Impact of COVID-19 on Oral and Dental Health Delivery and Recommendations for Continuation of Oral and Dental Health Services

COVID-19, which has caused a great panic by leaving millions of deaths in its wake worldwide, has affected the provision of oral and dental health services as in many fields. Especially dentists, who offer oral and dental health services by working in the oral region of the patients, are under a high risk of encountering the agent. This high risk has justifiably created a concern for them. Therefore, it has been quite challenging to provide oral and dental health services. In order to alleviate these concerns and to sustain oral and dental health services, many health organizations and institutions, especially the World Health Organization, have published recommendations and principles of practice, and announced financial support. In this section, we will examine the recommendations and practices regarding infection prevention and control measures by getting away from standard routine health service practices in order to be protected from COVID-19 epidemic and what areas they cover on a wide scale. By discussing the effects of these recommendations and practices on the provision of dental health services, we will try to determine the practices that will relieve concerns and are aimed at ensuring the provision of safe health services in terms of both patients’ health and health professionals’ health

The effects of different root canal irrigation protocols and artificial aging procedures on the bond strength between dentin and hybrid ceramic posts

The purpose of this study is to investigate the effects of different root canal irrigation protocols applied to the dentin and artificial aging procedures on the micro pushout bond strength (mPBS) between dentin and hybrid ceramic posts. Seventy-five single-rooted mandibular premolar teeth were divided into 5 groups (Gr1-5). 50 of the teeth were used for the mPBS tests (n = 10), whereas 25 were used for the smear layer examinations (n = 5). Post space were prepared and irrigated with different irrigation-protocols in each group. (Gr1:[SS], Gr2:[NaOCl] + SS, Gr3:[EDTA] + NaOCl + SS, Gr4:[MA] + NaOCl + SS, Gr5:[Ch] + NaOCl + SS). Post and core pattern were fabricated with pattern resin and a fiber post, after scanning, the posts were milled with Vita Enamic resin ceramic block, and cemented. After 7 days the roots were sliced at thicknesses of 1 mm; half of them were subjected to mPBS test, while the other half were tested after undergoing mechanical cycling for artificial aging. For data analysis, the Shapiro-Wilk test was utilized to test normal distributions, 3-way analysis of variance was used to compare mPBS, and Tukey’s HSD test was conducted for multiple comparisons. SEM analysis was performed for examination of failure modes and smear layer removal. Different root canal irrigation protocols affected mPBS significantly. While Gr4 had the highest mPBS, Gr1 had the lowest. Regarding to different zones, the highest mPBS was in coronal zone, and the lowest one was in the apical zone. The aging procedure also led to a statistically-significant decrease in mPBS. Most frequent failure modes were cohesive failure in dentin and mixed failure. Irrigation with 7%MA (Gr4) showed better performance than 17% EDTA (Gr3) in smear layer removal, especially at the apical zone of the tooth. This is critical for the success of root canal treatment and increased the mPBS to a higher extent in all zones of the tooth

Türk toplumunda radyoopak çene lezyonlarının değerlendirilmesi: Retrospektif bir çalışma

Background: Radiopaque lesions are frequently found in the periapical region. The diagnosis and treatment of these lesions can be challenging to the dentist. The present study presents the similar radiographic features of the lesions to help the clinician narrow the differential diagnosis and to aid in treatment planning. This study aims to evaluate the frequency and distribution of radiopaque lesions in a Turkish population. Materials and Methods: This retrospective study was conducted at the Department of Endodontics, Hamidiye Faculty of Dentistry, University of Health Sciences Turkey, İstanbul, Turkey. Data was obtained from digital panoramic images taken between 2018-2021. A total of 2.002 patients were included. The incidence of specific radiopaque lesions, like idiopathic osteosclerosis, condensing osteitis, odontoma, cementoblastoma, cementoosseous dysplasia, and fibrous dysplasia was evaluated with relation to gender. In addition to these, the frequency of pulp stones was also evaluated. Descriptive statistics and the chi-square test were used to evaluate the data. Results: Of the 1.912 patients diagnosed with radiopaque lesions, 960 (50.2%) were female and 952 (49.8%) were male. Radiopaque lesions were determined on 106 (5.5%) panoramic radiographs. While idiopathic osteosclerosis was found in 58 (3%), condensing osteitis was found in 33 (1.7%), odontoma was found in 1 (0.1%), cementoblastoma was found in 1 (0.1%), cemento-osseous dysplasia was found in 10 (0.5%) and fibrous dysplasia was found in 3 (0.2%) patients. Moreover, a pulp stone was found in 142 (7.4%) patients. No statistically significant difference was found between genders in any of the lesions (p>0.05), except for condensing osteitis (X²=0.024). Conclusion: The most common radiopaque lesions in the study were idiopathic osteosclerosis and condensing osteitis, while the least common was cementoblastoma and odontoma.Amaç: Periapikal bölgede radyoopak lezyonlar sıklıkla bulunmaktadır. Bu lezyonların teşhisi ve tedavisi diş hekimi için zorlayıcı olabilir. Bu lezyonlar benzer görüntüleme özelliklerine sahip olabilir ve bu çalışmada klinisyenin ayırıcı tanıyı daraltmasına ve hasta tedavisini planlamasına yardımcı olmak için temel radyografik özellikler sunulmaktadır. Bu çalışmada, Türk popülasyonunda radyoopak lezyonlarının sıklığı ve dağılımının incelenmesi amaçlandı. Gereç ve Yöntemler: Radyoopak çene lezyonlarının bu retrospektif çalışması Türkiye’de Sağlık Bilimleri Üniversitesi, Hamidiye Diş Hekimliği Fakültesi Endodonti Anabilim Dalı’nda yapılmıştır. Veriler 2018’den 2021’e kadar dijital panoramik radyografi görüntülerinden alınmıştır. Toplam 2002 hasta dahil edilmiştir. Bu çalışmada cinsiyete ek olarak idiyopatik osteoskleroz, kondensing osteitis, odontoma, sementoblastoma, semento-osseöz displazi ve fibröz displazi gibi radyoopak lezyonların görülme sıklığı değerlendirildi. Bunlara ek olarak pulpa taşı sıklığı da değerlendirildi. Verilerin değerlendirilmesinde tanımlayıcı istatistikler ve ki- kare testi kullanıldı. Bulgular: Radyoopak lezyon tanısı alan 1,912 hastanın 960’ı (%50,2) kadın, 952’si (%49,8) erkekti. Yüz altı (%5,5) panoramik radyografide radyoopak lezyonlar tespit edildi. Elli sekizinde (%3) idiyopatik osteoskleroz, 33’ünde kondensing osteitis (%1,7), 1’inde odontoma (%0,1), 1’inde sementoblastoma (%0,1), 10’unda sementoosseoz displazisi (%0,5) ve 3’ünde fibröz displazi (%0,2) bulundu. Dahası 142’sinde pulpa taşı (%7,4) bulundu. Kondensing osteitis (X²=0,024) dışında hiçbir lezyonda cinsiyetler arasında istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Sonuç: Çalışmada en sık radyoopak lezyonlar idiyopatik osteoskleroz ve kondens osteitis iken en az görüleni sementoblastoma ve odontoma idi

The importance of inflammatory biomarkers, IL-6 and PAPP-A, in the evaluation of asymptomatic apical periodontitis

To examine the use of IL-6 and PAPP-A along with the new imaging for scoring methods to determine the severity of apical periodontitis (AP). The scoring of disease severity in 121 patients with AP, using dental radiographs, was based on "The Apical Periodontitis Grading Scale" (APGS), as those having 1 tooth with AP and severity of 3-4 were classified as grade 1 (mild); those having > 1 tooth and severity of 3-4 as grade 2 (moderate) and those with at least one tooth with a severity of 5 as grade 3 (severe). 45 systematically and orally healthy volunteers were selected as the control group (grade 0). Dental demographic data of all participants were recorded. Besides, venous blood samples were collected to study their complete blood count and levels of IL-6 and PAPP-A. Both NLR and PAPP-A levels of the grade 3 AP patients were found significantly higher than those of the control group and grade 1 and grade 2 AP patients (2.55 +/- 1.40 vs 1.98 +/- 1.05, 1.94 +/- 0.58 and 1.86 +/- 0.50; 0.606 +/- 0.211 vs 0.422 +/- 0.273, 0.447 +/- 0.224 and 0.436 +/- 0.242,p < 0.01, respectively). AP grades identified by the new scoring system were moderately correlated with IL-6 levels (Spearmanr = 0.4168,p < 0.001). The risk of patients with IL-6 levels above 12.5 pg/ml to develop AP (relative risk) was found to be 2.19 times higher than that in those with lower IL-6 levels (98% Cl 1.233-3.905,p < 0.0024). APGS classification suggested to determine AP severity was found to be significantly correlated with levels of inflammatory markers IL-6 and PAPP-A

Association between C-reactive protein, neutrophil to lymphocyte ratio and the burden of apical periodontitis: A case-control study

WOS: 000461105700008PubMed ID: 30394169Objective: Endodontic originated chronic apical periodontitis (AP) is an inflammatory disease of periapical tissue. High-sensitivity C-reactive protein (hsCRP) as an inflammatory marker and hemogram indexes provide valuable information to clinicians for diagnosis, screening and follow-up of various diseases. The aim of this study was to investigate AP in terms of its association with hemogram indices and hsCRP levels. Material and methods: Study includes 104 patients with AP and 40 participants as the control group. 160 teeth were diagnosed as AP through digital radiographic images and scored with respect to Periapical Index (PAI) scoring. Afterwards, patients were categorized into 3 grades in accordance with both the number and the severity of AP. AP grade 0 was considered for the control group with regard to a new scoring system. Patients with only one tooth involved with AP with a PAI score of 3 or 4 were categorized as an AP Grade 1, when a patient had more than one tooth with a PAI score of 3 or 4 he was classified as an AP Grade 2 and a patient with at least one tooth scored as a PAI 5 was rated as an AP Grade 3. Hemograms and hsCRP levels were measured for each individual to establish a correlation with inflammatory markers. Results: The neutrophil/lymphocyte ratio (NLR) levels of patients with AP Grade 3 were significantly higher than all other AP grades (p<.05). hsCRP levels in patients with an AP Grade 2 and 3 were higher than both AP Grade 0 and 1 (p<.05). Conclusions: hsCRP levels of patients were reliable predictive indicators for AP severity in correlation with the new proposed scoring system for AP

Relationships among barodontalgia prevalence, altitude, stress, dental care frequency, and barodontalgia awareness: a survey of Turkish pilots

Background Gas expansion in body cavities due to pressure changes at high altitudes can cause barodontalgia. This condition may compromise flight safety. Aim To investigate relationships among barodontalgia awareness, dental visit frequency, and barodontalgia prevalence in civilian and military pilots operating at high altitudes. Materials and Methods Civilian pilots from Turkish Airlines and military pilots from the Turkish Air Force, flying between November 2022 and January 2023, participated in this study. A 20-question survey was administered to 750 pilots, covering topics such as barodontalgia awareness, dental visit frequency, breaks after dental treatments, in-flight pain, and pain type and severity. The voluntary surveys were distributed by email. Results Of the 750 pilots, 526 completed the survey; 61% were aware of barodontalgia, and 81% of pilots who had experienced it reported pain at altitudes <2000 feet. The study revealed higher barodontalgia awareness among pilots who had experienced it, with the highest prevalence among jet pilots. Pilots with barodontalgia also showed a higher frequency of dental visits (p < 0.001). Additionally, this group reported more frequent interruption of flight due to dental treatment (IFDT), more problems experienced in flights after treatment (PFAT), and higher instances of bruxism or teeth clenching during flight, suggesting stress and anxiety (p < 0.05). Conclusions Barodontalgia, a type of pain linked to stress, significantly impacts pilot performance, and can threaten flight safety, even at lower altitudes. Thus, there is a need to educate pilots about stress management, barodontalgia awareness, and the importance of regular dental check-ups

Is adrenomedullin upregulation due to apical periodontitis independent of periodontal disease?

To investigate the relationship between apical periodontitis [AP] severity and inflammatory markers [interleukin (IL)-12, tumor necrosis factor-alpha (TNF-α), and Mid-Regional Pro Adrenomedullin (MR-proADM)] in patients with AP. A total of 162 subjects were divided into three categories: AP group (n = 80), periodontitis (P) group (n = 42), healthy control group (n = 40). The scoring of disease severity in 80 AP patients without any periodontal disease, using dental radiographs, was based on “The Abscess Score” (AS), as those having at least 1 tooth with AP and severity of PAI 3–4 were classified as AS 1 (mild); those with only1 tooth and severity of PAI 5 as AS 2 (moderate) and those having > 2 tooth with severity of PAI 5 as AS 3 (severe). Blood samples were collected from all of the patients. Enzyme-linked immunosorbent assay was used to evaluate the samples. The MR-pro ADM levels of both the AP and P groups were considerably higher than the control group (p < 0.01). The IL-12 levels of the AP group were higher than the P and control groups (p < 0.05). TNF-α levels of the P group were significantly higher than both the AP and control groups (p < 0.01). MR-pro ADM levels of both the AP and Periodontitis groups were higher than the control group. TNF-α was a biomarker of periodontitis, while IL-12 was a biomarker of apical periodontitis