Alp Erdin Koyuturk

Effects of different topical agents on enamel demineralization around orthodontic brackets: an in vivo and in vitro study

BACKGROUND The aim of this study was to evaluate the in vivo and in vitro effects of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride containing topical agents in reducing enamel demineralization around orthodontic brackets, and to compare this with a control group. METHODS Twenty-one patients and 60 extracted premolars were divided into three groups: two experimental and one control. Tooth Mousse® (CPP-ACP gel; GC-Corp, Tokyo, Japan) and Fluoridin N5® (Fluoride gel; Voco-GmbH, Cuxhaven, Germany) were applied to tooth surfaces around orthodontic brackets in the experimental groups. Teeth were extracted after 60 days to evaluate the in vivo effects of the testing materials. For the in vitro experiment, samples were cycled for 14 days through a daily procedure of demineralization. All teeth were sectioned and evaluated by superficial microhardness analysis. An indentation was made from two positions (occlusal-cervical) and one depth (10 μm). RESULTS Comparisons of occlusal and cervical microhardness scores for all specimens showed no statistically significant side differences. A multiple comparison test showed that the use of CPP-ACP and fluoride containing topical gels were more significantly efficient than the control group (p<0.001). No significant differences were detected between CPP-ACP and the fluoride groups against demineralization. CONCLUSIONS In vivo and in vitro evaluations indicated that CPP-ACP and fluoride containing agents successfully inhibited caries around orthodontic brackets.

Effect of antibacterial monomer-containing adhesive on enamel demineralization around orthodontic brackets: An in-vivo study

INTRODUCTION The aims of this study were to evaluate the effect of an antibacterial monomer-containing self-etching adhesive in reducing enamel demineralization around orthodontic brackets in vivo and to compare it with the conventional adhesive system quantitatively. METHODS Fourteen orthodontic patients were randomly divided into 2 equal groups; they received brackets fitted to all their teeth, bonded with either Clearfil Protect Bond (Kuraray Medical, Okayama, Japan) (experimental group) or Transbond XT (3M Unitek, Monrovia, Calif) (control group). Block randomization to obtain equal numbers in each group was used. After 30 days, all first premolars were extracted with orthodontic indications and longitudinally sectioned. Demineralization was assessed by cross-sectional microhardness. Determinations were made at the bracket edge cementing limits and at occlusal and cervical points 100 and 200 μm away from the edge. In all of these positions, 6 indentations were made at depths of 10 to 90 μm from the enamel surface. Analysis of variance (ANOVA) and the Tukey post-hoc test were used. The statistical significance level was set at P <0.05. RESULTS ANOVA showed statistically significant differences for adhesive type, position, depth, and their interactions (P <0.05). The multiple comparison test showed that the antibacterial monomer-containing adhesive was significantly more efficient than the conventional adhesive system, reducing enamel demineralization in almost all evaluations (P <0.05). CONCLUSIONS The results indicated that using antibacterial monomer-containing adhesive for bonding orthodontic brackets successfully inhibited caries in vivo. This cariostatic effect was localized at the area around the brackets and was significant after 30 days.

Dental development in children with mild-to-moderate hypodontia

INTRODUCTION The aim of this study was to compare dental development in a group of children with mild-to-moderate hypodontia with a matched group. METHODS A study group of 70 children (43 girls, 27 boys) with hypodontia, aged 5.3 to 12.5 years, was matched for race, age, and sex with 140 healthy, normal control subjects. The childrens dental ages were calculated by using a modified dental-age estimation method. Differences between dental and chronologic ages were analyzed by t tests, and the correlations between differences in dental and chronologic ages and the numbers of missing teeth were analyzed with the Spearman correlation test. RESULTS Dental development in children with mild-to-moderate hypodontia was significantly delayed compared with the control group (P <0.05); however, the mean difference did not exceed 0.3 years in either sex. No correlation was observed between the differences in dental and chronologic age and the severity of hypodontia. CONCLUSIONS Children with mild-to-moderate hypodontia had delayed dental development of a few months; this was statistically significant. Because of individual variations, each patient should be carefully examined.

Effects of Chlorhexidine and Povidone-Iodine Mouth Rinses on the Bond Strength of an Orthodontic Composite

The purpose of this study was to determine whether the application of two antibacterial mouth rinses to etched and unetched enamel affects the shear bond strength (SBS) of an orthodontic composite resin. Eighty-five lower human incisors were divided into five groups, ie, group 1: control group, no mouth rinse was used; groups 2 and 3: mouth rinses were applied to the intact enamel surface before etching; groups 4 and 5: mouth rinses were applied to the etched enamel. A bonding agent and a composite resin were applied to the teeth surface. For shear bond testing, the specimens were mounted in a universal testing machine, and an apparatus attached to a compression load cell was applied to each specimen until failure occurred. The data were analyzed using analysis of variance and Tukey honestly significance tests. Fracture modes were analyzed by Mann-Whitney U-test. There was no statistically significant difference between the SBS values of group 1 (31.64 +/- 3.62 MPa) and group 4-five experimental applications (P > or = .05). However, the SBS value of group 3 (36.56 +/- 5.95 MPa) was significantly larger than those of group 4 (30.00 +/- 4.97 MPa) and group 5 (30.26 +/- 7.30 MPa). In addition, no significant differences were observed between group 1 and groups 2 (34.33 +/- 7.26 MPa) and 3 (36.56 +/- 5.95 MPa) (P > or = .05). Because the application of chlorhexidine and povidone-iodine before acid etching did not cause any decrease in bond strength, it is advisable for use under the orthodontic resin composite to obtain an antibacterial effect or to prevent the risk of bacteremia.

In vivo effects of amorphous calcium phosphate-containing orthodontic composite on enamel demineralization around orthodontic brackets

BACKGROUND The aim of this study was to evaluate the in vivo effects of an amorphous calcium phosphate-containing orthodontic composite in reducing enamel demineralization around orthodontic brackets, and to compare it with the control. METHODS Fourteen orthodontic patients were divided into two equal groups. They received brackets fitted to all first premolars, bonded with either Aegis Ortho® (The Bosworth Co.), an ACP-containing orthodontic composite (experimental group), or Concise® (3M Dental Products), a resin-based orthodontic composite (control group). After 30 days, the teeth were extracted and longitudinally sectioned, and evaluated by superficial-microhardness analysis. The determinations were made at the bracket edge cementing limits and at occlusal and cervical points 100 and 200 μm away from the edge. In all of these positions, indentations were made at depths of 10, 20, 30, 50, 70, and 90 μm from the enamel surface. Analysis of variance (ANOVA) and Tukey post hoc test was used. The statistical significance level was set at p<0.05. RESULTS The ANOVA showed statistically significant differences for position, material, depth, and their interactions (p<0.001). The multiple comparison test showed that the ACP-containing orthodontic composite was significantly more efficient than the control composite, reducing enamel demineralization in almost all evaluations (p<0.001). CONCLUSIONS Present results indicated that ACP-containing orthodontic composite for bonding orthodontic brackets successfully inhibited demineralization in vivo. This effect was localized to the area around the brackets and was statistically significant after 30 days.

A retrospective evaluation of traumatic dental injury in children who applied to the dental hospital, Turkey

OBJECTIVE The purpose of this study was to analyze traumatic dental injuries in children visiting the dental hospital emergency department in Samsun of Turkey, in the period from 2007 to 2011. MATERIALS AND METHODS Data of age, gender, causes of dental trauma, injured teeth, type of dental injuries, the application period, the dental treatments, and traumatic dental injuries according to the seasons were obtained from the records at dental hospital. RESULTS Of all 320 patients with traumatic dental injury, 205 were boys and 115 were girls with a boys/girls ratio 1.78:1. Traumatic dental injury was observed more frequently in the 7-12 age groups: 52.5% in girls and 67.8% in boys. Falls are the major cause of traumatic dental injury in the age group 6-12 (51.4%). Sport activities are a common cause of traumatic dental injury in the 7-12 age group (34.2%). Patients visited a dentist within approximately 2 h (57.1%). The upper anterior teeth were subjected to trauma more frequently than the lower anterior teeth. The maxillary central incisors were the most commonly affected teeth, and the mandibular canins were the least affected teeth. In primary teeth, avulsion was the most common type of dental injury (23%); on the other hand, enamel fractures were the most common type of dental injury (30.6%) observed in permanent teeth. In the primary dentition, the most commonly performed treatments were dental examination and prescribing (70%). The most common treatment choices in permanent teeth were restoration and dental examination (49.7 and 15.8%, respectively). CONCLUSION The results of the study show that the emergency intervention to traumatized teeth is important for good prognosis of teeth and oral tissues. Therefore, the parents should be informed about dental trauma in schools, and dental hospital physicians should be subjected to postgraduate training.

Influence of different tooth types on the bond strength of two orthodontic adhesive systems

The aim of this investigation was to evaluate the effects of different tooth types on the shear bond strength (SBS) of two orthodontic resin adhesive systems in vitro. Two hundred extracted sound human teeth were used in the study. Ten teeth of each tooth type were the mounted in acrylic resin leaving the buccal surface of the crowns parallel to the base of the moulds. In each experimental group, the adhesives (Transbond XT™ and Light Bond™) were applied to the etched enamel surfaces. The orthodontic composite resins were then applied to the surface in cylindrical-shaped plastic matrices. For SBS testing, a force transducer (Ultradent™) was applied at a crosshead speed of 1 mm/minute at the interface between the tooth and composite until failure occurred. Data were analysed using two-way analysis of variance (ANOVA), Kruskal–Wallis one-way ANOVA, a Bonferroni adjusted Mann–Whitney U-test, and an independent t-test. Generally, it was found that tooth type had a significant effect on SBS (P < 0.05) with Light Bond™ showing a higher SBS than Transbond XT™ (P < 0.05). The highest bond strengths were observed for the upper central incisor and lower molars with Light Bond™ (P < 0.05) and the lowest mean bond strengths for the upper molars and lower canine with Transbond XT™ (P <0.05). The results demonstrated that enamel SBS was significantly altered by both tooth type and adhesive system. Thus, the findings of this study confirm that enamel bond strength is not uniform for all teeth. These results may also explain the variability in the enamel-bonding efficacy of adhesives.

A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities

PURPOSE The purpose of this study is to determine the properties of the dental procedures performed on children with dental problems under general anesthesia and compared between the patterns of dental treatment provided for intellectual disability and non-cooperate healthy child. MATERIALS AND METHODS In this retrospective study, the records of patients between the ages of 4 and 18 who were treated under general anesthesia were evaluated. Patients were divided into two groups: Those with intellectual disability and healthy patients who had difficulty cooperating. A statistical analysis of the mean standard deviation was conducted with a focus on two factors: Age and dental treatment methods. RESULTS In this study, it was observed that restorative treatment and tooth extraction was generally higher in intellectual disability children than in their healthy children. When evaluating the health status of teeth, the value of decayed missing and filled teeth (dmf-t) was observed to be close in healthy and intellectual disability individuals in the 4-6 age groups; it was higher in individuals with intellectual disability in the 7-12 age groups. There was no significant difference in terms of periodontal treatment and fissure sealants in the 12-18 age groups. CONCLUSIONS By comparing the different patient groups who received dental treatment under general anesthesia, both the number of teeth extracted and DMF-T indices were higher in the disabled group. Therefore, especially more efforts should be made at encouraging these patients to visit the dentist earlier and receive primary preventive care.

Multiple dentoalveolar traumatic injury: a case report (3 years follow up)

Dental trauma with children and adolescents is a serious dental public health problem. Traumatic injuries on permanent teeth are common, and dramatic episodes can occur during childhood. Cases of dental avulsions and reimplantations, dentoalveolar fractures, several forms (lateral, extrusive and intrusive) of luxations, concussion, subluxation, gingival lacerations and hard, pulpal dental tissue lesions have been extensively reported. This case report presents the therapy for severe trauma caused by multiple traumatic injuries to the dentoalveolar complex of a patient.

Evaluation of the effect of food and beverages on enamel and restorative materials by SEM and Fourier transform infrared spectroscopy

Objectives To examine different types of restorative materials used in children as well as primary and permanent teeth enamel when affected by erosive foods. Materials and Method Buttermilk, fruit yoghurt, Coca‐cola, fruit juice, Filtek Z‐250, Dyract Extra, Fuji II LC, and Fuji IX and tooth enamel were used. Measurements were performed on 1‐day, 1‐week, 1‐month, 3‐month, 6‐month time periods by using ATR‐FTIR technique and surface of the specimens were examined with SEM. Results Permanent tooth showed the least change among human tooth samples when compared to restorative materials. Among filler materials, the most change was observed in Fuji IX. In terms of beverages the most changes on absorption peaks obtained from spectra were seen on the samples held in Coca‐Cola and orange‐juice. Conclusion The exposure of human enamel and restorative materials to acidic drinks may accelerate the degradation process and so reduce the life time of filler materials at equivalent integral exposure times longer than three months. Clinical Relevance Erosive foods and drinks having acidic potential destroy not only tooth enamel but also restorative materials. Microsc. Res. Tech. 77:79–90, 2014.