Timing for extraction of permanent first molars in school aged children: a pilot study.

Extraction of permanent first molars (P1Ms) could create gaps, tipping and/or rotating of neighboring teeth, which depend on the extraction timing. This study evaluated the outcomes of P1Ms extraction in children who were classified based on their permanent second molar's (P2Ms) dental calcification at the time of extraction. In this retrospective study, the evaluations were made for 406 panoramic radiographs (PRs) of children aged 7-14 years who had single P1M extracted. Twenty-nine children having pre- and post-treatment PRs were selected based on the inclusion criteria. First, 2 groups were formed based on the extraction time by using the pre-treatment PRs; Early extraction group (EE) (n = 15) including Nolla Grades 5-6-7, and late extraction group (LE) (n = 14) including Nolla Grades 8-9-10 for P2Ms. Then, the inclination degrees of neighbouring teeth on extraction side and contralateral quadrant (non-extraction) side were measured by using the post-extraction PRs. Mann-Whitney U test was employed, and the statistical significance was set at p < 0.05. The mesial tipping tendency of P2M was significant towards the extraction side both at EE or LE calcification grades of P2Ms (p > 0.05). The mesial inclination degrees of maxillary P2Ms showed no statistically significant difference between the two sides of LE group. The ideal extraction time should be determined according to the dental age to plan an appropriate occlusal maintenance.

Structural and mechanical analysis of three orthodontic adhesive composites cured with different light units.

OBJECTIVE: To evaluate the effects of three different curing units on the physical and mechanical features of three different orthodontic adhesive resin materials. MATERIAL AND METHODS: 45 specimens (5 mm in diameter, and 2 mm in thickness) of each of the three different adhesive composite resin materials (Transbond XT, Grengloo™ Adhesive and Light Bond Paste) were cured with three different light units (a polywave third generation (Valo), a monowave (DemiUltra), and a second-generation LED (Optima 10)). To quantify degree of conversion (DC), the Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy was used in transmission mode (ALPHA FT-IR Spectrometer, Bruker Optics, Germany). Vickers hardness value was recorded under constant load 100 g for 10 s with a microhardness tester (HMV M-1, Shimadzu Corp., Kyoto, Japan). The data were statistically analyzed using Kruskal-Wallis and chi-square tests. The level of significance was considered p < 0.05. RESULTS: The highest DC values were obtained as a result of curing with Optima 10. This rate was followed by Demi Ultra and Valo, respectively. Transbond XT samples showed a lower level of conversion than the samples of Light Bond Paste and Grengloo™ Adhesive. The top surfaces of each material showed higher hardness values than the bottom surfaces (p < 0.05). The Light Bond Paste showed the highest hardness values both on the top and bottom surfaces among the three materials, followed by Grengloo™ Adhesive. While the hardness values of the top surfaces of the samples cured with Demi Ultra and Valo light units were similar, higher hardness values are recorded with Valo on the bottom surfaces (Valo; 85.200/75.200 (top/bottom) versus Demi Ultra; 86.100/66.000 (top/bottom)). CONCLUSIONS: The different DC and the surface hardness properties were recorded for the resin as orthodontic adhesives depending on different light units. Shorter radiation time caused lower DC and surface hardness values.

Temporomandibular dysfunction assessment in children treated with the Hall Technique: A pilot study.

BACKGROUND: The Hall technique (HT) involves the placement of stainless steel crowns for treating asymptomatic carious primary teeth without tooth preparation or caries excavation. AIM: To investigate whether temporomandibular dysfunction (TM-D) manifests in children after HT. DESIGN: Healthy children (age: 5-9 years) with dentin caries were treated with HT in a university clinic, and TM-D signs and symptoms were monitored in this cohort clinical trial. The primary outcome was TM-D signs recorded using the clinical dysfunction index (Di) at pre-treatment: 0-, 1-, 3-, 6-, and 12-month follow-up visits. The secondary outcome was TM-D symptoms recorded using a questionnaire. The Di and symptoms were compared over time using McNemar's tests. RESULTS: Thirty-nine children were followed for 12 months after HT treatment. Four children were detected as having dysfunction signs throughout the study: muscle pain on palpation and clicking. The symptoms 'hearing a sound within the jaw joint' or 'bite felt uncomfortable or unusual' were reported by another four children. The Di and TM-D symptoms were not significantly different between pre-treatment and follow-up visits (P > .05). CONCLUSIONS: The HT does not seem to be connected to TM-D. Alternative TM-D assessment tools for studying non-persistent symptoms more comprehensively might be useful for future studies.

Polymerization characteristics of colored compomers cured with different LED units.

AIM:: Incomplete polymerization of a resin material used for dental restoration affects the properties of the restoration. We evaluated the structural and mechanical properties of three different colored compomers cured with three different LED units to observe the characteristic changes occurring in different matches. METHODS:: Polytetrafluoroethylene molds (5 mm in diameter and 2 mm in thickness) were used to prepare disk-shaped sample specimens. Nine sample groups (each of five specimens) were prepared, three each of different compomer resin colors (gold, berry, and silver). Samples were cured using three different LED units (Optima, VALO, and Demi Ultra), according to the manufacturers' instructions. Microstructural properties of samples were characterized by determining the degree of curing using Fourier-transform infrared spectroscopy and by analyzing sample morphology under a scanning electron microscope. The Vickers hardness, compressive strength, and elastic modulus of the samples were measured to investigate their mechanical properties. RESULTS:: The degrees of curing decreased in the order of silver > berry > gold for all curing units. Conversely, gold compomers exhibited poorer mechanical values than the berry and silver counterparts. The Optima 10 unit yielded slightly higher degrees of curing than the other devices, followed by Demi Ultra and VALO light-curing units, respectively. CONCLUSION:: The resin color affected the structural and mechanical properties of the compomers, possibly as a result of the complex interactions and relationships between the irradiation light and resin material, such as light absorbance and reflectance; thus, depending on the color as well as the curing protocol.

The Effect of Parenting Styles on Behavior Management Technique Preferences in a Turkish Population.

Purpose: The purpose of this study was to investigate the association between parenting style and parental preferences for behavior management techniques in a Turkish population. Methods: This cross-sectional study was conducted for a three-month period among the parents and children who applied for treatment in a university clinic. Parenting style was determined using the parenting style dimension questionnaire, and parental dental anxiety (PDA) was rated with the Modified Dental Anxiety Scale. Behavior management technique (BMT) preferences were rated by the parents after a videotape presentation. Chi-square tests and likelihood ratios were used for statistical analysis, and the significance level was set at P<0.05. Results: A total of 142 three- to 12-year-olds (mean age equals 6.83±2.71 years old) and their parents participated in the study. Most parents had an authoritative parenting style and preferred positive reinforcement. Parenting style and PDA were significantly associated with preferences for BMTs (P<0.05). Although the children with high-anxiety parents showed more negative behaviors and the children with low-anxiety parents behaved more positively, this difference was not statistically significant (P>0.05). In addition, PDA was not associated with parenting styles (P>0.05). Conclusions: Parenting style and parental dental anxiety should be considered in the selection of behavior guidance techniques.

Effect of short-term mechanical stimulation on the salivary concentrations of vitamin C, vitamin E, total antioxidant capacity and total oxidant status.

Oxidative stress biomarkers of oral and systemic diseases can be found in saliva. However, there is no uniformity for the saliva collection time in these kinds of analyses and saliva composition may change because of mechanical stimulation. Therefore, the aim of this work was to determine the effect of mechanical stimulation for 10 min on the concentrations of vitamin C, vitamin E, total antioxidants and total oxidants in saliva. Saliva samples from individuals of both sexes, aged between 18 and 38 years, were collected for 10 min at 2 minintervals. Saliva flow rate in each 2 min period was measured, as well the total oxidant state, the total antioxidant capacity, vitamin C and vitamin E concentrations. All analyses were performed in triplicate and were determined using colorimetric tests. The results were analysed using t-test, Friedman's test and analysis of variance (ANOVA) for repeated measures. Mauchly's sphericity test was applied and, if necessary, technical corrections were made using the Greenhouse-Geisser test. We found no significant difference between the amounts of saliva produced across the collection times. Total oxidant status, total antioxidant capacity, vitamin C and vitamin E concentrations remained stable. Based on our findings, saliva can be collected for 10 min or less with masticatory stimulation without any variations in the concentration of the variables analysed. However, we suggest using saliva samples after two minutes of mechanical stimulation.

Structural and mechanical properties of a giomer-based bulk fill restorative in different curing conditions.

The main goal of this study was to compare the polymerization degree of bulk-fill giomer resin cured with three different light-curing units (LCUs): a polywave third-generation (Valo); a monowave (DemiUltra: DU); and a second-generation LED (Optima 10: Opt) LCUs by using structural and mechanical properties. Giomer samples of 2 and 4 mm cured with three LCUs were employed in vitro analysis. The degree of curing (DC%) was determined with Fourier-Transform Infrared Spectroscopy (FTIR). Microstructural features were observed with scanning electron microscopy (SEM). Flexural strength (FS), compression strength (CS), elastic modulus and fracturing strain were determined for mechanical properties. Surface microhardness (SMH) values were also measured. Oneway ANOVA, two-way analysis of variance and Tukey multiple comparison tests were used for statistically analyzing the FS and SMH. DC% values were 58.2, 47.6, and 39.7 for the 2 mm samples cured with DU, Opt., and Valo LCUs, respectively. DC% values of the 4 mm samples were 50.4, 44.6, and 38.2 for DU, Opt, and Valo, respectively. SMH values were Valo, Opt

Quantitative evaluation of dental anxiety indicators in the serum and saliva samples of children treated under general anesthesia.

OBJECTIVES: Dental anxiety level has been previously associated with oral health status. Since general anesthesia (GA) allows dental treatments to be performed in anxious children with a high number of caries, we aimed to evaluate the dental anxiety levels of these children before and after dental treatments performed under GA. MATERIALS AND METHODS: Thirty-eight children with high anxiety aged between 35 and 72 months who required multiple dental treatments to be performed under GA were included in the study. Frankl's Behavior Rating Scale, sitting patterns, Facial Image Scale, and Children's Fear Survey Schedule-Dental Subscale (completed by the children's parents) were recorded before and after the dental treatments performed under GA. Pre-treatment and post-treatment biochemical parameters, including cortisol, alpha-amylase, and chromogranin A levels, in saliva and serum samples were also evaluated. RESULTS: The psychometric scales showed a statistically significant reduction in the post-treatment dental anxiety levels of the children compared with the pre-treatment anxiety levels. Additionally, the biochemical parameters measured in the serum and whole saliva samples showed a decrease after treatments performed under GA. CONCLUSIONS: Our study results suggest that performing dental treatments under GA can reduce the dental anxiety levels of children with a high number of caries.

Structural and mechanical properties of a giomer-based bulk fill restorative in different curing conditions

ABSTRACT Objective: The main goal of this study was to compare the polymerization degree of bulk-fill giomer resin cured with three different light-curing units (LCUs): a polywave third-generation (Valo); a monowave (DemiUltra: DU); and a second-generation LED (Optima 10: Opt) LCUs by using structural and mechanical properties. Material and methods: Giomer samples of 2 and 4 mm cured with three LCUs were employed in vitro analysis. The degree of curing (DC%) was determined with Fourier-Transform Infrared Spectroscopy (FTIR). Microstructural features were observed with scanning electron microscopy (SEM). Flexural strength (FS), compression strength (CS), elastic modulus and fracturing strain were determined for mechanical properties. Surface microhardness (SMH) values were also measured. Oneway ANOVA, two-way analysis of variance and Tukey multiple comparison tests were used for statistically analyzing the FS and SMH. Results: DC% values were 58.2, 47.6, and 39.7 for the 2 mm samples cured with DU, Opt., and Valo LCUs, respectively. DC% values of the 4 mm samples were 50.4, 44.6, and 38.2 for DU, Opt, and Valo, respectively. SMH values were Valo, Opt<DU at top of the samples; Valo<DU, Opt at 2 mm, and DU, Valo<Opt at 4 mm depth. Giomer samples cured with Opt and DU exhibited higher FS values than Valo. CS values were similar but compressive modulus and fracturing strain (%) varied depending on the curing protocol. Conclusions: Based on the results, it can be concluded that curing device and protocol strongly affect crosslinking reactions and thus DC%, SMH, compressive modulus and strain at break values. Consequently, it can be deduced that curing protocol is possibly the most important parameter for microstructure formation of highly-filled composite restoratives because it may bring some structural defects and physical frailties on restorations due to lower degree of polymerization.

The Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate on Molar-Incisor Hypomineralisation: A Pilot Study.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) application on noncarious MIH (molar-incisor hypomineralisation) lesions using a DIAGNOdent device (KaVo), which measures laser fluorescence within the mineral structure of the tooth. MATERIALS AND METHODS: A total of 461 subjects age 7-12 (mean ±â€¯SD was 9.9 ±â€¯1.6) years were examined. Fifty- four children were diagnosed with MIH and divided into 2 groups. A total of 38 teeth met the inclusion criteria and were included in the study. Group 1 subjects (n = 15) used a paste containing 10% CPP-ACP, and group 2 subjects (n = 23) used a paste containing 10% CPP-ACP with 0.2% NaF (CPP-ACFP) for one month. RESULTS: After the application of the pastes for one month, significant decreases were found in the mean DIAGNOdent readings for both groups (CPP-ACP p = 0.0015 and CPP-ACFP p = 0.0001). However, the percentage decreases in both groups were not significantly different from each other (60.4% and 45.5% in CPP-ACP and CPP-ACFP groups, respectively). CONCLUSION: This pilot study shows that using CPP-ACP and CPP-ACFP had a positive effect in reducing hypomineralisation on enamel surfaces of MIH-diagnosed teeth for a one month period. It is important to diagnose molar-incisor hypomineralisation at an early stage to prevent excessive caries develeopment. Therefore, further clinical studies are necessary on the long-term application of these kinds of nanocomplexes.

Quantitative proteomic analysis of the effect of fluoride on the acquired enamel pellicle.

The acquired enamel pellicle (AEP) is a thin film formed by the selective adsorption of salivary proteins onto the enamel surface of teeth. The AEP forms a critical interface between the mineral phase of teeth (hydroxyapatite) and the oral microbial biofilm. This biofilm is the key feature responsible for the development of dental caries. Fluoride on enamel surface is well known to reduce caries by reducing the solubility of enamel to acid. Information on the effects of fluoride on AEP formation is limited. This study aimed to investigate the effects of fluoride treatment on hydroxyapatite on the subsequent formation of AEP. In addition, this study pioneered the use of label-free quantitative proteomics to better understand the composition of AEP proteins. Hydroxyapatite discs were randomly divided in 4 groups (n = 10 per group). Each disc was exposed to distilled water (control) or sodium fluoride solution (1, 2 or 5%) for 2 hours. Discs were then washed and immersed in human saliva for an additional 2 hours. AEP from each disc was collected and subjected to liquid chromatography electrospray ionization mass spectrometry for protein identification, characterization and quantification. A total of 45 proteins were present in all four groups, 12 proteins were exclusively present in the control group and another 19 proteins were only present in the discs treated with 5% sodium fluoride. Relative proteomic quantification was carried out for the 45 proteins observed in all four groups. Notably, the concentration of important salivary proteins, such as statherin and histatin 1, decrease with increasing levels of fluoride. It suggests that these proteins are repulsed when hydroxyapatite surface is coated with fluoride. Our data demonstrated that treatment of hydroxyapatite with fluoride (at high concentration) qualitatively and quantitatively modulates AEP formation, effects which in turn will likely impact the formation of oral biofilms.