Halenur Altan

Familial Mediterranean Fever (FMF) is an autoinflammatory disease that affects children's emotional well-being due to recurrent pain attacks. It can significantly impact oral health and compliance during dental examinations. This study aimed to investigate whether there were differences between children diagnosed with FMF and healthy children in terms of dental findings (DMFT/dmft, gingival index, plaque index, bruxism, saliva pH), compliance with dental examination (Frankl behaviour scale), and parental dental anxiety (C-DAS). Additionally, the effects of age, gender, age of symptom onset, age at diagnosis, colchicine dosage, attack frequency, hospitalisation, and disease severity on dental findings and compliance with dental examination were investigated using regression analyses in the FMF group. A case-control study was conducted involving 60 children diagnosed with FMF and 60 healthy children matched for age and gender. The DMFT/dmft index, gingival and plaque index, presence of bruxism, saliva pH, Frankl score, and parental C-DAS scores were recorded for all participants. In the FMF group, Pras disease severity score, age of symptom onset, age at diagnosis, colchicine dose, and attack frequency were evaluated. Pearson's Chi-Square Test, Monte Carlo-Corrected Fisher's Exact Test, and Yates's Correction were used to examine associations between categorical variables and groups. The Mann-Whitney U test was applied to compare differences between two independent groups for variables that did not follow a normal distribution. Linear Regression Analysis was used for normally distributed dependent variables. Statistical significance was set at p < 0.05. The prevalence of bruxism in the FMF group was significantly higher than in the healthy group (p < 0.001). No significant differences were found between the groups in terms of DMFT/dmft, gingival index, plaque index, saliva pH, Frankl score and parental C-DAS scores (p > 0.05). While oral health in children with FMF appears comparable to that of healthy children, a higher prevalence of bruxism was observed. Increased disease severity may reduce compliance with dental examinations. To help manage these issues, dentists should consider implementing regular monitoring and management plans for bruxism, such as stress-reduction techniques, oral appliances, and counselling on proper oral hygiene practices. The emotional state, disease severity, and pain experiences should be considered in dental management for children with FMF.

Background/Aims: Children's color preferences serve as significant projective indicators of their internal emotional states and sensory experiences.This study aimed to investigate the relationship between localized pain (joint, chest, throat, head, and abdominal) and color selection among pediatric patients diagnosed with Familial Mediterranean Fever (FMF).Methods: In this cross-sectional clinical study, 93 pediatric FMF patients visiting a Pediatric Dentistry clinic were evaluated. Participants were questioned regarding the presence and localization of pain characteristic of FMF.Color preferences during both symptomatic and asymptomatic periods were recorded. Initial data categorization included a broad spectrum (white, red, blue, purple, yellow, black, and green), which was subsequently refined into reduced color clusters (white, red, blue, and black) for advanced statistical modeling.Results: Statistical analysis revealed no significant correlation between unique color preferences and the presence of joint, chest, head, or abdominal pain (p>0.05). Similarly, color choices remained consistent during pain-free intervals. However, when utilizing reduced color groupings, a statistically significant association was identified specifically between the presence of throat pain and color preference (p=0.038).Observations indicated a notable shift toward the color red during episodes of pharyngeal discomfort.Conclusion: While the presence of generalized FMF-related pain does not universally dictate color choice, the specific correlation between sore throats and an increased preference for red suggests that certain physiological stressors trigger distinct emotional and perceptual associations.These findings indicate that color-based assessment tools can serve as valuable non-verbal adjuncts for dental and medical practitioners in decoding the subjective pain experiences of children.

Background: Dental treatments in uncooperative or special needs children are generally performed under sedation or general anesthesia. The aim of this study was to retrospectively evaluate the reasons for performing dental treatments under general anesthesia or sedation and to analyze the applied treatment approaches in these pediatric patients. Materials and Methods: The records of children in the primary dentition period who were treated under general anesthesia or sedation at the Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University between January 2022 and December 2022 were reviewed. Demographic characteristics, health status (disability, systemic disease, or healthy condition), presence of panoramic or periapical radiographs, and the frequency of performed dental procedures were evaluated. Data were analyzed using SPSS version 23, with Chi-square and Fisher’s exact tests applied, and the significance level was set at p<0.05.Results: Among the 100 patients included in the study, 49 were female and 51 were male. Sedation was administered to 29 patients, while 71 received general anesthesia. Eighty-two patients were systemically healthy, and 18 had chronic diseases or disabilities. Radiographic imaging was obtained in 80 patients. Twenty-eight children were aged 0-3 years, and 72 were aged 4-6 years. A total of 865 teeth were treated, including restorative (55.26%), extraction (38.84%), and pulpal (5.89%) procedures. A statistically significant difference was found between the general anesthesia and sedation groups in terms of treatment type and intensity (p<0.001), as well as between age groups regarding radiographic imaging (p=0.006).Conclusions: In pediatric dentistry, dental procedures performed under general anesthesia and sedation are becoming increasingly common. Pediatric dentists play a crucial role in providing appropriate treatment approaches for child patients and in raising public awareness on this issue.

Our study aims to assess mandibular trabecular bone microarchitecture and cortical bone density in prematurely born children compared to term-born peers, using fractal dimension (FD) analysis and mandibular cortical index (MCI) and panoramic mandibular index (PMI) derived from panoramic radiographs. Our study included 152 panoramic radiographs obtained for diagnostic purposes from 76 premature group (30 girls and 46 boys) and 76 control group (30 girls and 46 boys). The mean age of the premature group was 7.35 ± 1.92, and that of the control group was 7.33 ± 1.9. Analyses revealed that premature individuals had a significantly higher prevalence of deteriorated cortical bone patterns (MCI Type 2/3) compared to controls (p < 0.001). Logistic regression analysis showed that increasing age (OR: 0.541; p = 0.002) and gestational age (OR: 0.696; p = 0.045) significantly reduced the risk of developing porous bone structure. FD values in the left condyle and right interdental region were statistically significantly higher in the control group than in the patients born premature group (p < 0.05). FD analysis shows partially compromised mandibular trabecular microarchitecture in patients born premature. MCI distribution reveals greater cortical bone thinning and irregularity. These findings suggest reduced quality and long-term fragility. Clinical caution is necessary regarding alveolar resorption. Monitoring the potential long-term effects of increased preterm survival on bone quality and jawbone structure represents an important clinical requirement from both pediatric and dental perspectives.

Background and objectives: This study aimed to investigate the effects of familial Mediterranean fever (FMF)—a chronic inflammatory disease—on dental maturation regarding dental development using three dental age estimation methods. Methods: The orthopantomograms of 78 children diagnosed with FMF were compared with those of 78 systemically healthy control children. Demirjian, Willems, and Cameriere’s methods were used to estimate the dental age from seven teeth in the left mandible on the orthopantomograms. The data were analyzed using R statistical software. Results: The mean difference between dental age (DA) and chronological age (CA) using the Demirjian method was 0.646 in the control group and 0.753 in the FMF group (p = 0.595). For the Willems method, the mean DA versus CA difference was 0.283 in the control group and 0.322 in the FMF group (p = 0.835). Regarding the Cameriere method, the mean difference between DA and CA was −0.399 for the control group and −0.435 for the FMF group (p = 0.863), indicating no significant differences. At the ±1-year threshold, the Willems method showed the highest accuracy (69.87%), followed by the Cameriere method (66.67%), whereas the Demirjian method had the lowest accuracy (54.49%). These results suggest that the Willems method provides a more reliable estimate of chronological age within a ±1-year margin compared with the other two methods. Conclusions: Of the dental age estimators, the Willems method gave the closest age estimates. The Demirjian method overestimated the chronological age in both healthy children and children with FMF. For Turkish children receiving regular colchicine therapy, dental maturation was unaffected by FMF, suggesting that effective inflammatory control might preserve odontogenesis.

Child Drawing: Hospital (CD: H) was developed as a tool to measure the emotional state of hospitalized school-age children. This scale consists of sections A, B and C, which allow understanding of anxiety through children’s drawings. The CD: H Scale, which is widely used in medicine, has only been validated in two different cultures. The adaptation and validation of the scale in the field of dentistry has recently started to take place in the literature. In our study, we aimed to conduct a Turkish validation study of the Child Drawing: Hospital (CD: H) Scale and to evaluate dental anxiety and pain experienced during treatment through drawing. Pediatric patients between the ages of 5–12 who attended the Pediatric Dentistry Department between 2018 and 2020 were included in the study. Following the translation of the CD: H Scale into Turkish and linguistic-cultural validation, the behaviors of pediatric patients during treatment were evaluated with the Frankl Behavior Rating Scale, the pain they experienced during treatment with the Wong- Baker Face Rating Scale, and their anxiety levels were evaluated with the pictures drawn by the patients at the end of the treatment. The data were analyzed with IBM SPSS v23, and the significance level was taken as p < 0.05. Within the scope of the scale’s reliability-validity study, the Intra-Class Correlation Coefficient (ICC) was evaluated with test-retest consistency. For section A, B,C and total score reliability was found to be positive and strong level correlation. The Turkish version of the CD: H Scale is a reliable and valid scale that can be used to evaluate the dental anxiety of Turkish pediatric patients. ClinicalTrials (NCT05236101/11.02.2022), ‘retrospectively registered’.

Different educational methods play an important role in oral hygiene education programs. This study aims to evaluate the impact of various educational methods on the oral hygiene knowledge of primary school children. A total of 490 primary school students participated in this cross-sectional study. The students were assigned to one of three groups: a verbal explanation group, an animation group, or a peer-led reels group. Before and after the intervention, the students completed questionnaires assessing their oral hygiene knowledge. A significant increase was observed in the post-educational knowledge levels of the children in three educational methods (p < 0.001). The study found that the main effect of educational methods was statistically significant (p < 0.001). However, effects of gender, and tablet/mobile phone use, respectively, were not statistically significant (p = 0.694, p = 0.641). The animation group (6.73) and the verbal expression group (6.57) had the highest post-training knowledge levels, respectively, while the peer-led reels group had the lowest (5.95) (p < 0.001). All three educational methods are effective in promoting oral hygiene, but due to the accessibility and consumption of information in the current technological era, animation videos may be more useful and suitable for modern education. ID: NCT06569745; Date: 21.08.2024; ‘retrospectively registered’.

Altan H, et al. J Dent Anesth Pain Med. 2025 Jun;25(3):191-199. https://doi.org/10.17245/jdapm.2025.25.3.191

Fraktal kavramı kırılmış ya da parçalanmış anlamına gelen Latince "fractus" sözcüğünden türetilmiş ve ilk olarak 1975'te matematikçi Benoit B. Mandelbrot tarafından öne sürülmüştür. Fraktal geometri, karmaşık kendine benzeyen şekilleri karakterize etmek için kullanılan nicel bir araç sunar. Fraktal boyut, karmaşıklığı ölçen nicel bir parametredir. Fraktal boyutun hesaplanması amacıyla birçok yöntem kullanılmıştır. Diş hekimliğinde en sık kullanılan yöntem White ve Rudolph’un 1999 yılındaki çalışmalarında yararlandığı “kutu sayma yöntemi”dir. Diş hekimliğinde fraktal boyut analizi kullanılarak dental materyal analizi, diş dokusu analizi, çürük tayini, temporomandibular eklem bozuklukları, oral kanserler, çeşitli sistemik hastalıklar, tedavi ve iyileşme izleme gibi pek çok konuda çalışma yapılmaktadır. The term fractal is derived from the Latin word "fractus", which means fragmented or broken. It was first put forward by Polish mathematician Benoit B. Mandelbrot in 1975. Fractal geometry offers a quantitative tool to characterize complex self-similar shapes, and therein lies its applicability. The concept of fractal dimension arises as a quantitative parameter that measures complexity. Many methods have been used to calculate the fractal dimension. The most frequently used and popular method in dentistry is the "box counting method", which was used by White and Rudolph in their study in 1999. In dentistry, fractal dimension analysis is used to study many subjects such as dental material analysis, tooth analysis, caries detection, temporomandibular joint disorders, oral cancers, various systemic diseases, treatment and recovery monitoring.