Oral Health Status of Outpatients with Schizophrenia in Ankara, Türkiye: A Descriptive Study. / Ayakta Tedavi Gören Sizofreni Hastalarinin Agiz Sagligi Durumu: Tanimlayici Bir Çalisma (Ankara-Türkiye).

OBJECTIVES: To evaluate the oral health status and denture treatment needs of a group of outpatients with schizophrenia. METHODS: One hundred and eighty-eight patients diagnosed with schizophrenia were evaluated. Socio-demographic characteristics, eating habits, alcohol consumption, smoking status, oral hygiene attitudes, medical status, medications and the data related to dental visit were obtained via structured questionnaire of 45 questions. Medication information were confirmed from hospital records. The DMFT score (the Total of decayed, missing and filled teeth), denture status, Community Periodontal Index of Treatment (CPITN) and attachment loss were recorded in accordance with the criteria defined by the WHO. RESULTS: The mean DMFT score was 11.1±8.6. Total number of teeth decreased, while the number of decayed teeth and DMFT scores increased with age (p<0.001). There was no relationship between the anticholinergic effects of antipsychotics and the teeth count, number of decayed, filled and missing teeth, and the DMFT scores. The CPITN assessment revealed that 71.6% of the patients had healthy periodontium, 7.4% exhibited gingival bleeding upon probing, and 21% had dental calculus. Psychotropic medication and tooth brushing habits were associated with CPITN scores. Male sex was associated with higher frequency of denture need (p<0.001), while no association was observed with the education level and antipsychotic use (p>0.001). CONCLUSION: Physicians and dentists have to work in coordination to maintain good oral health of patients with schizophrenia. Patients should be encouraged for regular dental check-ups and dentist should take utmost care of the oral hygiene maintenance.

Six-year clinical evaluation of bulk-fill and nanofill resin composite restorations.

OBJECTIVES: This study aims to compare the performance of a bulk-fill and a nanofill resin composite in class II restorations after 6 years. MATERIALS AND METHODS: Fifty patients having at least two class II carious lesions were recruited for the study. One lesion in each patient was randomly assigned to be restored using either the Tetric EvoCeram Bulk Fill (TB) or Filtek Ultimate (FU) resin composites with their respective adhesives. One hundred four restorations were placed by two calibrated operators. Restorations were evaluated at baseline and annually over the course of 6 years by two examiners using modified USPHS criteria. Data were statistically analyzed using the Chi-square and Cochran Q tests (p < 0.05). RESULTS: Sixty-six restorations in 33 patients were evaluated after 6 years. Only one restoration was lost from FU group at 5 years. At the end of 6 years, marginal discoloration was observed in three (9.1%) TB and eight (36.4%) FU restorations creating a significant difference between the groups (p < 0.05). The FU group showed a significant increase in marginal discoloration at 6 years from the baseline (p < 0.05). Marginal adaptation was rated as Bravo for 9.1% and 24.2% of TB and FU restorations, respectively (p > 0.05). Significant degradation was observed within each group in terms of marginal adaptation (p < 0.05). There were no statistically significant differences between the groups for the other criteria tested (p > 0.05). CONCLUSIONS: Bulk-fill restorations performed better for marginal discoloration. The remaining clinical performance criteria of bulk-fill and nanofill resin composite restorations were similar after 6 years. CLINICAL RELEVANCE: Bulk-fill resin might be a better alternative to incrementally placed restorative in terms of marginal discoloration under clinical conditions.

Comparative evaluation of different adhesive strategies of a universal adhesive in class II bulk-fill restorations: A 48-month randomized controlled trial.

OBJECTIVES: To compare the clinical performance of the universal adhesive used in etch-and-rinse (ER) and self-etch (SE) adhesive strategies for 48-month in class II bulk-fill restorations. METHODS: A total of 84 class II bulk-fill resin composite (Tetric EvoCeram Bulk Fill) restorations were placed in 35 participants by one operator using the universal adhesive's (Adhese Universal VivaPen) etch-and-rinse or self-etch mode randomly. The restorations were evaluated by two calibrated examiners at baseline and after 6-, 12-, 24-, 36- and 48-month using modified USPHS criteria. The comparison of the two adhesive strategies for each evaluation criteria was performed with the chi-square test. The baseline scores were compared with those at the recalls using the Friedman and Cochran's Q-test (p < .05). RESULTS: At 48-month, 74 restorations were evaluated in 30 participants (recall rate: 85.7%). Marginal discoloration was statistically more frequent in SE approach (p < .05), whereas no significant difference was observed between the two strategies in terms of marginal adaptation (p > .05). There were statistically significant differences between the baseline and 48-month recall in the SE group in terms of marginal adaptation and discoloration (p < .05). In ER group, significant differences were found between baseline and 48-month only for marginal adaptation (p < .05). None of the restorations showed post-operative sensitivity. Secondary caries was observed in one restoration from SE group. CONCLUSIONS: The tested bulk-fill restorative exhibited better clinical performance only in terms of marginal discoloration when the universal adhesive was used with ER strategy. CLINICAL RELEVANCE: Though ER approach of the tested universal adhesive appears to be advantageous in terms of marginal discoloration, both adhesive strategies had similar impact on the clinical success of bulk-fill resin restorations.

Does laser etching have an effect on application mode of a universal adhesive?-A microleakage and scanning electron microscopy evaluation.

This study aimed to evaluate the microleakage of a universal adhesive's different application modes incorporated with Er,Cr:YSGG laser on Class V resin composite restorations. Sound human molar teeth (n = 30) were used for microleakage evaluations. Specimens with 60 standardized Class V cavities were divided into five groups according to the adhesive modes of universal adhesive, Adhese Universal (n = 12). Group 1-etch-and-rinse mode with phosphoric acid; Group 2-etch-and-rinse mode with Er,Cr:YSGG laser; Group 3-selective-etch mode with phosphoric acid; Group 4-selective-etch mode with Er,Cr:YSGG laser; Group 5-self-etch. After restorations were performed with a resin composite, Tetric N-Ceram, the specimens were polished and subjected to thermocycling (10,000X). Following immersion in 0.5% basic fuschin for a day, the teeth were sectioned and the degree of microleakage was determined along the tooth-resin composite interface using a light microscopy(40X). Five specimens from each group were examined by scanning electron microscopy. The Kruskal-Wallis, Siegel Castello, and Wilcoxon tests were used for statistical analyses (α = .05). At the enamel margins, significant differences were obtained among the groups (p < .05). Significantly higher microleakage scores were detected in Group 5 in comparison with Groups 1, 2, and 3. There were no significant differences between different adhesive strategies at the dentin margins (p > .05). While analyzing enamel and dentin microleakage scores, no statistically significant differences were observed in Groups 4 and 5 (p > .05). The laser application time and the adhesive modes of universal adhesives could affect the microleakage at the enamel margins. Different adhesive modes of universal adhesives combined with laser etching had no influence on the microleakage scores of dentin margins.

Thirty-six-month clinical evaluation of different adhesive strategies of a universal adhesive.

AIM: The aim of this clinical trial was to evaluate and compare the performance of a universal adhesive with different adhesive strategies in the restoration of non-carious cervical lesions (NCCLs) over a 36-month period. MATERIAL AND METHOD: One hundred sixty-five NCCLs in 35 patients (13 female, 22 male) with at least 3 lesions each were included in this study. Three groups were formed according to the adhesive strategy used (n = 55): selective-etch mode, etch-and-rinse mode, or self-etch mode of a universal adhesive, Single Bond Universal. The same nanofilled resin composite, Filtek Ultimate, was used for all restorations by a single operator. The restorations were evaluated by two calibrated examiners at baseline and at 6, 12, 18, 24, and 36 months in accordance with the modified USPHS criteria. The chi-square test was used for intergroup comparison and Cochran's Q test for intragroup comparison (∝ = 5%). RESULTS: At 36 months, the recall rate was 98.1% and three restorations, one from each group, had failed because of retention loss (P > 0.05). The self-etch mode group showed 17 bravo scores for both marginal staining and marginal adaptation after 3 years, which was significantly different from the selective-etch and etch-and-rinse groups (P < 0.05). For all groups, the only statistically significant difference was found when baseline and 36-month evaluations were compared in terms of marginal staining (P = 0.000). When the marginal adaptation values at 36 months were compared with those at the baseline, statistically significant differences were found in the etch-and-rinse and self-etch mode groups (P < 0.05). Neither secondary caries nor postoperative sensitivity was observed at any recall. CONCLUSION: All adhesive modes showed similar retention rates. Although all restorations were clinically acceptable, restorations in self-etch mode showed less satisfying performance for marginal staining and marginal adaptation. CLINICAL RELEVANCE: At the end of 36 months, the Single Bond Universal adhesive received acceptable scores according to the modified United States Public Health Service (USPHS) criteria. However, clinicians should be aware that its use in self-etch application mode tends to result in marginal staining and marginal deterioration when compared with etch-and-rinse and selective-etch application modes.