Three Dimensional Evaluation of Marginal Microleakage at the Adhesive Interface between Different Fissure Sealants and Enamel: Micro-CT Analysis

Summary Background/Aim: Sealing ability and adhesion to enamel of fissure sealants are quite critical in prevention of dental caries. The objective of the present study was to assess the marginal microleakage of different material-based pit and fissures with non-invasive and invasive techniques by using the Micro-CT method. Material and Methods: 30 extracted human permanent molars were randomly assigned to three sealant groups (n=10) as resin-based ClinPro, giomer-based BeautiSealant, and glass ionomer-based Fuji IX-GP. Half of each group was randomly divided into two parts as non-invasive and invasive techniques. The volumetric analysis of marginal microleakage between the enamel-material interface was performed by using Micro-CT. The results were analyzed with Student’s t, One-Way ANOVA, Tukey and Games-Howell tests. Statistical significance level was considered as 0.05. Results: In non-invasive technique, Fuji IX-GP showed statistically significantly lower marginal microleakage values than Clinpro (p=0.022). Other comparisons were not significant (p>0.05). However, in invasive technique, microleakage values both of Fuji IX-GP and BeautiSealant were significantly lower than Clinpro (p<0.001, p<0.001). Besides, regardless of the sealant material, the invasive technique showed significantly superior results than non-invasive technique regarding marginal microleakage. Conclusions: Considering the clinical conditions, it was concluded that glass ionomer-based Fuji IX-GP and giomer-based BeautiSealant could be used as alternative to resin based sealants. Additionally, invasive technique (fissure preparation) can be recommended to reduce marginal microleakage.

Prevalence of Dental Number Anomalies Among A Group of Turkish Children

Summary Background/Aim: The study aimed to evaluate the prevalence and distribution of congenital dental number anomalies in the permanent dentition among a group of Turkish children in the Inner Aegean Region of Turkey. Material and Methods: A total of 5377 patients aged 7–9 who visited our clinic for the first time between September 2018 and September 2019 were investigated. The children were examined for tooth agenesis and supernumerary teeth using panoramic radiographs taken for various reasons and clinical records reviewed. Dental number anomalies were evaluated according to gender and localization. Descriptive and comparative statistical analyses were performed using the SPSS package software program Version 23. Results: For the study, the data of 1987 patients (947 female, 1040 male) were examined. The tooth agenesis was found in 109 patients (5.5%), the supernumerary teeth were found in 24 patients (1.2%). The prevalence of tooth agenesis was 5% in males, 6% in females. There was no statistical difference between genders (p>0.05). The distribution of tooth agenesis according to jaws and sides by gender was not statistically different (p>0.05). The most commonly missing teeth were mandibular left second premolar (37.6% of patients) and mandibular right second premolar (33% of patients). According to types of teeth and gender, molar tooth agenesis was seen more common in females than males (p<0.05), there was no significant difference in other types of teeth by gender. The prevalence of supernumerary teeth were 1.9% in males, 0.4% in females and the difference between genders was found to be statistically significant (p<0.05). All the supernumerary teeth were located in the anterior maxilla, and half of them were mesiodens. Conclusions: Early diagnosis and appropriate treatment choice are very important managing complications associated with congenital dental number anomalies and for differential diagnosis of characteristic syndromes.

Effects of COVID-19 Pandemic on Turkish Private Practice Dentists’ Economic Well-Being

Summary Background/Aim: Coronavirus disease 2019 (COVID-19) is a global health concern. The COVID-19 pandemic has not only health implications but also important social, economic, and political consequences. Dental practices have currently cancelled elective procedures and restricted services to the provision of emergency dental care in order to prevent transmission of COVID-19, which has had serious financial implications. Although several reports about the economic consequences of the COVID-19 pandemic have been prepared, no study has analyzed the potential impact of a pandemic on the economy of private-practice dentists. In this context, the purpose of this study is to determine how the COVID-19 has shaped the economic behavior of Turkish private-practice dentists and study the underlying mechanisms. Material and Method: A total of 312 private practice dentists were included in the study. The researchers developed a closed-ended questionnaire that contained 10 questions and was divided into three parts. The first part captured demographic information (age, gender, and professional experience of dentists). The second part measured the economic effects of the pandemic. The third part explored the dentists’ economic behavior in the post-pandemic period. Results: Over half (52.6%) of the dentists stated that during the pandemic, they only cared for patients in emergency situations. Most (97.4%) of the dentists stated that the pandemic affected their economic situation negatively, and 66.7% of dentists stated that they could not meet their routine clinical expenses during the pandemic. In the post-pandemic period, 52.6% of dentists are considering increasing their treatment fees, and 19.2% of dentists are considering dismissing some of their employees for economic reasons. Conclusions: The significant limitation of clinical and surgical activities in private dental practice caused by the COVID-19 pandemic has had a very significant negative effect on private-practice dentists’ economic well-being.

Quality of Information about Accelerated Orthodontics on Instagram

Summary Background/Aim: Social media has become popular in recent years in dentistry. This study aims to evaluate the posts shared on Instagram related to accelerated orthodontic treatment. Material and Methods: The first 100 posts were selected for #acceleratedorthodontics and #speedbraces hashtags and analyzed. The type of posts, posts’ purpose, the source of posts, the number of likes and comments, the number of followers and followings of the users who uploaded the posts were recorded. Four posts in #speedbraces were irrelevant and the remaining 196 posts were evaluated. Results: The sources of the posts include 60 orthodontists, 20 dental pages, 9 dental clinics, 8 periodontologists, 3 surgeons in #acceleratedorthodontics hashtag. Also, 37 posts were preop-postopt, 34 of them were advertising, 14 of them were surgical information, 12 of them were professional information, and 3 of them were personal sharing in #acceleratedorthodontics hashtag. When the aims of the shares were evaluated, it was observed that 56 were for advertisement, 23 were for patient information, 7 were for entertainment, 6 were experience and 4 were preop-postop comparison in #speedbraces hashtag. Conclusions: The posts related to accelerated orthodontics on Instagram are insufficient in terms of the content. The patients should be guided to reach the correct sources of information by orthodontists.

Accidental Injection of EDTA Instead of Anesthesia Solution during Root Canal Treatment: Case Report

Summary Background/Aim: Many irrigation solutions are used during root canal treatment. It is unacceptable to confuse irrigation solutions with anesthetic solution and inadvertently inject the patient. After such an error, local and systemic serious complications can be seen in the patient. The purpose of this case report is to show how careless use of etilendiamin tetraacedic acid (EDTA) can result in important complications, and offer some treatment methods for curing symptoms resulting from such complications. Case Report: A 17% EDTA solution, was inadvertently injected in the buccal mucosa of a 20-year-old male during routine root canal treatment. Severe pain, bleeding and mucosal swelling occurred shortly after the injection. Irrigation with saline was performed by sliding the mucoperiosteal flap at the injection site. Then the flap was sutured primary. At the control one week later, there were no areas of necrosis in the patient, but ecchymosis occurred. Decalcified areas were not detected in dental volumetric tomography examination. Conclusions: The dentists must apply the precautions of EDTA irrigation solution during the root canal treatment and manage the treatment of this clinical complication.

Characteristics and Prevalence of Anterior Buccal Mandibular Depression Area in Cone Beam Computed Tomography Images

Summary Background/Aim: The purpose of this study was to assess the anterior buccal mandibular depressions (ABMD) prevalence and clinical characteristics at cone beam computed tomography images (CBCT). Material and Methods: 198 CBCT images with minimal depression between the mandibular molars were evaluated retrospectively. Presence and location of ABMD, its maximum depth, maximum width, cortical width, if any, alveolar crest width at maximum depth, the distance between maximum depth and alveolar crest apex and existing teeth in the relevant region were examined in cross-sectional views. Panoramic radiography of ABMD patients was evaluated for trabecular pattern and radiopacity to determine the area of interest. The possible lingual depression area on the maximum depth of ABMD slice was investigated and the same measurements for ABMD was performed. The presence of aperture / foramen in the ABMD area was also investigated. Results: The prevalence of ABMD was found as 43.43% where 82 cases were at bilateral side and 4 cases were only at left side. Lingual depression was observed in 20.7% right side and 30.2% left side of the ABMD cases. There was no statistically significant difference for maximum depth between different age groups. Most frequent location was observed in lateral and canine region (27.4%) followed by lateral-first premolar area (25.6%). Least frequent location was at canine-second premolar area (1.2%). Conclusions: ABMD is a lesser known area with a high prevalence observed on CBCT images. The detectability of the area on panoramic radiographs is limited. Clinicians should take into consideration ABMDs’ characteristics to avoid confusion with periapical pathologies. Failure to detect these areas before implant surgeries may cause complications. For this reason, it is important to be examined in detail for ABMD before surgery.

Treatment of Gunshot-Related Mandibular Fracture with Splint-Guided Reduction: Case Report

Summary Background/Aim: Gunshot injury-related mandibular fractures often have a complex pattern, characterized by comminution, bone loss, and soft-tissue avulsion. The management is difficult and varies between individual cases. Case Report: A 41-year-old male patient presented with marked swelling and ecchymosis in the left mandibular region. Intraorally, he had a deviated open bite on the left side. A unilateral comminuted mandibular fracture was diagnosed by panoramic radiograph and computed tomography. An acrylic dental splint-guided open reduction and internal fixation, including intermaxillary fixation through brackets and intermaxillary elastics, was planned. No complications were observed throughout the healing period, and healing at the fracture site was satisfactory. The occlusion returned to the preinjury position and was stable. Conclusions: This case report shows that successful functional and esthetic results can be achieved with a strict patient-specific treatment protocol for a comminuted mandibular fracture due to gunshot injury.

Sealing Efficiency of MTA, Accelerated MTA, Biodentine and RMGIC as Retrograde Filling Materials

Summary Background/Aim: This in-vitro study evaluated the apical-sealing ability of MTA, MTA+10% CaCl2, Biodentine™ and RMGIC when used as retrograde material. Material and Methods: A total of 80 single-rooted bovine incisors were decoronated, instrumented, and divided into 4 groups according to retrograde material, as follows: Group 1: MTA (ProRoot MTA, Dentsply); Group 2: MTA (ProRoot MTA, Dentsply) + 10% CaCl2; Group 3: Biodentine (Biodentine®, Septodont); Group 4: RMGIC (Nova Glass -LC, Imicryl). Root surfaces were isolated with nail polish, and teeth were immersed in 2% methylene blue dye at 37°C for 48 h. The extent of dye penetration (mm) was measured under a stereomicroscope. Results: RMGIC had the highest mean-rank dye penetration score (MP=49.05), followed by MTA (MP=43.65), Biodentine (35.95) and MTA+CaCl2 (MP=33.35). The results of paired comparison tests found the mean microleakage value of MTA+10% CaCl2 and Biodentine (Group 3) to be significantly lower than that of RMGIC (respectively; p=0,020, p=0,019). No significant difference was found in the other group comparisons (p> 0.05). Conclusions: These results suggest that the addition of an accelerator to MTA may reduce microleakage following endodontic surgery. Biodentine can be used as an alternative to MTA on retrograde obturation.

Canal Configuration of Maxillary Premolars in Cukurova Population: A CBCT Analysis

Summary Background/Aim: Aim of this study was to evaluate the anatomy of root-canal systems and numbers of permanent maxillary premolars’ roots and canals, using cone beam computed tomography scans. Material and Methods: In this retrospective and observational study, maxillary right/left and first/second premolars of patients who were screened with cone beam computed tomography for various reasons in a Turkish dental school, were examined. Evaluated parameters were age, gender, canal configuration (Vertucci classification) and numbers of roots and canals. Chi-square test was used for statistical analysis. The level of significance was set at p<0.05. Results: A total of 1086 maxillary premolars including 555 first premolars and 531 second premolars were examined in 331 patients (186 female, 145 male). Presence of two roots was shown in 75% of first premolars. 76.3% of second premolars were found to have a single root. Most common canal configuration was type IV (73.2%) for first premolars and type II (32.4%) for second premolars. There was a significant relationship between gender and numbers of first and second premolars’ roots and canals. Conclusions: High heterogeneity of maxillary premolar root-canal system anatomy should be considered during endodontic treatment.

Application of Bio-Resorbable Membranes in Preventing Complications of Lower Jaw Surgery

Summary Background/Aim: Prevention of inflammation and alveolar bone atrophy is very important in oral surgery. The aim of this study was to compare the use of two osteoplastic bio-resorbable membranes in order to prevent inflammatory complications and atrophy of the alveolar part of the mandible after surgical interventions. Material and Methods: We examined 86 patients 45-70 years old who were classified into four groups. In group 1, there were 21 patients who had a “bio-resorbable membrane type 1 implanted. The group 2 consisted of 23 persons treated with bio-resorbable membrane type 2. Only the occurrence of inflammatory complications after the placement of these membranes was monitored. Group 3 included 20 persons treated with membrane type 1 and group 4 included 22 patients treated with membrane type 2 to prevent both inflammatory complications and atrophy of the alveolar part of the mandible. The level of atrophy of the alveolar bone after one year was determined by cone-beam computed tomography. The obtained data were statistically evaluated. Results: Six inflammatory complications (“dry socket”) have been identified in operated patients treated with a membrane type 1 (the first and the third groups). Only two “dry socket” occurred in patients treated with membrane type 2 (the second and fourth groups). Group 4 had significant advantages in the alveolar crest height 14.6 (11.2-22.3) and in its width 7.7 (5.1-10.2) both in relation to the indices of group 3 (11.1 (9.7-20.4) and 6.2 (4.2-9.0). Conclusions: The bio-resorbable membrane type 2 prevented inflammatory complications in the short postoperative period after surgical interventions, as well as, the atrophy of the mandible.