Uzay Koç Vural

Treatment method and restorative material preferences of dental practitioners

Objective: The present study is aimed to investigate the preference profiles of treatment methods used by private dental practitioners in Ankara for deep carious lesions of mature permanent teeth. Methods: Private dental practitioners (general/specialist), in five districts of Ankara, were provided with a questionnaire comprising demographic characteristics and their preferred treatment methods for two simulated clinical cases related to deep caries excavation technique for anterior (Case A) and posterior, permanent teeth (Case B) with restorative material choices. The questionnaire was delivered personally to the participants who accepted the invitation. Documentation was retrieved back at another appointment after 1–3 weeks intervals. Data were analyzed using frequency analysis and Chi-square tests. Results: A total of 371 dentists, aged 25–69 years, took part in the study representing a response rate of 51.38%. Valid responses were 328 (168 males and 160 females) due to incomplete questionnaires. In Case A, complete caries excavation was the preferred treatment method (62.5%) followed by stepwise excavation (28.4%). Dentists, who had an excessive workload, indicated a stepwise excavation treatment significantly less than the dentists who had less workload (P = 0.001). In Case B, the preferences were narrowly distributed between complete caries excavation (50.9%) and stepwise excavation (42.4%). Composite restoration (31.7%) was more selected than amalgam (27.1%) with complete excavation technique. Workload has no effect on the treatment options of the posterior tooth with deep dentin caries. Conclusion: Dentists mostly adopted traditional caries removal technique. There is no uniform treatment method of deep carious lesions among dentists in anterior and, especially in posterior regions in Ankara, Turkey.

Comparison of two different methods of detecting residual caries

Objectives The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo. Materials and Methods A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fishers Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05. Results Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%). Conclusions Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.

Diagnostic methods for dental caries used by private dental practitioners in Ankara

Objectives: This study aimed to investigate the preference profiles of various types of diagnostic tools and methods used by private dental practitioners in Ankara for detecting dental caries. Methods: Private dental practitioners, in five districts of Ankara, were provided with questionnaires comprising demographic characteristics, possession of dental imaging systems, and methods used for caries diagnosis. The questionnaires were retrieved after 1-3 visits. Of 722 questionnaires, 371 were returned. Data were analyzed using frequency analysis and Chi-square tests. Results: The completed questionnaires were obtained from 160 women and 168 men, the response rate was 51.4% aged 25-69 years; 28.4% of them were specialists. Most participants possessed a dental radiography (RG) device. Air drying and sharp explorers were the most commonly preferred methods used for caries diagnosis. There was no significant association between using a sharp explorer and sex or being a specialist (P = 0.110, 0.226, respectively). Almost one-third of the dentists with an experience of <11 years, never used an RG device to detect occlusal caries (P = 0.003). Only three participants reported the use of DIAGNOdent, while two participants used fiber-optic transillumination (FOTI). Conclusions: It was observed that visual-tactile examination using sharp explorer accompanied with radiographs were among the main instruments used for detecting carious lesions. Usage of magnification tools, FOTI, and DIAGNOdent were low.

Clinical assessment of mineral trioxide aggregate in the treatment of deep carious lesions

Objective: This clinical study aimed to assess the effectiveness of mineral trioxide aggregate (MTA) and calcium hydroxide (Ca[OH]2) in the treatment of deep carious lesions using the direct complete caries excavation technique. Subjects and Methods: Hundred permanent molars/premolars were capped either with Ca (OH)2 (n = 49) or MTA (n = 51) and restored with composite resin in 73 patients. Periapical radiographs were taken prior to the treatment, at 6 months and 12 months. Two calibrated examiners clinically and radiographically assessed the periapical pathology and pulpal symptoms. Inter-group comparisons of the observed values were analyzed using Fishers exact test. Significance was predetermined at α = 0.05. Results: Recall rates were 100% at 6 and 12 months. Four teeth capped with Ca(OH)2 (two each at the end of 6 and 12 months) and one tooth capped with MTA (at the end of 12 months) received endodontic emergency treatment because of symptoms of irreversible pulpitis that were clinically and/or radiographically established. There was no significant difference between the protection of the tooth vitality and pulp capping agents at 6 and 12 months (P = 0.238, P = 0.606, respectively). Conclusion: Both materials were clinically applicable at the end of 12 months.

Clinical Performance and Epidemiologic Aspects of Fractured Anterior Teeth Restored with a Composite Resin: A Two‐Year Clinical Study

PURPOSE To investigate the etiologic factors, effect of age and gender on dental trauma, and to evaluate the performance of composite resin on the fractured crown of permanent anterior teeth. MATERIALS AND METHODS Over a 2-year period, 73 permanent teeth from 51 patients with dental trauma were treated with direct composite resin restoration. Informed consent and standardized trauma forms were completed by the patient; teeth were restored with a submicron hybrid composite resin (Spectrum TPH) and respective adhesive system (Prime&Bond NT). Sixty-nine teeth were directly restored without fiber posts, while four were treated with fiber posts. Two experienced clinicians, besides the operator, evaluated each restoration at 6-, 12-, and 24-month follow-ups according to US Public Health Service (USPHS) criteria for the following characteristics: anatomical form, marginal adaptation, color match, marginal discoloration, surface roughness, and caries. Data were analyzed using the Wilcoxon Signed Rank, Kruskal-Wallis, Mann-Whitney U, and Siegel and Castellan tests. RESULTS A total of 73 traumatized teeth in 51 patients aged from 14 to 64 years (mean age 25.47 ± 14.058 years) were assessed according to the Ellis classification and restored over a 2-year period. Crown fractures were more common in the maxilla (84.9%) and caused by falls (58.8%). At the end of 24 months, a total of ten restorations were lost. The survival rate after 24 months was 82.14%. There were statistically significant differences in marginal adaptation between the 6-, 12-, and 24-month follow-ups. Although changes in marginal discoloration over time were not significant (p = 0.194), changes in color match were significant (p = 0.029). CONCLUSION Within the limitations of this study, direct composite restorations were accepted as clinically satisfactory.

ETIOLOGIC FACTORS AND CLINICAL EVALUATION OF RESTORED FRACTURED ANTERIOR TEETH: AN OBSERVATIONAL STUDY

Purpose: The aims of this study were to investigate the etiologic factors and to evaluate performance of composite resin on fractured crown in permanent anterior teeth at 6 and 12 months. Subjects and Methods: Records from 51 patients were retrieved from a Dental School Clinic, comprising 73 fractured anterior teeth directly restored with a submicron hybrid composite (Spectrum TPH) resin and respective adhesive system (Prime and Bond NT) were evaluated. The United States Public Health Service criteria were used to assess the clinical evaluation. Data were analyzed using the Wilcoxon Signed Rank, Kruskal–Wallis, Mann–Whitney U, and Siegel and Castellan tests. Results: Seventy-two maxillary incisors and one canine of 51 patients were evaluated. The patient’s age at the time of therapy ranged from 14 to 64 years old (mean 25.47). Mostly observed crown fracture was seen in upper incisors (84.9%) and due to falls (58.8%). At the 6-month follow-up, one patient lost one restoration and at the 12-month, one patient lost one and one lost two restorations. A statistically significant difference was found in terms of marginal adaptation between 6 and 12 months. Conclusion: In this short-term observation period, remaining tooth structure was conserved and good patient compliance was achieved. Factors such as esthetic and/or cost should be considered to indicate the direct composite restorations.