Effect of the use of remineralization agents before resin infiltration on the treatment of initial enamel lesions: an in-vitro study.

AIM: This study aimed to evaluate the effect of the use of remineralization agents before the application of resin infiltration on the treatment of initial enamel lesions. MATERIALS AND METHODS: Eighty buccal enamel samples were prepared from human molars, and artificial initial lesions were formed after 96 h of incubation with a demineralizing solution. The samples were randomly divided into 8 groups (n = 10) including a remineralizing agent (Tooth Mousse, Medical Mineral Gel, Remin Pro), resin infiltration (ICON), and a combined treatment of both. Remineralizing agents were applied in pH cycle for 7 days. Baseline, demineralization, and after-treatment fluorescence (FluoreCam and DIAGNOdent Pen), surface microhardness (HMV-2T), surface roughness (M300C), OCT (Maestro-2) and ultrasonic system (Novascope 4500) data were obtained for all groups. The sample surfaces were examined under SEM/EDX (SU3500) at x1000. Data were statistically analyzed using the Two-Way Robust ANOVA and Bonferroni tests (p < 0.05). RESULTS: There was no statistically significant difference between the groups for microhardness, roughness, OCT, DIAGNOdent Pen, ultrasound, and FluoreCam size/intensity values (p = 0.582; p = 0.963; p = 0.884; p = 0.923; p = 0.051; p = 0.268; p = 0.793 respectively). The effect of the treatment procedure showed a significant difference (p < 0.001), except for the roughness values (p = 0.984). The lowest Calcium (Ca) ratio (%atomic) was observed in the RI group in the EDX analysis. CONCLUSION: Remineralizing agents and resin infiltration methods may be used in combination or alone in the treatment of initial enamel lesions. Combining remineralizing agents with resin infiltration does not alter the efficacy of the treatment.

Comparative cell viability of dentin-bonding adhesive systems on human dental pulp stem cells: time-dependent analysis.

BACKGROUND: Restorative materials are in prolonged contact with living tissues such as oral mucosa, dentin, pulp, periodontal, and periapical tissues. Therefore, the potentially harmful effects of these materials and their components on oral tissues should be evaluated before clinical use. This study aimed to compare the cell viability of different adhesive systems (ASs) on human dental pulp stem cells (hDPSCs). METHODS: Three ASs that combining methacryloyloxydecyl dihydrogen phosphate (MDP) monomer with new hydrophilic amide monomers [Clearfil Universal Bond Quick(CUBQ), Kuraray Noritake], self-reinforcing 3D monomer [Bond Force II(BFII), Tokuyama)], and dual-cure property [Futurabond DC(FBDC), VOCO] were used. Three (n = 3) samples were prepared for each group. Dental pulp stem cells were isolated from ten patients' extracted third molar teeth. Samples were incubated in Dulbecco's modified Eagle's medium (DMEM) for 24 h (h), 72 h, and 7 days (d) to obtain extracts. For the control group, cells were cultured without DBA samples. Cell viability of ASs extracts was measured using a cell proliferation detection kit (WST-1, Roche). Statistical analysis was performed using two-way ANOVA and post-hoc (Duncan) tests (p < 0.05). RESULTS: At 24 and 72 h statistically significant differences were determined between control and BFII, control and FBDC groups (p < 0.05), while no differences between control and CUBQ groups (p > 0.05). On the 7th d, statistically significant differences were found between the control and experimental groups (p < 0.05), while no differences between experimental groups (p > 0.05). A statistically significant difference was detected for the BFII group over the three-time interval (p < 0.05). The lowest cell viability was observed for the FBDC group at 24 h, and the difference was statistically significant when compared with 72 h and 7th d (p < 0.05). CONCLUSION: All ASs showed different cell viability values at various exposure times. It should be taken into consideration that pH values, as well as the contents of ASs, have a significant effect on the cell viability.

Evaluation of knowledge and awareness about teledentistry among dentists and patients living in Turkey.

BACKGROUND: Teledentistry is a field of telemedicine that combines digital technology and clinical dentistry, enabling remote communication between dentists and patients. OBJECTIVES: The aim of the present study was to evaluate the knowledge and awareness of dentists and patients about teledentistry in Turkey. MATERIAL AND METHODS: This cross-sectional study was conducted among general and specialist dentists in Turkey, and dental patients in Edirne, Turkey. A questionnaire prepared in Google Docs was shared virtually among Turkish dentists, as well as administered to the patients referred to the university dental clinic in Edirne. RESULTS: Among the 336 dentists participating in the study, 69.9% were female, 39.6% were working in the profession for 1-5 years, and 48.5% were specialist dentists. A total of 86.9% of dentists stated they would like to use teledentistry for radiological examinations, some follow-up examinations, and for follow-up during holidays. There were 21.1% of dentists who thought that teledentistry practices could be the new standard of oral healthcare, and only 34.0% were willing to try such practices. Among the 447 patients in the study, 49.9% were female, 79.0% were aged 20-44 years, and 54.4% had middle income. There were 74.5% of patients who stated that it would be easier to communicate with the dentist via a teledentistry application, 80.3% of patients in the underserved regions stated it would facilitate access to the dentist, 76.3% of patients stated that it would reduce costs, and 88.8% of patients thought that this method could help overcome the problem of isolation during the coronavirus disease 2019 (COVID-2019) pandemic period. CONCLUSIONS: Based on the results, it can be said that the teledentistry approach would provide convenience for both dentists and patients in terms of dentist-patient communication, cost and efficiency of dental care.

Depth of cure, mechanical properties and morphology of dual-cure bulk-Fill composites / Profundidad de curado, propiedades mecánicas y morfología de resinas compuestas duales

This study evaluated selected structural and physical properties, such as degree of conversion (DC), Vickers hardness (VHN), and compression strength (CS), of three new dual-cure bulk-fill resin-based composites (RBCs; ACTIVA, HyperFIL, and Fill-Up) and compared them to those of a conventional RBC (Filtek Z250) at three clinically relevant depths. Samples (n=180) were prepared in three depths (2,4, and 6mm). Fourier-transform infrared spectroscopy (FTIR) analysis and VHN and CS tests were performed. The DC value was calculated by considering the relative change in the aliphatic C=C peaks. The fractured surfaces of representative samples were characterized using scanning electron microscopy (SEM). Data were statistically evaluated using two-way analysis of variance and post hoc Bonferroni tests (p<0.05). According to the VHN results, Filtek Z250 showed the highest bottom/top hardness ratio (97.94±1.01) at 2mm thickness and ACTIVA showed the lowest bottom/top hardness ratio (43.48±5.64) at 6mm thickness (p<0.001). According to the FTIR results, the DC decreased with increasing thickness in all materials (p<0.05). Filtek Z250 showed the highest (301±12.4 MPa) and ACTIVA exhibited the lowest (232±17.2 MPa) CS values at 2mm thickness (p<0.05). The lowest CS values were obtained for ACTIVA, and the highest values were obtained for Filtek Z250 for samples with thicknesses of 4 and 6mm, respectively (p<0.05). The structural features of restorative composites, such as the resin chemistry and filler type and content, and the operational parameters (i.e., material thickness and curing conditions) strongly affect crosslinking reactions and thus the DC, VHN, and CS values.

Este estudio evaluó propiedades físicas y estructurales, como el grado de conversión (DC), la dureza Vickers (VHN) y la resistencia a la compresión (CS), de tres nuevos compósitos a base de resina de curado dual tipo bulk (RBC; ACTIVA , HyperFIL y Fill-Up) y los comparó con los de una resina compuesta convencional (Filtek Z250) en tres profundidades clínicamente relevantes. Se prepararon muestras (n=180) en tres profundidades (2,4 y 6mm). Se realizaron análisis de espectroscopia infrarroja por transformada de Fourier (FTIR) y pruebas VHN y CS. El valor de DC se calculó considerando el cambio relativo en los picos alifáticos C=C. Las superficies fracturadas de muestras representativas se caracterizaron mediante microscopía electrónica de barrido (MEB). Los datos se evaluaron estadísticamente mediante análisis de varianza de dos vías y pruebas post hoc de Bonferroni (p<0,05). De acuerdo con los resultados de VHN, Filtek Z250 mostró la relación de dureza inferior/superior más alta (97,94±1,01) con un espesor de 2mm y ACTIVA mostró la relación de dureza inferior/superior más baja (43,48±5,64) con un espesor de 6mm (p<0,001). De acuerdo con los resultados de FTIR, la DC disminuyó al aumentar el espesor en todos los materiales (p<0,05). Filtek Z250 mostró los valores de CS más altos (301±12,4 MPa) y ACTIVA los más bajos (232±17,2 MPa) a 2mm de espesor (p<0,05). Los valores más bajos de CS se obtuvieron para ACTIVA y los valores más altos para Filtek Z250 para muestras con espesores de 4 y 6mm, respectivamente (p<0,05). Las características estructurales de las resinas compuestas de restauración, como la química; además del tipo y contenido del relleno, y los parámetros operativos (es decir, el espesor del material y las condiciones de curado) afectan en gran medida las reacciones de interacción química y, por lo tanto, los valores de DC, VHN y CS.

Resistance to fracture of simulated external cervical resorption cavities repaired with different materials.

The aim of the study was to evaluate the fracture resistance (FR) of teeth with simulated external cervical resorption (ECR) cavities repaired with different materials. Following the shaping of the 80 human permanent maxillary central incisors, standard ECR cavities were prepared and restored with a nanohybrid composite resin; a high viscosity GIC Equia Forte Fill; Biodentine; Biodentine + nanohybrid composite resin; MTA BIOREP; MTA BIOREP + nanohybrid composite resin. Then, the root canals were obturated with AH Plus and gutta-percha. The roots were embedded acrylic resin blocks and fracture strength test was applied. The highest FR was observed in the Biodentine group, while the lowest was in Equia group (p < 0.05). No significant results were observed among composite, Biodentine + composite, MTA BIOREP + composite and MTA BIOREP (p > 0.05). Biodentine may be a preferable material for repairing ECR cavities. Adding a composite layer on MTA BIOREP and Biodentine did not improve the FR of these materials.

Influence of etching Mode and composite type on bond strength to biodentine using a ''No-Wait'' universal adhesive / Influencia del modo de grabado y del tipo de resina en la resistencia adhesiva al Biodentine utilizando un adhesivo universal tipo "no-wait"

Abstract: The purpose of this study was to compare the shear bond strength (SBS) of four resin-based composite materials to a silicate-based cement using a ''no-wait'' universal bond with self-etch (SE) and etch-and-rinse (ER) modes. Acrylic blocks (n=80, 2mm depth, 5mm diameter central hole) were prepared. The holes were filled with BiodentineTM (BD) and divided into 4 main groups (n=20) according to the composite resin type used: Group FZ250: FiltekTM Z250 Universal Restorative (microhybrid), Group SDR: SDR Plus U Bulk Fill Flowable (low-viscosity bulk-fill), Group FBP: FiltekTM Bulk Fill Posterior (high-viscosity bulk-fill), Group EF: EsFlow™ Universal Flowable Composite (nanohybrid). A 'no-wait' universal bond (Clearfil Universal Bond Quick) was used for bonding application. Then each group was divided into 2 subgroups according to the etching mode applied (ER and SE). SBSs were measured and stereomicroscope was used to identify the failure modes. Selected samples of fracture surfaces were imaged by SEM. Tukey's post-hoc and One-way ANOVA tests were used to analyze data. There were statistically significant differences among the composite groups (p 0.05). The SBS of BD to the resin composites depends on the composite type but application of the 'no-wait' universal bond in different etching modes is regardless of the SBS of BD to resin composites.

Resumen El objetivo de este estudio fue comparar la resistencia de adhesión al cizallamiento (SBS) de cuatro resinas con un cemento a base de silicato utilizando una adhesivo universal "no-wait" de autograbado (SE) y grabado y lavado (ER). Se prepararon bloques acrílicos (n=80, de 2mm de profundidad y un agujero central de 5mm de diámetro). Los agujeros se rellenaron con BiodentineTM (BD) y se dividieron en 4 grupos principales (n=20) según el tipo de resina compuesta utilizada: Grupo FZ250: FiltekTM Z250 Universal Restorative (microhíbrido), Grupo SDR: SDR Plus U Bulk Fill Flowable (bulk-fill de baja viscosidad), Grupo FBP: FiltekTM Bulk Fill Posterior (bulk-fill de alta viscosidad), Grupo EF: EsFlow™ Universal Flowable Composite (nanohíbrido). Para la aplicación de la adhesión se utilizó un adhesivo universal "no-wait" (Clearfil Universal Bond Quick). A continuación, cada grupo se dividió en 2 subgrupos según el modo de grabado aplicado (ER y SE). Se midieron los SBS y se utilizó el estereomicroscopio para identificar los modos de fallo. Las muestras seleccionadas de las superficies de fractura se analizaron mediante SEM. Se utilizaron las pruebas post-hoc de Tukey y ANOVA de una vía para analizar los datos. Hubo diferencias estadísticamente significativas entre los grupos de composites (p0,05). La SBS de la BD a los composites de resina depende del tipo de composite, pero la aplicación de la unión universal "no-wait" en los diferentes modos de grabado es independiente de la SBS de la BD a los composites de resina.

Perceptions of dental students towards online education during the COVID-19 pandemic.

PURPOSE: This study evaluated the usage habits, attitudes, and perceptions of undergraduate dental students toward distance (online) learning and identified variables related to those attitudes. MATERIALS AND METHODS: The study included 1,605 undergraduate dental students who participated voluntarily. The data collection tool consisted of a distance learning attitude scale, a questionnaire on personal information, and open-ended questions. The perceptions of dental students to distance education according to the year and type of dental school they attended were evaluated. RESULTS: Most students expressed that distance learning in dental courses was not as effective as traditional face-to-face education (59.1%, n=949). While students studying at state universities had a more negative view of distance education, the satisfaction scores of the first-year students were found to be significantly lower than the other students (p<0.05). CONCLUSION: Dental students were generally unhappy with the interruption of traditional education caused by COVID-19 and having to continue their education online. However, under the circumstances, they saw it as an advantage allowing them to continue their education and avoid a complete suspension.

Knowledge, stress levels, and clinical practice modifications of Turkish dentists due to COVID-19: a survey study.

Dentists are exposed to the highest risk of occupational respiratory and droplet infections by working face-to-face with patients. The aim of this study was to investigate the knowledge of symptoms and modes of transmission of COVID-19, stress levels and clinical practice modifications of Turkish dentists during the COVID-19 pandemic. An online survey (15 questions) was sent to Turkish dentists from May 5 to 12 May, 2020. The survey comprised questions about dentists' demographic characteristics, their knowledge about COVID-19, stress levels and the measures taken in dental clinics against COVID-19. This study included a total of 1,095 Turkish dentists. The data were expressed as frequency with percentage values for overall variables. Dentists were most familiar with high fever among the symptoms of COVID-19 (99.4%) and 99.2% of them reported that COVID-19 was transmitted with eye, mouth and nasal mucosa contact on surfaces contaminated with the droplets of infected persons. While the stress levels of females were higher than males, the stress levels of dentists with more than 20 years of professional experience were found to be lower. Regarding the precautions to be taken as a preventive measure when working again, 86.6% of the dentists took precautions by increasing daily patient care intervals and only 38.4% of the dentists wore an N95 mask. During this pandemic, knowing the conditions about when the treatments can be applied and the precautions to be taken will shed light on dentistry staff. Current recommendations of national authorities about the coronavirus should be followed.

Dentin erosion preventive effects of various plant extracts: An in vitro atomic force microscopy, scanning electron microscopy, and nanoindentation study.

The overall consumption of acidic beverages has become more common, making the prevention and treatment of dental erosion an important consideration. The aim of this in vitro study was to evaluate the effect of various plant extracts in preventing dentin erosion. Seven experimental groups (fluoride-free water, fluoride-containing mouthwash [Colgate Plax], green tea, rosehip, clove, pomegranate, and grape seed) were formed, each consisting of 20 bovine dentin samples. The specimens were exposed daily to demineralization and remineralization cycles three times per day over 5 days through a 5-min plant extract application before each erosive episode. Surface roughness, nanohardness values, and morphological changes on dentin surfaces were examined using atomic force microscopy (AFM), nanoindentation, and scanning electron microscopy (SEM). The data were subjected to Kruskal-Wallis and Friedman tests (p < .05). There were statistically significant differences between the groups in terms of nanohardness values (p < .05), except for the pomegranate and grape seed groups. The highest nanohardness value was observed in the clove group (1.24 ± 0.34 GPa), whereas the lowest nanohardness value was noted in the grape seed group (0.20 ± 0.04 GPa). The nanohardness values of positive and negative control groups after erosion cycles were statistically higher than the initial nanohardness values (p < .05).There was no statistically significant difference between the groups in surface roughness values (p > .05). Macromolecular deposits were observed both in the SEM and AFM images of the pomegranate, Colgate, and rosehip groups. It can be concluded that the clove extract group is more successful in preventing dentin erosion than the other groups. Green tea is also effective in preventing dentin erosion, similar to clove extract. The application of plant extracts may be a new treatment strategy in preventing dentin erosion. Plant extracts may also reduce the severity of existing dentin erosion. Clove and green tea extracts may present novel natural therapy potential by inhibiting dentin erosion.

Knowledge, stress levels, and clinical practice modifications of Turkish dentists due to COVID-19: a survey study

Abstract: Dentists are exposed to the highest risk of occupational respiratory and droplet infections by working face-to-face with patients. The aim of this study was to investigate the knowledge of symptoms and modes of transmission of COVID-19, stress levels and clinical practice modifications of Turkish dentists during the COVID-19 pandemic. An online survey (15 questions) was sent to Turkish dentists from May 5 to 12 May, 2020. The survey comprised questions about dentists' demographic characteristics, their knowledge about COVID-19, stress levels and the measures taken in dental clinics against COVID-19. This study included a total of 1,095 Turkish dentists. The data were expressed as frequency with percentage values for overall variables. Dentists were most familiar with high fever among the symptoms of COVID-19 (99.4%) and 99.2% of them reported that COVID-19 was transmitted with eye, mouth and nasal mucosa contact on surfaces contaminated with the droplets of infected persons. While the stress levels of females were higher than males, the stress levels of dentists with more than 20 years of professional experience were found to be lower. Regarding the precautions to be taken as a preventive measure when working again, 86.6% of the dentists took precautions by increasing daily patient care intervals and only 38.4% of the dentists wore an N95 mask. During this pandemic, knowing the conditions about when the treatments can be applied and the precautions to be taken will shed light on dentistry staff. Current recommendations of national authorities about the coronavirus should be followed.