Evaluation of Possible Associated Factors for Early Childhood Caries and Severe Early Childhood Caries: A Multicenter Cross-Sectional Survey.

OBJECTIVES: The present study evaluated associated factors for developing early childhood caries (ECC) and Severe-ECC (S-ECC) in a group of children aged 24-71 months. Potential positive effects of early dental visit on formation of ECC is investigated as well. STUDY DESIGN: This was a multicenter, cross-sectional study conducted at three governmental and university pediatric dentistry clinics in 408 preschool children who were randomly selected from a total of 4116 children. The questionnaires administered to the mothers by interview and intraoral examination performed by calibrated pediatric dentists. The children were evaluated in three groups according to their caries experience as who had caries free, ECC and S-ECC. RESULTS: The following factors were significantly associated with caries formation: 1. Prolonged (i.e., >18 months) breastfeeding in preterm babies (OR=2.4) 2. Prolonged breastfeeding in children who started tooth brushing after 1.5 years of age (OR=3.7), 3. Sugar (p<0.001) and fruit-juice consumption (p<0.0001), and 4. Lack of periodic dental examination (p<0.05). Parental smoking habit does not significantly affect ECC development. Nocturnal bottle feeding and nocturnal feeding also affected S-ECC formation significantly (p=0.043 and p=0.005, respectively). CONCLUSIONS: There is a significant difference between the children with caries and caries-free associated with the brushing initiation age started before or after 18 months. If a child is under the risk of multiple caries factors, it is very difficult to evaluate which habits affect the caries formation or increase the severity of the caries lesions.

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.

Three-dimensional tooth crown size symmetry in cleft lip and cleft palate.

OBJECTIVE: To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. MATERIALS AND METHODS: Dental casts of 72 individuals with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], and 18 unilateral right [URCLP]) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. RESULTS: Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P < .01); LL dimension: mandibular first premolar (URCLP, P < .05); OG dimension: maxillary central incisor and first premolar (ULCLP, P < .05 and P < .01, respectively), central incisor (BLCLP, P < .01), mandibular canine and first premolar (ULCLP, P < .01), and first molar (ULCLP, P < .05). Tooth crown size asymmetries were also recorded in the Class I group. CONCLUSIONS: Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group.

Turkish women's self-reported knowledge and behavior towards oral health during pregnancy.

OBJECTIVES: The purpose of this study was to evaluate oral health care knowledge and behavior of women during pregnancy. SUBJECTS AND METHODS: The study population consisted of 351 mothers with children under 3 months of age who presented at Gülhane Medical Academy's Department of Pediatrics for a routine child check-up. Mothers were asked to complete a questionnaire about their knowledge and behavior regarding dental care during pregnancy. RESULTS: All the women who participated in the study had dental insurance, and most of them had high levels of education. Of the 351 mothers, 263 (75%) had heard about possible connections between oral health and pregnancy outcome, and 165 (47%) believed tooth and periodontal problems could affect pregnancy outcome. However, 256 (73%) women still believed that calcium would be drawn out of their teeth by the developing baby, and 151 (43%) believed in the erroneous statement 'A tooth for a baby'. 241 (68.7%) women had experienced oral health problems during pregnancy; however, only 48 (13.7%) visited a dentist during their pregnancy. CONCLUSIONS: Turkish women, despite having knowledge that adverse pregnancy events may be related to dental and periodontal problems, did not seek oral health care during pregnancy. This suggests the need to better educate medical providers to inform pregnant women to obtain oral health care during pregnancy.

Effects of deep sedation on behaviors and side effects in children undergoing different dental procedures.

PURPOSE: The purpose of this study was to determine behavioral characteristics and side effects in children undergoing restorative dental treatment with or without dental extractions under deep sedation. METHODS: This study comprised 68 healthy 4- to 7-year-old children; 34 each were assigned to extraction and restorative groups. Children's behaviors were assessed using the following scales: (1) modified Frankl scale (preoperative period); (2) modified Houpt behavior rating scale (venipuncture period); and (3) modified Wilton behavior scale (recovery period). All complications observed during and after sedation were also recorded. RESULTS: The occurrence of agitation was higher in the extraction group; however, this difference was statistically significant only at 15 minutes after completion of sedation. In both groups, the most common side effects observed were: involuntary movement (during sedation); sleepiness; agitation and dizziness (during the early recovery period); irritability; crying; and sleepiness (following hospital discharge). CONCLUSIONS: Agitation may be observed during procedures involving extractions. Few side effects were observed during and after the sedation procedure in both groups.

Treatment of aggressive external root resorption with calcium hydroxide medicaments: a case report.

Intrusive luxation is an injury involving the axial displacement of a tooth into the alveolar socket. This paper describes apexification using calcium hydroxide medicaments of an immature permanent central incisor in which spontaneous re-eruption as well as severe inflammatory external root resorption was observed following traumatic intrusion. A 10-year-old boy was referred to the Department of Pediatric Dentistry 3 days after having fallen at school. Intraoral examination revealed intrusive luxation and an enamel-dentin crown fracture of the maxillary left central incisor (Tooth 21). The tooth was not sensitive to percussion and responded positively to electric pulp test. Radiographic examination indicated that the tooth had an open apex and had been intruded approximately 3-4 mm relative to the cemento-enamel junction of the adjacent right central incisor. The tooth was left for possible spontaneous re-eruption. The crown fracture was temporarily restored using glass ionomer cement, and the patient was scheduled for recall in 2 weeks, at which time intraoral examination revealed spontaneous re-eruption of the tooth. However, radiographic examination also showed inflammatory external root resorption. The root canal was accessed and filled with a calcium hydroxide paste; however, follow-up examination indicated continuing resorption after 1 month. Calcium hydroxide plus points (CHPP) was chosen as an alternative treatment. At the end of 6 months of CHPP treatment, examination showed no further progression of external resorption and complete apexification of the tooth. After a 24-month follow-up period, no signs of pathosis were observed.

Cytotoxic effects of halogen- and light-emitting diode-cured compomers on human pulp fibroblasts.

OBJECTIVE: The aim of this study was to determine the cytotoxic effects of three different compomers (Dyract AP, Compoglass, and Hytac) cured using a halogen light-curing unit (LCU) and a light-emitting diode (LED) LCU on human pulp fibroblasts. METHODS: Specimens of three compomers were added to human pulp fibroblast cultures. Cytotoxicity was evaluated over 96 h using the agar overlay method. RESULTS: All three compomers tested were found to be moderately cytotoxic to human pulp fibroblasts, regardless of whether they were cured using halogen or LED LCUs. The decolorization zone of Hytac was significantly larger than those of the other compomers tested (P < 0.05). Dyract AP and Compoglass specimens showed greater decolorization when cured with LED than with halogen LCUs (P < 0.05). CONCLUSION: Compomers are potentially toxic to human pulp fibroblasts, and the type of curing unit may affect compomer toxicity.

Evaluation of 3-dimensional tooth crown size in cleft lip and palate patients.

INTRODUCTION: The aims of this study were to evaluate 3-dimensional (3D) tooth crown sizes in patients with cleft lip and palate (CLP) and to compare them with those of a Class I control group. METHODS: Orthodontic dental casts were used of 72 subjects with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], 18 unilateral right [URCLP]) and 53 adolescents in the permanent dentition stage with Class I occlusion. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements were recorded by the same examiner using a digital caliper. Statistical analyses were conducted, including repeatability, analysis of variance (ANOVA), and the Duncan tests. RESULTS: Maxillary and mandibular premolar MD dimensions were larger in the CLP groups than in the control group. The smallest MD dimensions were those of the maxillary right lateral incisors in the BCLP group (P <0.05). The maxillary left lateral incisor MD dimensions in the ULCLP group were smaller when compared with other CLP groups (P <0.001). In general, all LL and OG measurements were smaller in the CLP groups than in the Class I group in both dental arches. CONCLUSIONS: In general, MD, LL, and OG dimensions of CLP patients were smaller than those of the Class I subjects, not only in the affected maxillary dental arch, but also in the mandibular dental arch. Variations in 3D tooth dimensions were found among all CLP types. The lateral incisor in the cleft region was the smallest. A 3D tooth-size evaluation should be included in the diagnostic records to determine precise treatment planning and final occlusion in CLP patients.

Familial occurrence of nonsyndromal multiple supernumerary teeth. A rare condition.

The occurrence of multiple supernumerary teeth is a rare phenomenon and is often found in association with syndromes such as cleidocranial dysplasia, Gardners syndrome, or cleft lip and palate. Only a few examples of nonsyndromal multiple supernumerary teeth have been reported in the literature. There is a predilection for the mandible and in the premolar area followed by the molar and anterior regions. This article reports the presence of nonsyndromal multiple supernumerary teeth involving both jaws in children and in their mothers. The clinical and radiographic appearance of the anomalies and treatment modalities are discussed.

Effects of saliva contamination on shear bond strength of compomer to dentin in primary teeth.

PURPOSE: To investigate the effects of saliva contamination on the bond strengths of two compomers applied to primary teeth dentin during different bonding stages. METHODS: 30 extracted human non-carious primary molars were prepared for shear bond-strength testing. Specimens were randomly divided into three groups of 10. Prime & Bond NT (acetone-based) and Futura Bond A & B (water-based) adhesives were tested under the following conditions: (a) non-contaminated conditions; (b) after contamination of the dentin surface with fresh whole saliva for 20 seconds and removal of excess saliva before adhesive application; and (c) contamination of the dentin surface with fresh whole saliva for 20 seconds and removal of excess saliva after adhesive curing. Following adhesive application Dyract AP or Glasiosite was applied via a polytetrafluroethylene split mould and light-cured to the dentin surface. Shear bond strengths were measured using an Instron Universal testing machine running at a crosshead speed of 1 mm/minute. After measuring shear bond strengths, specimens were prepared for SEM evaluation and identification of failure type. Results were analyzed by two-factor experiment with repeated measures as one factor. RESULTS: No statistically significant differences were found among the shear bond strengths (P > 0.05) of the groups. The results revealed that saliva contamination of dentin surfaces before or after adhesive application did not affect the shear bond strength of either compomer.

Regional odontodysplasia: report of a case.

Regional odontodysplasia is a rare developmental anomaly involving both mesodermal and ectodermal dental components in groups of contigous teeth. RO affects the primary and permanent dentition in the maxilla and mandible or both jaws. Generally, it is localized in only one arch. The maxillary arch is affected more often than the mandibular arch. The affected teeth tend to be in a consecutive series that does not cross the midline, although some cases do not follow this pattern, as in the present case, have been documented. Radiogaphically wide pulp chambers and thin poorly defined hard tissue outlines described as a "ghost teeth" appearance, are typical features. A case of regional odontodysplasia in a 5 year old male patient is presented. The clinical and radiogaphical findings of this developmental anomaly and treatment are described.

Dentin dysplasia type I: report of atypical cases in the permanent and mixed dentitions.

Dentin dysplasia type I is a rare hereditary disturbance of dentin formation characterized clinically by nearly normal appearing crowns and severe hypermobility of teeth. Radiographic analysis shows obliteration of all pulp chambers, short, blunted, and malformed roots, and periapical radiolucencies of noncarious teeth. This paper presents 2 cases demonstrating both classic and atypical features of type I dentin dysplasia in the mixed and permanent dentitions. The clinical, radiographic, and histopathologic\findings of this condition and treatment are described.