Shear bond strength of calcium silicate-based cements to glass ionomers.

BACKGROUND: A shear bond strength between the biomaterial and restorative material is crucial for minimizing bacterial microleakage and ensuring a favorable long-term prognosis for vital pulp therapy. This study aimed to conduct a comparative evaluation of the shear bond strength between calcium silicate-based biomaterials utilized in vital pulp treatment and various glass ionomer cement materials, both with and without the application of adhesive agents. METHODS: A total of 270 acrylic blocks, each featuring cavities measuring 4 mm in diameter and 2 mm in depth, were prepared. Calcium silicate-containing biomaterials (ProRoot MTA, Medcem Pure Portland Cement, and Medcem MTA), following manufacturers' instructions, were placed within the voids in the acrylic blocks and allowed to set for the recommended durations. The biomaterial samples were randomly categorized into three groups based on the restorative material to be applied: conventional glass ionomer cement, resin-modified glass ionomer cement, and bioactive restorative material. Using cylindrical molds with a diameter of 3.2 mm and a height of 3 mm, restorative materials were applied to the biomaterials in two different methods, contingent on whether adhesive was administered. After all samples were incubated in an oven at 37 °C for 24 h, shear bond strength values were measured utilizing a universal testing device. The obtained data were statistically evaluated using ANOVA and post-hoc Tukey tests. RESULTS: The highest shear bond strength value was noted in the Medcem MTA + ACTIVA bioactive restorative material group with adhesive application, while the lowest shear bond strength value was observed in the ProRoot MTA White + Equia Forte HT Fil group without adhesive application (P < 0.05). CONCLUSION: Activa Bioactive Restorative may be considered a suitable restorative material in combination with calcium silicate-based biomaterials for vital pulp treatment. The application of adhesives to calcium silicate-based biomaterials can effectively address the technical limitations.

Evaluation of pediatric dentists' knowledge and approaches to tooth discoloration.

In recent years, esthetic expectations have come to the fore in pediatric dentistry, as in every field of dentistry. Therefore, to better meet patients' expectations, the steps taken to determine and improve the current level of knowledge of pediatric dentists on tooth discoloration gain importance. This study aims to measure the knowledge levels of pediatric dentists regarding tooth discoloration. A 33-questioned survey created online was emailed to pediatric dentists between March and December 2021. The first part included four multiple-choice and two open-ended questions regarding demographic characteristics. The second part was to measure the participants' knowledge of tooth discoloration. The last part was to evaluate the clinical approaches of the participants. Participants who agreed to answer all of the questions were included in the study (n = 129). The knowledge levels of the participants were scored according to the accuracy of their answers. The data were statistically analyzed using descriptive statistics and chi-square tests. Of the pediatric dentists who participated in this study, 16.3% had high knowledge, 79.8% had medium knowledge, and 3.9% had insufficient understanding of tooth discoloration. There was no correlation between time since dental school graduation and time spent practicing as a pediatric dentist (p > 0.05). The group with the highest average level of knowledge was the group most frequently encountered with tooth discoloration in the clinic (p ≤ 0.05). On average, pediatric dentists had moderate knowledge of tooth discoloration. The group with the highest average expertise in this field was the group that most frequently encountered and treated tooth discoloration. Information on tooth discoloration due to systemic factors was insufficient. To increase the knowledge level of pediatric dentists about the causes and treatments of tooth discoloration, it may be beneficial to establish training programs during and after specialization education.

Ectopic eruption of maxillary permanent first molars: Predictive factors for self-corrected and impacted outcome.

OBJECTIVE: The aim of this study was to describe the occurrence, angulation and mesialisation ratio of the ectopic eruption of the maxillary permanent first molar (PFM) and its correlation with the pathological resorption of maxillary primary second molar (PSM). METHODS: This retrospective study was performed using the subsequent panoramic radiographs of 11.924 child patients aged 6-10 years. Ectopic eruption status is categorised as self-corrected and impacted types. To evaluate the differences between the two groups (self-corrected and impacted), the angulation of PFM, mesialisation ratio of PFM, and degree of adjacent PSM root resorption were also assessed. The data were statistically analysed using ANOVA and chi-square tests. Pearson correlation was used to analyse whether a quantitative relationship exists between PFM mesialisation ratio and PSM root resorption. RESULTS: Ectopic eruption frequency was determined as 0.83%. The distribution of ectopic eruption according to gender shows a higher prevalence in males than females. In most cases of ectopic eruption, the eruption status was impacted. The impacted PFMs showed more negative vertical and positive horizontal angle between the PSM and PFM. There was no significant difference between eruption status and angles. Mesialisation ratio of impacted PFMs was significantly higher than self-corrected PFMs. There was significant difference between the PFM mesialisation ratio and the degree of PSM root resorption. CONCLUSION: Even if eruption disturbances do not occur frequently, making an early diagnosis is important to begin treatment at an optimal time. Although the relationship between horizontal and vertical angles and the ectopic eruption pattern is controversial, it is one of the clinical determinants. The mesialisation ratio of the impacted type was significantly higher than the self-corrected type. Self-correction of PFM was reduced in PSM with grade III and IV root resorption.

A pilot study of a deep learning approach to submerged primary tooth classification and detection.

AIM: The aim of the study was to compare the success and reliability of an artificial intelligence (AI) application in the detection and classification of submerged teeth in panoramic radiographs. MATERIALS AND METHODS: Convolutional neural network (CNN) algorithms were used to detect and classify submerged molars. The detection module, based on the stateof- the-art Faster R-CNN architecture, processed a radiograph to define the boundaries of submerged molars. A separate testing set was used to evaluate the diagnostic performance of the system and compare it with that of experts in the field. RESULT: The success rate of the classification and identification of the system was high when evaluated according to the reference standard. The system was extremely accurate in its performance in comparison with observers. CONCLUSIONS: The performance of the proposed computeraided diagnosis solution is comparable to that of experts. It is useful to diagnose submerged molars with an AI application to prevent errors. In addition, this will facilitate the diagnoses of pediatric dentists.

Candidate gene sequencing reveals mutations causing hypoplastic amelogenesis imperfecta.

OBJECTIVE: Amelogenesis imperfecta (AI) is a rare hereditary disorder affecting the quality and quantity of the tooth enamel. The purpose of this study was to identify the genetic etiology of hypoplastic AI families based on the candidate gene approach. MATERIALS AND METHODS: We recruited three Turkish families with hypoplastic AI and performed a candidate gene screening based on the characteristic clinical feature to find the pathogenic genetic etiology. RESULTS: The candidate gene sequencing of the LAMB3 gene for family 1 revealed a heterozygous nonsense mutation in the last exon [c.3431C > A, p.(Ser1144*)]. FAM20A gene sequencing for families 2 and 3 identified a homozygous deletion [c.34_35delCT, p.(Leu12Alafs*67)] and a homozygous deletion-insertion (c.1109 + 3_1109 + 7delinsTGGTC) mutation, respectively. CONCLUSION: The candidate gene approach can be successfully used to identify the genetic etiology of the AI in some cases with characteristic clinical features. CLINICAL RELEVANCE: Identification of the genetic etiology of the AI will help both the family members and dentist understand the nature of the disorder. Characteristic clinical feature can suggest possible genetic causes.

Effectiveness of Different Cleaning Solutions in Removing Residual Caries-Detector Dyes.

OBJECTIVE: Caries-detector dyes (CDDs) have proven useful in the identification and removal of carious dentin. However, residues of these cleaning agents may remain in the oral cavity. This study conducted spectrophotomectric analyses to evaluate the effectiveness of different cleaning agents in removing residual CDDs from the oral cavity. MATERIAL AND METHOD: Ninety freshly extracted human third-molar teeth were used in the study. Tooth occlusal surfaces were ground to expose dentin. Specimens were randomly distributed into 3 groups according to CDD [Seek Caries Indicator (SCI), Caries Detector (CD), Caries Marker (CM)], and each group was further divided into 3 sub-groups according to cleaning solution [distilled water (DW), 3% NaOCl, and 3% H2 O2 )]. CDDs were applied to dentin surfaces according to the manufacturer's instructions and then rinsed with a cleansing solution. The effectiveness of cleaning solutions in removing CDD residues was determined according to color change by comparing spectrophotometric measurements of tooth color before CDD application and after cleaning. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's HSD test (α = 0.05). RESULT: For all CDDs groups, the smallest color differences were observed in the 3% NaOCl sub-groups (P < .05), and the largest in the distilled water sub-groups (P > .05). When compared to the other CDD groups, the SCI group yielded the greatest color differences for all cleaning-agent sub-groups. CONCLUSION: Cleaning solutions such as 3% NaOCl or 3% H2 O2 can be used to remove residual CDD from dentin surfaces. CLINICAL SIGNIFICANCE: This study compared the effectiveness of three different cleaning agents in caries removal process.

Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the acid resistance of the primary enamel.

BACKGROUND: This study aimed to investigate the effects of a fluoride varnish with added Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) treatments on acid resistance of primary teeth enamel. METHODS: Enamel specimens obtained from 40 primary incisors (for surface microhardness testing) and 40 primary molars (for demineralization depth measurement) were randomly divided into four groups (n = 10 incisors and 10 molars) each according to surface treatment: no treatment (control), MI varnish (1-8 % sodium fluoride and 1-5 % CPP-ACP), Clinpro White (1-5 % sodium fluoride and <5 % modified tricalcium phosphate), Duraphat (<5 % sodium fluoride). Specimens were stored for 24 h in a moist environment. After varnish residues were removed, specimens were subjected to pH cycling. The effects of fluoride varnishes were evaluated according to surface microhardness, lesion depth and structural changes. Results were analyzed by ANOVA and Tukey's tests. RESULTS: The lowest changes in surface microhardness and lesion depth occurred in MI varnish group, followed by the Clinpro White, Duraphat and no treatment (control) group (for percentage of loss surface microhardness -20.80, -34.60, -57.80 and -73.40; for lesion depth values 23.60 µm ± 3.36, 29.85 µm ± 3.27, 40.37 µm ± 3.41 and 54.56 µm ± 4.16, respectively). Statistically significant differences in both surface microhardness and lesion depth were observed among all groups (P < 0.05). CONCLUSIONS: Within the limitations of this in vitro study, fluoride varnish containing CPP-ACP was more effective in increasing the acid resistance of primary enamel than other fluoride varnishes. However, further clinical research is needed to confirm these in vitro results.

Partial Pulpotomy with BioAggregate in Complicated Crown Fractures: Three Case Reports.

This report describes three cases of complicated crown fractures treated with partial pulpotomy using BioAggregate. Three maxillary permanent central incisors with complicated crown fracture were treated by partial pulpotomy using BioAggregate and reviewed clinically and radiographically for 24 months. Throughout this period, there was no spontaneous pain, periapical radiolucency, and coronal discoloration; the pulp was observed to be vital. Based on these findings, it was concluded that BioAggregate can be used in partial pulpotomy treatment of complicated crown fracture.

Effect of Immediate Dentin Sealing on the Bonding Performance of Indirect Restorations: A Systematic Review.

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.

Two-year follow-up of indirect posterior composite restorations of permanent teeth with excessive material loss in pediatric patients: a clinical study.

PURPOSE: To evaluate the clinical effectiveness of indirect composite restorations in permanent molars with excessive substance loss in pediatric patients who have undergone root canal treatments. MATERIALS AND METHODS: Molars of 29 pediatric patients underwent endodontic treatment. Sixteen molars were restored with an indirect posterior composite resin restoration and 13 molars were restored with a direct posterior composite resin restoration. The success of the restorations was evaluated for 2 years based on United States Public Health Service (USPHS) criteria, photographs after staining with basic fuchsine, and radiographic data. Data obtained from both groups were compared using the Mann-Whitney U-test and Wilcoxon signed rank test. RESULTS: Evaluation of the clinical and radiographic data revealed no observable, statistically significant differences between the posterior and the indirect posterior composites (p > 0.05). However, evaluation of photos taken of the patients' molars after staining with basic fuchsin revealed that direct posterior composites showed increased staining on the margins of the restorations after six months (p < 0.05). CONCLUSION: Considering the difficulties of restoring endodontically treated permanent teeth with excessive substance loss in child patients, indirect restorations may be seen as a better option.

Timing of permanent teeth eruption in Turkish children.

OBJECTIVE: To identify the mean time of permanent teeth eruption in children aged 5-15 years in Samsun, Turkey. STUDY DESIGN: A total of 1,491 children aged 5-15 years (Female: 773; Male: 718) were included in this study. Teeth were recorded as either "not erupted" or "erupted," which was defined as having at least one cusp visible in the oral cavity. Differences between eruption times for males and females and for maxillary and mandibular teeth were analysed using independent t-tests. RESULTS: Eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars (p < 0.05). For both females and males, the first teeth to erupt were the central incisors and first molars, and the last to erupt were the second premolars, molars and canines. Mandibular incisors and canines erupted significantly earlier than their maxillary counterparts in both females and males (p < 0.05). CONCLUSION: In comparison with other studies, eruption times ofpermanent first molars, central and lateral incisors were delayed by several months, whereas eruption times of other teeth were accelerated by several months. The findings regarding eruption times should be considered when planning dental treatment.

Translated Mutant DSPP mRNA Expression Level Impacts the Severity of Dentin Defects.

Hereditary dentin defects are conventionally classified into three types of dentinogenesis imperfecta (DGI) and two types of dentin dysplasia (DD). Mutations in the dentin sialophosphoprotein (DSPP) gene have been identified to cause DGI type II and III and DD type II; therefore, these are not three different conditions, but rather allelic disorders. In this study, we recruited three families with varying clinical phenotypes from DGI-III to DD-II and performed mutational analysis by candidate gene analysis or whole-exome sequencing. Three novel mutations including a silent mutation (NM_014208.3: c.52-2del, c.135+1G>C, and c.135G>A; p.(Gln45=)) were identified, all of which affected pre-mRNA splicing. Comparison of the splicing assay results revealed that the expression level of the DSPP exon 3 deletion transcript correlated with the severity of the dentin defects. This study did not only expand the mutational spectrum of DSPP gene, but also advanced our understanding of the molecular pathogenesis impacting the severity of hereditary dentin defects.

The effects of children's drinks on the color stability of various restorative materials.

OBJECTIVE: To evaluate the effects of exposure to various children's drinks on the color stability of different esthetic restorative material commonly used in pediatric dentistry. STUDY DESIGN: Cylindrical specimens (15 x 2mm) were prepared from four different restorative materials (Fuji IX, Fuji II LC, Dyract Extra, and Filtek Z250). For each material, 20 specimens were prepared and divided into four groups. Each group was stored in a different solution (distilled water chocolate milk, cola, grape juice) for 24 hours. A colorimeter was used to measure the color of each specimen both before and after staining. Color change (deltaE*) was calculated, and data was analyzed using two-way ANOVA and Tukey HSD tests. RESULTS: For all restorative materials, the lowest deltaE* values were recorded for specimens stored in distilled water (0.42), followed by chocolate milk (0.88), grape juice (3.45) and cola (3.97). Among the four restorative materials tested, Fuji II LC showed the most color change (3.71) and Fuji IX the least (1.33). There were statistically significant differences among above groups (p < 0.05). CONCLUSIONS: DeltaE* values were acceptable for all materials tested, with the exception of Fuji II LC. Therefore, the use of RMGIC should be avoided in anterior restorations in children due to esthetic reasons.

Effects of Deproteinization on Bond Strength of Composite to Primary Teeth Affected by Amelogenesis.

Purpose: The purpose of this study was to evaluate the effect of different dentin deproteinization treatments on the microtensile bond strength (µTBS) of composite resin to primary dentin affected by hypocalcified amelogenesis imperfecta (AI). Methods: Flat dentin surfaces were obtained from both extracted hypocalcified AI-affected and sound primary molars and then randomly allocated into three groups according to surface treatment (deproteinization with sodium hypochlorite [NaOCl], deproteinization with chlorine dioxide [ClO2], nontreated controls). µTBS of specimens were measured with a universal testing machine, and data were analyzed using one-way analysis of variance and Tukey's tests. Results: The µTBS values for all groups with sound primary teeth were significantly higher than those of the comparable groups of hypocalcified AI-affected primary teeth (P<0.05). There were no statistically significant differences between the µTBS values of the control and the NaOCl groups for either the hypocalcified AI-affected or sound primary teeth (P>0.05); however, the µTBS values for the ClO2 groups were significantly higher than those of both the control and NaOCl groups (P<0.05). Conclusions: Within the limitations of this in vitro study, deproteinization with ClO2 can be considered effective in enhancing dentin bonding of hypocalcified AI-affected primary teeth.

Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion.

This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n = 10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey's tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p < 0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.

Solubility of two resin composites in different mouthrinses.

AIM: This study aimed to compare the solubility of a universal restorative resin composite (Filtek Z250; FZ250) and a silorane-based resin composite (Filtek Silorane; FS) after immersion in alcohol-containing mouthrinse, alcohol-free mouthrinse, and artificial saliva. METHODS: 30 discs (10 mm × 1 mm) were prepared from each material and desiccated until a constant mass was obtained. Specimens were immersed in the test solutions for two days and desiccated again. Solubility was calculated based on the change in weight of each specimen before and after immersion. Data was analyzed using two-way ANOVA and Tukey's Post Hoc test (P < 0.05). RESULTS: Solubility values for both resin composites were the highest in the alcohol-containing mouthrinse. FZ250 showed greater solubility than FS; the difference was only significant in artificial saliva. CONCLUSION: Both resin-composite materials tested exhibited some degree of solubility in each of the test solutions. The use of an alcohol-free mouthrinse may be preferable for patients with extensive composite restorations.

Shear bond strength of self-adhering flowable composite on dentin with and without application of an adhesive system.

PURPOSE: The aim of this study was to evaluate the shear bond strength (SBS) of conventional and self-adhering flowable resin composites on the dentin surfaces of primary and permanent teeth and to evaluate the effect of the application of an adhesive system under self-adhering flowable resin composite on SBS. METHODS: Prepared permanent and primary tooth dentin surfaces were randomly distributed into 3 groups according to application protocols as follows: group 1: Vertise Flow; group 2: OptiBond + Filtek Ultimate; and group 3: OptiBond + Vertise Flow. A universal testing machine was used to measure SBS of prepared specimens, and data were analyzed using 1-way ANOVA and Tukey test. RESULTS: Statistically significant differences were observed among all groups for primary and permanent teeth (P<0.05). The highest values were observed in group 2, followed by group 3, in both permanent and primary teeth. SBSs of all groups were significantly higher for permanent teeth than for primary teeth (P<0.05). CONCLUSION: Although SBS values of Vertise Flow groups were lower than those for conventional flowable resin composite groups, with further developments in material technology, self-adhering materials could be promising materials especially for pediatric dentistry.

Evaluation of survival of 3 different fixed space maintainers.

PURPOSE: The purpose of this study was to provide a comparative evaluation of the survival times and failure rates of different types of fixed space maintainers (SMs). METHODS: A total of 30 4- to 10-year-olds were selected for the study. Children were divided into 3 groups, according to type of SM, namely: band and loop (B&L), direct bonded (DB), and fiber-reinforced composite (FRC). Patients were recalled once every 3 months for clinical evaluation for 1 year or until failure. The survival times of SMs were estimated by means of the Kaplan-Meier method, and confounding factors were investigated using Cox regression analysis. RESULTS: Mean survival time was highest for B&L SMs (11.20 months), followed by DB SMs (9.20 months) and FRC SMs (6.70 months). There were statistically significant differences noted between types of SMs (log rank=11.99; P=.002). The Cox proportional hazards model revealed that age, sex, dental arch, and side of the jaw were not significantly correlated with "success of SMs" (P>.05). CONCLUSIONS: Band and loop fixed space maintainers showed superior performance in terms of both survival time and success rates versus direct bonded and fiber-reinforced composite space maintainers.

Effect of different topical fluoride applications on the surface roughness of a colored compomer.

OBJECTIVE: The aim of this study was to evaluate the effect of neutral sodium fluoride (NNaF) gel and acidulated phosphate fluoride (APF) gel on the surface roughness of colored compomer (Twinky Star), conventional compomer (Compoglass F) and resin-modified glass-ionomer cement (RMGIC) (Photac-Fil). MATERIAL AND METHODS: A total of 45 standardized disc-shaped specimens were prepared for each material. After 24 h, finishing and polishing of specimens were done with aluminum oxide disc. Surface treatments with topical fluoride agents or distilled water (control) were performed four times, and interspersed with 8 pH cycles, simulating high cariogenic challenges. After the treatment, the surface roughness (Ra) was determined using a profilometer. In each group, specimens with Ra closest to the mean were examined with a scanning electron microscope (SEM) at x1,000 and x3,500 magnifications. Two-way ANOVA was used to evaluate Ra measurements, and the differences in Ra values between subgroups for each material and each topical applications were compared by Tukey's highly significant difference pairwise comparisons. RESULTS: No statistically significant difference in Ra between the Twinky Star and Compoglass F was found. However, Photac Fil showed significantly higher Ra than these materials after all surface treatments. There was a general trend of Ra increase from controls to NNaF and APF gels for all materials. SEM observations revealed that the surface micromorphology of Twinky-Star did not differ significantly from that of Compoglass F. CONCLUSION: Both the compomers and the RMGIC showed significantly higher surface roughness when subjected to APF gel application.