Green tea extract solutions can control bacterial biofilms formed on space maintainers.

BACKGROUND: Microorganisms in the mouth are protected from negative environmental conditions by forming biofilms; however, the use of anti-plaque agents in children is not preferred due to toxic side effects. Green tea has been reported to have anti-microbial and anti-dental caries properties. AIMS: The aim of this study was to assess the ability of green tea extract to prevent the formation of biofilm on the teeth of children using space maintainers. METHODS: Bacteria were isolated from samples obtained from children aged between 8 and 10 years. The micro-titer plate method and Congo red agar were used to assay biofilm formation. Green tea leaves were obtained from Rize, Turkey. Methanol, hexane and distilled water were used for preparing the extracts. The effects of green tea extract and chlorhexidine on biofilm formation were examined using scanning electron microscopy. RESULTS: Presence of S. mutans 3,3, S. anginosus 2.1.b, S. dysgalactie 6.1.4.1, and E. faecium 10.2. was measured in the biofilm samples. The extracts showed a bacteriostatic effect on the test bacteria, and among the green tea extracts, the methanol extract was found to exhibit the highest efficacy against biofilm formation by S. mutans 3.3. CONCLUSION: Green tea extract showed good efficacy in controlling bacterial growth, and is recommended as a better-tasting alternative for daily oral hygiene due to a lack of known side effects.

Evaluation of the fissure sealants applied to erupting permanent molars in accordance to eruption stages: A prospective study.

BACKGROUND: The aim of this study is to evaluate the clinical success of different fissure sealants applied to erupting permanent first molars by taking into consideration the stages of tooth eruption. MATERIALS AND METHODS: Two hundred healthy children between ages 5 and 8 with the inclusion criteria were examined. The erupting permanent first molars were evaluated and those at stage 3 or 4 were selected. An investigator placed three different fissure sealants (giomer, hydrophilic, and hydrophobic resin-based). At the end of 18 months, retention loss, development of new dental caries, localization of retention losses, marginal integrity, and marginal discoloration were evaluated. RESULTS: The rate of tooth with total retention at stage 3 was significantly higher (P < 0.05). The development of dental caries in teeth at stage 4 was found to be significantly higher than that of stage 3 (P < 0.05). In terms of marginal integrity, the difference between stages of tooth eruption is similar (P > 0.05). Regarding marginal discoloration, fissure sealants applied at stage 3 were considered to be more successful than those applied at stage 4 (P < 0.05). CONCLUSIONS: We may conclude that the tooth eruption affects clinical success and giomer-based fissure sealants may not be an alternative for resin-based fissure sealants in erupting teeth.

A long-term clinical study on individuals with amelogenesis imperfecta.

BACKGROUND: The aims of this study are to present sociodemographic and familial characteristics, clinical and systemic findings, dental treatment needs, and concomitant dental anomalies in patients with amelogenesis imperfecta (AI) and to evaluate time-varying conditions in these long-term follow-up patients. MATERIALS AND METHODS: Records of patients with AI who were examined in the Department of Pediatric Dentistry between 1999 and 2017 were reviewed. Information about sociodemographic characteristics, history of AI and consanguinity in family, systemic conditions, reasons for referral to the clinic, oral hygiene habits and gingival health, occlusion findings, and performed treatments were gathered. Dental anomalies in radiographs were also evaluated. Baseline and final situations of the patients were assessed. Statistical analyses were performed. RESULTS: Of 75 patients aged 3-15 years with follow-ups up to 12 years, 34 had AI in their families and 15 were born from consanguineous marriages. Nephrocalcinosis has been observed in 5 patients. Main reasons for referral to the clinic were related to esthetic and hypersensitivity concerns. Twenty-two patients had gingivitis, and during follow-up process, gingival problems could not be completely prevented due to poor oral hygiene habits. Vertical dimension loss, open-bite, and cross-bite were seen in 16, 15, and 10 patients, respectively. Of the patients, 63% experienced restorative, 33% stainless steel crown, 17% endodontic, 8% prosthetic treatments, and 24% had retreatment needs. Concomitant dental anomalies were dens invaginatus, taurodontism, ectopic eruption, delayed eruption, hypodontia, and pulpal calcification. CONCLUSION: Early diagnosis and interventions considering the time-varying conditions with long-term follow-ups provide significant improvements in clinical maintenance of patients with AI.

An educational programme designed for the evaluation of effectiveness of two tooth brushing techniques in preschool children.

AIM: This study aimed to evaluate oral and dental health status of preschool children, to teach them two different brushing techniques, and to determine the effectiveness of such techniques. MATERIALS AND METHODS: One hundred sixty three healthy children from three preschools in Isparta (Turkey) that were willing to participate in the study were included. A questionnaire was distributed to the parents. All children were given an oral and dental health education. Examinations were done in the classrooms, and plaque index and dft-dfs values were recorded. In each preschool, the horizontal scrub technique was randomly taught to a group of children, and the Fones technique to other group, and children were asked to apply the technique taught. Plaque index scores were recorded again, measurements were repeated at 1 week, and 1, 3 and 6 months. Data were analysed statistically. RESULTS: The questionnaires showed children's and parents' inadequate oral hygiene behaviours. Plaque index values for both techniques decreased from baseline at 1 week, and 1, 3 and 6 months. Values at month 6 were closer to baseline. The horizontal scrub technique was applied more easily and it provided an effective decrease on plaque index scores. No statistically significant difference was found for dft and dfs values. CONCLUSION: The educational programme with regular repeated tooth brushing training presented significant improvements in the oral health behaviours. The horizontal scrub technique was deemed more suitable than the Fones technique for preschool children.

The effects of psychostimulants on oral health and saliva in children with attention deficit hyperactivity disorder: A case-control study.

INTRODUCTION: This study investigated the dental health problems and saliva characteristics of children under psychostimulant therapy for attention-deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS: One hundred and twenty children aged 7-12 years were divided into three groups. Groups 1-2 comprised children diagnosed with ADHD: those who had not yet started psychostimulant therapy (Group 1) and those already receiving long-term psychostimulant therapy (Group 2). Group 3 comprised healthy, nonmedicated children. Possible side effects of psychostimulants were investigated at the beginning of study in Group 2 and after 3 months drug use in Group 1. Bruxism and dental erosion prevalence, salivary Streptococcus mutans count, buffering capacity, and stimulated salivary flow rate (SSFR) were measured, and salivary α-amylase, calcium, total protein, and proline-rich acidic protein (PRAP) levels were quantified in the beginning of the study. Data were analyzed using the Kruskal-Wallis test. RESULTS: The most frequently reported side effects of psychostimulants were decreased appetite, dry mouth, and increased fluid consumption. The prevalence of bruxism and dental erosion was higher in Groups 1 and 2 than in Group 3, but the differences were not significant (P > 0.05). In Group 2, subjective dry mouth feel was reported by 32.5% of patients and 17.5% had a very low SSFR. Salivary α-amylase, calcium, total protein, and PRAP levels were lower in Group 2 than the others, but the differences were not significant (P > 0.05). CONCLUSIONS: ADHD and psychostimulant therapy do not appear to be significantly related to decreasing SSFR or protective saliva components against dental caries. However, a systematic investigation of the long-term safety of psychostimulants is needed. The most effective method of maintaining dental health of children with ADHD is frequent appointments focusing on oral hygiene practices accompanied by dietary analyses.

Evaluation of oral health status and influential factors in children with autism.

AIMS: The aim of the present study was to comparatively analyze oral health status and influential factors in children with autism living in the Western Mediterranean Region of Turkey. SUBJECTS AND METHODS: This cross-sectional study was conducted in two steps: 1 - questionnaire and 2 - interview. This study was conducted at the Department of Pediatric Dentistry, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey, within the period from March to July 2016. Although the questionnaire part involved 126 children with autism and 111 children without autism, 63 children who did not satisfy the inclusion criteria were excluded from the study in the interview part. The forms were sent to previously determined schools, and factors such as age, socioeconomic status, medical history, dental history, eating habits, bad habits, and treatment methods preferred by children's parents were analyzed. Later, interviews with the children were carried out by the same researcher and their oral health conditions were recorded. RESULTS: Children with autism often have nutritional problems, and early initiation of special education appears effective in preventing these conditions. Although children with autism apply for dental services, the rate for these children receiving dental services is considerably low and most of the services rendered are tooth extractions. CONCLUSION: It appears that the oral status of children with autism is affected negatively by many factors. Thus, the parents, the educators, and the dentists should be aware of this fact and encouraged to improve such children's oral hygiene and provide the dental care they need.

Dentin permeability of carious primary teeth.

BACKGROUND: Many in vitro studies have used dentine permeability to evaluate the efficacy of various restorative and preventative procedures. The easiest way to evaluate dentine permeability is to calculate its hydraulic conductance (Lp) using fluid filtration methods. Research has examined electronic hydraulic conductance measurement methods that give more precise and reliable results for the permeability of dentine than the classical method. To our knowledge, no study has examined the dentine permeability of carious primary teeth. AIM: This in vitro study determined the dentine permeability of carious primary molars precisely with a new electronic hydraulic conductance measurement system and compared them with healthy primary molars. DESIGN: The study examined 60 carious and noncarious primary second molars with no restorations, fractures, or cracks at different root resorption stages. RESULTS: The results showed that the dentine permeability increased with the severity of caries in primary teeth. CONCLUSION: The dentine permeability of carious primary teeth was higher than that of noncarious primary teeth. Therefore, treatment of primary teeth should be performed more quickly.

Probiotics: can they be used to improve oral health?

The role of probiotic bacteria in improving human health has been an attractive subject for researchers since the beginning of the 20(th) century. They have been used to control gastro-intestinal infections, to promote immunity and to prevent various diseases (allergies, urogenital infections, etc.). However, the use of beneficial bacteria in the field of dentistry has only recently gained interest. Investigation of the effects of probiotic bacteria on oral health has become an important research subject. These studies are still in the early stages, however results show that probiotic bacteria are effective against tooth caries, periodontal disease, oral mucosal lesions and oral malodour. This review provides information on the effects of probiotics--well-known for their effects on general health, and therefore more widely used in healthcare--on oral and dental health, in order to promote their use/prescription by physicians and patients.

Who will win the race in childrens' oral cavities? Streptococcus mutans or beneficial lactic acid bacteria?

Adhesion to oral soft and hard tissue is crucial for bacterial colonisation in the mouth. The aim of this work was to select strains of oral lactic acid bacteria that could be used as probiotics for oral health. To this end, the adhesive properties of some lactic acid bacteria were investigated. Seventeen lactic acid bacteria including two Streptococcus mutans strains were isolated from the oral cavity of healthy children, while other strains were isolated from fermented meat products. The bacterial strains were applied to teeth surfaces covered with saliva or without saliva. A significant diversity in adhesion capacity to teeth surfaces among the lactic acid bacteria was observed. Lactic acid bacteria isolated from the oral cavity adhered the best to teeth surfaces covered with saliva, whereas lactic acid bacteria isolated from fermented meat samples adhered the best to tooth surface without saliva. All strains of lactic acid bacteria were able to reduce the number of S. mutans cells, in particular on saliva-coated tooth surface. Therefore, they might have potential as probiotics for the oral cavity.

Longitudinal occlusal changes during the primary dentition and during the passage from primary dentition to mixed dentition among a group of Turkish children.

AIM: To determine the changes in the molar and canine relationships in transition from the primary to the mixed dentition in 98 subjects selected among Turkish children living in the Erzurum city centre. METHODS: This study is based on a 3-year follow-up of 98 children (46 girls, 52 boys) between the ages of 4 and 6 years at the start of the study. The survey focused on the investigation of the changes that appeared in the occlusal relationships in the primary dentition and in the transition to the mixed dentition according to gender and age. RESULTS: The findings indicated that 73.6 % of the 98 cases evaluated in the primary dentition developed a Class I molar relationship, and 26.4 % developed a Class II molar relationship. As 64.3 % FTP, 22.4 % DS, and 13.3 % MS molar occlusal relationships were evaluated at baseline; 22.4 % FTP, 11.2 % DS, and 66.3 % MS molar occlusal relationships were evaluated at the end of the third year. While 75.5 % Class I, 11.2 % Class II, and 13.3 % Class III primary canine occlusal relationships were evaluated at baseline; 53.1 % Class I, 5.1 % Class II, and 41.8 % Class III primary canine occlusal relationships were evaluated at the end of the third year. With increased age, a statistically significant difference (p < 0.001) was found in flush terminal plane, mesial step, and primary canine occlusal relationships and no statistically significant difference (p > 0.05) was found in distal step relationships. CONCLUSION: Malocclusions observed in the primary dentition are signs of malocclusions in the permanent dentition.

Comparison of the reliability of laser Doppler flowmetry, pulse oximetry and electric pulp tester in assessing the pulp vitality of human teeth.

This study was designed to evaluate and compare the reliability of laser Doppler flowmetry (LDF), pulse oximetry (PO) and electric pulp tester (EPT) for assessing the pulpal status as a vitality test method by calculating their sensitivity, specificity and predictive values. Data were collected from 59 pairs of maxillary anterior teeth (38 pairs of central, 21 pairs of lateral incisors) in 51 patients (range 12-18years, mean age 14·6±1·73years, 28 women, 23 men). The teeth with complete endodontic fillings constituted the study group, and the healthy, contralateral teeth of the same patients were constituted the control group. The calculated sensitivity was 0·915 for the EPT and 0·813 for the PO. And the specificity of EPT was 0·881 and PO was 0·949. The difference between the LDF values obtained from the study, and control group was statistically significant (P=0·0001). The findings of this study indicated that LDF can reliably discriminate the vitality of the teeth with a sensitivity and specificity of 1·0 for this sample. Laser Doppler flowmetry was found to be a more reliable and effective method than PO and EPT of assessing the pulpal status of human teeth.

The prevalence of anterior teeth with dens invaginatus in the western Mediterranean region of Turkey.

AIM: To assess the prevalence and type of dens invaginatus in anterior teeth of a selected population and to report associated dental complications. METHODOLOGY: The records of patients examined in the Department of Paedodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey between 1999 and 2006 were screened and a total of 2477 patients who had complete records with satisfactory radiographs were selected. The type of dens invaginatus and the presence of apical pathosis was determined from radiographs. Other dental abnormalities, syndromes and systemic diseases were noted. Variations in crown shape were also recorded. RESULTS: Dens invaginatus was detected in 300 out of 2477 patients, with a prevalence of 12%; 82% of affected patients had dens invaginatus bilaterally. Maxillary lateral incisors were the most affected teeth. The majority of the teeth had normal crown morphology (95%). The most commonly seen type of dens invaginatus was type I (94%). Overall 33% of the patients with type III dens invaginatus and 4% of the patients with type II dens invaginatus had apical pathosis. No associations with other systemic diseases and syndromes and some limited association with hypodontia and dens evaginatus were detected. CONCLUSION: A careful oral examination, radiographs, a suitable treatment plan and follow-up programme are crucial for early diagnosis and treatment for teeth with dens invaginatus.

Case series: a clinical study of 27 cases of dentoalveolar root fractures in children and adolescents.

AIM: This was to assess fracture type, treatment delay, splinting periods and various treatment methods on periradicular healing of root fractures in a group of patients attending a Paediatric Dentistry clinic. METHODS: Records and radiographs of children with root-fractured teeth, referred during 1999-2003, were assessed. STATISTICS: Correlation analysis was performed using Spearman rank test. RESULTS: There were 27 root-fractured teeth in 20 patients aged between 8-18 years. One root-fracture occurred in 13 patients (65%) and 7 (35%) had two root-fractured teeth; all maxillary teeth and the most affected teeth were central, followed by lateral, incisors. Only 4 patients were seen on the day of the trauma. The commonest cause of injury was a fall (12 patients), followed by collisions, bicycle and motorcycle accidents. Treatments consisted of: splinting, splinting+pulp therapy, extraction of coronal fragment accompanied with orthodontic interventions and restorative procedures, and surgical operations. Healing was related to treatment delay, location and type of fracture, and splinting time. Statistical analysis showed significant correlations only between healing type and splinting time. CONCLUSIONS: Preventive educational programs concerning traumatic dental injuries are needed in Turkey and mandatory use of mouthguards and preventive use of helmets with bicycles and motorcycles.

Griscelli syndrome: a case report of Reye's syndrome and atopic dermatitis history.

Griscelli syndrome (GS) is a rare autosomal recessive disorder that results in pigmentary dilution of the skin and the hair (silver hair), with the presence of large clumps of pigment in hair shafts, and an accumulation of melanosomes in melanocytes. Sixty cases of GS have been reported in the literature, but we could find no description of its oro-dental symptoms. Reye's syndrome (RS) is characterized by acute noninflammatory encephalopathy and renal and hepatic failure, while atopic dermatitis (AD) is a skin disorder with an immunologic basis. The aim of this paper is to describe the oro-dental and physical findings in a girl who had been diagnosed with GS at 3.5 years of age; she also had AD as well as a history of RS at infancy. We discuss the possible relationship between the three syndromes.

Clinical features of hypodontia and associated dental anomalies: a retrospective study.

OBJECTIVE: Hypodontia is the most commonly known developmental dental anomaly in man. This paper aims to investigate the characteristics of tooth absence and associated dental anomalies among the patients attending our paediatric dentistry clinic. SUBJECTS AND METHODS: For this study, 192 patients aged between 1 and 18 years with congenitally missing teeth were selected among the patients who attended the Department of Paediatric Dentistry of Süleyman Demirel University between January 2000 and December 2003. Clinical and radiographic examinations were performed by two dentists in order to detect the missing teeth. RESULTS: We determined 503 congenitally missing teeth in 192 patients (male = 93, female = 99), excluding third molars. Twelve of these teeth were deciduous and 491 were permanent. A higher incidence of missing teeth was observed in girls than boys, in mandibular arch than maxillary and on the right side than left side. However the differences between arches and sides were not statistically significant in both sexes. CONCLUSION: The diagnosis of the hypodontia should be performed as early as possible, thus alternative treatment modalities can be planned and performed in a multidisciplinary team approach, in order to establish an aesthetic and functional dentition in the future.

An in vitro study of the diffusibility of intracanal medicaments.

In this study, the diffusion properties of the vapors of four canal antiseptics were examined. Tricresol, camphore-chlorophenol, Cresophene, and povidone-iodine in clinical doses were tested against Staphylococcus aureus and Streptococcus faecalis. Forty-five extracted human maxillary central incisor teeth were used, and their root canals were prepared. A small amount of antiseptic was placed on a cotton pellet in the pulp chamber of each tooth, and the chamber was sealed with Cavit. Vapors from each of the test medicaments produced zones of inhibition on Staphylococcus aureus and Streptococcus faecalis. The study showed that vapors of the test medicaments do pass through the apex of a tooth and thus have a potential effect at the periapical area. The largest zone of inhibition resulted from the vapor of tricresol.

[The characteristics of antibacterial root canal-filling materials]. / Kanal dolgu maddelerinin antibakterial özelliklerinin arastirilmasi.

The filling material of endomethasone Spad, N2, AH26, Diaket, Iod paste which are used in clinics often are evaluated from the point of view of their antibacterial effects to the microorganisms which are isolated from root canals. In the study, streptococcus were defined as the most often producing microorganisms in the canals. It was observed that, on the producing microorganisms, the most effective filling materials were spad and N2, following these were AH26, Diaket the less effective filling materials were endomenthasone and iod paste.