Synthesis, Antimicrobial Activities, and Molecular Modeling Studies of Agents for the Sortase A Enzyme.

Sortase A (SrtA) is an attractive target for developing new anti-infective drugs that aim to interfere with essential virulence mechanisms, such as adhesion to host cells and biofilm formation. Herein, twenty hydroxy, nitro, bromo, fluoro, and methoxy substituted chalcone compounds were synthesized, antimicrobial activities and molecular modeling strategies against the SrtA enzyme were investigated. The most active compounds were found to be T2, T4, and T19 against Streptococcus mutans (S. mutans) with MIC values of 1.93, 3.8, 3.94 µg/mL, and docking scores of -6.46, -6.63, -6.73 kcal/mol, respectively. Also, these three active compounds showed better activity than the chlorohexidine (CHX) (MIC value: 4.88 µg/mL, docking score: -6.29 kcal/mol) in both in vitro and in silico. Structural stability and binding free energy analysis of S.mutans SrtA with active compounds were measured by molecular dynamic (MD) simulations throughout 100 nanoseconds (ns) time. It was observed that the stability of the critical interactions between these compounds and the target enzyme was preserved. To prove further, in vivo biological evaluation studies could be conducted for the most promising precursor compounds T2, T4, and T19, and it might open new avenues to the discovery of more potent SrtA inhibitors.

Patient perceptions and attitudes regarding post-orthodontic treatment changes.

OBJECTIVES: To determine patient perceptions and attitudes regarding posttreatment changes at least 2 years after completion of orthodontic treatment. MATERIALS AND METHODS: A total of 125 patients (75 females, 50 males, aged 22.93 ± 2.98 years) were enrolled at least 2 years after debonding. Participants had either vacuum-formed retainers (VFRs) or bonded retainers (BRs). Posttreatment changes were evaluated digitally by comparing tooth positions at debonding and at least 2 years after debonding. A questionnaire was used to assess patient attitudes. Retainer usage, awareness of relapse, satisfaction with their current occlusion, and whether posttreatment changes were severe enough for them to consider retreatment were investigated. RESULTS: All patients showed some posttreatment changes in irregularity. Only 74% of patients wearing VFRs and 47.1% of patients wearing BRs were aware of posttreatment changes. Patients were more likely to notice posttreatment changes if there was an increase in mandibular irregularity of 1-3 mm. Awareness of posttreatment changes in the upper arch was higher in both groups. The majority of participants were satisfied with the results even if they noticed some minor posttreatment changes (VFR, 69.4%; BR, 76.5%). Dissatisfaction with posttreatment changes did not necessarily mean that a patient wanted retreatment. CONCLUSIONS: A total of 26% of patients wearing VFRs and 52.9% of patients wearing BRs were unaware of posttreatment changes. Approximately half of the patients who noticed posttreatment changes were still satisfied with the result 2 years after debonding. Even patients dissatisfied with the effect of posttreatment changes do not necessarily want retreatment.

Retrospective evaluation of the effectiveness of teledentistry approach during COVID-19 in pediatric dentistry: A parental perspective.

Objective: Dentistry necessarily requires close face-to-face contact with patients, so it was largely halted during the COVID-19 pandemic. During this pandemic, teledentistry (TD) could be a novel way to resume dental practice. It was aimed to investigate the satisfaction of the parents who received teledentistry (TD) service in a pediatric dentistry clinic during the COVID-19 pandemic, as well as other factors that may have contributed to this satisfaction. Methods: It was conducted using a telephone survey to interview the parents who used the TD system between June and December 2020. The survey includes participant demographics, COVID-19 anxiety, TD system, reasons for using TD, and Internet use in the field of health. Five-point Likert scale was used. A Chi-squared test was used and p < 0.05 was accepted as significant. Results: Most of the participants stated that they had no trouble connecting to the TD system (82.5%), and 119 participants reported that the system helped them to solve their health problems. Significant relationships (p < 0.05) were found between overall satisfaction and parental job, level of education, anxiety level (3 questions), and use of the Internet in healthcare (4 questions), whereas no associations were found regarding the other variables (p > 0.05). Conclusions: Parents benefited greatly from the TD system and would be open to using it after the pandemic. The education and parental job categories of parents, anxiety level, and use of the Internet in healthcare seem to have relationships with overall satisfaction.

Evaluation of the effect of pediatric drugs and an oral rinse on primary teeth discoloration.

BACKGROUND: Changes in the color of the teeth are a common dental finding associated with clinical and esthetic problems. Especially, the discoloration of primary teeth can cause parental concern and have a negative effect on social interactions between preschool children. OBJECTIVES: The aim of the study was to evaluate the effect of pediatric drugs and an oral rinse on the discoloration of primary teeth. MATERIAL AND METHODS: Similar to medication intake recommendations, 7 primary teeth in each group were immersed for 1 min in one of 11 different solutions at 8-hour intervals for 1 week. The color values were obtained using a spectrophotometer (VITA EasyShade®) at baseline and after 1 week. The color change (ΔE*) values were calculated according to the CIELab system. The statistical analysis was conducted using the one-way analysis of variance (ANOVA) and Tukey's post hoc tests at a p-value <0.05. RESULTS: When comparing values L*, a* and b* at baseline and day 7, a statistically significant difference was found in the a* value for the teeth immersed in pseudoephedrine (p = 0.012). There were also statistically significant differences with regard to color change at day 7 (ΔE*7) between the pseudoephedrine and chlorhexidine as well as pseudoephedrine and control groups (p = 0.034 and p = 0.030, respectively). CONCLUSIONS: The ΔE*7 value for pseudoephedrine was 3.7 after 1 week, indicating that it may have the potential to cause significant tooth discoloration when used for a long period. Clinicians and children's families should be aware of the fact that some pediatric drugs can cause tooth discoloration.

Dental age estimation with two different methods in paediatric patients with hypothyroidism.

OBJECTIVE: This case-control study aimed to evaluate dental age estimation in children with hypothyroidism using two different methods in order to contribute to the literature about the most accurate method. DESIGN: In the study, panoramic radiographs of 80 patients with hypothyroidism aged 5-13 years and 80 randomly selected age and sex-matched healthy patients were examined retrospectively. The Cameriere's and the Nolla's methods were used for the dental age estimation. Dental ages and their differences with chronological ages were compared according to group and sex. RESULTS: No statistically significant difference in estimated dental age was found between the hypothyroidism and control groups using both methods (p > 0.05). Among all the males and females included in this study, the dental ages of the females calculated by Nolla's method were significantly lower than those of the males according to the chronological ages (p < 0.05). For females, in both the hypothyroidism (p < 0.001) and control (p = 0.001) groups, the dental age estimated by Cameriere's method was significantly closer to the chronological age compared to Nolla's method, although there was no statistically significant difference for males. CONCLUSION: Although the dental age of children with hypothyroidism showed similar results to that of healthy children, it is concluded that Cameriere's method led to more accurate results than Nolla's method in females for both healthy patients and patients with hypothyroidism.

Is zirconium or stainless steel the most suitable crown material for less dentin stress in endodontically treated teeth?

BACKGROUND: Stainless steel crowns (SSCs), which have been used frequently in the treatment of first permanent molars in children until now, has become less applicable due to its poor aesthetic appearance. Zirconia crowns (ZCs) have become more popular due to their aesthetic advantage. However, stress transmission of ZCs to dental tissues under occlusal forces in endodontically treated teeth has not been described. OBJECTIVE: The aim of this study was to compare the stress distribution of different crown materials (ZCS, SSCs) and adhesive materials on dentin in endodontically treated permanent teeth and to specify the crown-adhesive model with lower stress. METHODS: Finite element analysis (FEA) was used to apply a force of 300 N from the inner part of the buccal tubercles (vertical loading) and a lingo-buccal at an angle of 30 degrees (oblique loading) of the first permanent molars (FPM) with different crown (ZCS, SSCs) and adhesive (Glass ionomer cement, Resin modified glass ionomer cement, Resin cement) materials in twelve separate models. The von Mises values obtained from the models were compared and the optimal stress values were determined by FEA. RESULTS: The lowest stress values of dentin were found in zirconia crown model with glass ionomer cement (GIC) adhesive under vertical loading (26,793 Mpa). In the zircon crown and GIC adhesive model, less von Mises stress occurred on the dentin under all conditions. CONCLUSIONS: ZCs and GIC adhesive may be recommended for teeth with a high probability of dentin fracture.

Evaluation of the effects of chlorhexidine and several flavonoids as antiviral purposes on SARS-CoV-2 main protease: molecular docking, molecular dynamics simulation studies.

The recent outbreak of COVID-19 caused by a new human coronavirus called SARS-CoV-2, is continually causing worldwide human infections and deaths.The main protease (3CLpro), which plays a critical role in the life cycle of the virus, makes it an attractive target for the development of antiviral agents effective against coronaviruses (CoVs).Currently, there is no specific viral protein targeted therapeutics.Therefore, there is a need to investigate an alternative therapy which will prevent the spread of the infection, by focusing on the transmission of the virus.Chlorhexidine (CHX) and flavonoids agents have shown that they have a viral inactivation effect against enveloped viruses, and thus facilitate the struggle against oral transmission.Especially, some flavonoids have very strong antiviral activity in SARS-CoV and MERS-CoV main protease.This study was conducted to evaluate the CHX and flavonoids compounds potential antiviral effects on SARS-CoV-2 main protease through virtual screening for the COVID-19 treatment by molecular docking method.According to the results of this study, CHX, Kaempferol-3-rutinoside, Rutin, Quercetin 3-beta-D-glucoside and Isobavachalcone exhibited the best binding affinity against this enzyme, and also these compounds showed significant inhibitory effects compared to the SARS-CoV-2 main protease crystal structure inhibitor (N3).Especially, these compounds mainly interact with His41, Cys145, His163, Met165, Glu166 and Thr190 in SARS-CoV-2 main protease binding site. Further, MD simulation analysis also confirmed that stability of these interactions between the enzyme and these five compounds.The current study provides to guide clinical trials for broad-spectrum CHX and bioactive flavonoids to reduce the viral load of the infection and possibly disease progression.Communicated by Ramaswamy H. Sarma.

Investigation of the antimicrobial activities of various antimicrobial agents on Streptococcus Mutans Sortase A through computer-aided drug design (CADD) approaches.

BACKGROUND AND OBJECTIVE: Tooth decay is a common chronic disease that causes pain, tooth loss, malnutrition, anxiety and significantly affects half of the world's population. Streptococcus mutans (S.mutans), is considered the main pathogen causing tooth decay. Sortase A (SrtA), one of the surface proteins of S. mutans, is a potential target in the development of antimicrobial and caries prevention agents for preventing infections associated with biofilm formation. Recently, various SrtA inhibitors, including small molecules and natural product, especially, trans-chalcone, chlorhexidine (CHX) and flavonoid compounds, which exhibit effective inhibition against SrtA, have been identified. However, due to the limited number of inhibitors, multi-drug resistance and side-effects the discovery of new inhibitors for SrtA is essential. METHODS: In this case, various compounds aimed at the target enzyme underwent high-throughput screening with small molecule libraries. For this screening of a total of 178 compounds, 163 were found to be pharmacokinetically suitable by performing an absorption, distribution, metabolism, and excretion (ADME) analysis. Molecular docking was then applied to investigate the interaction mechanism among these suitable compounds and the target enzyme structure at the molecular level. RESULTS: According to the results of the study, six compounds (CHEMBL243796 (kurarinone), CHEMBL2180472, CHEMBL3335591, CHEMBL373249, CHEMBL1395334, CHEMBL253467 (Isobavachalcone)) exhibited lower docking scores (-7.18, -6.59, -6.53, -6.47, -6.43, and -6.39 kcal/mol, respectively) against S. mutans SrtA than the positive control CHX (-6.29 kcal/mol). Finally, the 100 ns molecular dynamic simulations and binding free energy calculations were performed for the structure stability analysis of the enzyme with CHEMBL243796 (kurarinone), which showed the lowest docking score. As a result of these studies, the stability of the critical interactions between kurarinone and the target enzyme was preserved during the simulation time. CONCLUSIONS: These results indicate that flavonoid and chalcone scaffold compounds are clinically more reliable and potent than CHX as novel inhibitory agents for inhibiting oral biofilm formation. These finding can provide important contribution to the future clinical trials in the development of therapeutically useful inhibitors of SrtA by virtually screening several chemical compounds more rapidly to select suitable compounds for the prevention and treatment of dental caries.

Consensus on glass-ionomer cement thresholds for restorative indications.

OBJECTIVE: The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications. METHODS: Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity. RESULTS: There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG. CONCLUSIONS: Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials. CLINICAL SIGNIFICANCE: This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties.

Evaluation of Dental Status and Temporomandibular Joint in Children With Generalized Joint Hypermobility.

OBJECTIVE: The aim of this study was to evaluate the dental status and temporomandibular diseases (TMDs)-related symptoms in children with generalized joint hypermobility (GJH) and compare them with healthy controls (HCs). METHODS: This is a cross-sectional, observational study carried out between September 2016 and April 2017. A total of 124 children with GJH (n = 62) and HC (n = 62) were enrolled. The GJH was assessed with the Beighton hypermobility score. The subjects were screened for dental status and TMD-related symptoms. The assessment included the index for "decayed," "missing," and "filled teeth" (DMFT, dmft); plaque; gingival bleeding; tooth mobility; and temporomandibular joint (TMJ) evaluation. RESULTS: The mean Beighton hypermobility score was 6.3 ± 1.2 in the GJH group. Visible plaque index and gingival bleeding index scores were found to be significantly higher in children with GJH then in the HC (p = 0.031, p = 0.023). No differences were found regarding the DMFT scores between the groups (p = 0.16). Temporomandibular disorder-related symptom frequencies were significantly higher in children with GJH (p < 0.001). The most common clinically determined sign of TMD was clicking with a maximum active mouth-opening. Combined TMJ symptoms and TMD were observed in approximately one third of the children with GJH. CONCLUSIONS: The presence of GJH in a child may be indicative of future dental or TMJ problems, and it may cause dental problems due to increased gingival bleeding index and visible plaque index scores. Therefore, children with GJH require preventive dental and TMJ care.

Traumatic Dental Injuries Occurred in Primary Teeth and their Sequel Effects on the Developmental Permanent Successors: A Controlled Study

ABSTRACT Objective: To examine the types of traumatic dental injuries of the primary teeth (TDI-p) and the long-term sequelae on permanent dentition (LSP) comparing with a control group (CG). In addition, a questionnaire that measures parents' knowledge and awareness was used. Material and Methods: The trauma group (TG) consisted of permanent teeth following TDI-p exposed teeth, while the CG consisted of permanent teeth following unexposed teeth with TDI-p of the same patients. In total, 141 teeth were evaluated in 27 patients. Data concerning such as teeth, when TDI-p occurred, types of treatments and types of LSP were collected. Chi-square test was used for intergroup comparison for gender, type of trauma, LSP, age of trauma and parameters in the parental information questionnaire. Significance level was p<0.05. Results: A statistically significant difference was found in the analysis between TG and CG (p<0.001). The prevalence of LSP due to TDI-p was 29.6% and the prevalence of sequelae in CG was 7.4%. The most common LSP was enamel hypoplasia (14.8%). Parents were aware of the importance of TDI-p, and they had insufficient knowledge about its management. Conclusion: TDI-p can be considered a high-risk factor in the development of LSP. Also, the lack of knowledge in parents should be supported by software-based application systems to be developed.

The effects of cavity disinfection on the nanoleakage of compomer restorations: an in vitro study.

PURPOSE: Cavity disinfection, in addition to routine caries removal methods, is recommended to eliminate the microorganisms. The aim of this study was to compare the effect of various systems Er,Cr:YSGG lasers, diode lasers and FotoSan and agents Corsodyl; Cervitec and Cervitec Plus and Fluor Protector-on the nanoleakage of compomer restorations when used for cavity disinfection. MATERIALS AND METHODS: A total of 40 intact human deciduous molar teeth containing Black V cavities (3×2×1.5 mm) on the buccal and lingual surfaces parallel to the cementoenamel junction were randomly divided into 8 groups according to the cavity disinfection methods. The antibacterial agents and systems were applied according to the manufacturer's instructions. Restorations were completed using a compomer. The restored teeth were then subjected to thermocycling for 500 cycles in a water bath at 5°C and 55°C with a dwell time of 30 seconds. After the thermocycling procedures, 1-mm sticks were obtained from the center of each cavity to prepare for the nanoleakage test. After the teeth were sectioned, they were immersed in 50 wt % ammoniacal silver nitrate solution for 24 hours and dipped in photo-developing solutions for 8 hours with fluorescent light irradiation. The samples were examined under a scanning electron microscope (SEM). The non-parametric Kruskal-Wallis and Mann-Whitney U test (p<0.05) were applied. RESULTS: The Er,Cr:YSGG laser group showed significantly less nanoleakage than all of the tested groups (p<0.01). The diode laser, Fluor protector and FotoSan groups showed similar nanoleakage to that of the control group (p>0.05). The Corsodyl (p<0.01) and Cervitec (p<0.001) groups showed significantly higher nanoleakage than the control group. CONCLUSION: Er,Cr:YSGG laser irradiation which showed lower nanoleakage scores from either control or tested groups can be recommended for cavity disinfection Additionally, a diode laser and FotoSan, which have antibacterial effects and no negative effect on leakage, can be used for cavity disinfection.

Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth.

The aim of the present study was to evaluate the effects of different remineralization agents associated with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) (0.5 W power, 20 Hz frequency, 60% water, 40% air, 25 mJ pulse energy, 8.84 J/cm2 fluence, 60 µs pulse duration, 600 µm tip diameter, and an approximate 1-1.5 mm distance to the target) laser irradiation on erosion induced by the consumption of carbonated drinks in human primary enamel. There were 8 groups and 10 primary teeth in each g0roup. The distribution was as follows: group 1, casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF); group 2, Er,Cr:YSGG laser+CPP-ACPF; group 3, fluor varnish; group 4, Er,Cr:YSGG Laser+fluoride varnish; group 5, ROCS® medical mineral gel; group 6, Er,Cr:YSGG laser + ROCS® medical mineral gel; group 7, Er,Cr:YSGG laser; and group 8, artificial saliva. The samples in the groups were submerged in artificial saliva and acid twice a day for 6 s at 6-h intervals and were then exposed to an erosion cycle 15 times. In the groups in which the Er,Cr:YSGG laser was applied in combination with the remineralization agents, the laser application was made first, and then the remineralization agents were applied for 4 min in each group. The Friedman and Wilcoxon signed-rank tests and the Bonferroni correction were used in statistical analyses, and the significance level was taken as p < 0.05. According to the results, all agents had a statistically significant difference (groups 1, 2, 3, 4, and 6: p = 0.005, p < 0.017; groups 5 and 7: p = 0.007, p < 0.017) between BL-RM periods. However, all agents had a statistically significant remineralization effect on primary teeth enamel (groups 1, 2, 3, 6, and 7: p = 0.005, p < 0.017; group 4: p = 0.011, p < 0.017) except that group 5 (p = 0.074, p < 0.017) between DM-RM periods. The coadministration of an agent with the laser did not make any difference at a statistical level (p = 0.804, p > 0.05). The results were supported by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. As a result of this study, CPP-ACPF had a notable impact in terms of the remineralization effect on eroded enamel, and the Er,Cr:YSGG laser alone may be an alternative method, which may be related to the modified hydroxyapatite structure, 38.5% H0.56Ca4.56O13P3Y0.44, that was determined in XRD analysis.

Comparison of treatment efficacy between hyaluronic acid and arthrocentesis plus hyaluronic acid in internal derangements of temporomandibular joint.

The aim of the study was to compare the effectiveness of hyaluronic acid (HA) injection and arthrocentesis plus HA injection for treating disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR). In this randomized clinical trial, patients were divided into 2 main groups: group I (DDwR) and group II (DDwoR). Sub-groups were made depending on allocated treatment: group Ia (arthrocentesis plus HA), group Ib (single HA), group Ic (control), group IIa (arthrocentesis plus HA), group IIb (single HA), and group IIc (control). The primary outcome variable was maximum pain on chewing, while maximum pain at rest, maximum non-assisted and assisted mouth opening, chewing efficiency, temporomandibular joint (TMJ) sounds, quality of life, treatment tolerability, and treatment effectiveness were secondary outcomes. The influences of individual study variables (gender, involved side, and duration of symptoms) on clinical outcomes were also examined. The study consisted of 116 TMJs of 90 patients (n = 45 in both main groups, TMJs = 58) aged 15-82 years. At the 6-month follow-up, improvement in all parameters, except for TMJ sounds, was recorded in all treatment groups, with no improvements in control groups. Notably, arthrocentesis plus HA showed superior improvement in chewing efficiency (p = 0.041) and quality of life (p = 0.047) of group I and quality of life (p = 0.004) in group II, compared to single HA. Furthermore, the duration of symptoms correlated with clinical outcomes. Both procedures successfully improved the symptoms of DDwR and DDwoR patients, but arthrocentesis plus HA injection seemed superior.

In vitro evaluation of the effects of frequently prescribed pediatric drugs on the microhardness of permanent tooth enamel.

BACKGROUND: Dental erosion is considered one of the oral cavity diseases. Frequent intake of liquid oral medications can be an effective factor in tooth erosion. OBJECTIVES: This study aimed to evaluate the effects of frequently prescribed pediatric drugs on the permanent dental enamel microhardness over a period of 14 days in vitro. MATERIAL AND METHODS: In this study, 11 pediatric drugs with different active ingredients were used; the control group consisted of teeth immersed in distilled water. The immersion cycles were applied 3 times a day for 1 min. The measurements of the samples prepared were taken at 0 (baseline), 7 and 14 days after the immersion cycles using a Vickers hardness testing machine. The pH, titratable acidity (TA) and buffering capacity of the syrups were assessed. RESULTS: The measurements of the tooth samples that were immersed in drug solutions except Deltacortril® showed that there was a significant difference between days 0, 7 and 14. The microhardness values for the tooth samples that were immersed in the Deltacortril drug solution decreased, but no significant difference was found. There were no statistically significant differences between the day 0, 7 and 14 measurements in the control group. CONCLUSIONS: Commonly used and prescribed pediatric drugs pose a risk for tooth erosion. Pediatricians should be aware of the effects of prescription drugs on erosion, and stress the need for compliancy with oral hygiene procedures.

Evaluation of the knowledge, attitudes and behaviors of pre-school teachers on oral and dental health in the city center of Trabzon.

PURPOSE: Educators can also contribute to the prevention of early childhood caries (ECC) by educating children about oral diseases and hygiene practices. The aim of this study was to assess the knowledge, attitudes, and behaviors of pre-school teachers concerning oral and dental health in Trabzon. SUBJECTS AND METHODS: The study was carried out with 226 pre-school teachers in the city center using a self-administered questionnaire to evaluate their knowledge, attitudes, and behaviors concerning the oral and dental health of children. RESULTS: Only 29.8% of the respondents had a prior dental education. Although 83% of the teachers said that regular visits to the dentist were effective for caries prevention, only 13.2% said that they made regular visits to a dentist. Approximately 65.8% of the teachers agreed that fluoride strengthens tooth enamel and 35.1% of the teachers said that there were oral health activities in their schools. Additionally, 74.6% of teachers said that they would participate in dental education about children's oral health in the future. CONCLUSION: Preventive dental health program could be implemented including the proper behaviors related to the importance and treatability of primary teeth, first tooth cleaning, dental visits, the use of fluoride toothpaste, and oral hygiene into the pre-school teachers' undergraduate education programs in the future. This program should be repeated at certain intervals for the prevention of ECC.

Retrospective evaluation of patients admitted to Karadeniz Technical University Pediatric Dentistry clinic due to trauma.

PURPOSE: Traumatic dental injuries are among the commonly observed problems in the primary and permanent teeth. The rate of prevalence of dental trauma varies globally. In this study, we investigated the type of dental trauma, related factors, and treatment procedures in children. SUBJECTS AND METHODS: During a 5-year period (January 2011-January 2016), 416 children aged in the range of 1-15 years were admitted to our clinic with dental trauma. The cause and type of the dental trauma in the primary and permanent teeth and their relation with gender and age were evaluated using the chi-square test, and their distribution by age was evaluated using regression analysis. RESULTS: Overall, girls and boys comprised 37% and 63% of the study population, respectively. The mean age was 8.5 years. Falls (61.1%) were the most common cause of traumatic dental injuries, and enamel-dentin fracture (26%) was the most common dental trauma type. CONCLUSION: Traumatic dental injuries in children are common. A large proportion of patients without any clinical symptoms (15.8%) did not seek any treatment after the trauma. Teachers, parents, and children should be informed about the action to be taken when dental trauma occurs and about the importance of immediately taking the child to a dentist after the trauma to ensure an accurate diagnosis, an optimal treatment plan, and positive outcome.

The effect of antimicrobial additives on the properties of dental glass-ionomer cements: a review.

Aim: The aim of this article is to review the literature on the use of antimicrobial additives in glass-ionomer dental cements. Method: An electronic search between 1987 and the end of 2017 was performed using PubMed, Web of Science and Google search engines with the terms glass-ionomer, glass polyalkenoate, antibacterial and antimicrobial as the key words. The search was refined by excluding the majority of references concerned with cement antimicrobial properties only. Extra papers already known to the authors were added to those considered. Results: A total of 92 relevant articles have been cited in the review of which 55 are specifically concerned with the enhancement of antibacterial properties of glass-ionomers, both conventional and resin-modified, with additives. In addition, information is included on the uses of glass-ionomers and the biological properties of the antibacterial additives employed. There are several reports that show that additives are typically released by diffusion, and that a high proportion is usually left behind, trapped in the cement. Additives generally increase setting times of cements, and reduce mechanical properties. However, smaller amounts of additive have only slight effects and the longer-term durability of cements appears unaffected. Conclusion: Modified glass-ionomer cements seem to be acceptable for clinical use, especially in the Atraumatic Restorative Treatment (ART) technique.

Effect of Dentists' Appearance Related with Dental Fear and Caries aStatus in 6-12 Years Old Children.

OBJECTIVE: The aims of this study were to determine the prevalence of dental fear, the relationship between dental fear and dental caries and the dentist appearance most likely to reduce anxiety among children. In this way, dental treatment could be made more effective by changing the dentist's appearance. STUDY DESIGN: The "Children's Fear Survey Schedule-Dental Subscale" and a questionnaire 'designed to examine the children's preferences for their dentist's appearance', were administered to 810 patients between 6-12 years of age. Patients were examined after completing the questionnaires, and their DMFT/dmft indexes were determined. Patients were divided into three subgroups according to their CFSS-DS scores. RESULTS: Among patients, anxiety scores differed significantly by age and gender (p=0.046, p=0.001). Specifically, higher anxiety scores were identified among 6- to 8-year-olds and in female patients relative to their respective counterparts. A statistically significant association between anxiety and dental caries was detected. (DMFT p=0.030/dmft p=0.015), and DMFT/dmft scores were found to be higher among patients with high levels of dental anxiety than among patients with low levels of dental anxiety. Additionally, children were highly perceptive of and exhibited strong preferences for the appearance of their dentist. CONCLUSION: Anxiety and dental caries were associated; small alterations in a dentist's appearance may reduce dental anxiety among children.

Release of antimicrobial compounds from a zinc oxide-chelate cement.

This study examined the release of cetylpyridinium chloride and benzalkonium chloride from fatty acid chelate temporary dental cement and their antimicrobial effects. The cement was Cavex Temporary, and either cetylpyridinium chloride or benzalkonium chloride was added (1% or 5% by mass), incorporating into the base paste. Release of the additives was determined by reverse-phase high-performance liquid chromatography. Possible chemical interactions between the cement components and additives were examined by Fourier transform infrared (FTIR) spectroscopy. Antimicrobial effects were assessed by measuring the zone of inhibition around sample discs after 24 h in a Streptococcus mutans culture. FTIR spectroscopy showed no interaction with cement components. For both additives, release was by diffusion for approximately the first 6 hours, with equilibration after about 2 weeks. Diffusion coefficients were 1.76 m2 s½ to 8.05 × 10-12 m2 s½ and total release was 10.3 to 44.7% of additive loading. Zones of inhibition with additive were significantly larger than those for control discs. In conclusion, the antimicrobial properties of Cavex temporary cement are improved by the addition of the antimicrobial compounds cetylpyridium chloride and benzalkonium chloride, which are released by a diffusion process.