Ilknur Tanboga

The effect of low level laser therapy on pain during dental tooth-cavity preparation in children

AIM: To evaluate the effect of low level laser therapy on pain during cavity preparation with laser in paediatric dental patients. STUDY DESIGN AND METHODS: The study was carried out on 10 children aged 6 to 9 years old for a total of 20 primary molar teeth. For laser preparation an Er: YAG laser was used. Half of the preparations were treated by low level laser therapy (LLLT) before laser preparation and the remaining half without LLLT (non-LLLT) before laser preparation. All cavities were prepared by ER:YAG laser, restored with light-cured composite resin following the application of acid etching and bonding agent. Children were instructed to rate their pain on the visual analogue scale (VAS) from 0 to 5 points. Statistical analyses were performed using Mann Whitney U test. REsulTs: VAS Median (min–max) scores were 1(0–2) for LLLT and 3(1–4) for the non-LLT treated children. Between LLLT and non-LLLT groups results were statistically significant (p<0.01). CONCLUSIONS: The use of LLLT before cavity preparation with laser decreased pain in paediatric dental patients.

Early Childhood Caries Is Associated with Genetic Variants in Enamel Formation and Immune Response Genes

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of an imbalance of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred and fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in 10 genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC, whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene interactions can act as protective or risk factors for ECC. These factors together contribute to the presence and severity of the disease.

Aquaporin 5 Interacts with Fluoride and Possibly Protects against Caries

Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.

In Vivo Evaluation of the Treatment Outcome of Pulpotomy in Primary Molars Using Diode Laser, Formocresol, and Ferric Sulphate

OBJECTIVE The purpose of this study was to assess whether the diode laser (DL) pulpotomy method is a suitable alternative to formocresol (FC) and ferric sulphate (FS) pulpotomies in human primary teeth. BACKGROUND DATA Pulpotomy is the amputation of infected coronal pulp to maintain radicular pulp vitality and function. Although FC is regarded as the gold standard for pulpotomy in primary teeth, concerns about its safety have been reported. Lasers are an effective nonpharmacological alternative for treating pulp in children. METHODS This study included 120 primary molars in 58 children 5-9 years of age who underwent an identical conventional pulpotomy technique; the molars were allocated to FC, FS, and DL groups. After removal of the coronal tissue, complete hemostasis of the remaining pulp in the DL group was achieved by DL at 1.5 W, 30 Hz, and 50 mJ, with a 10 sec exposure time. For the FC group, diluted FC (1:5 Buckleys formocresol) was used for 5 min., and for the FS group, a 15.5% FS solution was used for 15 sec. Treatments in all groups were completed with stainless steel crowns and monitored clinically and radiographically at 1, 3, 6, 9, and 12 months. RESULTS The clinical success rates at 12 months were 97%, 95%, and 100%, whereas the radiographic success rates were 87%, 79%, and 75%, for the FC, FS and DL groups, respectively. The differences in the results were not statistically significant according to the χ(2) test (p>0.05). CONCLUSIONS DL pulpotomy offers a high clinical success rate, however considering radiographic success rate, it may not replace traditional FC and FS pulpotomies in primary molars.

Conventional endodontic treatment of primary molars using metronidazole as an intra-canal medicament: a pilot study

AIM: This was to evaluate the clinical and radiographic outcomes of an antibacterial drug (Metronidazole, Nidazol, IE Ulagay Ilac A.S) application as an intra-canal medicament combined with pulpectomy in infected primary molar teeth. METHODS: The study material consisted of data collected from children treated at the Dental School Dept. of Paediatric Dentistry in Marmara University between 2000 and 2004. Clinical and radiographic data were collected over 2 years from patients who had received a topical application of metronidazole in root canal dressing before a pulpectomy was completed. Clinical success parameters were: no abscess formation, no fistula, no pain and no pathologic mobility at treated teeth with metranidazole dressing. The overall success and failure rates were analysed. Radiographic diagnosis was standardized between investigators and intra and inter-rater reliability assessed. Both investigators read and evaluated all radiographs, after a comparison of results, a consensus was agreed upon for each result. STATISTICS: All data were entered into an Excel format and SPSS 11.0 P < 0.05 were used for Windows and Chi-square for statistical analyses. RESULTS: There were 64 molars assessed for clinical and radiographic success. Considering the eruption times, success rate was 75% as determined by the last follow up clinically and radiographically according to predetermined success criteria. In the 64 molars, 4 cases demonstrated loss of the alveolar bone, 3 exhibited varying degrees of root resorptions on radiographic examination and 3 showed clinical pathologic mobility. Fistulae were observed in only 1 case and early loss was detected in 5 cases. CONCLUSION: These results suggest that main factors responsible for failure may be associated with uncertain mixing proportions of the metronidazole paste and inadequate maxillary restorations. But some modifications in preparing the paste could increase its efficacy.

Microbial Profile and Dental Caries in Cleft Lip and Palate Babies Between 0 and 3 Years Old

Objective: The aim of this study was to examine the microbiological changes in newborn babies with cleft lip palate from birth up to age 3 and to correlate them with their caries levels and mothers’ microbiological data and to compare with normal infants. Basic Research Design: Prospective. Settings: Marmara University, Faculty of Dentistry, Pediatric Dentistry Clinic, and Şişli Hamidiye Etfal Education and Research Hospital New Born Clinic. Patients/Participants: Cleft lip palate (n = 21) and healthy (n = 13) newborns and their mothers. Material and Methods: Intraoral samples were taken from babies in each group at least 3 times over the 3 years. Saliva samples of the mothers were collected just after the birth of the babies and examined microbiologically. Dental caries was noted as either present or absent. Results: The most frequent microorganisms were candida, found at birth (n = 9, 42%) in cleft palate with or without cleft lip (CP±L) group. The number of babies infected with Lactobacilli were found to be significantly higher in the CP±L group than in the control group at birth (P = .029) and after eruption of the first primary tooth (P = .030). Mutans Streptococci were found in 10% of babies with CP±L at birth. Initial caries was identified in 20% of the babies with an oral cleft compared with 0% of the controls after eruption of the first primary incisors. Conclusion: The results show that the CP±L babies must be considered as a group with an increased caries risk.

Acknowledgement to Reviewers 2014

Adair, P. Adams, G. Aleksejuniene, J. Alves, L. Amaechi, B. Anderson, P. Armfield, J. Arnold, W. Arthur, R. Ashley, P. Bader, J. Baelum, V. Baumann, T. Bertacci, A. Bhawal, U. Bjorndal, L. Bottenberg, P. Boushell, L. Bowen, W. Bradshaw, D. Braga, M. Breschi, L. Brighenti, F. Broadbent, J. Bronkhorst, E. Buchalla, W. Burnside, G. Burrow, M. Campus, G. Carey, C. Carpenter, G. Carvalho, J. Caufield, P. Charone, S. Chow, L.C. Clarkson, B. Creeth, J. Darvell, B. Dashper, S. Davies, J.