Gul Yildiz Telatar

Background: To investigate the efficacy of direct clinical assessment and digital photographs obtained with smartphones, intraoral cameras, and macro cameras in the diagnosis of occlusal caries ex vivo and in vivo according to the International Caries Detection and Assessment System (ICDAS) II criteria. Methods: Ex vivo (n = 46) and in vivo (n = 268) permanent molars were evaluated both visually and using bite-wing radiographs by 2 dentists according to the ICDAS II criteria, and the consensus was accepted as the gold standard. The occlusal surfaces were photographed by a different clinician using 4 different camera types (Samsung Galaxy A71 phone, Samsung Galaxy A70 phone, Super Cam CF689 intraoral camera, and Canon EOS 400D macro camera). Two examiners evaluated the photographs on the computer screen. Sensitivity, specificity, and interexaminer agreement were calculated. Results: Inter-examiner agreement was assessed using weighted Cohen’s kappa statistics ex vivo 0.63 to 0.79; in vivo 0.70 to 0.87. Regarding agreement with the reference standard, the highest weighted kappa value in the ex vivo assessment was obtained with the Samsung Galaxy A70 (0.72), whereas in the in vivo assessment, the Samsung Galaxy A71 showed the highest weighted kappa value (0.63). The intraoral camera demonstrated lower agreement than the other devices, while the macro camera showed agreement values comparable to those obtained with the smartphones. Diagnostic accuracy was higher for initial and moderate caries lesions compared to severe caries across all imaging modalities Conclusion: The Samsung Galaxy A70 and A71 smartphones demonstrated agreement levels comparable to those of the macro camera and generally higher than those of the intraoral camera for the detection of occlusal caries. Overall, photographic assessment showed higher accuracy for the diagnosis of initial and moderate occlusal caries lesions than for severe lesions according to the ICDAS II criteria.

Objective: This study investigated the capability of several remineralizing agents to enhance the laser fluorescence values of artificially produced enamel caries lesions under in vitro conditions. Methods: Fifty permanent incisors were selected and demineralized to create standardized artificial lesions. Specimens were randomly assigned to five groups (n = 10): untreated control, casein phosphopeptide amorphous calcium phosphate (CPP-ACP (Tooth Mousse™)), casein phosphopeptide–amorphous calcium phosphate fluoride (CPP-ACPF (MI Paste Plus™)), the gel supplies bioactive forms of calcium, phosphate, and magnesium gel (CaGP (ROCS mineral gel) and NaF varnish. Laser fluorescence values (DIAGNOdent®) were recorded at baseline, after demineralization, and following 2- and 6-week remineralization periods. Statistical analyses included descriptive tests, the Friedman test, and the Kruskal–Wallis test (p<0.050). Results: Reduction in laser fluorescence values of NaF group was significantly lower than all other study groups (p<0.050). Remineralization at the 2nd week was significantly correlated with baseline (r=0.416; p<0.050) and demineralization (r=0.641; p<0.010). Remineralization at the 6th week was significantly correlated with baseline (r=0.322; p<0.05), demineralization (r=0.561; p<0.010), and application (r=-0.330; p<0.050). Conclusion: CPP-ACP, CPP-ACPF, and CaGP remineralization agents showed higher success in 6th week remineralization compared to NaF. In multivariate analysis, CPP-ACPF and CaGP remineralization agents provide more significant success compared to the others for 6th week remineralization.

Background: This study aimed to assess the diagnostic accuracy of digital intraoral photographs obtained using smartphones and a macro camera in evaluating oral health among adults. Methods: A total of 200 adult patients underwent clinical and radiographic examinations using the Decayed, Filled Teeth (DFT) Index, Caries Assessment Spectrum and Treatment (CAST) Index, Plaque Index (PI), and Modified Gingival Index (MGI). Intraoral photographs were taken using three devices: Samsung S23 Ultra, iPhone 14 Pro, and Canon EOS 400D with macro lens. Following the clinical recording of DFT, CAST, PI, and MGI scores by two calibrated examiners as the reference standard, intraoral photographs were captured by a third dentist and independently evaluated by two separate blinded examiners to compare the diagnostic accuracy of the devices against the clinical findings. Non-parametric analyses were conducted using the Friedman test with Dunn’s post hoc test, Wilcoxon test and agreement between clinical and photographic methods was evaluated via the Bland–Altman method ( p < 0.05). Results: The macro camera demonstrated the highest inter-rater reliability for FT scores (ICC = 0.886), while iPhone-derived MGI scores showed the lowest reliability (ICC = 0.624). Statistically significant differences were found among all imaging devices for all indices ( p < 0.001), except for MGI. Bland–Altman analysis showed that most values fell within the 95% limits of agreement, indicating good concordance with clinical data. Conclusions: Smartphone and macro camera photographs provided comparable diagnostic results for caries and restorations. However, limitations remain in the assessment of periodontal parameters via photographic methods. Smartphone-based intraoral photography can serve as a practical diagnostic tool in teledentistry.

Objective: The aim of this study was for the first time to evaluate of intraoral digital photography in assessing buccal surface of anterior composite restorations using a smartphone (iPhone 14 Pro), a smartphone with a lens (2IN1 Phone Macro Lens), and a digital camera with a macro lens (Canon Rebel XTi), compared to clinical examination, based on World Dental Federation (FDI) criteria. Methods: A total of 185 anterior composite restorations were evaluated by calibrated restorative dentistry specialists. Restorations were scored according to the FDI criteria as intact, requiring repair, or needing replacement. Clinical examination was considered the gold standard. Photographs were taken under standardized conditions, and inter-observer and inter-method agreement were analyzed using Cohen’s Kappa and intraclass correlation coefficient (ICC). Results: High inter-observer agreement was observed across all methods (Kappa = 0.928–1.0). Good to excellent agreement was found between clinical examination and digital photography methods for FDI final scores (Kappa = 0.775–0.973, p < 0.001). Photographs taken with the lens-equipped smartphone and macro camera showed higher agreement with clinical examination (Kappa = 0.973). Conclusion: Digital photography, particularly with a lens-equipped smartphone and macro camera, offers effectiveness comparable to clinical examination in evaluating anterior composite restorations. Clinical relevance: This study demonstrates that intraoral digital photography, particularly with a lens-equipped smartphone and macro camera, achieves diagnostic outcomes closely aligned with clinical examination using FDI criteria. While smartphones alone are practical, lens-assisted imaging enhances accuracy, supporting its use as a cost-effective alternative to professional macro cameras.

Dental caries is a common oral disease with significant implications for oral health. To develop effective interventions, assessing oral health perceptions

Aim: Polyethylene terephthalate glycol (PET-G) materials are frequently used in dental practice. Most vacuum formed retainers (VFRs) and trays for bleaching agents are made from PET-G materials. The aim of this in vitro study was to evaluate the color stability of different branded VFRs, made from PET-G material, in various beverages. Materials and Methods: Two different PET-G materials, Atmos (American Orthodontics, Washington, USA) and Duran (Scheu Dental, Iserlohn, Germany) were tested after thermoforming over a metal casting model of 15 mm diameter and 6 mm height for color stability. Ten samples from each brand were immersed in four different beverages (water, tea, coffee, and coke), and a total of 80 samples were evaluated on the 7th and 14th days using a spectrophotometer. Color changes were evaluated based on the L*,a*,b* color system, according to Commission Internationale de l'Eclairage (CIE). One-way ANOVA was used for ∆E. Student’s t-test and Bonferroni tests were applied to compare the variables. The level of statistical significance was set at P < .05 Results: There were statistically significant differences between Atmos and Duran. (P < .001). Duran showed significant color changes with tea, coffee, and water (p< 0.05) while Atmos were more resistant to discoloration. Conclusion: It was observed that different PET-G materials showed varying performance against discoloration. Duran was more prone to discoloration compared with Atmos. Tea had the greatest discoloration effect on all groups.

Objectives: To examine the amount of residual monomer released from adhesive-precoated flash-free brackets and compare it to traditional light cure and chemical cure adhesives. Materials and methods: Sixty stainless steel brackets were bonded on upper premolar teeth using three groups of adhesive systems: Adhesive-precoated flash-free system, Transbond XT light cure, Sia chemical cure. The extracts of 0.5 ml of liquid samples were taken on the first, 7th, 21st, and 35th days. To determine the amount of residual monomer release, extracted samples were analyzed using a liquid chromatography device. Results: Urethane-dimethacrylate, triethylene glycol dimethacrylate, hydroxyethyl methacrylate and Bisphenol A-glycidyl methacrylate monomers were released from all study groups. The amount of total monomer release except hydroxyethyl methacrylate was detected as greater in adhesive-precoated flash-free system. Among the study groups, the chemical cure group showed the highest hydroxyethyl methacrylate monomer release. Conclusions: This in vitro study indicate that the APC flashless system exhibited the greatest release of residual monomers, suggesting that its possible cytotoxic effects need to be evaluated prior to clinical application. Clinical relevance: This is the first study that evaluates the residual monomer release from adhesive-precoated flash-free brackets. The novel bracket system has a different mesh structure at the bracket base compared to traditional systems with different chemical components which might alter the amount of residual monomer release. To investigate the harmful effects of adhesives used in orthodontic applications is very important for the health of the patient and the orthodontist.

Aim: To evaluate the effects of papain (Brix 3000), bromelain, sodium hypochlorite (NaOCl), and chlorine dioxide (ClO ₂ ) application to the deep dentin surface on shear bond strength (SBS), microleakage, and dentin surface properties. Materials and Methods: Deep dentin surface ( n = 100) for evaluating SBS, class V preparation at the buccal surface for testing microleakage ( n = 100), and deep dentin slices ( n = 20) for evaluating surface properties were conducted on the 220 molar teeth. Four different deproteinizing agents (Brix 3000, 40% bromelain, 5.25% NaOCl (Chloraxid), and 0.12% ClO ₂ ) were applied to the dentin, and then the universal adhesive was used in self-etch (SE) and etch&rinse (E&R). Deproteinizing agents were not applied to the control group. All of the samples were subjected to 5000 cycles of thermal aging at 5ºC–55ºC. SBS (MPa) was tested by a universal testing machine. The microleakage of resin composite bonded with different adhesive modes was evaluated under a stereomicroscope. The changes in the surface morphology were examined with scanning electron microscopy (SEM) and attenuated total reflection – fourier transform infrared spectroscopy (ATR-FTIR). Results: ClO ₂ exhibited the highest bond strength among deproteinizing agents. Compared to the SE mode, E&R mode significantly showed higher bond strength ( p < .05). In gingival margin, bromelain SE exhibited the highest marginal leakage, while Brix 3000 SE had the lowest mean microleakage score. Conclusion: Deproteinizing with ClO ₂ was effective in improving the SBS of universal adhesive in the E&R mode to deep dentin. Deproteinization with bromelain before universal adhesive in SE mode showed more microleakage on both the occlusal and gingival surfaces.

Orthodontic appliances in the oral cavity may cause problems such as white spot lesions, dental plaque, periodontal disease and root resorption. The aim of this study was to investigate the association between orthodontic treatment and oral health parameters including visible dental plaque, gingival recession and white spot lesions (WSLs). A total of 170 patients (86 females, 84 males) were randomly selected to determine visible dental plaque, gingival recession and white spot lesions by using pre-treatment and post-treatment oral photographs. Except of previously extracted teeth, maxillary and mandibular incisors, canine, 1st and 2nd premolars and 1st molar were evaluated. There was a significant difference between the T0 (before treatment) and T1 (after treatment) groups in visible plaque (P< 0.001). The distribution of gingival recession frequencies according to Miller classification before treatment did not differ from the after treatment (P=.082). A statistically significant increase in the severity of WSL was detected between the two time points (P< 0.001). Males have been shown to have higher WSL incidence after treatment. In conclusion, the present study showed that visible dental plaque and white spot lesions significant increase after orthodontic treatment. Considering the relationship between oral health and orthodontic treatment, clinicians and patients should know the risks and take precautions.

Aim: To examine the effects of fluoride, hydroxyapatite, and bromelain-containing toothpaste types on the surface roughness of nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers. Materials and Methods: A total of 160 specimens were fabricated using nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers. Each material group was divided into four subgroups ( n = 5) as follows: Control (C), fluoride toothpaste (FT), bromelain toothpaste (BT), and hydroxyapatite toothpaste (HT). Surface roughness values of all specimens were examined using an optical profilometer and a scanning electron microscope at 500, 1,000, and 3,500 magnifications. Results: The highest average roughness value (Ra; µm) was obtained from the conventional glass ionomer material ( P < .001). While the mean Ra value was 0.155±0.116 µm at baseline, it was 0.262±0.203 µm in the fluoride group, 0.237±0.192 µm in the hydroxyapatite group, 0.260±0.293 µm in the bromelain group, and 0.198± 0.187 µm in the control group ( P < .001). Conclusion: We have found that brushing with various types of toothpaste containing fluoride, bromelain, and hydroxyapatite may not result in obtaining different surface roughness values from different types of restorative materials. Differences in surface roughness values of restorative materials may be found at different magnifications under scanning electron microscope.