Evaluation of partial pulpotomy treatment in cariously exposed immature permanent molars: Randomized controlled trial.

BACKGROUND AND AIMS: This study aimed to assess the outcomes of partial pulpotomy treatments using different biocompatible materials which were Biodentine®, mineral trioxide aggregate (MTA), and calcium hydroxide (CH) in cariously exposed pulp tissue in immature permanent molars. MATERIALS AND METHODS: Fifty-four teeth of 50 patients, which had cariously pulp exposures were randomly divided into Biodentine®, MTA, and CH groups for partial pulpotomy treatments and finally restored with stainless steel crowns at the same appointment. Clinical and radiographical success was evaluated by the absence of any clinical and radiographical signs and symptoms for 12 months. Also, Image J was used for the quantitative assessment of length developments for mesial and distal roots. P value of less than 0.05 was considered statistically significant. RESULTS: Partial pulpotomy treatments showed high overall success rate (87%). On the other hand, Biodentine and MTA showed higher success rates compared to CH without any statistical significance (P = 0.09). Besides, mesial and distal root lengths displayed a continuous and significant increase in each group at sixth month follow-up (P = 0.01; P = 0.03). CONCLUSIONS: Favorable results demonstrated that Biodentine, MTA, and CH might be recommended as suitable agents for partial pulpotomy treatment in cariously exposed immature molars with clinical diagnosis of normal pulp or reversible pulpitis.

Evaluation of the impact of early childhood caries, traumatic dental injury, and malocclusion on oral health-Related quality of life for Turkish preschool children and families.

AIM: The aim of this study was to assess the impact of the presence of early childhood caries (ECC), traumatic dental injury (TDI), and malocclusion, as well as severe conditions, on the oral health-related quality of life (OHRQoL) of preschool children and families. MATERIALS AND METHODS: A cross-sectional survey was conducted in children aged 1 to 6 years old, who attended to the Department of Paediatric Dentistry, Gazi University. The questionnaires were adapted to Turkish, and OHRQoL was measured using the Turkish version of Early Childhood Oral Health Impact Scale (T-ECOHIS). Children were classified into four main groups, two subgroups in each group based on their severity conditions-Group 1: ECC group; Group 2: TDI group; Group 3: Malocclusion group; Group 4: Control group. Parents answered the questions about sociodemographic conditions and T-ECOHIS. The Kolmogorov-Smirnov test was used for non-normal distribution and Kruskal-Wallis and Mann-Whitney tests were used to compare T-ECOHIS score regarding ECC, TDI, and malocclusion. RESULTS: Both simple and severe conditions of TDI showed a negative impact on the family and child based on T-ECOHIS scores (P < 0.05). The severe condition of ECC and malocclusion showed significantly negative impact on family (P > 0.05) but not on child (P > 0.0.5). CONCLUSION: The presence of ECC, TDI, and malocclusion has a negative effect on OHRQoL of Turkish preschool children and specially their families. So, public health programs should be carried out about oral health for raising parents' and children's awareness and increasing OHRQoL.

Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

Clinical and radiographic outcomes of direct pulp capping therapy in primary molar teeth following haemostasis with various antiseptics: a randomised controlled trial.

AIM: This was to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) therapy in primary molar teeth following haemostasis with various antiseptics for 12 months. MATERIALS AND METHODS: A total of 70 vital primary molar teeth with deep dentin caries were randomly allocated to different antiseptic groups. After observing the pinpoint exposure, 0.9% saline solution (SS, control), 0.5% sodium hypochlorite (SH), 2% chlorhexidine digluconate (CHX), or 0.1% octenidine dihydrochloride (OCT) was applied with sterile cotton pellets for 3 min before calcium hydroxide (CH) DPC therapy. Statistical evaluation: The intergroup radiographic success criteria were analysed using a Kruskal-Wallis test in each follow-up period at a confidence interval of 95%. RESULTS: After 12 months, all groups showed a clinical success rate of 100% (no clinical failures were observed at the time of pulpectomy or extraction), and the overall radiographic success rates were OCT (100%) > SH (94.74%) > CHX (93.3%) > SS (84.21%), respectively (p > 0.05). OCT did not exhibit any failures. The undesirable radiographic failure types (pulpectomy or extraction) were mostly observed in the SS group. CONCLUSION: Compared with SS, the success of conventional CH usage in DPC therapy of primary molar teeth could be enhanced by providing acceptable disinfection features with antiseptic solutions. OCT seems to have relative beneficial effects compared to SH and CHX.

Clinical and radiographic success rates of mineral trioxide aggregate and ferric sulphate pulpotomies performed by dental students.

AIM: The purpose of this study was to evaluate and compare the clinical and radiographic findings of ferric sulphate (FS) and mineral trioxide aggregate (MTA) as vital pulpotomy materials in primary molars. MATERIALS AND METHODS: Participants, including 40 boys and 53 girls ranging between 5 and 10 years of age (mean age 7.7 years), were selected from the patient population at the University of Gazi Department of Paediatric Dentistry. The children were healthy and cooperative, with at least 1 symptom-free restorable and vital primary molar with deep carious lesions. The pulpotomies were performed by fifth-year undergraduate dental students. Members of the senior staff at the clinics supervised all of the procedures. Clinical and radiographic evaluations were performed at 1-, 3-, 6-, 9- and 12-month recall. The data were statistically analysed with chi-squared tests followed by a multiple comparison test. RESULTS: The follow-up evaluations revealed that the clinical success rates were 84.7% for FS and 94.7% MTA. The radiographic success rates were 78.2 % for FS and 92.1 % for MTA. No significant difference was found between the clinical and radiographic outcomes of the two groups at all follow-ups (P >0.05). CONCLUSION: The most common radiographic failure was internal resorption in both types of pulpotomies. Both MTA and FS can be suggested as an appropriate medicament for primary teeth pulpotomies.

Evaluation of a new intraoral controlled fluoride release device.

The aim of the study was to determine the pharmacokinetics of a new hydroxyapatite-Eudragit RS100 diffusion-controlled fluoride-releasing system designed for intraoral use with a 0.15 mg F(-)/day release for a 1-month period. Matrix tablets, each containing 18 mg of sodium fluoride, were bonded to the buccal surface of the first maxillary molar teeth of 20 subjects (age 20-23 years). Morning and evening salivary and urinary samples were collected 5 days before the study and every day for the 1st week, then once a week for 1 month. Fluoride ion measurements were done using the microdiffusion method. The salivary and urinary fluoride concentrations were significantly raised during the treatment period (p < 0.05). Morning salivary fluoride levels were higher than evening salivary fluoride levels (p < 0.05) whereas evening urinary fluoride levels were higher than morning urinary fluoride levels (p < 0.05). The statistically significant increase in salivary fluoride levels indicates a caries-preventive role for this device.

Effects of topical Catalase application on dental pulp tissue: a histopathological evaluation.

OBJECTIVES: recently, the role of antioxidant enzymes in wound healing and their therapeutic potential has been a subject of interest in medical sciences. However there is restricted knowledge on the results of topical application, optimal therapeutic dosage and carrier types. The purpose of this study was to investigate the wound healing response of dental pulp after direct pulp capping with an antioxidant enzyme; Catalase (C-40). METHODS: three mongrel dogs were used in this study. A total of 32 perforated Cl V preparations were treated with either 0.8mg (n=16) or 1.6mg (n=16) Catalase (C-40) which was incorporated in gelatin carriers whereas 16 control teeth had carriers without Catalase. One millimeter thick Teflon disks were placed over the gelatin pellets and the cavities restored with silver amalgam. Short term and long term histopathologic reactions were evaluated after 7 and 90 days. RESULTS: there were no statistically significant differences between the inflammatory cell responses of control and either dosage groups of Catalase at the 7-day evaluation period. However, after 90 days, better tissue healing was observed in the teeth treated with Catalase, resulting in significant differences with the control group. CONCLUSIONS: it can be concluded that the results of this study encourage the topical use of antioxidant Catalase as a pulp-capping agent. However, further studies are required to determine optimal antioxidant dosages.

Microleakage of light-cured resin and resin-modified glass-ionomer dentin bonding agents applied with co-cure vs pre-cure technique.

This in vitro study evaluated the effect of dentin bonding agents in reducing microleakage after three months in Class V restorations restored with Z100 resin composite. Materials tested were three types of resin-based dentin bonding agents: a multi-step (Scotchbond Multi-Purpose); a one-step (Scotchbond One-Step); a self-etching, self-priming (Clearfil Liner Bond) and a resin-modified glass ionomer (GC Fuji Bond LC). Class V cavity preparations with occlusal margins in enamel and gingival margins in cementum were prepared both on labial and lingual surfaces of extracted premolar teeth. Restorations (two per tooth) were distributed randomly into nine test groups (n = 10) consisting of the various DBAs applied with co-cure and pre-cure techniques, and no dentin bonding as a negative control group. Samples were stored in saline for three months, thermocycled, stained with silver nitrate, then sectioned through the middle of the preparation to facilitate the removal of the composite resin restoration. For groups treated with the pre-cure technique, the differences between the enamel leakage values of SBMP-control, CFLB-control and SB1S-control subgroups were significant (p < 0.05). For enamel leakage values of groups treated with the co-cure technique, the differences between the SBMP-control, SB1S-control, CFLB-control and Fuji LC-control subgroups were significant (p < 0.05). For cementum leakage values of groups treated with pre-cure technique, the difference between the CFLB-control and the Fuji, SBMP and SB1S groups was significant (p < 0.05). No significant differences could be detected between the cementum leakage values of groups treated with the co-cure technique (p > 0.05). The differences between the values obtained with application of CFLB with the pre-cure and co-cure techniques at the cementum margins were found to be statistically significant (p = 0.02). No statistically significant differences could be detected between the pre-cure and co-cure values of the other test materials. Generally for every group, cementum microleakage values were greater than enamel microleakage values (p < 0.05). The use of Scotchbond Multi-Purpose, Scotchbond One-Step and Fuji Bond LC with the co-cure technique to decrease the application time did not cause any significant increase in microleakage. Only pre-curing using Clearfil Liner Bond provided better microleakage properties than the other pre-cured adhesives.

The effect of bonding agents on the microleakage and bond strength of sealant in primary teeth.

This in vitro study investigated the effect of use of three dentine bonding agents: Scotchbond Multi-Purpose Plus (3M Dental Products, St. Paul, Minnesota, U.S.A.), Syntac (Vivadent, Schaan, Liechtenstein), Optibond Dual Cure (Kerr, Romulus, MI, U.S.A.) on microleakage and shear bond strength of a fissure sealant (Helioseal F, Vivadent, Schaan, Liechtenstein) bonded to either dry or wet (saliva contaminated) enamels of primary teeth. Newly extracted 112 non-carious primary teeth were sectioned and embedded in resin blocks. Eight groups were formed for each test. Each group consisted of 14 specimens. Group 1 and 2: fissure sealant was applied directly to etched enamel in dry and wet condition, respectively; Group 3 and 4: fissure sealant was applied onto etched and Scotch-bond Multi-Purpose Plus treated enamel in dry and wet condition, respectively; Group 5 and 6: fissure sealant was applied onto etched and Syntac treated enamel in dry and wet condition, respectively; Group 7 and 8: fissure sealant was applied onto etched and Optibond Dual Cure treated enamel in dry and wet condition, respectively. The results revealed that the use of an enamel-dentine bonding agent under fissure sealant increased the bond strength and decreased the microleakage. The use of enamel-dentine bonding agents under sealant in moisture contaminated conditions gave better results than applying sealant alone onto non-contaminated teeth. Finally, Scotchbond Multi-Purpose Plus yielded the best results for both tests.

Superoxide dismutase activity in healthy and inflamed pulp tissues of permanent teeth in children.

The free radicals play an important role in the tissue damage. Oxygen-derived free radicals are controlled by various cellular defense mechanisms consisting of enzymatic such as superoxide dismutase, catalase, glutathion peroxidase and nonenzymatic scavenger components. Superoxide dismutase (SOD) is responsible for the dismutation of the superoxide radicals into hydrogen peroxide and molecular oxygen. In this study, pulp samples extirpated from the teeth of the 27 children between 10-15 ages which diagnosed to be healthy, reversible pulpitis or symptomatic irreversible pulpitis were evaluated for the activity of superoxide dismutase enzyme. There were statistically significant differences between healthy and reversible pulpitis, and between reversible and symptomatic irreversible pulpitis groups. The SOD activity of the reversible pulpitis group were significantly lower than the irreversible pulpitis and healthy pulp groups. The evaluation of the data revealed that the quantity of SOD as a vitality protector enzyme is low at the beginning of the inflammation as a consequence of rapidly depletion and/or destruction of this enzyme, but as the inflammation proceeds the pulp tissue showed adaptation to this situation.

Enamel fluoride levels after orthodontic band cementation with glass ionomer cement.

The aim of this investigation was to examine the fluoride uptake by enamel after application of glass ionomer cement for orthodontic band cementation compared with zinc phosphate cement. The study was conducted on 21 children whose mean age was 14 years. All the children were reared in the Middle Anatolian cities where the water fluoride concentration was below the level of 0.50 ppm. The subjects were randomly divided into three groups. The first experimental group, had seven subjects whose teeth were topically fluoridated with 2 per cent NaF solution, before orthodontic band cementation with zinc phosphate cement. The second experimental group also had seven subjects whose orthodontic bands were cemented with glass ionomer cement. The third group, consisted of seven control subjects and no dental procedures were performed in this group. All the participants were followed for 3 months and at the end of this period maxillary first premolars, which were in the ninth developmental stage according to Nolla (1960), were extracted for orthodontic purposes. The enamel fluoride concentrations were determined on the left maxillary first premolars at three successive etch depths by means of a fluor ion electrode, whereas the calcium concentrations were determined with an atomic absorption spectrophotometer. The results of this investigation showed that in both cementation groups enamel fluoride concentrations at three successive etch depths were highly increased compared with the control group. However, the difference between the cementation groups was not statistically significant.

Salivary and urinary fluoride levels after 1-month use of fluoride-releasing removable appliances.

Forty children aged 8-10 years participated in this study. Half (n =20) of them used orthodontic appliances which contained fluoride-releasing devices embedded in the lingual surface of the appliance and the other half used orthodontic appliances prepared from a fluoride-releasing acrylic polymer. Prior to the adjustment of appliances and after 1, 7, 14, 21 and 30 days salivary and urinary samples were collected and the fluoride concentrations were determined. The mean fluoride release was highest during the first week. However, the values decreased considerably after that and the curves for the two groups became parallel. The results indicate that fluoride-releasing removable appliances could be useful for a prolonged release of low concentrations of fluoride without any systemic effect.

Apical microleakage of primary teeth root canal filling materials by clearing technique.

The purpose of this study was to evaluate apical leakage of primary teeth root canals sealed with four different root canal filling materials by clearing technique. Dye penetration ratios of all groups were measured by light microscopy. The mean dye penetration was determined in the group of ZOE to be 0.57 mm. This ratio was 1.05 mm in the group of ZOE + glutaraldehyde (GA). In the groups of Kri I and Ca(OH)2, dye penetrations were 0.47 mm, 0.56 mm respectively. The highest apical leakage value was evaluated in the glutaraldehyde + ZOE group (p<0.05), whereas, no statistical difference was found between the other groups.

Slime production by coagulase-negative staphylococci in the infected pulps.

In this study; slime factor which is produced by coagulase negative Staphylococci was investigated in infected pulps of 145 primary and permanent teeth. Staphylococci were isolated in 27% of the cultures and all of the isolated Staphylococci were coagulase negative (CNS) in permanent teeth whereas 75% of isolated Staphylococci were coagulase negative in primary teeth. Slime production rate was the same for both groups and 22% of CNS were found slime positive. It is thought that slime production is important not only in endodontic microbiology, but also in other fields of dentistry for the explanation of the pathogenesis of infection.

The effect of various irrigants on the adaptation of paste filling in primary teeth.

Adaptation of paste filling in primary teeth irrigated with different solutions were studied in vitro. Irrigants being evaluated were EDTA with NaOCl, NaOCl with H2O2 and glutaraldehyde. ZOE paste was used as a root canal filling. Examination was made with SEM. Insufficient adaptations were found in all groups.

[The occurrence of cavitation after orthodontic bonding. A case report]. / Ortodontik bonding sonrasi kavitasyon olusumu. (Bir vaka nedeni ile).

In this case report occurrence of cavitation on the lingual enamel surfaces of teeth after orthodontic direct bonding a canine to canine lingual retainer is presented and possible reasons which might play a role in their formation was investigated by "SEM" and "electron microprobe analyzer". Although the morphologic structure is normal, a mineral loss is detected and it is thought that an easier dissolution of enamel is occurred by the penetration of saliva and plaque microorganisms throughout the enamel-resin junction.

Relation of ectodermal dysplasia and hypodontia.

Ectodermal dysplasia and hypodontia were diagnosed in three families who referred to Gazi University Pedodontic Department in 1989. From the view point of dentistry, it is intended to point out the genetic transitive character of ectodermal dysplasia and its possible relation with hypodontia. Also; some approaches to satisfy the patients in social and psychological aspects besides replacing the functional and cosmetic demands were carried out.

[Apexification during active orthodontic treatment]. / Aktif ortodontik tedavi sirasinda apeksifikasyon.

An apexification procedure is performed on a maxillary left central incisor tooth of a fourteen years old girl who has chronic apical periodontitis and undergoing active orthodontic treatment. After a one-year clinical and radiological follow-up, formation of apical closure is observed. As a result, apexification can be suggested as a successful treatment procedure in such cases.

[Orthodontic treatment of a dilacerated maxillary central incisor]. / Dilasere bir maksillar kesicinin ortodontik tedavisi.

A case is presented in which orthodontic treatment was applied to correct the axial inclination of a dilacerated maxillary central incisor. Also, it is considered that after a 24 month clinical and post-operative radiographic follow-up of the case the vitality of the tooth is maintained and the root resorption avoided.

[Effect of various polishing techniques on restorative resin discoloration]. / Cesitli polisaj yöntemlerinin restoratif resin renklesmeleri üzerine etkisi.

The color stability of the composite filling material (Adaptabond-Hybrid) polished with different techniques -pumice-brush, sof-lex XT, adaptic polish-was tested by reflectance spectrophotometry. Samples were dipped in tea-coffee staining solution for the periods of 1, 2 or 4 weeks. All the samples were better than the group polimerized with celluloid matrix strip. No significant difference were found between the groups pumice-brush, sof-lex XT and adaptic polish for the periods 1, 2 and 4 weeks.