Anti-microbial efficiency of gaseous ozone's combined use with fluoride and chlorhexidine on time-related oral biofilm: an in situ study on pediatric patients.

Oral biofilm formation is the main reason for both caries progression and soft tissue diseases. Preventing the formation and promotion of biofilm has been known as the first attempt to prevent the development of caries and soft tissue problems in the oral cavity. The present study aimed to assess the effect of ozone and its combined use with chlorhexidine (CHX) and fluoride on the complex biofilm formation of pediatric patients under in situ conditions. Extracted bovine teeth were sterilized and cut into 2 × 3 mm2 sections. The samples were placed in removable maxillary plates and 10 healthy individuals (6 boys, 4 girls; aged 7-14 years) were asked to wear these plates for 6, 24 and 48 hours. Afterwards, the tooth samples were removed, and anti-plaque agents were applied to the time-related plaque formation. Plaque thickness and viable bacterial percentages were detected by confocal laser scanning microscopy. All materials used in the study decreased the plaque formation and the percentage of viable microorganisms compared with the control group (physiological saline). In 6- and 24-hour biofilm evaluations, ozone-CHX was the most effective group in decreasing the plaque thickness (P > 0.05). Ozone-CHX and Ozone-Fluoride groups were found to be better in 48-hour biofilm assessments in caries-free group (P > 0.05). Ozone-CHX group showed a better inhibitory effect on the viability of microorganisms in 6-, 24- and 48-hour biofilm formations (P < 0.05). Although CHX has been known as the gold standard for inhibiting the oral biofilm formation, according to the results of the study, gaseous ozone and its combined use with CHX have shown better results in reducing the biofilm thickness and viable bacterial percentages of in situ formed time-related biofilm formation in pediatric patients. The use of gaseous ozone can be preferred in clinical conditions in pediatric patients instead of the CHX agents.

A Comparison of Hard and Soft Occlusal Splints for the Treatment of Nocturnal Bruxism in Children Using the BiteSTRIP®.

OBJECTIVE: Bruxism is defined as a parafunctional activity. It could be in diurnal or nocturnal form, based on the time it occurs. The purpose of the study compares the effectiveness of occlusal splint treatments in children with nocturnal bruxism using the BiteStrip®. STUDY DESIGN: The muscle activity of children was measured using the BiteStrip®. The groups used occlusal splints during nighttime sleep for three months, at the end of which their muscle activity were measured again through the use of the BiteStrip®. RESULTS: Muscle pain in palpation and pain in the dynamic position of TMJ pain was significantly reduced in patients using soft occlusal splint (p=0.01). There was no significant change in the BiteStrip® score in both group I (p=0.11) and group II (p=0.61). CONCLUSION: Soft occlusal splints could reduce pain caused by nocturnal bruxism on muscle and TMJ. The relationship between treatment results and BiteStrip® scores of patients using soft occlusal splint or hard occlusal splint are not significantly.

Does the heat generated by fluorescence-aided caries excavation system effect the pulp temperature of primary teeth irreversibly? An in-vitro evaluation of the temperature changes in the pulp chamber.

BACKGROUND: This study aimed to analyze the effect of the Fluorescence Aided Caries Excavation (FACE) and the remaining dentin thickness on the temperature changes of the pulp chamber. MATERIAL AND METHODS: Freshly extracted deciduous molars and a pulpal microcirculation model were used in the study. The sample size was calculated according to power analyses (power at 90%) based on previous studies. Thus, 40 samples were needed. Standard cavities (3x3 mm) were designed to obtain a 2 mm distance through to the pulp chamber, and in each tooth (n=10), these cavities were modified to obtain 1.5 mm, 1mm, and 0.5 mm final distance through to the pulp. Coronal parts of the teeth were placed on an acrylic plate with three gaps for feeding and extraction needles and the thermocouple. The temperature changes were recorded from the initial time to 15 s and 30 s,1 min, 1.5 min, 2 min, 2.5 min, 3 min intervals. RESULTS: The results showed that hence the thickness between cavity floor and pulp chamber was decreased, and application time of FACE was increased, an increase in temperature changes was detected. However, the recorded values were not mean to cause irreversible damages to the pulp chamber. CONCLUSIONS: The recent study showed that Face is an appropriate caries detecting system that does not affect the pulp chamber's health, and it can be safely used in the primary teeth. Key words:Caries assessment, dental caries, dental pulp, pediatric dentistry.

Evaluation of calcium (Ca2+) and hydroxide (OH-) ion diffusion rates of indirect pulp capping materials.

INTRODUCTION: The aim of this study was to evaluate and compare the calcium (Ca2+) and hydroxide (OH-) ion release of 4 artificially produced pulp capping materials (MTA, Biodentin, TheraCal LC, Calsimol) used for indirect pulp capping treatment. METHODS: In total, 70 freshly extracted human third molar teeth were used for the study. Cavities of extracted teeth were prepared by round burs. The remaining dentin thickness (1 ± 0.3 mm) tissue was measured by a micrometer and cone beam computerized tomography. Indirect pulp capping was performed in the cavities using Calcimol, MTA, TheraCal LC and Biodentin. The leached Ca2+ were measured using optical emission spectrometry and the release of OH- ions using a pH meter. The measurements were performed after 24 hours, 7 days and 28 days in saline solution. Statistical analysis was performed using 1-way and 2-way analysis of variance (ANOVA) tests (p<0.05). RESULTS: Ca2+ ions were detected in treated saline solution during the experimental period for all materials. All the measurements of Biodentin and Theracal LC levels for Ca2+ ions were higher than those of the other materials (p<0.05). For all materials, Ca2+-ion release increased during the first 7 days followed by a linear decrease during the subsequent study periods. The Biodentine group showed the highest OH- ion rates compared to the other materials in the 24-hour examination period, while the scores gradually decreased during the subsequent measurement periods (p<0.05). CONCLUSIONS: Tricalcium silicate materials such as Biodentine and TheraCal LC used in this study may be preferable for indirect pulp capping because of their stimulation of hard tissue formation and ion-releasing ability.

Effect of toothbrushing on color changes of esthetic restorative materials.

PURPOSE: The aim of this study was to evaluate the effects of various drinks and toothbrushing on the color changes of esthetic restorative materials used in pediatric dentistry. MATERIALS AND METHODS: Forty specimens were prepared from each of three restorative materials (compomer [Dyract AP], glass ionomer cement [Ionofil Molar AC, Voco], composite resin [Filtek Z 250]). Specimens were divided into four groups for immersion in three different staining solutions (cherry juice, cola, chocolate milk) and distilled water. Each group was subdivided into brushing and non-brushing groups. The specimens in the brushing subgroups were brushed with toothpaste once a day using an electric toothbrush. Color was measured using a colorimeter, and color changes were calculated between baseline and 1, 7, 30, 60 days. Data was analyzed using Kruskal-Wallis, Mann-Whitney U, Wilcoxon, and Wilcoxon Signed Rank tests. RESULTS: All the solutions evaluated yielded color changes, and these changes were significantly greater for composite resin than for glass ionomer cement or compomer (p < 0.006). Brushing significantly decreased the color changes of restorative materials (p < 0.004). CONCLUSION: Brushing significantly influenced the color stability of esthetic restorative materials. The results of this study also showed that glass ionomer cements and compomers had higher color stability than composite resins. CLINICAL SIGNIFICANCE: The color stability values after brushing may better reflect the discoloration of the esthetic restorative materials. Any color stability study model should consider the effects of toothbrushing that can remove the adsorbed colorants. The results of this study also showed that glass ionomer cements and compomers can be used in anterior restorations of children with their higher color stability than composite resins.