Funda Yanikoglu

Caries detection with DIAGNOdent and ultrasound

OBJECTIVE The objective of this study was to evaluate the repeatability of 2 nondestructive caries detection methods, ultrasound (ULS) and DIAGNOdent, for the detection of approximal caries lesions, and to evaluate 2 tips provided for the DIAGNOdent. STUDY DESIGN White/brown-spot lesions (n = 42) were captured by a digital camera, and measured by test methods and confocal laser scanning microscope (CLSM). Intra- and inter-observer reliability, accuracy, and Cohens kappa and Spearmans rho statistics were used. RESULTS At DIAGNOdent, intra-observer agreements were 78.5%, 66.7% for A tip and 59.5%, 47.6% for B for 2 examiners, respectively. Accuracy of both tips was 50% for the first examiner; 45.3% for A and 47.6% for the B tip for the second examiner. All ULS measurements were accurate, reliable, and positively and significantly correlated between examiners. CONCLUSION The A tip of the DIAGNOdent was found to be better than the B tip for the detection of enamel caries. All DIAGNOdent and ULS measurements were positive and significantly correlated for both examiners. Both methods demonstrated high repeatability and accuracy.

Direct composite laminate veneers: three case reports.

Re-establishing a patient’s lost dental esthetic appearance is one of the most important topics for contemporary dentistry. New treatment materials and methods have been coming on the scene, day by day, in order to achieve such an aim. Most dentists prefer more conservative and aesthetic approaches, such as direct and indirect laminate veneer restorations, instead of full-ceramic crowns for anteriors where aesthetics is really important. Laminate veneers are restorations which are envisioned to correct existing abnormalities, esthetic deficiencies and discolo-rations. Laminate veneer restorations may be processed in two different ways: direct or indirect. Direct laminate veneers have no need to be prepared in the laboratory and are based on the principle of application of a composite material directly to the prepared tooth surface in the dental clinic. Indirect laminate veneers may be produced from composite materials or ceramics, which are cemented to the tooth with an adhesive resin. In this case report, direct composite laminate veneer technique used for three patients with esthetic problems related to fractures, discolorations and an old prolapsed restoration, is described and six-month follow-ups are discussed. As a conclusion, direct laminate veneer restorations may be a treatment option for patients with the esthetic problems of anterior teeth in cases similar to those reported here.

Direct Midline Diastema Closure with Composite Layering Technique: A One-Year Follow-Up

Objective. Maxillary anterior spacing is a common aesthetic complaint of patients. Midline diastema has a multifactorial etiology such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Appropriate technique and material for effective treatment are based on time, physical, psychological, and economical limitations. Direct composite resins in diastema cases allow dentist and patient complete control of these limitations and formation of natural smile. Clinical Considerations. In this case report a maxillary midline diastema was closed with direct composite resin restorations in one appointment without any preparation. One bottle total etch adhesive was used and translucent/opaque composite resin shades were layered on mesial surfaces of the teeth that were isolated with rubber dam and Teflon bands. Finishing and polishing procedures were achieved by using polishing discs. Patient was informed for recalls for every 6 months. Conclusions. At one-year recall no sensitivities, discolorations, or fractures were detected on teeth and restorations. Direct composite resins seemed to be highly aesthetic and durable restorations that can satisfy patients as under the conditions of case presented.

Ultrasound May Aware Us about Initial Root Caries Lesion

Since it is difficult to obtain a well-bonded restoration at root surface, it becomes important to detect root caries at the initial stage. The aim of this study was to detect and to quantify a root surface lesion at the initial stage and quantify the amount of remineralization. The additional aim was to evaluate the effectiveness of the recent diagnostic devices (Ultrasound, Quantitative Light Induced Fluorescence (QLF), DIAGNOdent), compared to Confocal Laser Microscopy (CLSM), for detection of the initial root caries in vitro. The specimens (4 mm × 2 mm × 3 mm) (n: 64) were prepared from the selected extracted human teeth. Before demineralization with in vitro microbial caries model, specimens’ halves (baseline) were covered with nail varnish. The specimens were evaluated by the following nondestructive methods: Ultrasound, QLF, DIAGNOdent systems and a destructive method; CLSM (n=5) after demineralization and remineralization. Following demineralization and obtaining the measurements by the systems, the specimens were randomly distributed into three groups (n: 21, each group) for remineralization. In the first group, the specimens were kept in artificial saliva (0 ppm fluoride); in the second group, 1100 ppm fluoride was applied (2 × 1); and in the third group both 1100 ppm fluoride (2 × 1), and Bifluoride12 varnish were applied once a week, for five weeks. All systems differentiated demineralization from baseline, including Ultrasound. All systems also differentiated in assessing the remineralization from baseline. There was difference between demineralization and remineralization between the control method, Confocal microscopic evaluations, and Ultrasound. Remineralization differences of 1100 ppm F toothpaste and/or varnish were found to be different from demineralization by the QLF system. DIAGNOdent only noticed remineralization by 1100 ppm Fluoride and varnish applied group compared to demineralization. Actually both remineralization groups were not found as different from each other by all detection systems here. There was not any significant difference between demineralization and 0 ppm fluoride groups by all methods as well. It was concluded that demineralization of root surface incipient lesions could be detected by the novel nondestructive methods of Ultrasound, DIAGNOdent and QLF in vitro. Remineralization of initial root caries lesion may require different treatment regimen in in vitro studies.

Caries Experience of Black Stained Teeth Using ICDAS II

Background: Black Tooth Stain (BS) is one of the local extrinsic discolorations generally seen on cervical area of a tooth and associated with low caries experience. The aim was to analyse caries status of black stained teeth by International Caries Detection and Assessment System (ICDAS II). Methods: A total of 111 teeth with BS and 144 with non-BS teeth of 10 subjects were recorded. ICDAS Scores after visual (naked eye, mirror-sound and digital photography) and radiographic examinations. Group 1 ICDAS 0 scores has indicated ‘non-carious’; group 2 ICDAS 1-2 as reversible lesion (White spot lesion) and group 3 ICDAS 3,4,5,6 were saved as ‘cavitated carious’ teeth. All teeth which have restorations, crowns and such appliances were excluded from the data. Results: The proportion of the teeth without caries is significantly higher among the teeth with black-stain (BS) than the teeth without BS. (62.2% and 36.1% respectively; X2=18.231, p<0.001). More detailed analysis showed that statistically significant difference exists between all of the three groups (p<0.001). Additionally, six of total 10 patients were reported as suffering from Fe+ deficiency with different degrees. Conclusion: Black stained teeth showed less caries scores compared to non-BS. While it was a tooth-specific and local formation, ICDAS II enabled exact and tooth-specific definition.

Clinical Success of IPS Empress II Inlays/Onlays

For the dental restorations, ceramic materials have increasing popularities because of their biocompatibility and superior esthetics. IPS Empress which is leucite-reinforced glass ceramic is one of the most popular ceramics. IPS Empress II was developed in following years which is stronger than IPS Empress. In the dental applications some problems occur about ceramic restorations. Hence,this study was performed to examine the six-year clinical performance of IPS Empress II ceramic onlay and inlay restorations.