Arzu Pinar Erdem

Mineral trioxide aggregate for obturation of maxillary central incisors with necrotic pulp and open apices

There are few reports on treatment of necrotic pulps with mineral trioxide aggregate (MTA) for apexification. Five immature teeth with necrotic pulps were treated with the use of an apical plug of MTA for apexification. All teeth were central incisors that had premature interruption of root development caused by a previous trauma. According to the treatment protocol, the root canals were rinsed with 5% NaOCl; then calcium hydroxide paste was placed in the canals for 1-6 weeks. The apical portion of the canals were filled with MTA. The rest of the canals were obturated with lateral condensation of the gutta-percha applied with a canal sealer. At 6 months, 1 year and 2 year follow-up periods the clinical and radiographic appearance of the teeth showed the resolution of the periapical lesions and continued root end development in all except in the one case in which the MTA was extruded out the apex. MTA can be considered a very effective option for apexification with the advantage of reduced treatment time, good sealing ability and high biocompatibility.

Effects of Two Fluoride Varnishes and One Fluoride/Chlorhexidine Varnish on Streptococcus mutans and Streptococcus sobrinus Biofilm Formation in Vitro

Aims: The aim of this study was to evaluate and to compare the effect of two fluoride varnishes and one fluoride/chlorhexidine varnish on Streptococcus mutans and Streptococcus sobrinus biofilm formation, in vitro. Study design: Standard acrylic discs were prepared and divided into groups based on the varnish applied to the disc surface: Fluor Protector, Bifluoride 12, and Fluor Protector + Cervitec (1:1). Untreated discs served as controls. In the study groups, biofilms of S. mutans and S. sobrinus were formed over 24 h, 48 h, and 5 days. The fluoride concentrations in the monospecies biofilms and viable counts of S. mutans and S. sobrinus were investigated. Results: In all study groups, a statistically significant increase in the viable number of S. mutans and S. sobrinus cells was observed between 24 h and 5 days. In both monospecies biofilms, the greatest antibacterial efficacy was detected in the Fluor Protector and Fluor Protector + Cervitec groups at 24 h. For all groups, the amount of fluoride released was highest during the first 24 h, followed by a significant decrease over the next 4 days. A negative correlation was detected between fluoride concentration and antibacterial effect in those groups with biofilms containing both species. Despite the release of high levels of fluoride, the greatest number of viable S. mutans and S. sobrinus cells was detected in the Bifluoride 12 group. Statistics: The data were analyzed using GraphPad Prism software (ver. 3). Conclusions: The Fluor Protector + Cervitec varnish exerted prolonged antibacterial effects on S. mutans and S. sobrinus biofilms compared to the other varnishes tested.

Enamel–Renal–Gingival syndrome, hypodontia, and a novel FAM20A mutation

Enamel–Renal–Gingival Syndrome, Hypodontia, and a Novel FAM20A Mutation Piranit Nik Kantaputra,* Chotika Bongkochwilawan, Massupa Kaewgahya, Atsushi Ohazama, Hulya Kayserili, Arzu Pinar Erdem, Oya Aktoren, and Yeliz Guven Center of Excellence in Medical Genetics Research, Chiang Mai University, Chiang Mai, Thailand Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Chiang Mai University, Chiang Mai, Thailand Craniofacial Genetics Laboratory, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand Dentaland Clinic, Chiang Mai, Thailand Division of Oral Anatomy, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan Medical Genetics Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey Department of Pedodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey

Root healıng wıth MTA after horıizontal fracture

BACKGOUND: Root fractures in permanent teeth are uncommon injuries and represent complex healing patterns. Fractures occur most often in the middle third of a root and rarely at the apical third. CASE REPORTS: Case 1: A 10-year old boy attended the Dept. Paediatric Dentistry Clinic (Istanbul University) after an accident at school 4 hrs earlier. Clinically there was a swollen upper lip, pain on the periapical region of the tooth and horizontal root fractures in the middle third of both roots of teeth 11 and 21 were noted on periapical radiography. Case 2: An 8-year old boy was involved in a bicycle accident 3 months prior to attending. A maxillary splint was present on incisor 11. Clinically an enamel-dentine crown fracture and radiographically a horizontal mid-third root fracture, were seen. Case 3: An 11-year old boy attended after a bicycle accident 1 month before, involving tooth 21. Clinically there was mobility, slight discolouration and radiographically a horizontal mid-third root. TREATMENT: In all cases only the coronal segment of roots were treated and MTA was placed as a fracture line plug. FOLLOW-UP: At 36 months follow up all teeth were asymptomatic and clinical and radiographic investigation of the teeth revealed excellent healing patterns. CONCLUSION: MTA can be considered as a good choice for a definitive root filling material in horizontal tooth root fractures with excellent biological and physical properties.

A new method to estimate dental age

Abstract Objective. The aim of this study was to evaluate the accuracy of Demirjians method in estimating the dental age in Turkish children and to estimate the validity of Demirjians standards for the studied population. Materials and methods. Panoramic radiographs of 756 northwestern Turkish children aged 5–13 years were examined. The new method for dental age estimation for both genders was studied to determine the relationship between dental age, chronological age and Demirjians scores. Descriptive statistics were used and analysis of correlation was carried out between chronological age, dental age and Demirjians scores. The difference between dental age and the chronological age was determined with the paired t-test. Results. The results showed that northwestern Turkish children had delays in dental maturity. The new method was applied to Demirjians scores and dental age scales for both genders were obtained. The tables were used to adapt Demirjians scores to dental age determination in Turkish children using the new formula. Conclusions. The developmental standards used by Demirjian are not suitable for northwestern Turkish children. The methods for determining dental development must have population-specific standards. The established gender-specific equations and the new tables are more appropriate for dental age assessment in northwestern Turkish children.

MAXILLARY INCISOR TRAUMA IN PATIENTS WITH CLASS II DIVISION 1 DENTAL MALOCCLUSION: ASSOCIATED FACTORS

Purpose: The aim of this study was to assess the association between the presence of maxillary incisor trauma (MIT) with age, gender, dentition type, the degree of overjet (OJ), lip form, respiratory type and dental arch form in patients with Class II division 1 dental malocclusion. Subjects and Methods: 256 patients (mean age: 15.80 ± 2.2) were included in this study. The patients’ gender, dentition type, superior lip form, dental arch form and respiratory type were recorded. Participants were divided into four groups according to the severity of OJ: 3.5 mm<Group 1 (OJ I) ≤6 mm with competent lip, 3.5 mm<Group 2 (OJ II) ≤ 6 mm with incompetent lip, 6 mm<Group 3 (OJ III) ≤9mm, 9 mm<Group 4 (OJ IV). Mann Whitney-U test was used to examine the group differences for trauma and non-trauma groups. Logistic regression analysis was used to assess the factors for trauma and their risk indicators. Results: 3.5 mm<OJ II≤ 6 mm with incompetent lip had the highest odds of experiencing MIT among the OJ groups with an odds ratio (OR) of 3.143 and 95% confidence interval (CI) 1.125-2.779. The odds were 3.572 times higher in the group with short lip form than found in the group with normal lip form (OR 3.572, 95% CI 1.130-2.340). Conclusion: The age, gender, respiratory type and dental arch form were not significantly associated the risk of MIT. OJ between 3.5 mm and 6 mm (with incompetent lip) and short lips increased the risk of having maxillary incisor trauma in patients with Class II division 1 malocclusion.

ZİHİNSEL ENGELLİ ÇOCUKLARDA DAVRANIŞ YÖNETİMİ VE TEDAVİ YAKLAŞIMLARI-Behavior Management and Treatment Considerations For Children With Intellectual Disability

oz Engelli bireylerin agiz-dis sagligi; genel sagliklari icin alinan ilaclar, uygulanan terapiler ya da karyojenik diyetler ile gunluk agiz bakiminin saglanmasindaki guclukler nedeniyle olumsuz etkilenmektedir. Bu makalede, zeka geriligi, Anahtar kelimeler: Zihinsel engellilik, davranis yonetimi, Down sendromu, Otizm, Fragile X sendromu ve ogrenme guclugu olan cocuklarda genel/dental bozukluklar irdelenmistir. Bu derlemede hasta grubuna yonelik davranis yonetimi ve periodontal, restoratif, endodontik, protetik acidan tedavi yaklasimlari degerlendirilmistir. Bilindigi gibi zihinsel engelli bireylerde agiz hastaliklarindan korunmanin hayati onemi vardir. Bu nedenle koruyucu programlar erken baslatilmali ve uzun bir sureye yayilmalidir. Ideal olani agiz hijyen uygulamalarinin, gunluk rehabilitasyon egitimi ve guclendirici terapi programlari ile desteklenmesidir. dental tedavi ABSTRACT Oral-dental health of disabled individuals has been effected due to use of general health drugs, application of therapies or cariogenic diets and some difficulties in practice of daily mouth care. In this review, general/dental disabilities are examined on children with mental disability, Down syndrome, otism, Fragile X syndrome and learning disability. Behavior management and treatment considerations in terms of periodontology, restorative, endodontic, prosthodontics for these type of patients are examined. As it is known that protection of mentally disabled patients from oral diseases take an important place in his/her life. Therefore preventive programs have to be started as early as possible and lasted in a long period. The best way of this can be pointed out that the oral hygiene practices are supported by daily rehabilitation training and intensified therapy programs. Keywords: Intellectual disability, behavior management, dental treatment