics of gubernacular canals (GCs) in impacted/unerupted permanent teeth and to determine whether these characteristics differ as a result of the presence of eruption disturbances or pathologic conditions associated with impacted/unerupted teeth. STUDY DESIGN: GCs were retrospectively analyzed by using cone beam computed tomography in 250 patients with 753 impacted/unerupted permanent teeth (105 males, 145 females; mean age, 21.09 ± 14.45 years; range 6-70 years). RESULTS: The rate of detection of GCs was significantly lower in cases with eruption disturbances than in those without eruption disturbances. An inverse correlation was observed between age and detection of GCs. Similarly, root resorption of adjacent teeth and resorption of impacted/unerupted teeth were associated with lower rates of detection of GCs. However, no association was found for widening of the follicular space. Regression analysis determined disturbed eruption pattern as the most important factor for the absence of GCs. CONCLUSIONS: The absence of GC may indicate a disturbed eruption pattern of the tooth and may increase the risk of complications related to impaction resulting in a tooth that is more likely to remain unerupted.

Morphological evaluation of rat incisor enamel and dentin induced by pregnancy and lactation using a scanning electron microscope.

This study assessed the effects of pregnancy and lactation on the morphology of the dentine tubules and external enamel surface of rat incisor teeth using a scanning electron microscope (SEM) equipped with an energy dispersive x-ray (EDX) system. Twenty-four female Wistar rats were divided into three groups; group A rats were at the end of pregnancy, group B rats were in the post-lactation period and group C rats, the control group, were unmated. The outer enamel surface and openings of the dentine tubules at the neck regions of the incisors were observed under the SEM and photographed. Examination of the incisor teeth of pregnant and post-lactation rats revealed scratches on the enamel surface. There were few eroded areas and slight changes and the dentine tubules of the pregnant group were fully or partially occluded on the entire surface of the enamel in the lactating rats. Almost all dentine tubules of the rats in this group were open. During the study, EDX analysis of calcium, phosphate and magnesium was also performed at 20 kV and 0 degree tilt. The results of EDX analyses of magnesium were significantly lower in the pregnant group compared with the lactation and control groups for the dentine in the neck region (p<0.05). The calcium values increased in the lactation group compared with those of the rats in the other two groups (p<0.05). These results might indicate that changes during pregnancy and lactation affect the content and morphology of mineralized dental hard tissue.

Impact of xerostomia on oral complaints in a group of elderly Turkish removable denture wearers.

The aim of this study was to examine the correlation of subjective dry mouth assessment (xerostomia) with age, sex, denture type, wear duration, denture stability, subjective discomfort, soreness in denture-bearing tissues, and dissatisfaction with chewing, tasting, or speaking in a group of elderly Turkish removable denture wearers. The participants of this study were 229 healthy subjects, 101 males (mean age: 68.1+/-5.2 years) and 128 females (mean age: 66.4+/-4.2 years), all aged 60 years and above. A self-administered structured questionnaire on sensation of dry mouth, its effects in the oral mucosa and ability in the oral functions were given to the participants. Associations of the categorical variables were examined using the chi(2)-test (p<0.05). Satisfaction in the ability of speaking, tasting foods, chewing hard food was determined statistically significant in patients without dry mouth (p<0.05). Overall satisfaction of dentures was significantly higher in patients without dry mouth (p<0.05). Participants with having dry mouth reported soreness in denture-bearing tissues in both complete and removable partial denture (RPD) wearers. It was also found that oral dryness significantly affects oral functions in terms of the satisfaction with removable denture and the ability in the oral functions independent to education level or gender.

Effects of oral health behaviors and socioeconomic factors on a group of Turkish adolescents.

OBJECTIVE: To investigate the effects of socioeconomic factors and oral health behaviors on adolescents in Turkey. METHOD AND MATERIALS: Data were collected through a self-administered questionnaire. The sample consisted of 582 randomly selected adolescents, 309 boys and 273 girls, who presented over a 3-month period with various complaints to the Hacettepe University Medical Faculty Adolescent Clinic. RESULTS: Halitosis complaints were higher in the 11-, 12-, and 13-year-old groups than in other age groups (P < .05). When the sex factor was examined, prevalence of dental fear was found to be higher among girls, while irregular toothbrushing was seen more among boys. In parallel to the increase in the education levels of the parents, an increase was seen in the regular dental visits by the adolescents (P < .05). As the socioeconomic status of the family increased, frequency of dental visits, rate of dental floss usage, and number of teeth with restorations increased. In parallel with the dental visit increase, the rate of restored teeth increased. Of those who did not have regular dental visits because of financial difficulties, however, the rate of teeth with restorations was low. CONCLUSION: A strong correlation exists between the oral health behaviors, socioeconomic and sociodemographic factors, and the oral health status of Turkish adolescents.

Does menstrual cycle effect buffer capacity of stimulated saliva?

The present study was performed to analyze buffer capacity (BC) and flow rate of stimulated saliva during menstrual cycle. Two salivary samples were taken from 17 subjects during the menstrual cycle. BC was determined according to electrometric method. Both variables showed no hormone dependency. The results suggest that the salivary protection against acid attacks is constant in healthy nonpregnant women.

Evaluation of mandibular bone density to predict osteoporosis in adolescents with constitutional delayed growth.

OBJECTIVE: The aim of this study is to evaluate the correlation between constitutional delayed growth (CDG) and mandibular bone trabeculation as well as bone density on panoramic radiographs using a computer software program. METHODS: Panoramic radiographs obtained from 25 patients with CDG and 25 healthy adolescents were evaluated for this study. Patients were selected from admission to Hacettepe University, Faculty of Medicine, Section of Adolescent Medicine in the first half of the year 2002. All panoramic radiographs were taken under standard conditions, and were randomized and then converted to digital images for density analysis using a scanner. The images were transferred to Osiris computer software program for the evaluation of bone density from 4 different regions on the mandible (right and left mandibular angle and condyle). RESULTS: The CDG group had higher values for the risk of osteoporosis considering the right (t=3.360, p=0.002) and the left condyle (t=3.620, p=0.001) (t-test for independent samples). It was also seen that the CDG group was again at higher risk in comparison to the control group when left mandibular angle values were measured (z=-2.447, p=0.014) (Mann Whitney-U test). CONCLUSION: We suggest that panoramic radiographs, which are transformed into digital format, can be valuable and economic tools for detecting the risk of osteoporosis in adolescents with CDG.

Severe hypodontia and asymptomatic bilaterally ectopic impacted teeth in the coronoid processes: a case report.

An asymptomatic case in which severe hypodontia and mandibular ectopic impacted teeth in the coronoid processes are visualized through panoramic radiographs, is presented.

Effects of pregnancy and lactation on the microhardness of rat incisor dentine and enamel.

Pregnancy and lactation affect the rate of maternal dentine apposition and mineralization in the rat. In this study we have measured the effects of pregnancy and lactation on the degree of mineralization of dentine and enamel by using the microhardness method in rat incisors. At incisal sections, pregnant and lactation group enamel values were increased compared to that of a control group; the pregnancy and post-lactation period dentine values decreased slightly compared to the control group. At neck sections, pregnant and lactation group enamel values were decreased compared to that of the control group; the pregnancy and post-lactation period dentine values were also decreased slightly compared to the control group. At the post-lactation period neck section dentine mineralization was decreased compared with the incisal section. As a result, enamel and dentine layers of rat incisors are affected to varying degrees by these changes in mineralization levels during the maternal period.

Spontaneously healed root fracture: report of a case.

Blows to the facial region can cause root fractures especially in anterior teeth. Fractures below the alveolar crest have a very high potential for healing and treatment consists of reduction and rigid splinting immediately after trauma. The aim of the treatment is to obtain reunion of the fragments. Although the fracture can heal spontaneously, the prognosis will not be as good as the correctly treated ones. The purpose of this paper is to report a case of spontaneously healed root fracture.