Mesut Enes Odabaş

Accuracy of two different apex locators in primary teeth with and without root resorption

The objective of this study was to assess the accuracy of two frequency apex locators, Root ZX (Morita, Kyoto, Japan) and Endex (Osada, Tokyo, Japan) in primary teeth with and without root resorption in vitro. For this study, 90 sound extracted primary teeth (60 molars and 30 incisors; 93 roots with visible resorption and 51 roots without) were selected. A total of 144 root canals were included. After access preparation, root canal lengths were measured visually. The teeth were embedded in an alginate model developed specifically for testing apex locators. Electronic length was determined with two different frequency apex locators, Root ZX (Morita, Kyoto, Japan) and Endex (Osada, Tokyo, Japan). Statistical evaluation was performed using Mann–Whitney U and Wilcoxon W tests (p < 0.05). Results revealed that both apex locator devices did not show similar values to visual length measurements with statistically significant differences in primary teeth with root resorption (p < 0.05). For the teeth without root resorption, Endex showed similar values to visual length measurements with no statistically significant differences (p > 0.05), but Root ZX values were different than visual length and the differences were statistically significant (p < 0.05). There were no significant differences between the two apex locators considering the presence of root resorption. The two frequency apex locators can be recommended for use in root canal therapy for primary teeth with and without root resorption, only if electrical determination of root canal length is supported with other diagnostic measures.

Clinical evaluation of the plaque‐removing ability of three different toothbrushes in a mentally disabled group

The aim of the study was to evaluate the efficacy of plaque removal of three different toothbrushes on mentally disabled children in two different age groups. A manual triple‐headed brush (SuperBrush; Dento Co. AS [junior, regular]) compared with a new manual toothbrush (CrossAction; Oral‐B [35 compact, 40 regular]) and an electric toothbrush with an oscillating rotating head (Braun Plaque Control 3D [Braun 3D]; Oral‐B [D15525]). Fifteen children aged 6–12 (Group A) and 15 children aged 13–18 (Group B) with mild mental disabilities participated in the single‐blind clinical study. To obtain a plaque‐free condition at baseline, professional tooth‐cleaning was performed on each participant. After instructions on how to use the toothbrushes, each group started the experiment. After 1 week of application, the Quikley Hein (QH) plaque index and the approximal plaque index (API) were used to assess the oral hygiene status of each participant. This was followed by a week of recess before each group switched to the next type of toothbrush. The study lasted for 5 weeks. Compared to the two other brushes, the Braun 3D was more effective in removing plaque (means of QHI: 1.54 (Braun 3D), 1.77 (SuperBrush), and 2.15 (CrossAction) in total; means of API 1.37 (Braun 3D), 1.52 (SuperBrush), 1.94 (CrossAction). The study indicated that the electric toothbrush is the most effective for removing dental plaque in mentally disabled children, whereas the SuperBrush is a good alternative.

Short-term antimicrobial properties of mineral trioxide aggregate with incorporated silver-zeolite

The purpose of this in vitro study was to determine whether adding silver-zeolite (SZ) to mineral trioxide aggregate (MTA) would enhance the antimicrobial activity of MTA against Staphylococcus aureus (ATCC #25923), Enterococcus faecalis (ATCC #29212), Escherichia coli (ATCC#25922), Pseudomonas aeruginosa (ATCC #27853), Candida albicans (ATCC #90028), Porphyromonas gingivalis (ATCC #33277), Actinomyces israelii (ATCC #12102), and Prevotella intermedia (ATCC# 15032). SZ was added at 0.2% and 2% mass fraction concentration to MTA powder. The control group was MTA powder with no SZ. The antimicrobial effect test was accomplished by placing freshly mixed MTA specimens on agar plates inoculated with microorganisms and comparing the zones of inhibition at 24, 48, and 72 h. The amounts of silver ion release from MTA specimens were measured with atomic absorption spectrophotometry at 10-min, 24-, 48-, and 72-h periods. The pH of MTA specimens was measured with a pH meter at 10-min, 24-, 48-, and 72-h periods. MTA with 2% and 0.2% SZ specimens showed inhibitory effects on some microorganisms at all time periods, whereas no antimicrobial activity showed for P. intermedia and A. israelii. MTA without SZ inhibited C. albicans, E. Coli, and P. intermedia. The highest silver release was detected in 2% SZ MTA at 24 h. The incorporation of SZ may enhance the antimicrobial activity of MTA.

Clinical and radiographic outcomes of calcium hydroxide and formocresol pulpotomies performed by dental students

OBJECTIVE The aim of this study was to compare the clinical and radiographic success rates of 3 pulpotomy techniques: formocresol, calcium hydroxide, and calcium hydroxide/iodoform. STUDY DESIGN The pulpotomies were performed by fifth-year undergraduate dental students. Members of senior staff at the clinics supervised all of the procedures. Informed consent was obtained from each childs parents. The teeth were randomly assigned to the experimental (calcium hydroxide and calcium hydroxide/iodoform) or control (formocresol) groups. After coronal pulp removal and hemostasis, remaining pulp tissue was covered with calcium hydroxide or calcium hydroxide/iodoform paste in the experimental groups. In the control group, formocresol was placed with a cotton pellet over the pulp tissue for 5 minutes and removed; the pulp tissue was then covered with zinc oxide-eugenol. All teeth were restored with stainless-steel crowns. Clinical and radiographic successes and failures were recorded at 1-, 3-, 6-, and 12-month follow-ups by the authors. Data were statistically analyzed using chi-squared tests. RESULTS The follow-up evaluations revealed that the clinical success rates were 89.7% for formocresol, 33.3% for calcium hydroxide, and 17.2% for calcium hydroxide/iodoform. The radiographic success rates were 89.7% for formocresol, 33.3% for calcium hydroxide, and 13.8% for calcium hydroxide/iodoform. CONCLUSIONS Formocresol was superior to calcium hydroxide and calcium hydroxide/iodoform pastes for primary molar pulpotomies. Internal resorption was the most common radiographic failure in all 3 pulpotomy techniques.

Antibacterial effect of a new haemostatic agent on oral microorganisms.

Objective: The purpose of this study was to determine the antibacterial effect of a newly developed haemostatic agent Ankaferd Blood Stopper® (ABS) and Ferric Sulphate (FS) on various oral microorganisms. Study design: Bacterial strains were freshly incubated in their specific broth media. For each of the strains, 3 wells per each agent, with a 5 mm diameter were made under aseptic conditions in the specific agar media. Then they were filled with a test agents or 0.2% chlorhexidine digluconate (CHX) (control group). After 24h and 48h incubation periods, inhibition zones were measured. Results: ABS showed antibacterial effect on all test microorganisms except Lactobacillus acidophilus and Lactobacillus salivarius. Ferric sulphate and CHX have antibacterial effect on all microorganisms. When the test agents compared, the inhibition zones of the ABS were found smaller than the ferric sulphate and CHX. Conclusions: Although ferric sulphate and ABS have antibacterial effect, ferric sulphate had better antibacterial activity than ABS on oral microorganisms under in vitro condition. FS and ABS not only exhibit the haemostatic activity but also antimicrobial activity. Key words:Ankaferd blood stopper, ferric sulphate, haemostatic agent, haemostasia, bleeding, bactericide.

In vitro comparison of digital and conventional bitewing radiographs for the detection of approximal caries in primary teeth exposed and viewed by a new wireless handheld unit

OBJECTIVES The aim of this study was to compare the diagnostic quality of a new wireless handheld unit (ADX4000; Dexcowin Co. Ltd, Korea) on conventional bitewings and its LCD screen for the detection of approximal caries in primary teeth. METHODS In total, 108 approximal surfaces of primary teeth were examined in vitro by 3 observers. Conventional films were viewed under subdued lighting conditions on a conventional view box. Digital 3.5 inch images were displayed on the built-in monitor of the ADX4000 and digital 17 inch images were viewed on a 17 inch monitor. The true caries diagnosis was based on histological assessment of the approximal surfaces after sectioning the primary teeth. Receiver operating characteristic (ROC) curve (A(z)) analysis was used to assess the diagnostic quality of imaging modalities. RESULTS The areas under the ROC curves ranged from 0.786 (digital 17 inch) to 0.813 (digital 3.5 inch). No statistically significant differences were found between the three modalities for detecting approximal caries. CONCLUSIONS It was concluded that the diagnostic quality of conventional film and digital images, which were exposed and viewed by a new wireless handheld unit, was comparable.

The success rates of a glass ionomer cement and a resin-based fissure sealant placed by fifth-year undergraduate dental students.

AIM: To evaluate retention and caries prevention of a glass-ionomer cement (GIC) and a resin-based fissure sealant placed by fifth-year undergraduate dental students. METHODS: The study was conducted according to a split-mouth, randomised clinical trial. Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study. The children were selected from a population that had a high risk for dental caries. Sealant materials were applied by fifth-year undergraduate dental students on 346 fissures of the first permanent molars in 173 children. The ages of the children ranged from 7–15 years (mean 9.4). Two researchers at the clinics supervised all of the procedures. Intra-examiner reproducibility and inter-examiner reproducibility were 0.90 and 0.86, respectively, for the clinical assessment of sealant retention and caries evaluation. RESULTS: GIC sealants were completely lost in 31.9% and resin-based sealants in 16.6% (p<0.05). The total retention rates of GIC sealants and resin-based sealants were 13.8% and 20.8%, respectively. After 24 months, the caries increment was 3.4% for GIC sealants and 4.8% for resin-based sealants (p>0.05). CONCLUSIONS: The retention of GIC sealants was markedly inferior to the retention of resin-based sealants; however, GIC when used as a pit and fissure sealant was slightly more effective in preventing occlusal caries.

Comparison of laser fluorescence devices for detection of caries in primary teeth.

The aim of this in vivo study was to evaluate the performance of fluorescence-based devices in detecting occlusal caries lesions in primary molars compared with conventional methods. Two examiners assessed 44 occlusal surfaces of first and second primary molars in 20 patients using two fluorescence devices: DIAGNOdent (LF) and DIAGNOdent pen (LFpen). Teeth were also assessed by visual examination and bitewing radiograph. Histological examination served as the gold standard after extraction. By using the McNemar test, the sensitivity, specificity, accuracy, and area under the receiver operating curve were calculated as outer enamel (D1), inner enamel (D2) and dentine caries (D3) lesion thresholds. The intra- and inter-examiner reproducibility were calculated using the Cohens unweighted kappa statistics. At the D1 threshold, the LFpen sensitivity was statistically higher than LF and radiographic examination (P < 0.001), whereas there was no statistically significant difference among the groups at the D2 and D3 thresholds (P > 0.05). All methods demonstrated the highest sensitivity values at D3. At the D1 and D2 thresholds, there were no significant differences between the LFpen specificity and the other methods. All methods presented similar performance in detecting all lesions considering the area under the receiver operating curve. The LFpen showed better performance than LF. Furthermore, visual examination and the LFpen device seem to be sufficient for detection of occlusal caries in primary molars.

A pilot study of the effects of a vacuum sealing barrier method for photostimulable phosphor plates regarding plate damage and prevention of microbiologic cross-contamination

OBJECTIVE The aim of this study was to evaluate the effectiveness of a new sealing method for preventing cross-contamination of photostimulable phosphor (PSP) plates. STUDY DESIGN Twelve new PSP plates were divided into 3 groups (PSP-a, PSP-b, and PSP- c) and placed in 3 different barriers (2 different brands of envelopes and a vacuum sealing method). All plates were exposed to X-rays with an aluminum step wedge, and the images were evaluated for the presence of any artifacts. After radiography, the PSP plates were removed from the barriers. The barriers and the PSP plates were disinfected and culture performed to assess any microorganism burden. Subsequently, the PSP plates were coated again with all barriers. The barriers were then contaminated and microbiologic specimens were collected. Subsequently, the barriers were wiped with alcohol. The PSP plates were removed, and microbiologic specimens were obtained. RESULTS No artifacts were recorded on the radiographic images on the sensors in any group. Microorganisms were detected on the PSP plates placed in envelopes. No colonization of microorganisms was detected on the vacuum sealed PSP plates. CONCLUSIONS The new vacuum-sealing method may be useful in preventing cross-contamination of PSP plates during radiographic procedures.

Does placement of rubber dam effect the arterial oxygen saturation in children? A clinical study

Abstract The aim of this study was to evaluate the effect rubber dam placement on the arterial oxygen saturation level in children. Thirty children were randomly allocated to one of two groups: Group A — 15 patients in this group had rubber dam isolation of the maxilla, and Group B — 15 patients had rubber dam isolation of the mandible. The children were healthy and cooperative. The arterial oxygen saturation was taken before each injection, before starting the intervention, i.e. 5min after the injection, and at 5-min intervals. All SpO 2 values were recorded every 30 seconds over a 30 minute period. There were no statistically significant differences in arterial oxygen saturation in all reading sessions for both groups ( P >0.05). The use of rubber dam did not decrease the arterial oxygen saturation level in children.