A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results

OBJECTIVE: The purpose of this study was to investigate the clinical performance of high-strength glass ionomer cement (HSGIC) and resin-modified glass ionomer (RMGIC) in single and multiple surface carious cavities in the field conditions. MATERIAL AND METHODS: A split-mouth design, including ninety-one fillings placed on contra lateral molar pairs of 37 children, was used in permanent dentition. As filling materials, a HSGIC (Ketac Molar/3M ESPE) and a RMGIC (Vitremer/ 3M ESPE) were used with the Atraumatic Restorative Treatment (ART). Baseline and 6, 12 and 24-month evaluations of the fillings were made with standard-ART and USPHS criteria by two examiners with kappa values of 0.92 and 0.87 for both criteria. RESULTS: According to the USPHS criteria, the retention rates of RMGIC and HSGIC restorations were 100% and 80.9% for single surface, and 100% and 41.2% for multiple surface restorations after 24 months, respectively. Irrespective of surface number, RMGIC was significantly superior to HSGIC (p= 0.004), according to both standard-ART and USPHS criteria. CONCLUSION: The results indicate that RMGIC may be an alternative restorative technique in comparison to high-strength GIC applications in ART-field-trials. However, further clinical and field trials are needed to support this conclusion

Rural dentistry: Is it an imagination or obligation in community dental health education?

During the past two decades, epidemiologic studies in less developed or developing countries have clearly reported that caries prevalence shows the distinctive patterns over the word, even though it is declining in many developed countries. Due to huge rural districts where arrival is problematic and ineffective dental and preventive care centers in most suburban districts, there has been significant difference between the different parts of the communities to provide dental care service, and unfortunately the sole preventive measure has been limited with the advising of using the tooth brush and paste. The problems are usually arisen not only from the inadequacy of trained personnel but also from the absence of an effective economic and pragmatic system which aims to effectively dispense the dental service to all over the country. For this reason, the basic aim of dental care should be to carry out the many dental services in a multidisciplinary manner within the first appointment and to serve the people at their own homes and/or districts. Clearly, the needed multidisciplinary dental care system can lead to a new educational doctrine for rural dental practice. This versatile and practical training program based on specific perceived needs of a specific population(s) could need a new educational program. So, various preventive and/or restorative procedures included by this new doctrine could be named as “rural dentistry.” In this review, with the examples from the many in vivo studies carried out under rural conditions over the world, the probable practices in this specific dental doctrine have generally been exemplified.Keywords: Chlorhexidine, fissure sealant, fluoride varnish, prevention, rural dentistryNigerian Medical Journal | Vol. 53 | Issue 1 | January-March | 201

Effect of Intracanal Medication with Calcium Hydroxide and 1% Chlorhexidine in Endodontic Retreatment Cases with Periapical Lesions: An In Vivo Study

Calcium hydroxide (Ca(OH)2) has been widely used as an intracanal medicament for endodontic retreatment, but very few studies used both Ca(OH)2 and 1% chlorhexidine (CHX) as intra-canal medicaments. The purpose of this study was to assess the in vivo effectiveness of a combination of Ca(OH)2 and 1% CHX as intracanal medicaments in endodontic retreatment cases with periapical lesions. Methods: Previous cases of endodontically treated teeth with periapical pathosis in 70 patients (36 men and 34 women, age range 18-60 years) were included. Of these teeth, 59 had received root canal treatment and 11 had been subjected to previous apical surgery, indicating endodontic failure. Following the routine procedures, including canal reshaping and irrigation with 2% CHX, a canal medication material containing Ca(OH)2 powder and a 1% CHX solution was placed into the root canals. Over a 6-week period, the intracanal medication was periodically changed until the teeth became asymptomatic. Patients were recalled at 3-month intervals for radiographic and clinical examination. Results: Our clinical and radiographic assessment of retreatment cases showed complete healing in 41 (64%) teeth, incomplete healing in 9 (14%) teeth, and failure in 14 (22%) teeth. For complete healing teeth, the healing time varied from 6 to 36 months. The size of the periapical lesions and previous surgical treatment had no influence on the prognosis. Conclusion: Our results suggest that a combination of Ca(OH)2 and 1% CHX can be successfully used as intracanal medicament for disinfection in endodontic retreatment cases with periapical lesions. [J Formos Med Assoc 2007;106(3):217-224

Evaluation on different preventive measures in the children living in rural districts of south-eastern anatolia: 24 month-result of a field trial

Son yıllarda, değişik ülkelerde izlenen yaygın çürük azalımına rağmen, Türkiye gibi gelişmekte olan çoğu ülkelerde diş çürüğü hala önemli bir sağlık sorunu olarak devam etmektedir. Çok değişkenli bir hastalık olmasına rağmen, çürüğün kontrol altına alınmasındaki temel sorunlarda birisi de koruyucu-tedavi edici uygulamaların, toplumun değişik seviye­lerine ulaştırılmasındaki güçlüğüdür. Bu çalışmada; dişhekimiiği hizmetinin sınırlığı olduğu Güneydoğu Anadolu kırsalındaki çocuklarda değişik koruyucu uygulamalar incelenmiştir. Diyarbakır kentine 55 kilometre uzaklıktaki Eğil ilçesi yatılı bölge okulu çalışma alanı olarak seçildi. Yaşları 9-17 arasında değişen toplam 120 çocuk 3 gruba ayrıldı. Bunlar; grup 1: cam-ionomer fissür örtücü gurup, grup 2: kontrol grubu ve grup 3: florjel grup. Tüm koruyucu uygulamalar okul ortamında ve bir grup dişhekimi ve dişhekimiiği öğrencisi tarafından gerçekleştirildi. İki hekim tarafından gerçekleştirilen ilk muayenenin sonrasında çocuklar ikinci yılın sonunda tekrar muayene edildi. Grup 1A 2 ve 3 için iki yıllık ortalama çürük artışı sırasıyla 00.07±0.6, 0.82±0.95, 0.68±0.75 olarak belirlendi. Gruplar arasındaki fark istatistiksel olarak anlamlı bulundu (p<0.0001). Sonuç olarak; sınırlı şartlara rağmen, ART yüzey örtücüler gibi basit koruyucu uygulamaların Güneydoğuanadolu uzak kırsalında yaşayan çocuklarda etkin olabileceği belirlendi.Despite dramatic and common reduction in various countries, dental caries is still epidemic in various developing countries as seen in Turkey. Although it is a mult/factorial disease, one of the basic problems to fight with dental caries is the limitations of the preventive and operative treatment alternatives to attain to various part of the community. In this study, various preventive measures have been studied in a child group living in rural south-eastern Anatolia in where dental service is limited. A regional boarding school in Eğil district, 55 kilometers Diyarbakir city, was selected as study site. One-hundred-twenty children whose age range was 9 to 17 were divided 3 groups as follows; group 1- ART-glass-ionomer sealant group, group 2- control group, and group 3- fluoride gel group. Each preventive procedure was performed in the school promises by a group of dentist and dental students. After the baseline examination performed by two dentists using WHO caries criteria, re-examination was performed at 24* month. Mean caries increment for group 1, 2 and 3 were 0.07&plusmn;0.6, 0.82&plusmn;0.95, 0.68&plusmn;0.75, respectively. The differences were statistically significant (p&lt;0.0001). It was concluded from these results that although limited preventive opportunities, pragmatic preventive measures such as ART-fissure sealant, could be effective in the children living in far-rural of south-eastern Anatolia

İlköğretİm okullarında standart bİr koruyucu yöntem olarak fırça İle flor jel uygulamasının değerlendİrİlmesİ: dört yıllık alan çalışması sonuçları

Amaç: Bu çalışma; bir il merkezindeki tüm ilköğretim okullarını kapsayan, basitleştirilmiş bir koruyucu diş hekimliği yöntemi olan Fırça ile florlu jel uygulamasının orta ve uzun süreçteki etkilerinin değerlendirilmesi amacıyla planlanmıştır. Gereç ve Yöntemler: 2007 yılında Kırıkkale ili merkezine bağlı ilköğretim birinci sınıfta öğrenim gören çocuklardan, çalışma ve kontrol grubuna eşit dağılmak üzere toplam 480 çocuk çalışmaya dâhil edildi. Çalışma grubuna %2lik nötral florlu jelin diş fırçası ile çocuklara birebir fırçalatılması (brush-on gel application) yöntemi ile yılda 4 defa ve 3 yıl boyunca olmak üzere toplam 12 uygulama yapılırken, kontrol grubuna ise yılda en az bir kere sınıf ortamında fırçalama eğitimi verildi. Grupların başlangıç, birinci, ikinci ve dördüncü yıl muayeneleri Dünya Sağlık Örgütünün (DSÖ) muayene kriterlerine göre gerçekleştirildi. Bulgular: Grupların başlangıç, birinci ve ikinci yıldaki DMFT değerleri arasında istatistiksel olarak anlamlı farklılık mevcut değilken, dördüncü yıldaki DMFT değerleri (sırasıyla 0,330,72 ve 0,691,15) arasında anlamlı farklılık bulundu (p0,001). Grupların başlangıç ve ikinci yıldaki çürük yaygınlık yüzdeleri arasında anlamlı farklılık gözlenmezken, ikinci ve dördüncü yılındaki çürük yaygınlık yüzdeleri arasında anlamlı farklılık mevcuttur (sırasıyla p0,049 ve p0,004). Sonuçlar: İlköğretim okullarında gecikmiş tip hijyen eğitiminin de verilebildiği basitleştirilmiş koruyucu uygulamalar, çürük artışının kontrol altına alınabilmesi açısından bir fırsat oluşturabilir. Bununla beraber bu tip basit yöntemler, yüksek çürük riskli hastalarda yetersizdirler ve risk bazlı koruyucu yöntemlerin desteğine ihtiyaç duyarlar.Objectives: The aim of this study was to evaluate the medium-and long-term effect of brush on fluoride gel application which is a simplified preventive method in a city center including whole primary schools. Materials and Methods: In 2007, of the 2348 first grade primary school children (born in 1999) being teached at 37 primary school at Kirikkale city center, 480 were selected, and equally divided as control and study groups. While in study group, all children had routinely get brush on fluoride gel application four-times a year during 3&nbsp;years (total 12&nbsp;times), using 2 percent neutral fluoride gel; others were subjected to oral hygiene education at least one time a year. All the examination procedures were yearly performed using World Health Organization (WHO) criteria at the first-second and fourth year. Results: While there was no statistically significant difference between the groups at baseline, it was not true at 4th&nbsp; years DMFT results (DMFT values for control and study groups were 0,33±0,72 and 0,69±1,15, respectively. p0,001). Similar trend was observed at baseline and 4th&nbsp; year results for caries prevalence (p values for baseline and 4th&nbsp; year comparisons were p0,049 and p0,004, respectively). Conclusions: Considering as a simplified oral health preventive programs which may be important to established tooth-brushing habit could lead to an observational difference in caries prevalence. However, various primitive preventive methods could need to be supported by the risk-based additional preventive applications in high risk population