Therapeutic and protective effects of autologous serum in amikacin-induced ototoxicity.

OBJECTIVE: Possible therapeutic and protective benefits of intratympanic autologous serum application in amikacin-induced ototoxicity were investigated. METHODS: Twenty-four guinea pigs were separated equally into two groups: therapeutic (group A) and protective (group B). Transient evoked otoacoustic emissions were recorded before and after autologous serum application. Apoptotic cells were identified in the organ of Corti, spiral limbus and spiral ganglion by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling ('TUNEL') method. RESULTS: Transient evoked otoacoustic emission responses at 1, 1.4 and 2.8 kHz improved without significance after autologous serum application in group A (p > 0.05). A significantly protective effect of autologous serum was determined at 4 kHz in group B (p < 0.05). There were significantly fewer apoptotic cells at the spiral limbus in the therapeutic and protective groups compared to the control group (p < 0.05). CONCLUSION: Autologous serum may offer protection against ototoxicity-induced hearing loss, but it cannot restore hearing. Immunohistochemically, autologous serum significantly decreases activation of the intrinsic pathway of pro-apoptotic signalling in mesenchymal cells compared to neurons and neurosensory cells.

Randomized Clinical Trial to Evaluate MTA Indirect Pulp Capping in Deep Caries Lesions After 24-Months.

OBJECTIVE: This clinical study aimed to assess the efficacies of mineral trioxide aggregate (MTA) and calcium hydroxide [Ca(OH)2] in the treatment of deep carious lesions by the direct complete caries removal technique. METHODS AND MATERIALS: A total of 100 permanent molar/premolar teeth were capped with either Ca(OH)2 (n=49) or MTA (n=51) and restored with composite resin in 73 patients. Periapical radiographs were acquired prior to the treatment as well as at six, 12, and 24 months posttreatment. Two calibrated examiners performed the clinical and radiographic assessment of the periapical pathology and pulpal symptoms. Intergroup comparisons of the observed values were performed using the Fisher exact test. Significance was predetermined at α = 0.05. RESULTS: The recall rates were 100% at six and 12 months posttreatment and 98.6% at 24 months posttreatment. Four teeth capped with Ca(OH)2 (two each at six and 12 months posttreatment) and two capped with MTA (one each at 12 and 24 months posttreatment) received endodontic emergency treatment because of symptoms of irreversible pulpitis, which were clinically and/or radiographically established. There were no significant differences in pulp vitality between the two pulp-capping agents at six, 12, or 24 months posttreatment (p=0.238, p=0.606, and p=0.427, respectively). CONCLUSIONS: Both pulp-capping materials were found to be clinically acceptable at 24 months posttreatment.

Clinical assessment of mineral trioxide aggregate in the treatment of deep carious lesions.

OBJECTIVE: This clinical study aimed to assess the effectiveness of mineral trioxide aggregate (MTA) and calcium hydroxide (Ca[OH]2) in the treatment of deep carious lesions using the direct complete caries excavation technique. SUBJECTS AND METHODS: Hundred permanent molars/premolars were capped either with Ca (OH)2 (n = 49) or MTA (n = 51) and restored with composite resin in 73 patients. Periapical radiographs were taken prior to the treatment, at 6 months and 12 months. Two calibrated examiners clinically and radiographically assessed the periapical pathology and pulpal symptoms. Inter-group comparisons of the observed values were analyzed using Fisher's exact test. Significance was predetermined at α = 0.05. RESULTS: Recall rates were 100% at 6 and 12 months. Four teeth capped with Ca(OH)2 (two each at the end of 6 and 12 months) and one tooth capped with MTA (at the end of 12 months) received endodontic emergency treatment because of symptoms of irreversible pulpitis that were clinically and/or radiographically established. There was no significant difference between the protection of the tooth vitality and pulp capping agents at 6 and 12 months (P = 0.238, P = 0.606, respectively). CONCLUSION: Both materials were clinically applicable at the end of 12 months.

Diagnostic methods for dental caries used by private dental practitioners in Ankara.

OBJECTIVES: This study aimed to investigate the preference profiles of various types of diagnostic tools and methods used by private dental practitioners in Ankara for detecting dental caries. METHODS: Private dental practitioners, in five districts of Ankara, were provided with questionnaires comprising demographic characteristics, possession of dental imaging systems, and methods used for caries diagnosis. The questionnaires were retrieved after 1-3 visits. Of 722 questionnaires, 371 were returned. Data were analyzed using frequency analysis and Chi-square tests. RESULTS: The completed questionnaires were obtained from 160 women and 168 men, the response rate was 51.4% aged 25-69 years; 28.4% of them were specialists. Most participants possessed a dental radiography (RG) device. Air drying and sharp explorers were the most commonly preferred methods used for caries diagnosis. There was no significant association between using a sharp explorer and sex or being a specialist (P = 0.110, 0.226, respectively). Almost one-third of the dentists with an experience of <11 years, never used an RG device to detect occlusal caries (P = 0.003). Only three participants reported the use of DIAGNOdent, while two participants used fiber-optic transillumination (FOTI). CONCLUSIONS: It was observed that visual-tactile examination using sharp explorer accompanied with radiographs were among the main instruments used for detecting carious lesions. Usage of magnification tools, FOTI, and DIAGNOdent were low.

Clinical Performance of Composite Restorations with Resin-modified Glass Ionomer Lining in Root Surface Carious Lesions.

OBJECTIVE: The purpose of this study was to evaluate the clinical performance of composite restorations in root surface carious lesions with or without resin-modified glass ionomer lining. METHODS AND MATERIALS: The sample consisted of 25 female and 14 male patients. A maximum of four lesions were included for each patient. After caries removal, the depth, length, and width of the cavity were measured. Lesions in the same patient were randomly divided into two groups, and the dentin surfaces were either lined with resin-modified glass ionomer liner (Glass Liner II) or left as they were. Self-etch adhesive (All Bond SE) was applied and cured for 20 seconds. All cavities were restored with nanohybrid anterior composite resin (Clearfil Majesty Esthetic). Two experienced clinicians evaluated the marginal adaptation (retention) rate, anatomic form, secondary caries, sensitivity, and marginal staining of restorations at the end of the first week and at six, 12, and 18 months posttreatment. The data were statistically analyzed using the Chi-square and two-way repeated measures tests. RESULTS: At the end of 18 months, a total of five lined and three unlined restorations were lost. There was no significant relationship between marginal adaptation and cavity lining at six, 12, and 18 months (p>0.05). Although marginal stainings of restorations were mostly localized, the total number of localized or generalized discolored restorations increased with time (p<0.001). There was a statistically significant relationship between marginal staining and smoking (p>0.05). There was no significant relationship between marginal staining and frequency of toothbrushing at six, 12, and 18 months (p=0.286, p=0.098, and p=0.408, respectively). CONCLUSION: Within the limitations of this study, both restorative applications were accepted as clinically appropriate.

Root caries in 35-44 and 65-74 year-olds in Turkey.

OBJECTIVE: To assess the prevalence and related factors of root caries in Turkish 35-44 and 65-74 year-olds. BASIC RESEARCH DESIGN: In this cross-sectional study, using a proportional stratified cluster sampling, 1,631 subjects aged 35-44 years and 1,545 aged 65-74 years were examined. Data were collected via a structured, pre-tested face-to-face administered questionnaire and oral examination following WHO 1997 guidance. Statistical significance was evaluated with chi2 test and binary logistic regression analyses to determine the significance of explanatory variables. RESULTS: The prevalence of root caries was 20.1% in dentate 35-44 year-olds, 28.4% in 65-74 year-olds. Mean decayed root increased significantly with the increasing number of retained natural teeth (p = 0.010 for 35-44 and p < 0.001 for 65-74 year-olds). First molars were the most affected by root caries in both age groups. For adults, being male (OR = 1.37), rural residence (OR =1.50), being unschooled (OR = 3.07), no tooth brushing (OR = 1.83) and never visiting dentist (OR = 2.03) were the predictors of the presence of root caries. For elderly, rural residence (OR = 1.54), no tooth brushing (OR = 1.89), and never visiting dentist (OR = 2.38) were the determinants of root caries. CONCLUSION: There is a need for the increased implementation of oral health measures with increasing age in Turkey.

National survey of oral health status of children and adults in Turkey.

OBJECTIVES: To estimate the severity of dental caries and the periodontal status of children and adults in Turkey. BASIC RESEARCH DESIGN: This cross-sectional study was undertaken between September 2004 and February 2005. The Turkish Statistics Institute (TSI) selected a representative sample using the proportional stratified sampling method. The selected ages/age groups were 5, 12, 15, 35-44 and 65-74. At the end of the study, 7,833 individuals had been reached. Dental students were calibrated and examinations were done according to World Health Organization (WHO) guidelines during home visits. RESULTS: Only 30.2% of the 5-year-old group was caries-free, and the mean dmft was 3.7. Mean DMFT was 1.9 in 12- year-olds, 2.3 in 15-year-olds, 10.8 in 35-44-year-olds, and 25.8 in 65-74-year-olds. In both adolescents and adults, the prevalence of caries was higher among females than in males. In rural areas, the prevalence of caries was high among 5-year-olds, while DMFT was high in the elderly. The prevalence of dental caries was similar for 12- and 15-year-olds in urban and rural areas. Slightly less than half (48.0%) of 65-74 year-olds were edentulous. Healthy periodontal tissue was noted in 56.2% of fifteen-year-olds. In the 35-44 yr-old age group, calculus problems were high (62.6%), and 1.2% had attachment losses of 6 mm or greater. Rural subjects had more severe periodontal problems than their urban counterparts. CONCLUSION: Community-based oral disease prevention programs are needed urgently for the promotion of oral health in Turkey.

Sealant and composite bond strength to enamel with antibacterial/self-etching adhesives.

INTRODUCTION: The enamel in pits and fissures undergoing preventive or ultraconservative resin restorations may be affected by secondary caries. An antibacterial adhesive bond may be a useful choice to prevent and reduce demineralization. OBJECTIVES: The purpose of this study was to determine the shear bond strength of an experimental antibacterial bond, a self-etch bond, and an ormocer-based adhesive bond using an ormocer-based fissure sealant and a composite resin on intact enamel. METHODS: Twenty-four extracted human molars were sectioned bucco-lingually to obtain two flat and sound enamel surfaces. Forty-eight specimens were randomly assigned into four groups. The groups were prepared to receive the following treatments: (1) Admira Bond + Admira Seal (n = 10); (2) ABF Bond + Admira Seal (n = 11); (3) Clearfil SE Bond + Clearfil AP-X (n = 12); and (4) ABF Bond + Clearfil AP-X (n = 11). A cylindrical mould was placed over the bonded surface, and both materials were applied according to the instructions. The teeth were thermocycled 500 cycles between 5 and 55 degrees with a dwell time of 30 s. For shear bond strength testing, the load was applied vertically to the base of the mould. The cross-head speed was 5 mm min(-1). RESULTS: The maximum load that a specimen can withstand until failure was determined and shear bond strength was calculated by dividing the load at failure by the surface area of the mould. The results (median, minimum and maximum, respectively) for the four groups were: (1) 7.9, 4.2 and 13.6 MPa; (2) 8.6, 2.6 and 15.9 MPa; (3) 5.9, 5.3 and 8.2 MPa; and (4) 8.8, 3.0 and 19.2 MPa. Kruskal-Wallis and Mann-Whitney U-tests were performed for the statistical analysis. Groups 3 and 4 were statistically significantly different (P = 0.005; P < 0.05). There was no statistically significant difference between the sealant and composite groups for ABF (P = 0.375). Fracture sites were viewed by microscope under x 16 magnification to determine if the mode of failure was adhesive or cohesive. The results (number of adhesive failed specimens and number of cohesive failed specimens, respectively) for the four groups were: (1) 7 and 3; (2) 3 and 8; (3) 2 and 9; and (4) 8 and 3. CONCLUSION: The ABF bond has sufficiently physical qualities to be used under fissure sealant and composite resin on uncut enamel, its antibacterial efficiency notwithstanding.

Validity of a laser fluorescence system (DIAGNOdent) for detection of occlusal caries in third molars: an in vitro study.

The aim of this study was to compare the validity of the measurements of the laser fluorescence device, KaVo DIAGNOdent, with the result of polarized light microscopy in the detection of occlusal fissure caries in extracted third molars. Ten impacted, surgically removed, and 25 extracted third molars with macroscopically intact occlusal surfaces were selected. The DIAGNOdent measurements of the occlusal test site were recorded by two observers at intervals of 2 days. The teeth were then sectioned at the specified test sites for histological examinations. Prepared specimens were evaluated under the polarized light microscopy and all images were scored with the caries classification of D1 (sound and fissure lesion in the half of the outer enamel), D2 (enamel decay) and D3 (dentin decay) level (gold standard). The kappa value for the inter-observer repeatability was calculated and the value 0.83 for the first measurements and 0.67 for the second measurement were obtained,respectively. Inter-observer correct classification percentages were 88.5 and 77.1 for the first and second measurements, respectively. The kappa value for intra-observer repeatability was 0.79 for the first observer and 0.75 for the second observer. Intra-observer correct classification percentage values were 85.7 and 82.8 for the first and second observer, respectively. Value of specificity for the detection of enamel caries at D1 level was 0.74 and sensitivity values at D2 and D3 levels were 0.66 and 1.00, respectively. The present study indicates that the DIAGNOdent provides not only almost perfect agreement but also sufficient repeatability at D1, D2, D3 levels and better specificity at D1 level as well as lower sensitivity at D2 level and excellent sensitivity at D3 level.