Effect of Biodentine on secondary caries formation: An in vitro study.

PURPOSE: To compare the effects of two materials, Biodentine and conventional glass-ionomer cement (CGIC), on secondary caries formation around restorations when used as a dentin replacement material. METHODS: 30 approximal cavities were prepared on mesial and distal surfaces of 15 caries-free human premolar teeth extracted for orthodontic or periodontal reasons. Cavities were filled with A: Biodentine as a base + Filtek Z250 composite (n = 15) or B: CGIC as a base + Filtek Z250 composite (n = 15). The materials were applied according to the manufacturers' instructions. Teeth were thermocycled, and placed in a demineralizing solution for 5 weeks. Secondary caries formation was assessed using the International Caries Detection and Assessment System (ICDAS) II and quantitative computer- aided image measurement of caries depth. RESULTS: The computer-aided measurements showed that the Biodentine group had significantly lower lesion depth measurements than the CGIC group (P = 0.004). However, there was no significant difference among the groups based on the ICDAS II scores (P > 0.05).

The effect of temperature and contact time of sodium hypochlorite on human roots infected with Enterococcus faecalis and Candida albicans.

The aim of this study was to evaluate the effectiveness of 2.5 % NaOCl at different temperature and time intervals on Enterococcus faecalis and Candida albicans-infected human roots. A total of 112 root cylinders prepared from extracted single-rooted humans were infected by E. faecalis (Group A, n = 56) or C. albicans (Group B, n = 56); 3 root cylinders served as negative controls. Both groups were further divided into 6 subgroups according to three contact times (30 s, 1 min, 5 min) with NaOCl at two different temperatures (25 or 37 °C). Microorganism growth was controlled at the 24th and 48th hours. Statistical analysis was performed using the Chi-square test. While NaOCl at 25 °C for 5 min was the most effective irrigation regimen to eliminate E. faecalis (p < 0.001), NaOCl at 37 °C for 5 min exhibited significantly superior antifungal properties (p < 0.05). At the same contact times, difference in the temperature of NaOCl did not affect the growth of either E. faecalis or C. albicans. As a result, the irrigation time of NaOCl was more effective than the temperature to eliminate E. faecalis, while pre-heating of NaOCl to 37 °C increased its effectiveness on C. albicans at 5 min contact time.

A comparative study of qualitative and quantitative methods for the assessment of adhesive remnant after bracket debonding.

The amount of the residual adhesive after bracket debonding is frequently assessed in a qualitative manner, utilizing the adhesive remnant index (ARI). This study aimed to investigate whether quantitative assessment of the adhesive remnant yields more precise results compared to qualitative methods utilizing the 4- and 5-point ARI scales. Twenty debonded brackets were selected. Evaluation and scoring of the adhesive remnant on bracket bases were made consecutively using: 1. qualitative assessment (visual scoring) and 2. quantitative measurement (image analysis) on digital photographs. Image analysis was made on scanning electron micrographs (SEM) and high-precision elemental maps of the adhesive remnant as determined by energy dispersed X-ray spectrometry. Evaluations were made in accordance with the original 4-point and the modified 5-point ARI scales. Intra-class correlation coefficients (ICCs) were calculated, and the data were evaluated using Friedman test followed by Wilcoxon signed ranks test with Bonferroni correction. ICC statistics indicated high levels of agreement for qualitative visual scoring among examiners. The 4-point ARI scale was compliant with the SEM assessments but indicated significantly less adhesive remnant compared to the results of quantitative elemental mapping. When the 5-point scale was used, both quantitative techniques yielded similar results with those obtained qualitatively. These results indicate that qualitative visual scoring using the ARI is capable of generating similar results with those assessed by quantitative image analysis techniques. In particular, visual scoring with the 5-point ARI scale can yield similar results with both the SEM analysis and elemental mapping.

Effect of ozone pretreatment on the microleakage of pit and fissure sealants.

OBJECTIVE: This study investigated the effect of ozone pretreatment on the microleakage and marginal integrity of pit and fissure sealants placed with or without a self-etch 6th generation adhesive. STUDY DESIGN: Freshly-extracted, human third molars were randomly assigned into two main groups (n = 48): Group A: Fissures were pretreated with ozone; Group B: Fissures were left untreated. The teeth were further randomly divided into two subgroups (n = 24/each) so that half of teeth were sealed with a conventional fissure sealant (Fissurit F, Voco, Germany), while the remaining half received the same sealant bonded with a self-etch adhesive (Clearfil Protect Bond, Kuraray, Japan). Following thermal cycling (1000X), the specimens were subjected to dye penetration within 0.5% basic fuchsin for 24h. The extent of dye penetration was measured by image analysis. Kruskal Wallis and Mann-Whitney U tests were used for statistical analysis of the data (p = 0.05). Two randomly-selected sections from each group were observed under SEM RESULTS: In all groups, ozone pretreatment significantly reduced the extent of microleakage (p < 0.001). SEM investigation demonstrated better adaptation of the sealants in ozone-pretreated groups. Clearfil Protect Bond did not improve the marginal seal of Fissurit F (p > 0.05). CONCLUSION: Ozone pretreatment favorably affected the marginal sealing ability of the tested fissure sealants.

In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate as a potential tooth transport medium: viability and apoptosis in L929 fibroblasts.

Casein phosphopeptides (CPP) are derived from casein, which accounts for 80% of the total protein in bovine milk . The purpose of this in vitro study was to evaluate the potential use of a CPP-amorphous calcium phosphate (CPP-ACP) preparation as a transport medium for avulsed teeth. L929 fibroblastic cell line was plated in 24-well culture plates. Following incubation, the cells were treated with 10(-3), 10(-4), 10(-6), 10(-8), 10(-12) dilutions of a water-based CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan). Untreated cells served as controls. The L929 cells were counted at the 1st, 3rd and 7th days. Propidium iodide/acridine orange staining was used to assess apoptosis of treated cells and of the positive control. For each concentration (dilution), statistical analysis of cell survival within time was performed using two-way analysis of variance (ANOVA, P = 0.05). One way ANOVA and Tukey tests were applied to compare the effect of different concentrations on cell survival at each evaluation day (P = 0.05). Except for the 10(-3) and 10(-4) dilutions, all groups demonstrated an increase in cell numbers at days 1 and 3, followed by a decrease at day 7. Irrespective of the increase or decrease in cell viability, time-dependent changes for each dilution group were significantly different. Cells in the 10(-3) and 10(-4) dilution groups demonstrated a rapid apoptotic response. A relatively few number of apoptotic cells were observed in the 10(-6) and 10(-8) dilution groups, while no sign of apoptosis was evident in the 10(-12) dilution group and control. These results suggest that when highly diluted, the tested CPP-ACP preparation may help preserve L929 cell viability in the short term without inducing apoptosis.

Microleakage of self-etch primer/adhesives in endodontically treated teeth.

BACKGROUND: The authors evaluated the coronal marginal leakage of endodontically treated teeth bonded with four self-etching adhesives and one total-etch adhesive system. MATERIALS AND METHODS: The investigators prepared Class II cavities in 60 extracted human premolars. They performed conventional endodontic therapy using a resin-based sealer and gutta-percha points. They randomly assigned each tooth to a group receiving one of the following adhesives: Adper Prompt L-Pop (3M ESPE, Seefeld, Germany), Clearfil SE Bond (Kuraray, Osaka, Japan), FL Bond (Shofu, Kyoto, Japan), Single Bond (3M ESPE) or Xeno III (Dentsply De Trey, Konstanz, Germany). They restored all teeth with resin-based composite material (Z250, 3M ESPE). Specimens underwent thermocycling and dye penetration and were sectioned longitudinally. The authors photographed the sections under a stereomicroscope. They transferred the images to an IBM-compatible personal computer for quantitative assessment of dye penetration using image analysis software. They analyzed data by means of Kruskal-Wallis and Mann-Whitney U tests (P = .05) and evaluated two specimens from each group under scanning electron microscopy. RESULTS: None of the tested self-etch adhesives completely eliminated microleakage. Dye leakage was restricted to the coronal cavity walls; it did not migrate toward the pulp chamber or toward the root canal. Single Bond and Clearfil SE Bond showed significantly lower dye penetration values at occlusal and gingival margins. CONCLUSIONS: The coronal sealing performance of the tested self-etch adhesive systems in endodontically treated teeth was material-dependent. The use of Clearfil SE Bond in such teeth can help achieve a marginal seal comparable to that achieved with Single Bond.

Er,Cr:YSGG laser pretreatment of primary teeth for bonded fissure sealant application: a quantitative microleakage study.

PURPOSE: Laser pretreatment of dental hard tissues prior to preventive or restorative procedures has been a subject of research. Unground primary enamel bears a prismless superficial layer which is known to be acid resistant. This in vitro study was conducted in order to evaluate the potential use of Er,Cr:YSGG laser in the pretreatment of occlusal surfaces of primary teeth prior to bonded fissure sealant application. MATERIALS AND METHODS: Occlusal surfaces of human primary mandibular molars were used (n =140). After pretreatment with Er,Cr:YSGG laser (group A) or not (group B), occlusal fissures were treated with one of the following in each of 7 subgroups (n = 10): 1. phosphoric acid-etch only; 2. Clearfil SE Bond; 3. FL Bond; 4. Adper Prompt L-Pop; 5. NRC+Prime & Bond NT; 6. One-Up Bond F; 7. Xeno III. All teeth were sealed with Fissurit F. The specimens were thermocycled (1000 times) and stored thereafter in distilled water at 37 degrees C for 8 months. Following immersion in 0.5% basic fuchsin solution, three bucco-lingual sections were made from each tooth. They were digitally photographed and the extent of dye penetration along the enamel-sealant interface was measured (in mm) with image analysis software. RESULTS: There was no difference between the Er,Cr:YSGG laser pretreated group (group A) and the nonlased grou (group B) (p > 0.05). The lowest microleakage values were observed in subgroups A1 and B1. Within the laser pretreated group, subgroups A1, A4, and A5 showed lower microleakage scores when compared to subgroups A2, A3, A6, and A7 (p < 0.05). As for the nonlased group, subgroups B1, B3, B4, and B5 demonstrated significantly lower microleakage scores than subgroups B2, B6, and B7 (p < 0.05). CONCLUSION: Er,Cr:YSGG laser pretreatment was not found to influence the resistance to microleakage of bonded fissure sealant application in primary teeth.

Qualitative and quantitative evaluation of enamel after various stripping methods.

INTRODUCTION: In this study, we investigated ultramorphology, surface roughness, and microhardness of permanent and deciduous tooth enamel after various stripping methods. METHODS: One hundred twenty deciduous and permanent teeth (n = 60 each) were used. Qualitative (scanning electron microscopy) and quantitative (surface roughness and microhardness tests) experiments were carried out in the following experimental groups: group 1, stripping disk; group 2, diamond-coated metal strip; group 3, stripping disk and Sof-Lex discs (3M-ESPE, Seefeld, Germany); group 4, diamond-coated metal strip and Sof-Lex discs; group 5 (chemical stripping), 37% orthophosphoric acid in conjunction with diamond-coated metal strip; group 6 (control), no stripping. Surface roughness values (Ra) for permanent and deciduous enamel were evaluated with Welch analysis of variance (ANOVA) and Tamhane tests, and Kruskal-Wallis and Mann-Whitney tests, respectively. Microhardness values were evaluated statistically with Kruskal-Wallis, 1-way ANOVA, and Duncan tests. RESULTS: Deciduous and permanent teeth showed similar results in terms of surface roughness and surface morphology. Groups 3 and 4 had the smoothest deciduous and permanent enamel surfaces, whereas chemical stripping (group 5) produced the roughest surfaces in both enamel types. Stripping did not lead to a significant change in the microhardness of permanent enamel. CONCLUSIONS: All stripping methods significantly roughened the enamel surfaces. Polishing the stripped surface with Sof-Lex discs decreased the roughness.

Accuracy of the third molar index for assessing the legal majority of 18 years in Turkish population.

In the last few years, forced and unregistered child marriage has widely increased into Turkey. The aim of this study was to test the accuracy of cut-off value of 0.08 by measurement of third molar index (I3M) in assessing legal adult age of 18 years. Digital panoramic images of 293 Turkish children and young adults (165 girls and 128 boys), aged between 14 and 22 years, were analysed. Age distribution gradually decreases as I3M increases in both girls and boys. For girls, the sensitivity was 85.9% (95% CI 77.1-92.8%) and specificity was 100%. The proportion of correctly classified individuals was 92.7%. For boys, the sensitivity was 94.6% (95% CI 88.1-99.8%) and specificity was 100%. The proportion of correctly classified individuals was 97.6%. The cut-off value of 0.08 is a useful method to assess if a subject is older than 18 years of age or not.

The reliability of Cameriere's method in Turkish children: a preliminary report.

Dental age estimation in children is an important issue both legally and medically. Currently, however, there is a lack of contemporary dental age estimation standards for a Turkish population. This study assessed the accuracy of Cameriere's method by examining the panoramic radiographs of 573 healthy Turkish children between the ages of 8 and 15 years. Radiographs of the left permanent developing mandibular teeth, except wisdom teeth, were evaluated. All subjects were divided into 7 groups according to their chronological age. The Intra-class Correlation Coefficient was used to determine the intra- and inter-observer agreement error. A comparison of the distributions of estimation errors among age groups was performed using the Nemenyi test. There were no significant differences between inter-observer (p=0.352), and intra-observer readings after 2 weeks (p=0.275 and p=0.273, respectively). The dental age was underestimated when using Cameriere's method with a mean difference of -0.35 years (-0.24 years for girls and -0.47 years for boys). The median values of the differences between dental and chronological age were -0.44 years in boys (range: -3.70, 4.06) and -0.21 years in girls (range: -2.74, 3.29). In addition, the differences between dental and chronological ages in the different age groups decreased with increasing chronological age. Results from the Nemenyi test implied that Cameriere's method is more accurate for girls than for boys in this cohort of a Turkish population.

Oro-facio-dental findings of rubinstein-taybi syndrome as a useful diagnostic feature.

Rubinstein-Taybi Syndrome (RTS) is a rare multiple congenital syndrome characterized by distinctive facial features, mental and growth retardation, broad thumbs and great toes. This case report describes the oro-dental manifestations, as well as, orthodontic evaluation of a 9-year-old male patient who had RTS. The remarkable oro-dental features were talon-like cingulum on maxillary central incisors, unerupted supernumerary teeth. Cone-beam computerized tomography was taken in order to identify his skeletal anomalies, bilateral cross-bite and a narrow maxilla were diagnosed. Dental treatments were completed under i.v sedation due to the patient's inability to cooperate during dental treatment. Perioparetive and postoperative courses were uneventful. Following dental treatments, orthodontic therapy was initiated with a fixed rapid maxillary expansion appliance.

Hall versus conventional stainless steel crown techniques: in vitro investigation of marginal fit and microleakage using three different luting agents.

PURPOSE: This study's purpose was to investigate microleakage and marginal discrepancies in stainless steel crowns (SSCs) placed using conventional and Hall techniques and cemented with three different luting agents. METHODS: Seventy-eight human primary maxillary second molars were randomly assigned to two groups (N=39), and SSCs were applied either with the Hall or conventional technique. These two groups were further subgrouped according to the material used for crown cementation (N=13 per group). Two specimens in each group were processed for scanning electron microscopy investigation. The extent of microleakage and marginal fit was quantified in millimeters on digitally photographed sections using image analysis software. The data were compared with a two-way independent and a two-way mixed analysis of variance (P=.05). RESULTS: The scores in the Hall group were significantly worse than those in the conventional technique group (P<.05). In both groups, resin cement displayed the lowest extent of microleakage, followed by glass ionomer and polycarboxylate cements (P<.05). CONCLUSIONS: Stainless steel crowns applied using the Hall technique displayed higher microleakage scores than those applied using the conventional technique, regardless of the cementation material. When the interaction of the material and technique was assessed, resin cement presented as the best choice for minimizing microleakage in both techniques.

Oral findings and clinical implications of patients with congenital neutropenia: a literature review.

Neutropenia is a granulocyte disorder characterized by a dramatically low number of neutrophils, the most important type of white blood cell. The condition results in susceptibility to severe pyogenic infections. Some people are born with it (congenital neutropenia), and others develop it as young children. The disease is so-called chronic neutropenia when lasting more than two months. This article reviews the definition, clinical properties and common oral manifestations of congenital neutropenia in order to highlight the importance of diagnosis, oral hygiene maintenance and dental treatments.

Autotransplantation of a supernumerary tooth to replace a misaligned incisor with abnormal dimensions and morphology: 2-year follow-up.

Autotransplantation is a viable treatment option to restore esthetics and function impaired by abnormally shaped teeth when a suitable donors tooth is available. This paper describes the autotransplantation and 2-year follow-up of a supernumerary maxillary incisor as a replacement to a misaligned maxillary incisor with abnormal crown morphology and size. The supernumerary incisor was immediately autotransplanted into the extraction site of the large incisor and was stabilized with a bonded semirigid splint for 2 weeks. Fixed orthodontic therapy was initiated 3 months after autotransplantation. Ideal alignment of the incisors was accomplished after 6 months along with radiographic evidence of apical closure and osseous/periodontal regeneration. In autogenous tooth transplantation, a successful clinical outcome can be achieved if the cases are selected and treated properly.

Vasorelaxant effect of a self-etch adhesive system through calcium antagonistic action.

Etch-and-rinse adhesives can cause vasorelaxation via mechanisms occurring in the endothelium and smooth muscle, including the release of nitric oxide (NO). This effect might promote or aggravate bleeding if such adhesives are placed inadvertently on iatrogenic pulp microexposures. The present study assessed the vasoactive potential of a newer generation self-etch adhesive, Clearfil Protect Bond (CPB), on isolated rat aorta. Cumulative concentrations of the primer, bond, and mixture of CPB elicited concentration-dependent relaxation of phenylephrine-induced active tonus in the rat aorta, demonstrating that the tested self-etch adhesive can lead to vasorelaxation of pulp vessels that is mediated by Ca(2+) antagonistic effect. The vasorelaxant effect of CPB or its components was mediated neither via endothelium-dependent NO and prostanoid-dependent mechanisms nor by K(+) efflux through K(+) channels. Mechanical removal of the endothelium did not significantly alter the relaxation induced by CPB. Assuming these data can be extrapolated to the clinical situation, CPB, either in mixed form or by its components, can lead to vasorelaxation of pulp vessels that is mediated by a Ca(2+) antagonistic effect. If CPB is placed inadvertently on pulp microexposures during direct pulp capping, this effect might promote bleeding that might impair healing and, via plasma exatravasation, might compromise resin infiltration and polymerization.

Self-inflicted orodental injury in a severely burned child.

The purpose of this report was to describe the case of a self-inflicted oral injury in a 1 1/2-year-old child that may be related to chronic pain caused by a severely burned body. In the present case, the patient lost his mandibular primary incisors due to continuous teeth clenching. He further traumatized the socket, resulting in severe ulceration. Extraction of the maxillary central and lateral incisors under local anaesthesia was performed to prevent further injury and additional medical problems.