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Objective:People with disability have worse oral health than the healthy ones usually because of their inability to perform good daily oral hygiene, lack of knowledge of their caregivers and inadequate health policies. This study aimed to evaluate the oral health-related knowledge, practices and opinions of a group of caregivers in the biggest care home in Turkey.Materials and Methods:A total of 170 caregivers were requested to complete a questionnaire prior to receiving training regarding oral health. The chi-square test was used to evaluate the statistical significance.Results:Among the 322 residents with disability, 255 (79.2%) had mental disability and 64 (19.9%) had physical disability. Of the caregivers, 147 volunteered to participate (response rate 86.5%). Their mean age was 41.4 years. More than half of the caregivers (n=98, 66.6%) had been working for 5 to 14 years. Most of them (81.6%) reported that they performed oral hygiene procedures for 228 residents, and 97 (44.1%) reported that they brushed the teeth of residents three times per day. However, 102 caregivers reported that they did not know about the significance of dental plaque. Nearly two-thirds of the caregivers (n=95, 64.6%) had not previously received any education regarding oral care and 98 declared that they need training, of whom 74 requested that it should be practical. Female caregivers needed oral care training more than male caregivers. Although not statistically significant, caregivers who have been working for ≤5 years and those with at least a high school education reported more need for oral care training. The caregivers working ≤5 years had the least level of previous education on oral care.Conclusion:The caregivers need comprehensive training on oral health in the biggest care home in Turkey to be able to provide adequate oral health care for the disabled residents.

Objective: The aim of this study is to evaluate the relationship between packaged product label and medication package insert reading habits of parents and their children’s oral/dental health. Study design: A questionnaire including demographic characteristics and label/insert reading habits was filled by parents of 301 children who referred to the Pediatric Dentistry Department. The children were examined intraorally and dmft/DMFT and ICDAS II scores were recorded. The data were evaluated statistically. Results: Label and medication package insert reading were found in 71.4% and 88.4% of the parents, respectively. Label reading increased as the age of the child and the number of children in the family increased. Medical package insert reading increased as the mother’s education and SLS/paraben knowledge increased. Decrease of 1 point in ICDAS II resulted in the 1.410 times increase in the rate of medical package insert reading of the parents. Conclusion: It is concluded that improving the label and medical insert reading rate of the parents would be effective for providing better oral and dental health for their children.

Introduction Esophageal atresia (EA) is a congenital anomaly, presenting multifactorial etiology. Swallowing problems and gastroesophageal reflux disease may accompany EA, which have adverse effects on oral health. Materials and Methods In this descriptive study, intraoral examination of the children with repaired EA and of the dental patients without systemic/chronic disease was performed. Dental caries, dental erosion, and halitosis status were evaluated using the International Caries Detection and Evaluation System II, and the Basic Erosive Wear Examination indices as well as the Halimeter, respectively. Results There were 19 (n = 12 male; n = 7 female) case subjects and 16 (n = 10 male; n = 6 female) control subjects whose age ranged between 14 and 72 months. Among cases, 15 children had dental caries (78.9%; initial caries n = 4, moderate caries n = 4, and extensive caries n = 7). Of the controls, 13 had dental caries (81.2%; initial caries n = 5, moderate caries n = 5, and extensive caries n = 3). Although the median scores of decayed, missing, filled teeth (dmft) and decayed, missing, filled surfaces (dmfs)—for primary dentition—were not statistically significantly different between two groups, both dmft and dmfs were found to be higher among the case subjects (p = 0.172 for dmft; p = 0.230 for dmfs). Furthermore, six children with repaired EA had dental abnormalities (in shape, number, or calcification) and six children with repaired EA had dental erosion. The Halimeter measurement was performed for five case children of whom three had oral malodor, and for seven control children of whom two had oral malodor. Conclusion Regular dental counseling adopting the multidisciplinary team approach for patients with EA is necessary to ensure better general and oral health.

Triplication is a rare dental anomaly and defined as the fusion of three teeth. In the present case report, a five-year-old healthy girl with the triplication of the two mandibular primary right incisors along with a supernumerary tooth was presented. A periapical radiograph, panoramic radiograph and cone-beam tomography of the triple tooth revealed separate pulp chambers combining in the cervical area and forming one pulp canal along the root. In the treatment planning, pit and fissure sealant was applied for prevention and the patient was recalled for regular follow-up appointments. After 24 months, the triple tooth had been replaced by the permanent successor without any dental abnormality.

This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisors by endodontic treatment and the use of mineral trioxide aggregate (MTA) apical plugs. A 10-year-old boy was referred to the clinic with a chief complaint of pain in his maxillary central incisors, which had experienced subluxation trauma 2 years earlier. Periapical radiograph of the teeth showed incomplete root development with wide-open apices and large periradicular lesions. The canals were gently debrided using K-files in conjunction with 2.5% NaOCl irrigation and 2% chlorhexidine for final flush. The root canals became asymptomatic after employing the same endodontic regimen for three visits. MTA plugs were placed in the apical area of the root canals, and the rest of the canal space was obturated by warm compaction of gutta-percha and AH Plus sealer. Resolution of the large periapical lesions was observed 2 months after treatment. At 18 months, the periapical areas revealed radiographic evidence of bone healing. Following successful removal of the toxic content of the root canal, placement of MTA plugs resulted in both healing of the periradicular radiolucency and regeneration of the periapical tissue.

This report describes the 24-month clinical and radiographic outcome of an unintentionally extruded mineral trioxide aggregate (MTA) apical plug. A 9 year old boy presented with a previously traumatized, immature central incisor; associated with a large periradicular lesion. During placement of MTA in the treatment of wide open apex, the material was inadvertently extruded into the periapical region upon a sudden movement of the child. No intervention was made, except for obturation of the remaining root canal two weeks later. The radiographic follow up at 12 and 24 months confirmed successful management through the non surgical approach, as evidenced by advanced healing of the periapical lesion and regeneration of the periradicular tissue in the absence of clinical symptoms.

Background. The design of the bristles of a toothbrush can affect the overall efficacy of toothbrushing. Aim. To evaluate and compare a number of selected features associated with the bristle (length, number and end-rounding quality) of manual child and adult toothbrushes. Design. The bristle lengths of 11 child and 29 adult toothbrushes were measured on digital micrographs using open source image analysis software. Bristles of tufts from five regions were counted and classified as acceptable or non-acceptable on stereomicroscopic images according to the end-rounding morphology. The data was evaluated statistically. Results. The number of bristles were similar in child and adult toothbrushes (P > 0.05). Despite significant differences in bristle end-rounding in some regions (P 0.05). Conclusions. The variations observed in the number, length and end-rounding quality of the bristles indicate inherent shortcomings of a majority of the tested toothbrushes in plaque removal efficacy, along with the potential for irritation on the gums.

The purpose of this study was to assess the clinical performance of composite restorations placed with different adhesive systems in primary teeth. In 32 patients, 128 composite restorations were placed using a split-mouth design as follows (4 groups/patient): three-step etch-and-rinse (Group 1), two-step etch-and-rinse (Group 2), two-step self-etch (Group 3), and one-step self-etch (Group 4). The restorations were clinically evaluated at baseline and at 6, 18, and 36 months according to the FDI criteria. There was no significant difference between the adhesive systems in retention of the restorations (p>0.05). Over time, there was a statistically significant decrease in marginal adaptation in all groups, whereas surface and marginal staining significantly increased in Groups 3 and 4 (p<0.05). The etch-and-rinse adhesive systems resulted in better marginal adaptation than the self-etch adhesive systems (p<0.05). It was concluded that preetching of the primary enamel might help improve the clinical performance of the self-etch adhesive systems in primary teeth.

The purpose of this study was to evaluate the effects of the total-etch and direct pulp capping techniques on the short-term response of mechanically exposed human primary tooth pulps using three commercially available adhesive resin systems. Class V cavities were prepared on the buccal surface of intact mandibular primary molars and exposed with a carbide bur on the cavity floor. The entire cavity except the exposure site received 36% phosphoric acid gel conditioning. Exposed pulps were capped with one of the three adhesive resins, followed by restoration of the cavities with the respective restorative materials. The teeth were extracted after 60 days and prepared according to normal histological techniques. Serial sections were stained with H/B for histological evaluations. The histopathological evaluation showed that a few of the samples in the Scotchbond Multi Purpose (SMP) and Prime & Bond 2.1 (PB) groups exhibited "attempted bridge formation", while no bridge formation was evident in the other samples. Syntac Single Component (Syntac) exhibited the most severe histological response, while the mildest reactions were observed in the SMIP group. Based on the conditions of the present study, direct pulp capping with dentin bonding agents following the total-etch technique in primary teeth can not be recommended.

This study evaluated the shear bond strengths of orthodontic brackets bonded to human premolars using five different combinations of flowable composites and one-step self-etching adhesives (n=12): (1) Adper Easy Bond+Filtek Supreme XT Flow; (2) Futurabond NR+Grandio Flow; (3) Clearfil S3 Bond+Clearfil Majesty Flow; (4) AdheSE One+Tetric EvoFlow; and (5) Transbond Plus Self Etching Primer+Transbond XT Light Cure Adhesive. After shear bond strength testing, adhesive remnant index (ARI) scores were given according to the amount of adhesive and resin remaining on the brackets. On shear bond strength, there were no statistically significant differences between Groups 2 and 4 and between Groups 3 and 5 (p>0.05). On ARI scores, the predominant ARI scores in Groups 1, 2, 3, and 5 were 4, 2, 5, and 4 respectively; in Group 4, they were 0 and 4. Results showed that some combinations of flowable composites and self-etching adhesives might not be suitable for orthodontic use due to their low shear bond strengths and high ARI scores -with the latter signaling the risk of damaging the enamel surface during debonding.

ABS TRACT Regional odontodysplasia (RO) is an unusual developmental anomaly which usually affects unilateral maxillary teeth of primary or permanent dentition. It is common in females and has typical clinical, radiographical and histological findings. In the present case, an unusual type of RO has shown. The patient was a 5-year-old male and the involved tooth was the primary mandibu lar right central incisor. Clinical findings of yellow-brown discoloration, malformation, malposi tion and severe mobility of the involved tooth were detected. A “ghost-like” appearance of the tooth which is one of the typical features of the abnomality was noticed radiographically. The in volved primary tooth was extracted and evaluated histologically. The histological analysis also con firmed the diagnosis of RO. In this case report, history and clinical, radiographical and histological features were discussed.

PURPOSE To investigate in otherwise healthy children the association between the caries index, the stimulated salivary flow rate (SFR), and the spectral Doppler findings of the changes in blood perfusion in the salivary glands during the secretion of saliva. MATERIALS AND METHODS The study group consisted of 38 children with a mean age of 9.47 ± 1.89 years. The caries index was calculated by determining the number of decayed, missing, and filled teeth. Groups A, B, and C represented subjects with low, moderate, and normal SFRs, respectively, calculated by obtaining chewing-stimulated whole saliva. All subjects were examined by color Doppler ultrasonography (CDUS) before and during secretory stimulation with lemon, by which maximum systolic velocity (MSV), pulsatility index (PI), resistive index (RI), and flow volume (FV) were calculated at the external carotid and facial arteries. RESULTS The differences for spectral indices obtained before and after stimulation were significantly different among Groups A, B, and C at the external carotid artery (P = 0.006 for delta MSV, P = 0.014 for delta PI, P < 0.001 for delta RI, and P = 0.022 for delta FV) and at the facial artery (P = 0.001 for delta MSV, P = 0.004 for delta PI, P < 0.001 for delta RI, and P < 0.001 for delta FV). In addition, significant correlations were calculated between the SFR and the aforementioned delta values. CONCLUSION CDUS enabled the evaluation of changes in blood perfusion in the salivary glands during salivary stimulation and may be a promising tool for the assessment of caries risk in children.

This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisors by endodontic treatment and the use of mineral trioxide aggregate (MTA) apical plugs. A 10-year-old boy was referred to the clinic with a chief complaint of pain in his maxillary central incisors, which had experienced subluxation trauma 2 years earlier. Periapical radiograph of the teeth showed incomplete root development with wide-open apices and large periradicular lesions. The canals were gently debrided using K-files in conjunction with 2.5% NaOCl irrigation and 2% chlorhexidine for final flush. The root canals became asymptomatic after employing the same endodontic regimen for three visits. MTA plugs were placed in the apical area of the root canals, and the rest of the canal space was obturated by warm compaction of gutta-percha and AH Plus sealer. Resolution of the large periapical lesions was observed 2 months after treatment. At 18 months, the periapical areas revealed radiographic evidence of bone healing. Following successful removal of the toxic content of the root canal, placement of MTA plugs resulted in both healing of the periradicular radiolucency and regeneration of the periapical tissue.

The design of the bristles of a toothbrush can affect the overall efficacy of toothbrushing.To evaluate and compare a number of selected features associated with the bristle (length, number and end-rounding quality) of manual child and adult toothbrushes.The bristle lengths of 11 child and 29 adult toothbrushes were measured on digital micrographs using open source image analysis software. Bristles of tufts from five regions were counted and classified as acceptable or non-acceptable on stereomicroscopic images according to the end-rounding morphology. The data was evaluated statistically.The number of bristles were similar in child and adult toothbrushes (P0.05). Despite significant differences in bristle end-rounding in some regions (P0.05), the overall quality of bristles were similar in child and adult toothbrushes (P0.05).The variations observed in the number, length and end-rounding quality of the bristles indicate inherent shortcomings of a majority of the tested toothbrushes in plaque removal efficacy, along with the potential for irritation on the gums.

The aim of this study was to quantify the buffer attributes (value, power, range and optimum) of two model systems for whole human resting saliva, the purified proteins from whole human resting saliva and single proteins. Two model systems, the first containing amyloglucosidase and lysozyme, and the second containing amyloglucosidase and alpha-amylase, were shown to provide, in combination with hydrogencarbonate and di-hydrogenphosphate, almost identical buffer attributes as whole human resting saliva. It was further demonstrated that changes in the protein concentration as small as 0.1% may change the buffer value of a buffer solution up to 15 times. Additionally, it was shown that there was a protein concentration change in the same range (0.16%) between saliva samples collected at the time periods of 13:00 and others collected at 9:00 am and 17:00. The mode of the protein expression changed between these samples corresponded to the change in basic buffer power and the change of the buffer value at pH 6.7. Finally, SDS Page and Ruthenium II tris (bathophenantroline disulfonate) staining unveiled a constant protein expression in all samples except for one 50 kDa protein band. As the change in the expression pattern of that 50 kDa protein band corresponded to the change in basic buffer power and the buffer value at pH 6.7, it was reasonable to conclude that this 50 kDa protein band may contain the protein(s) belonging to the protein buffer system of human saliva.

This case report presented a combined surgical/orthodontic treatment of an impacted permanent incisor of a 10-year-old boy. Trauma to the primary dentition caused the impaction of the maxillary left permanent central incisor. Application of push coil spring between the adjacent teeth created space for the impacted tooth. A button with an extension of ligature wire was bonded to the maxillary left permanent central incisor to bring it into the arch. The maxillary left permanent central incisor was brought to its proper position after 16 months of active orthodontic treatment.

This study evaluated the clinical performance of a polyacid-modified resin composite, Dyract AP (De Trey/Dentsply), under different conditioning methods in primary teeth. Eighty-one box-shaped cavity preparations (three restorations per patient) on the mesial or distal surfaces of primary first or second molars were prepared in 27 patients. The cavity preparations were either non pre-treated or pre-treated with 36% phosphoric acid or NRC (De Trey/Dentsply). The teeth were restored with PrimeBond NT (De Trey/Dentsply) and Dyract AP. The restorations were evaluated at baseline and 6, 12 and 18-month recalls according to the modified Ryge criteria by two calibrated operators. The data obtained from the clinical assessment of all restorations were subjected to statistical analysis by chi-square-tests at a 0.05 level of significance. The ratings of each criteria were compared among each evaluation period between treatment groups. Statistical analysis revealed no significant difference among each evaluation period between groups in regard to color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form and retention.

The treatment of a transverse complicated and a vertical uncomplicated crown-root fractures with a horizontal root fracture of a maxillary right central incisor is presented. Coronal fragments were extracted atraumatically and gingivectomy was performed with electrosurgery to expose the subgingival fragment. The root canal was treated with calcium hydroxide to perform the healing at the fracture site. After the root fracture healing, a post was cemented into the canal and the coronal fragment was attached with a composite resin. Examination 18 months after treatment revealed good aesthetics and normal function.

This study determined the radiopacity of 21 commercially available direct esthetic restorative materials with reference to an aluminum step wedge and an equivalent thickness of enamel and dentin. A total of 168 samples measuring 6 mm in diameter and 1 mm in thickness, with eight samples of each material, were prepared from restorative materials. Enamel and dentin samples 1-mm thick were also prepared by longitudinally sectioning eight extracted human permanent molars using a microslicing machine. The optical densities of each restorative material, along with one tooth section and an aluminum step wedge were measured from radiographic images using a transmission photodensitometer. The optical density values of the specimens were used to determine the aluminum thickness equivalent values. The data were analyzed with one-way analysis of variance (ANOVA) and Duncan's multiple range tests. The results showed statistically significant differences among materials. Tetric Ceram had the greatest radiopacity value and was higher than enamel. All materials except for the microfilled resin composite Filtek A 110 had radiopacity values greater than dentin and possessed sufficient radiopacity to meet ISO 4049 standard. Significant differences were found among materials of the same composition when compared to enamel.

This case report presented the orthodontic management of an ankylosed primary molar. Trauma to the maxillary right second primary molar resulted in the infraocclusion of the affected tooth as well as the mesial tipping of the adjacent first permanent molar and displacement of the permanent successor. After extraction of the ankylosed primary molar, orthodontic therapy was performed to upright the adjacent permanent molar and to gain the lost space of its permanent successor. By the application of orthodontic mechanics, the maxillary right permanent first molar was uprighted and the maxillary right permanent second premolar was brought to its proper position.

Many fluoride-releasing dental materials are being sold on the basis of their cariostatic properties. However, the amount fluoride release of these materials is still uncertain. This study investigated the fluoride release and uptake characteristics of four flowable resin composites (Heliomolar Flow, Tetric Flow, Wave, Perma Flo), one flowable compomer (Dyract flow), one conventional glass ionomer cement mixed with two different powder/liquid ratios (ChemFlex Syringeable and ChemFlex Condensable), one packable resin composite (SureFil), one ion-releasing composite (Ariston pHc) and one resin-modified glass ionomer cement (Vitremer). Seven discs (6-mm diameter and 1.5-mm height) were prepared for each material. Each disc was immersed in 3.5 ml of deionized water within a plastic vial and stored at 37 degrees C. The deionized water was changed every 24 hours and the release of fluoride was measured for 30 days. At the end of this period, the samples were recharged with 2 ml of 1.23% acidulated phosphate fluoride (APF) gel for four minutes. Then, all samples were reassessed for an additional 10 days. The fluoride release of all samples was measured with a specific fluoride electrode and an ionanalyzer. Statistical analyses were conducted using two-way repeated measure ANOVA and Duncan's multiple range tests. For all tested materials, the greatest fluoride release was observed after the first day of the study (p0.01) but gradually diminished with time. During the test period, Tetric Flow released the lowest amount of fluoride; however, no statistically significant difference was found from Wave and Heliomolar Flow (p0.05). Ariston pHc released the highest amount of fluoride, followed by ChemFlex Syringeable, Vitremer and ChemFlex Condensable. There were statistically significant differences among these materials (p0.05). Fluoride release of all materials were significantly increased after the first day following refluoridation and Ariston pHc released the greatest among all materials (p0.01). At the end of two days of refluoridation, the fluoride release rate for each material dropped quickly and stabilized within three days.

This study evaluated the microleakage of a flowable polyacid-modified resin composite used as a fissure sealant on air-abraded teeth in comparison to a resin-based fluoride sealant. Sixty extracted human third molars were divided into six subgroups (n = 10) under two main groups (fissure sealant materials). The occlusal surfaces of the teeth were air-abraded at 80 psi using 50 microm particles of aluminum oxide for 30 seconds, followed by rinsing and drying. Delton FS+ (Dentsply International) and Dyract Flow (Dentsply DeTrey) were applied to the teeth in subgroups following application of: a) an acid etching and bonding agent, b) bonding agent alone or c) air-abrasion alone, respectively. Acid etching (Delton EZ Etch, Dentsply International) and bonding agent application (PrimeBond NT, Dentsply DeTrey) were done according to the manufacturers' instructions. The teeth were thermocycled for 500 cycles between 5 degrees C and 55 degrees C with dwell time of 15 seconds. Basic fuchsin (0.5%) staining followed by buccolingual sectioning was performed. Microleakage was evaluated at 20x optical magnification. Kruskal-Wallis test was used to make comparisons among six subgroups. Pairwise comparisons were done with the Mann-Whitney U test with the level of significance set as alpha = 0.05. Dyract Flow application as a fissure sealant on air-abraded permanent teeth in combination with acid etching and/or bonding agent provided microleakage results comparable to Delton FS+. Results also showed that the use of air abrasion, alone, resulted in significantly higher microleakage scores.