Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study.

Objectives: The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods: Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results: The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions: The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

Comparison of the opinions and attitudes of medical doctors, dentists and mothers toward teething symptoms.

BACKGROUND: The signs and symptoms associated with teething can be local or systemic. It remains unclear whether the disturbances are caused by the eruption of primary teeth or whether they simply coincide with tooth eruption. Parents and healthcare professionals can have different perceptions about teething symptoms, especially in different cultural or socio-economic contexts. OBJECTIVES: The study aimed to compare the opinions and attitudes of medical doctors, dentists and mothers toward the symptoms of teething. MATERIAL AND METHODS: Data about the signs and symptoms was collected using a researcher-made questionnaire. The questionnaire was mailed in December 2019 to 800 randomly selected medical doctors and dentists working in the Central Aegean Region of Turkey. Mothers of children aged 0-3 years who were referred to the pediatric department were selected for the study. Data from 199 medical doctors (109 family physicians, 90 pediatricians), 293 dentists (169 general dentists, 124 pediatric dentists) and 352 mothers who completed the questionnaire was included in the study. The data was analyzed using the IBM SPSS Statistics for Windows program. RESULTS: Each participant identified at least one symptom related to teething. Statistically significant differences were found between the 3 groups in terms of symptoms except for stomach ache (p < 0.05). Gingival irritation was the most common symptom among dentists (95.6%) and mothers (70.7%), while irritability was the most common symptom among medical doctors (90.5%). Mothers believed to a greater extent than the other groups that fever, vomiting and cough were associated with teething (p < 0.05), whereas medical doctors tended to point to drooling, irritability, biting/chewing, diarrhea, and ear rubbing more often than the other groups (p < 0.05). In addition, sleep disturbance and loss of appetite were associated with teething less frequently by mothers as compared to the other groups (p < 0.05). CONCLUSIONS: In the present study, medical doctors, dentists and mothers reported unproven and controversial associations between teething and certain local or systemic symptoms. Mothers especially were more likely to believe that systemic symptoms that can be confused with other serious diseases were associated with teething.

The prevalence and influencing factors of gag reflex in children aged 7-14 years in the dental setting.

BACKGROUND: Gag reflex may occur in patients of all ages and often considered having a multifactorial aetiology. OBJECTIVE: The aim of the study was to evaluate the prevalence and influencing factors of gag reflex in Turkish children aged 7-14 years in the dental setting. METHODS: This cross-sectional study was carried out among 320 children aged between 7 and 14 years. First, an anamnesis form which include sosyodemographic status, monthly level of income, children past medical and dental experiences was filled by mothers. Children's fear levels were evaluated using the Dental Subscale of Children's Fear Survey Schedule(CFSS-DS) while mother's anxiety levels using the Modified Dental Anxiety Scale(MDAS). The revised dentist section of gagging problem assessment questionnaire (GPA-R-de) was used for both children and mothers. Statistical analysis was done with SPSS program. RESULTS: The prevalence of gag reflex among children was 34.1%, among mothers was 20.3%. The association between child and mother gagging was found statistically significant (χ2  = 53.121, p < 0.001). When the mother of the child gagged, the risk of child gagging increases 6.83 times (p < 0.001). Higher CFSS-DS scores of children increase risk of gagging (OR = 1.052, p = 0.023). Children who were previously treated mostly in public hospitals significantly more likely to gag compared with private dental clinics (OR = 10.990, p < 0.001). CONCLUSION: It was concluded that negative past dental experiences, previous dental treatments with local anaesthesia, history of hospital admission, number and place of previous dental visits, dental fear level of children, and low education level and gagging of mother have an influence on the gagging of children.

Shaping ability of novel nickel-titanium systems in printed primary molars.

BACKGROUND: Manual or mechanized instruments can be used for root canal preparation. Manual instrumentation using K-files is widely used in primary teeth, but there are many limitations. Mechanized root canal preparation can lead to easy access to all canals, decrease instrumentation time, and result in more funnel-shaped root canals, resulting in a more predictable uniform paste fill. AIM: This study aimed to evaluate the shaping ability and instrumentation time of VDW.ROTATE™ and EdgeTaper Platinum™ during the preparation of resin-printed primary molars. Hand K-files were used as a reference for comparison. DESIGN: Sixty-six resin-based maxillary second primary molars, obtained from extracted tooth cone-beam computed tomography (CBCT) image and printed on a three-dimensional printer, were divided into three groups: VDW.ROTATE™, EdgeTaper Platinum™, and K-files. The specimens were scanned using CBCT imaging before and after root canal preparation. Images were registered using a dedicated software, and changes (Δ) in the canal area, volume, and untouched canal surface were calculated. Instrumentation time was evaluated. Data were statistically analyzed using the SPSS program. RESULTS: There was no significant difference among the tested file systems for Δ canal volume and area (p > .05). VDW.ROTATE™, however, showed significantly lower untouched canal surface area than other systems in all roots (p < .001). The VDW.ROTATE™ was found to be significantly faster (6.47 ± 0.39 min) than EdgeTaper Platinum™ (7.71 ± 0.73 min) and K-files (8.22 ± 0.72 min), (p < .05). CONCLUSIONS: The shaping ability and the instrumentation time were directly influenced by the root canal instrumentation system used during the preparation of resin-printed primary molars, with VDW.ROTATE™ being the faster system and associated with the lower amount of untouched canal surface area.

The effect of parental presence and dental anxiety on children's fear during dental procedures: A randomized trial.

Objective: To evaluate the effect of anxiety of parent accompanying child on child's anxiety during treatment. Methods: The study included two groups: one group with 80 children whose parents were anxious, and the other group with 80 children with non-anxious parents, totaling 160 children. Each group was further randomized into subgroups, with and without parents accompanying their children. The children's heart rates were measured using a portable pulse oximeter during the treatment. The child's perception was measured using the Wong-Baker Faces Rating Scale, and another pediatric dentist rated child's behavior using the Frankl scale based on the treatment video that was limited to the child's appearance. Results: The highest pulse rates were observed in children accompanied by an anxious parent (p < .001). Values on the Wong-Baker scale did not differ according to parental anxiety and parental presence (p > .05). According to the dentist, the presence of parents negatively affected the anxiety of the child (p = .025), while the effect of parents' anxiety was not statistically significant (p = .514). Conclusions: The anxiety of parent accompanying the child affects child's anxiety. Parents with high anxiety appeared to negatively affect their children's behavior.

An 18-Month-Old Child with Infantile Pompe Disease: Oral Signs.

We aim to create an information platform by contributing orodental findings of Pompe disease to literature. An 18-month-old male patient with Pompe disease was referred to our clinic due to swelling of the gums. In first dental examination, a nonfluctuant, normal gingiva colored swelling at the right anterior region of maxilla was detected. His parents were recommended to perform finger massage to the region. Six months later, 51, 52, 62, and 74 numbered teeth had erupted, there was a fusion between 51 and 52 numbered teeth, 84 numbered tooth was seen to be erupted, and a swelling at the site of this tooth, similar to previous one, was present. Finger massage was recommended for this area as well, and the swelling was found to have decreased at the follow-up, one week later. Tooth eruption problems and developmental dental abnormalities should be included in the signs for Pompe disease.