Mesut Elbay

Evaluation of the injection pain with the use of DentalVibe injection system during supraperiosteal anaesthesia in children: a randomised clinical trial

PURPOSE The purpose of this study was to compare the use of a traditional syringe (TS) and the DentalVibe (DV) Injection Comfort System on the pain of needle insertion and injection of supraperiosteal (SP) anaesthesia into the mandibles and maxillas of children aged 6-12 years. METHODS The study was a randomised, controlled, crossover clinical trial, comprising 60 children requiring an operative procedure with SP anaesthesia on both their mandibular and maxillary molars, bilaterally. One of the molars was treated with a TS, and the contralateral tooth was treated with the DV for both arches. On each visit, subjective and objective pain was evaluated using the Wong-Baker FACES Pain Rating Scale and the Face, Leg, Activity, Cry, Consolability Scale. Patients were asked which technique they preferred. The data were analysed using Wilcoxon signed-rank test, Spearmans correlation test, and Mann-Whitney U-test. RESULTS No statistically significant differences were noted between TS and DV for pain during injection and needle insertion for supraperiosteal anaesthesia in either the maxillary and mandibular operative procedures. CONCLUSIONS Children experienced similar pain during SP anaesthesia administered with a TS and the DV, regardless of gender and jaw differences. DV was less preferred over the traditional procedure in children.

Multidisciplinary approach to delayed treatment of traumatic teeth injuries involving extrusive luxation, avulsion and crown fracture.

A 12-year-old boy with extrusion of the maxillary right central incisor, uncomplicated fracture of the left central incisor, avulsion of the mandibular right and left central incisors, and crown fracture of the mandibular right lateral incisor presented to the Kocaeli University Department of Pediatric Dentistry 20 days after sustaining the traumatic injuries. Orthodontic repositioning of the extrusive maxillary right central incisor was planned. Additionally, this tooth was necrotic and needed root canal treatment. The maxillary left central incisor and right mandibular lateral incisor were necrotic and needed root canal treatment. The orthodontic and endodontic treatments were successfully performed simultaneously. Restoration of the fractured mandibular right lateral incisor and maxillary left central incisor was completed with resin composite. Subsequent to orthodontic and endodontic treatment, prosthodontic rehabilitation was performed. At the two-year followup, the teeth appeared normal and the patient had no complaints.

Temporomandibular disorders and oral parafunction in children living with their parents and children living in institutional protective care: a comparative study.

AIM This study aimed: (i) to identify and compare the prevalence of temporomandibular disorders (TMDs) and oral parafunctions among children living in child-protection institutions (CLCPI) with children living with their parents (CLWP); (ii) to determine whether or not there is an association between oral parafunctions and TMDs; and (iii) to examine the possible impact of stress on TMDs. STUDY DESIGN The study was conducted on a total of 385 children who were divided into two groups: the CLCPI group (n = 184); and the CLWP group (control, n = 201). All children 8-18 years of age and living in protective-care facilities in Kocaeli, Turkey, were included in this study in the CLCPI group. The CLWP control group comprised children of the same age as those in the CLCPI group, but those in the CLWP group were living with their families and were randomly selected from one primary school, one elementary school and one high school in Kocaeli, Turkey. Each child in the study completed a questionnaire and underwent a clinical examination. RESULTS The overall prevalence of TMDs and oral parafunctions were higher in the CLCPI group than in the CLWP group (P < 0.05). The vast majority of participants reported at least one parafunction (CLCPI, n = 97.3%; CLWP, n = 93%). Problems related to family or friends were higher in the CLCPI group, whereas problems related to school lessons were higher in the CLWP group (P < 0.05). In both groups, positive associations were found between signs and symptoms of TMDs, oral parafunctions and stressful life events. CONCLUSION The prevalence of signs and symptoms of TMDs and oral parafunctions differed significantly between CLCPI and CLWP groups, with children of the CLCPI group found to be significantly more prone to TMDs and oral parafunctions than children of the CLWP group.

Intraligamentary and Supraperiosteal Anesthesia Efficacy Using a Computer Controlled Delivery System in Mandibular Molars.

PURPOSE The purpose of this study was to compare pain, efficacy and postoperative complications of anesthesia in first primary mandibular molars anesthetized with either intraligamentary (IL) or supraperiosteal (SP) anesthesia using a computer-controlled delivery system (CCDS). STUDY DESIGN This randomized, controlled-crossover, blind clinical trial was conducted with 90 children requiring bilateral extraction, pulpotomy or restorative treatment of first mandibular primary molars. A CCDS was used to deliver IL anesthesia to 1 deciduous tooth and SP anesthesia to the contralateral tooth in each patient. Severity of pain and efficacy of anesthesia during the treatments were evaluated using the Wong-Baker Faces Pain Rating Scale (PRS) and comfort and side effects were assessed using post-injection and post-treatment questionnaires. Data were analyzed using χ2 and Mann-Whitney U tests. RESULTS According to PRS scores, pain levels during extraction were significantly higher with IL when compared to SP. Patients reported significantly less pain during needle insertion with SP when compared to IL; however, rates of postoperative complications were significantly higher with SP when compared to IL. CONCLUSIONS CCDS-administered IL anesthesia and SP anesthesia were similarly effective when used during restorative treatment and pulpotomy of primary mandibular molars; however, SP was more effective than IL when used during extraction procedures.

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars

OBJECTIVES The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS). STUDY DESIGN The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann-Whitney U, Wilcoxon t, and Fisher exact tests. RESULTS Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively. CONCLUSIONS Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

Bir üniversite hastanesindeki pedodonti kliniğine başvuran 156 dental travma olgusunun değerlendirilmesi: Retrospektif araştırma

Amac: Bu calismanin amaci Kocaeli Universitesi Dis Hekimligi Fakultesi Pedodonti Anabilim Dalina 2015-2016 yillari arasinda travmatik dis yaralanmalari (TDY) nedeniyle basvuran cocuk hastalarin verilerinin restrospektif olarak degerlendirilmesidir.Gerec ve Yontemler: Kocaeli Universitesi Dis Hekimligi Fakultesi Pedodonti Anabilim Dali kliniginde calisan hekimlerin dijital ortamda doldurdugu formlar TDY’nin tipi, lokalizasyonu ve travmatik yaralanmadan etkilenen dis sayisi, numarasi, travmatik yaralanma sonrasi dis hekimine basvurma suresi ve dis yaralanmalarinin meydana geldigi aylar acisindan degerlendirilmistir. Elde edilen verilerin SPSS 20.0 (SPSS Inc., Chicago, IL, USA) paket programi kullanilarak frekans dagilimlari verilmis ve ki-kare testi ile analizleri gerceklestirilmistir.Bulgular: Yuz elli alti adet travma olgusundan 152’ sinde 244 adet disin yaralandigi, 3 olgunun dis yaralanmasi olmaksizin sadece yumusak doku yaralanmasi icerdigi ve 1 olgunun da dis yaralanmasi icermeksizin sadece sert doku yaralanmasi icerdigi tespit edildi. Travma olgulari kizlarda ve erkeklerde esit oranda goruldu (p > .05). 0-6 yas arasi hastalarda travma en cok evde gerceklesirken, 7-12 yas arasinda en sik okulda meydana geldigi tespit edildi. Travma nedenleri arasinda dusme birinci sirada yer aldi. Travma en cok maksiller on bolgede gozlenirken, hastalarin yalnizca %43’ u travma tedavisi icin dis hekimine 24 saat icerisinde basvurdu.Sonuc: Travma olgularinin en cok evde ve okulda gerceklesmesi ve hastalarin yarisindan cogunun tedavi icin 24 saat sonrasinda basvurmasi travma olgularinda erken mudahale acisindan toplumsal bilinc eksikliginin gostergesi sayilabilir. Cocuk hastalara uygun tedaviyi gerceklestirmek kadar toplumsal bilincin artirilmasi icin pedodontistlere buyuk sorumluluklar dusmektedir.

Management of two-rooted maxillary central and lateral incisors: A case report with a multidisciplinary approach involving CAD/CAM and CBCT technology

A thorough knowledge of the root morphology and variations closely relates with the success of endodontic therapy. Although it is rare, additional roots or canals may exist in maxillary incisors, which is an important variation to consider. This paper describes the multidisciplinary management of a maxillary central incisor and a lateral incisor, both of which presented two roots with aberrant crown morphology that was verified by cone beam computed tomography and restored with prosthetic rehabilitation involving full-contour monolithic zirconia crown after root canal treatment.

Management of an Intruded Tooth and Adjacent Tooth Showing External Resorption as a Late Complication of Dental Injury: Three-Year Follow-Up

Treatment and prognosis of intrusive luxation can vary depending on the age of the patient, type of dentition, stage of root development, and time and severity of the trauma. Some studies have demonstrated that intrusions of up to 3.0 mm have an excellent prognosis, whereas teeth with severe intrusion or teeth that are intruded more than 6.0 mm present an unfavorable prognosis because of the occurrence of inflammatory resorption and pulp necrosis. The aim of this case report is to present an 11-year-old male patient with complete intrusion of the permanent maxillary left lateral incisor, associated with the adjacent central tooth presenting external resorption, treated by immediate surgical repositioning and root canal treatment with a favorable prognosis. After long-term (3-year) clinical and radiographic follow-up, the teeth appeared normal and the patient was pleased with the outcome.