Sinem Birant

Purpose: This study aims to test and compare three caries measurement methods, the Caries Assessment Spectrum and Treatment (CAST), the International Caries Detection and Assessment System (ICDAS), and the Nyvad’s criteria, to assess the degree and severity of dental caries in primary molars.Materials & Methods: A descriptive cross-sectional study was conducted among 200 children aged 3-5 years to evaluate primary molars based on CAST, ICDAS II and Nyvad’s criteria by two calibrated dentists. Intra‐ and inter‐examiner reliability was established. Statistical significance was considered at p

Demirjian methods for dental age (DA) estimation in children aged 3-11 years and to test the hypothesis that the Willems method provides a closer estimation to chronological age (CA) than the Demirjian method. Methods: A total of 403 panoramic radiographs from children aged 3-11 years were randomly selected. Chronological age was calculated based on the date of radiographic examination. Dental age was estimated using Demirjian’s staging method and converted into Willems dental age (WDA) and Demirjian dental age (DDA). Agreement between CA and estimated DA was assessed using the intraclass correlation coefficient (ICC). Statistical significance was set at P < .05. Results: The sample consisted of 209 males (51.9%) and 194 females (48.1%). Across all age groups, mean WDA was significantly higher than mean CA (P = .001). The agreement between WDA and CA was excellent, with an ICC value of 0.912, indicating a compliance rate of 91.2%. In contrast, the Demirjian method showed lower agreement with CA across age groups. The calculated WDA and CA showed a substantial association, suggesting that the Willems technique is more appropriate for estimating age in Turkish youngsters. Conclusion: The Willems method demonstrated higher accuracy and stronger agreement with CA compared to the Demirjian method in children aged 3-11 years. These findings support the use of the Willems method for DA estimation in Turkish pediatric populations.

Hızla değişen ve gelişen diş hekimliğinde çocuk diş hekimliği alanı, kapsamı ve multidisipliner oluşuyla büyük önem taşımaktadır. Koruyucu diş hekimliği, dijital diş hekimliği, endodontik ve ortodontik uygulamalar ve çocuk diş hekimliğinde güncel teorik bilgilere bu eserde ulaşabileceksiniz. Kitapta klinik pratikte tanı ve tedavisinde zorlanılar molar keser hipomineralizasyonu, bruksizm gibi konularda bilgi sahibi olacak aynı zamanda günümüzde güncel olan dijital diş hekimliğine dair bilgiler edinecebileceksiniz. Ayrıca çocuk diş hekimliğinde önemli bir yer edinen koruyucu yaklaşımlarla birlikte aynı zamanda ileri düzeyde olan protetik tedavi hakkında güncel bilgi ve materyale erişip sağlayabileceksiniz. Birçok hekimin emeği ile hazırlanan bu kitap uzman diş hekimi ve diş hekimlerin, uzmanlık eğitimi alan asistan diş hekimleri ve diş hekimliği öğrencilerinin mevcut bilgilerini güncelleyecekleri bir kaynaktır.

This study aimed to evaluate the in vitro effects of commercially available teething gels with different formulations on epithelial barrier integrity and cellular viability. Six commercially available teething gels were tested at concentrations of 0.1%, 20%, 50%, and 80%. Cellular viability was assessed using the MTT assay in human gingival mesenchymal stem cells after 72 h of exposure. Epithelial barrier integrity was evaluated by measuring transepithelial electrical resistance (TEER) in HaCaT keratinocyte cells cultured on transwell inserts at 24, 48, and 72 h. Statistical analyses were performed using IBM SPSS Statistics 27, applying mixed-design and two-way ANOVA with appropriate post hoc tests, with significance set at p < 0.05. TEER values differed significantly according to gel type, concentration, and exposure time (p < 0.05). At 0.1%, significant intergroup differences were observed at 24 h (p = 0.001) and 72 h (p = 0.017), with Dentinox showing significantly lower TEER values than Gengigel, Aftamed, Buccotherm, and Jack N'Jill. At 20%, 50%, and 80% concentrations, Dentinox consistently exhibited reduced TEER levels at 24-72 h (p = 0.001), whereas Gengigel showed higher TEER values mainly at 24 h (20%) and 72 h (50%), and Buccotherm at 48 h across higher concentrations. MTT analysis revealed significant gel- and concentration-dependent differences at 20%, 50%, and 80% (p = 0.001). Jack N'Jill exhibited higher cell viability at 20%, while both Jack N'Jill and Buccotherm showed higher viability at 50% and 80%. Teething gels exert formulation, concentration, and time-dependent effects on epithelial barrier integrity and cellular viability, emphasizing the need for careful evaluation of products intended for infant use. This study demonstrates that teething gels with different formulations and concentrations can differentially affect epithelial barrier integrity and cellular viability. These findings highlight the clinical importance of carefully evaluating teething gel composition and concentration, particularly for products intended for use in infants and young children.

Saliva contains a variety of biochemical compounds, including antioxidants, and serves as the body’s first line of defense against oxidative stress caused by free radicals. The aim of this study was to investigate the effects of dental treatments on salivary oxidative stress biomarkers in children aged 3–5 years with severe early childhood caries (S-ECC) compared to children without caries. This study was conducted on 20 children aged 3–5 years with severe early childhood caries (S-ECC) and 20 children without caries. Salivary oxidative stress biomarkers and antioxidants were measured after the initial examination (T0), after the end of restorative treatments (T1), and after fluoride varnish applications (T2). Post hoc Bonferroni test was used to compare normally distributed parameters between T0-T1-T2 times. Pearson correlation analysis was used to examine the relationships between parameters that conform to normal distribution. The Mann-Whitney U test was used to compare the parameters in the control and experimental groups. Significance was evaluated at the p < 0.05 level. The mean dmft of the participants in the study group was 8.86 ± 14.5. Advanced oxidation protein products (AOPP), dityrosine (DT), kynurenine (KYN), advanced glycation end products (AGE), lipid hydroperoxides (LHP) and malondialdehyde (MDA) values decrease after the treatment of dental caries and protective fluoride varnish applications, while an increases in total thiol (TSH) and Cu/Zn-superoxide dismutase (Cu/Zn-SOD) values were observed after protective varnish applications compared to pre-treatment values. Antioxidant parameters at time T2 in the study group were statistically significantly higher than in the control group (p < 0.05). In the study group, there was no correlation between TSH and oxidative stress mediators in terms of changes at time T1 post-treatment compared to the pre-treatment period, while an inverse moderate relationship was found with AGE and LHP in terms of changes at time T2 post-treatment (p < 0.05). An increase in salivary antioxidants was detected after dental restorations were completed and protective fluoride varnish application, while a decrease in oxidative stress markers was detected. Fluoride varnish applications applied in the study group may further reduce the oral microbiome load and cause salivary oxidative stress markers to be significantly lower than in the control group.

The aim of this study is to evaluate the surface microhardness, surface chemical composition of bioactive restorative materials pre- and post- thermal aging. A total of 200 disc-shaped samples were prepared by using the materials: Cention N, ACTIVA BioActive Restorative, Equia Forte HT Fil, Glass Fill glass carbomer cement (GCP), and Fuji II LC. Vickers microhardness test were used to measure surface hardness. Scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM/EDS) was used to determine the characterization of the microstructures and elemental analysis of the materials. These measurements were repeated after thermal aging. One-Way ANOVA test, Bonferroni test and the Games-Howell test was used for data analysis. The significance level was accepted as 0.05. Cention N had the highest vickers microhardness value before thermal cycle. The highest fluoride ion ratio among the materials before thermal aging was detected in the Equia Forte HT Fil and Fuji II LC groups. While a decrease in fluorideF ion was detected in all groups except the Cention N group after thermal aging. It is observed that ACTIVA BioActive Restorative has a more microporous and rougher surface in the scanning electron microscopy image after the thermal cycle than in the image before the thermal cycle. The chemical properties of the materials and the properties of the filler particles may be related to the differences in the mechanical properties, surface characterizations and ion releases of the materials Thermal aging affected the microhardness, surface characteristics and elemental mass ratios of the studied materials. Alkasite bioactive materials are more similar to composite restorative materials and show better mechanical properties than other materials, but do not have the same effect on fluoride release. Most of the bioactive materials showed a decrease in the fluoride ion ratio after thermal aging, while no difference was found in the ion exchange of alkasite materials. Material selection should be made more carefully in caries-active individuals whose fluoride release is clinically important.

Objective: This study aimed to assess the different pathways between predictor factors such as zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding related to anterior open bite (AOB) in twins. Methods: The study was conducted in monozygotic (MZ) and dizygotic (DZ) twin children aged 3–15 years. AOB, atypical swallowing, mouth breathing, feeding type, duration of bottle use, and mouth opening status during sleep were recorded during oral examination. Partial least squares structural equation model (PLS-SEM) and sobel tests were performed to assess the total and indirect effects among the variables on AOB. Results: A total of 404 children (29.2% MZ;70.8% DZ) participated in this study. The effect of zygosity on mouth breathing in the PLS-SEM model was statistically significant. Conversely, it was determined that mouth breathing effected that atypical swallowing (p = 0.001). Atypical swallowing triggered AOB (p = 0.001). The atypical swallowing has a mediation effect between AOB and mouth breathing (p = 0.020). Mouth breathing causes atypical swallowing and therefore indirectly increases the likelihood of AOB. While breastfeeding decreases AOB incidence (p = 0.023), bottle feeding increases AOB incidence (p = 0.046). The sobel tests show that the fully mediator variable feature of mouth breathing is statistically significant in the negative relation between zygosity and atypical swallowing. Conclusion: The PLS-SEM model showed that mouth breathing triggers atypical swallowing and atypical swallowing triggers AOB. As a result of this chain of relationships, an indirect effect of zygosity on AOB was observed. According to sobel tests, zygosity has an indirect effect on atypical swallowing through mouth breathing, while mouth breathing has a positive indirect effect on AOB through atypical swallowing. Clinical relevance: This study identified the relationships between different factors and the presence of AOB. The findings of this study demonstrate in detail the relationships between AOB and zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding. Brestfeeding has a reducing effect on the frequency of AOB. Among the nutritional forms, breastfeeding ensures the proper development of the stomatognathic system by working the oro-facial muscles.

Background: The aim of this study is to examine the cytotoxic effects of dental gels with different contents, which are frequently used during teething, on gingival mesenchymal stem cells (G-MSCs). Method: The teething gels used in this study were Dentinox, Gengigel, Osanite, and Jack and Jill. The human gingival mesenchimal stem cells (hG-MSCs) were incubated with these teething gel solutions (0.1%, 50% and 80% concentrations). Reproductive behavior of G-MSCs was monitored in real time for 72 h using the xCELLigence real-time cell analyzer (RTCA) system. Two-way repeated Anova test and post hoc Bonferroni test were used to evaluate the effect of concentration and dental gel on 0-hour and 72-hour viability. Significance was evaluated at p < 0.05 level. Results: Teething gels prepared at 50% concentration are added to the G-MSC culture, the “cell index” value of G-MSCs to which Dentinox brand gel is added is significantly lower than all other groups (p = 0.05). There is a statistically significant difference between the concentrations in terms of cell index values at the 72nd hour compared to the 0th hour (p = 0.001). Conclusions: The local anesthetic dental gels used in children have a more negative effect on cell viability as concentration increases.

The purpose of this in vitro study was to assess the color stability of esthetic restorative materials after immersion in different pediatric drugs. Three different restorative materials namely composite resin, alkasite and high-viscosity glass ionomer cement(HVGIC) were used to prepare total 96 (32 from each) disc-shaped specimens(2mmx5mm). A spectrophotometer was used to record the color of each sample after sample preparation and 7 days following the staining technique. After 1-week period, ΔE ∗ values were calculated. The average color changes(ΔE) for all drugs/restorative materials ranged from 1.81 to 8.08. The most prominent alteration was found in Cough syrup-Alkasite(8.08 ± 2.62) and the least one was found in Cough syrup-HVGIC(1.81 ± 0.74) pairwise. The color change observed in Cough syrup-Alkasite group was statistically significantly higher than in Cough syrup-HVGIC (p < 0.05). Alkasite showed greater color alteration with all drugs compared to other materials and HVGIC showed better color stability with all drug formulations.

Objective: The present study aimed to evaluate the effect of remineralizing agents on demineralized enamel intended for use as fluoride substitutes or supplements for oral hygiene applications.Methodology: Enamel samples were obtained from 30 bovine teeth. The enamel blocks were stored in 20 mL of demineralization solution for 72 h. They were then brushed with the following toothpaste for the remineralization protocol: NaF, NaF/SnF₂ combination, NovaMin, or nano‐hydroxyapatite. SEM/EDX examinations and microhardness measurements of the samples were performed to investigate the remineralization efficacy of the studied toothpaste. One‐way analysis of variance (ANOVA) with post hoc Tukey's HSD test was used to analyze the change in microhardness values in different remineralization protocols (p < 0.05).Results: Differences in the mean remineralization (%RP) and hardness recovery (%HR) were determined between the groups (p < 0.05). Groups 1 and 4 showed significant differences in %RP (p < 0.05). In the SEM/EDX examinations, the samples treated with n‐HAp showed an accumulation of crystal deposits on the enamel surface, although at a lower density than those treated with NaF and NaF/SnF₂ combination.Conclusion: The remineralization strategy in toothpaste plays an important role in enamel remineralization. NovaMin‐containing toothpaste showed positive effects on the enamel surface with better Ca/P ratio. Toothpastes containing n‐HAp triggered less change in the increase of microhardness values compared to other toothpastes. The use of SnF₂ in toothpaste in combination with NaF significantly increased the binding of fluoride to demineralized enamel compared to toothpaste containing NaF alone.