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Abstract 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

Abstract Background/purpose: Twin studies are crucial to assess the relative contribution of genetic and environmental factors. This study was conducted to evaluate association between deleterious oral habits and dental caries–periodontal parameters among Turkish twins. Materials and methods: The study comprised 143 pairs of dizygotic (DZ) twins and 59 pairs of monozygotic (MZ) twins aged 3–15 years. Twins were examined for dental caries, plaque index, gingival index, bleeding on probing and deleterious oral habits. Mann Whitney U test was used to examine the data. Results: The MZ twin pairs consisted of 60 male and 58 female twin pairs, whereas the DZ twin pairs consisted of 144 male and 142 female. The mean age of the twins was 9.63 ± 3.0 in MZ twins and 9.47 ± 3.2 in DZ twins. The mean DMFS value of MZ twins with bruxism is higher than those of MZ twins without bruxism (P = 0.001). The mean DMFS value of DZ twins with pacifier sucking is lower than those without (P = 0.007). A statistically significant difference was found between MZ twins with and without nail biting in terms of bleeding on probing and dmfs values (P = 0.035; P = 0.012). The mean values of the plaque index increased due to the mouth breathing in DZ twins (P = 0.024). Regarding the bleeding on probing, there was a statistically significant difference between MZ twins with and without atypical swallowing (P = 0.016). Conclusion: These findings suggest that dental caries–periodontal parameters are similarly affected by deleterious oral habits in MZ and DZ twins.

Diş çürüklerinin oluşumunda birçok faktör etkili olmasına rağmen önlenebilen bir hastalıktır. Tat genleri de bu etkili faktörler rasında yer almakta olup diş çürüğünün başlıca nedenlerinden biri olan şeker alımında etkili olduğu bilinmektedir. Tat reseptörlerini ifade eden genlerdeki polimorfizmler ile diş çürükleri arasında ilişki olduğu belirlenmiştir. Çocuğun doğumdan önceki yaşamında annenin tükettiği besinlerin, bebeklerin gelecekteki beslenme tercihlerini etkilediği görülmektedir. Aynı şekilde bebekliğin ilk yıllarında tüketilen besinler de bireylerin ilerideki beslenme seçimlerini etkilemektedir. Bazı çalışmalarda tat reseptörlerini ifade eden genlerdeki çeşitli polimorfizmlerin besin seçimleri ile ilişkili olduğu gösterilmiştir. Ayrıca birçok çalışmada TAS1R2, TAS2R38 ve GLUT2 genlerinin polimorfizmleri incelenmiş ve bu çalışmaların çoğunda tat genlerindeki çeşitli polimorfizmlerin DMF-T, dmf-t ve ICDAS değerleri ile ilişkili olduğu ortaya konmuştur. Bu gen polimorfizmlerinin bir kısmının diş çürüğü oluşumunu engellediğini, bir kısmının ise diş çürüğü oluşumuna neden olduğunu belirten çalışmalar mevcuttur. Şekerli gıdaların neden olabileceği kanser, kalp-damar hastalıkları, obezite, hiperlipidemi, hipertansiyon ve diş çürüğü gibi hastalıkların önlenmesinde de genetik faktörlerin etkili olabileceği kanıtlanmıştır. Diş çürüğü ve genetik arasındaki ilişkiyi anlamak, bu hastalığın nedenlerini belirlemeye ve hastalığı önlemek için çürük risk gruplarını değerlendirmeye ve yönetmeye yardımcı olabilir.

Abstract Human ACP4 (OMIM*606362) encodes a transmembrane protein that belongs to histidine acid phosphatase (ACP) family. Recessive mutations in ACP4 cause non-syndromic hypoplastic amelogenesis imperfecta (AI1J, OMIM#617297). While ACP activity has long been detected in developing teeth, its functions during tooth development and the pathogenesis of ACP4-associated AI remain largely unknown. Here, we characterized 2 AI1J families and identified a novel ACP4 disease-causing mutation: c.774_775del, p.Gly260Aspfs*29. To investigate the role of ACP4 during amelogenesis, we generated and characterized Acp4 R110C mice that carry the p.(Arg110Cys) loss-of-function mutation. Mouse Acp4 expression was the strongest at secretory stage ameloblasts, and the protein localized primarily at Tomes’ processes. While Acp4 heterozygous (Acp4 +/R110C) mice showed no phenotypes, incisors and molars of homozygous (Acp4 R110C/R110C) mice exhibited a thin layer of aplastic enamel with numerous ectopic mineralized nodules. Acp4 R110C/R110C ameloblasts appeared normal initially but underwent pathology at mid-way of secretory stage. Ultrastructurally, sporadic enamel ribbons grew on mineralized dentin but failed to elongate, and aberrant needle-like crystals formed instead. Globs of organic matrix accumulated by the distal membranes of defective Tomes’ processes. These results demonstrated a critical role for ACP4 in appositional growth of dental enamel probably by processing and regulating enamel matrix proteins around mineralization front apparatus.

Abstract Background This study aimed to evaluate possible cytotoxic effects to gingival epithelial cells exposed to children toothpastes containing different detergent. Methods Tissues required for the isolation of human gingival epithelial cells were obtained by biopsy during the extraction of the impacted third molar tooth. Toothpaste solutions of different concentrations were prepared from five different children’s toothpastes with different detergent contents. Isolated gingival epithelial cells were stimulated with experimental groups consisting of toothpaste solutions (Colgate, Sensodyne, Splat, Nenedent, Perlodent) at different concentrations and a control group consisting of complete Dulbecco’s modified eagle medium. After the experiments, cell viability was evaluated using flow cytometry. 2 Way ANOVA was used to see the interaction effect of the main effects of toothpaste solution and concentration factors. Pairwise comparisons were made by Tukey post hoc tests. In the study, the significance level was taken as 0.05. Results As a result of the analysis, it was seen that the toothpaste solution and concentration factors and the interactions of these 2 factors were effective on the viable, early apoptotic, late apoptotic and necrotic cell rates. The statistically highest live cell ratios were detected in Splat’s toothpaste solutions (90.14% at 0.4% concentration) after the control group (90.82%) and the group with the lowest viability values was determined in Colgate group (75.74% at 0.4% concentration) (p

Abstract This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann–Whitney U tests, Kruskal–Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

Abstract Oligodontia is the congenital absence of six or more teeth and comprises the more severe forms of tooth agenesis. Many genes have been implicated in the etiology of tooth agenesis, which is highly variable in its clinical presentation. The purpose of this study was to identify associations between genetic mutations and clinical features of oligodontia patients. An online systematic search of papers published from January 1992 to June 2021 identified 381 oligodontia cases meeting the eligibility criteria of causative gene mutation, phenotype description, and radiographic records. Additionally, ten families with oligodontia were recruited and their genetic etiologies were determined by whole-exome sequence analyses. We identified a novel mutation in WNT10A (c.99_105dup) and eight previously reported mutations in WNT10A (c.433 G > A; c.682 T > A; c.318 C > G; c.511.C > T; c.321 C > A), EDAR (c.581 C > T), and LRP6 (c.1003 C > T, c.2747 G > T). Collectively, 20 different causative genes were implicated among those 393 cases with oligodontia. For each causative gene, the mean number of missing teeth per case and the frequency of teeth missing at each position were calculated. Genotype–phenotype correlation analysis indicated that molars agenesis is more likely linked to PAX9 mutations, mandibular first premolar agenesis is least associated with PAX9 mutations. Mandibular incisors and maxillary lateral incisor agenesis are most closely linked to EDA mutations.

Background/purpose: Dental pulp stem cells (DPSCs) play a crucial role in the tissue healing process through odontoblast like cell differentiation. The aim of this study was to evaluate the biocompatibility and compare the potential invitro cytotoxic effects of NeoMTA Plus, ProRootMTA and Biodentine on human dental pulp stem cells (hDPSCs). Materials and methods: To assess the effects of NeoMTA Plus, ProRoot MTA and Biodentine extracts at 1st, 3rd and 7th d on hDPCs, cell populations was determined by flow cytometry using an Annexin V detection kit. The data were analyzed statistically using the Kruskal–Wallis test. A p 0.05). Conclusion: All materials extracts are not cytotoxic and do not induce apoptosis in the hDPSCs. These results suggest that all the tested materials can lead to positive outcomes when used as reparative biomaterials.

Purpose: The aim of this study is to evaluate clinical success rate of resin-based fissure sealants applied at Istanbul University, Department of Pediatric Dentistry after 1 year of application. Materials and methods: Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study. The ages of children ranged from 7-13 (mean age:9.2±1.22). Resin-based fissure sealant was applied to the 322 fissures of the first permanent molars in 100 children. 12 months after the application, children were recalled for examination. Recall examinations were carried out by the same dentist. Fissure sealants were evaluated at 12th month by using Ryge criteria: Retention (R), precence of caries (PC), marginal adaptation (MA), marginal discoloration (MD) and cracking (C). Results: 12 months after the application, all of the children were recalled and fissure sealants were examinated. Our findigs are: R: Alpha 95 (29.5%), Bravo: 143 (44.4%), Charlie: 84 (26%); PC: Alpha 274, Bravo 48 (14.9%); MD: Alpha 322; MA: Alpha 279, Bravo 43 (13.3%); C: Alpha 321, Bravo 1 (0.3%). Conclusion: The preventive effects of the sealant are only maintained as long as it remains completely intact and bonded in place. After applying fissure sealants, patients must be recalled and sealants must be checked to provide retention and marginal adaptation.

Amaç:Diş gelişimi, çocuklarda büyüme ve gelişmenin önemli bir göstergesidir. Büyüme sürecinde boy ve kilo artışı ile diş boyutlarının artışı birbirlerine paralel seyreden parametrelerdir. Bu çalışmanın amacı; süt dişlerinin kuron boyu ve meziodistal (MD) genişlikleri ile çocuğun boyu, kilosu ve vücut kitle indeksi (VKİ) arasındaki ilişkinin belirlenmesidir. Gereç ve Yöntemler:Çalışmaya; İstanbul Üniversitesi Diş Hekimliği Fakültesi Pedodonti Anabilim Dalı kliniğine başvurmuş olan 3-6 yaş grubu 68 çocuk (34 kız, 34 erkek) dahil edilmiştir. Çocukların alt-üst çenesinden ölçü alınarak elde edilen alçı model üzerinden dijital bir kumpas yardımıyla dişlerin klinik kuron boyu ve meziodistal genişlik uzunlukları ile çocukların kilo, boy ve yaş değerleri kaydedilmiştir. Kaydedilen bu değerler arasındaki ilişki istatiksel olarak değerlendirilmiştir.Bulgular:Çalışmaya katılan 68 çocuğun 25’i (%36,8) 3-4 yaş grubunda iken 22’si (%32,4) 5 yaş grubuna, 21’i ise (%30,9) 6 yaş grubuna dahildir. Tüm yaş gruplarında 5. ve 7. bölgedeki dişlerin kuron boyu ortalamaları arasında ve meziodistal genişliği arasında anlamlı bir fark bulunmuştur (p=0,001). Gruplar arası karşılaştırmada erkeklerde #53 numaralı dişin kuron boyu için istatistiksel olarak anlamlılık saptanmıştır (p=0,019). Değerlendirmeye alınan tüm dişlerin kuron boyu ve MD genişliği ile VKİ değişkeni ile karşılaştırılmasında anlamlı bir ilişki bulunamamıştır (p>0,05).Sonuçlar:Bu çalışmada bireyin boyu ile dişin meziodistal genişliğine göre bireyin boyu ile kuron boyu arasında daha kuvvetli korelasyon olduğu belirlenmiştir. Bunun sonucunda süt dişlerinin kuron boyu ve meziodistal genişliğinin, çocukların muhtemel boylarını tahmin etmede kullanılması ve vücut ölçüleri arasında ilişki kurulmasının değerlendirilebileceği düşünülmektedir.Anahtar Kelimeler:kuron boyu, meziodistal genişlik, vücut kitle indeksi

The timing of primary tooth eruption is critical for children’s health planning and the diagnosis of specific growth disorders. The purpose of this study is to assess the relationship between twin pairs’ birth weight, gestational age, and gender, which are indicators of prenatal factors; breast-feeding duration, which is an indicator of postnatal factors; type of delivery, which is an indicator of maternal as well as genetic factors; and age of the primary tooth. Twin children aged from 3 to 15 years who applied to the clinic for the first dental examination constituted the sample group. In this twin study, 59 monozygotic (MZ) twin pairs and 143 dizygotic (DZ) twin pairs were included. Genetic (MZ vs. DZ), maternal (type of delivery, gestational age), perinatal (birth weight, gender), and postnatal (duration of breastfeeding) information was obtained, and effects on the children’s Eruption Timing of the First Primary Tooth (ETFPT) were examined. Statistical analysis was performed using the consistent partial least squares structural equation model (robust PLSc) technique. As birth weight increased, the age at first eruption became younger, but this change was different between MZ and DZ twins (p < 0.05). While the age at first tooth eruption was older in identical twins who were breastfed for the first 6 months, this increase was not observed in DZ twins. The mean of ETFPT was calculated as 7.31 months in MZ twins and 6.75 months in DZ twins. The effect of breastfeeding and birth weight on ETFPT may differ according to zygosity in twins. MZ twins may tend to take longer to experience the eruption of their first primary teeth.

Objectives: The purpose of this study is to compare the clinical, antibacterial and microbiological effects of the non-fluoride and fluoride toothpastes. Materials and Methods: In this study eighty children (3 to 12 years old) were divided into four groups and followed for four weeks. First and second groups (40 children, 6-12 years) used different fluoride toothpastes; third and fourth groups (40 children, 3-5 years) used nonfluoride toothpastes. The halitosis score, plaque index, gingival index, bleeding index, buffering capacities, Mutans Streptococci, Lactobacilli and yeast counts were recorded on 1st day, 7th day, 15th day and 30th day. First and second group; third and fourth group were compared with each other. Data were analyzed statistically by using Mann Whitney U tests, Wilcoxon Sign Test, Fisher Freeman Halton Exact Test and Mc Nemar Test with a significance level of p0.05), between groups on first day. All four toothpastes produced statistically significant reductions from 1st day to 30th days in scores of halitosis, plaque index, gingival index, bleeding index and buffering capacity (p0.05). Conclusion: All tested toothpastes proved to be safe and significantly effective clinical and microbiological features.

Purpose The low salivary pH and buffering capacity are caused by using heart failure medications. For this reason oral health should be supported in cardiac patients, it is necessary that they attend dental clinics for regular follow up. The aim of this study is to evaluate the relationship between the salivary oxidative stress markers and salivary pH, salivary buffering capacity, salivary flow rate and dental caries of children with congenital heart disease (CHD). Material and Methods This cross sectional study was carried out with 42 CHD and 42 healthy children. The participants’ gender, age, general health and medications, and caries scores (dfs/ DMFS) were written down, then their unstimulated saliva samples were collected. These specimens were evaluated in terms of the salivary secretion rate, salivary buffering capacity, pH, protein levels, superoxide dismutase (SOD), ferric reducing antioxidant power (FRAP), the thiobarbituric acid reactive substances (TBARS), protein carbonyl, protein thiols, total sialic acid. Results Both groups showed caries at similar levels. The salivary pH and buffering capacity were significantly less in the children with CHD than in the controls. The levels of TBARS and protein carbonyl were significantly higher in the children with CHD than in the controls. There was not any significant difference relating to the mean salivary secretion rate, protein levels, SOD, FRAP, protein thiols and total sialic acid. Conclusion The elevated TBARS and protein carbonyl levels in the patients with CHD were observed as an indicator of the free radical damage leading to oxidative stress.

Amaç: Travmatik dental yaralanmalar, dünyadaki çocuk popülasyonunda sıklıkla görülen problemlerden birisidir. Bu çalışmanın amacı 6-12 yaş arası okul çağı çocuklarında görülen travmatik dental yaralanmaların meydana gelme sıklığı ve travma ile ilişkili faktörlerin değerlendirilmesidir. Gereç ve Yöntemler:Bu çalışma, Nevşehir ve İstanbul illerinde bulunan toplamda beş farklı okuldan, ortalama yaşı 8.9±0.84 olan 897 çocuk (472 kız , 425 erkek) üzerinde yapılmıştır. Kayıtlar diş hekimleri tarafından cinsiyet, yaş, travmanın tipi, etkilenen dişin tipi, sağlanan tedavi, travmanın nedeni ve dental bilgilere göre (diş eksikliği, supernumerer diş, baş başa kapanış, overjet, openbite, deepbite, croosbite) değerlendirildi ve ailedeki ebeveynlerin çalışma durumu ile kardeş sayısının sosyoekonomik ve sosyokültürel olarak verileri kaydedildi. İstatistiksel değerlendirmeler p

The goal of the present work was to revisit published data to test if genetic variation in interferon regulatory factor 6 (IRF6) is associated with children born with cleft lip with or without cleft palate (CL/P) for cases with positive history of maternal smoking. From the 573 individuals originally studied, this reanalysis focused on 57 who had a positive history of maternal smoking during pregnancy (39 born with CL/P and 18 born without CL/P). Seven IRF6 markers (rs4844880, rs2235371, rs2013162, ra861019, rs2073487, rs642961, and rs658860) were tested for over-transmission of alleles and an alpha of 0.05 was considered statistically significant. All individuals born with CL/P were homozygous for the wild type allele of rs2235371 in comparison to just two individuals born without clefts (p = 0.0000001). For rs861019, individuals born with CL/P were more likely to have the variant allele (p = 0.006). A similar trend was seen for rs642961 (p = 0.09). The results suggest that statistical evidence of over-representation of IRF6 alleles in individuals born with CL/P may be unveiled only when maternal smoking during pregnancy is used as the inclusion criterion in the analysis.

Molar incisor hypomineralization (MIH) is an enamel condition characterized by lesions ranging in color from white to brown which present rapid caries progression, and mainly affects permanent first molars and incisors. These enamel defects usually occur when there are disturbances during the mineralization or maturation stage of amelogenesis. Both genetic and environmental factors have been suggested to play roles in MIH's development, but no conclusive risk factors have shown the source of the disease. During head and neck development, the interferon regulatory factor 6 (IRF6) gene is involved in the structure formation of the oral and maxillofacial regions, and the transforming growth factor alpha (TGFA) is an essential cell regulator, acting during proliferation, differentiation, migration and apoptosis. In this present study, it was hypothesized that these genes interact and contribute to predisposition of MIH. Environmental factors affecting children that were 3 years of age or older were also hypothesized to play a role in the disease etiology. Those factors included respiratory issues, malnutrition, food intolerance, infection of any sort and medication intake. A total of 1,065 salivary samples from four different cohorts were obtained, and DNA was extracted from each sample and genotyped for nine different single nucleotide polymorphisms. Association tests and logistic regression implemented in PLINK were used for analyses. A potential interaction between TGFA rs930655 with all markers tested in the cohort from Turkey was identified. These interactions were not identified in the remaining cohorts. Associations (p

Abstract Background Matrix metallopeptidase 20 (MMP20) is an evolutionarily conserved protease that is essential for processing enamel matrix proteins during dental enamel formation. MMP20 mutations cause human autosomal recessive pigmented hypomaturation‐type amelogenesis imperfecta (AI2A2; OMIM #612529). MMP20 is expressed in both odontoblasts and ameloblasts, but its function during dentinogenesis is unclear. Methods We characterized 10 AI kindreds with MMP20 defects, characterized human third molars and/or Mmp20−/− mice by histology, Backscattered Scanning Electron Microscopy (bSEM), µCT, and nanohardness testing. Results We identified six novel MMP20 disease‐causing mutations. Four pathogenic variants were associated with exons encoding the MMP20 hemopexin‐like (PEX) domain, suggesting a necessary regulatory function. Mutant human enamel hardness was softest (13% of normal) midway between the dentinoenamel junction (DEJ) and the enamel surface. bSEM and µCT analyses of the third molars revealed reduced mineral density in both enamel and dentin. Dentin close to the DEJ showed an average hardness number 62%–69% of control. Characterization of Mmp20−/− mouse dentin revealed a significant reduction in dentin thickness and mineral density and a transient increase in predentin thickness, indicating disturbances in dentin matrix secretion and mineralization. Conclusion These results expand the spectrum of MMP20 disease‐causing mutations and provide the first evidence for MMP20 function during dentin formation.

The aim of this article was to review the literature and present a case of regional odontodysplasia (ROD) with special emphasis on clinical and radiographic features. A 6-year-old girl was referred to our department with the chief complaint of missing her permanent maxillary left central incisor, lateral incisor, and both of her canines. The gingiva of the involved region was enlarged, fibrous, and tense. Radiographic examination showed abnormal tooth formation and shortened roots. After 3 years of follow up with temporary prosthetic rehabilitation, periodontal surgery was performed. Following forced eruption and levelling, abnormal tooth eruption and root development were observed. ProRoot MTA (Dentsply-Maillefer, Ballaigues, Switzerland) was used for root canal treatment. Intracanal fiber posts selected and access cavities were restored with composite resin. Prosthetic rehabilitation was completed with zirconia ceramic crowns. The time of diagnosis, characteristics of the present/existing symptoms, and functional and esthetic needs of the patient should be considered to determine the optimal treatment modality for ROD.

DOI: 10.26650/eor.2018.495The aim of this article was to review the literature and present a case of regional odontodysplasia (ROD) with special emphasis on clinical and radiographic features. A 6-year-old girl was referred to our department with the chief complaint of missing her permanent maxillary left central incisor, lateral incisor, and both of her canines. The gingiva of the involved region was enlarged, fibrous, and tense. Radiographic examination showed abnormal tooth formation and shortened roots. After 3 years of follow up with temporary prosthetic rehabilitation, periodontal surgery was performed. Following forced eruption and levelling, abnormal tooth eruption and root development were observed. ProRoot MTA (Dentsply-Maillefer, Ballaigues, Switzerland) was used for root canal treatment. Intracanal fiber posts selected and access cavities were restored with composite resin. Prosthetic rehabilitation was completed with zirconia ceramic crowns. The time of diagnosis, characteristics of the present/existing symptoms, and functional and esthetic needs of the patient should be considered to determine the optimal treatment modality for ROD.

Purpose: Traumatic dental injuries, majority of which occur at school and primary care given by teacher, should managed as soon as possible. The knowledge and attitudes of teachers is critical for the best prognosis of traumatized teeth. The purpose of this study was to evaluate knowledge and attitudes among elementary public and private school teachers in dental trauma management. Materials and Methods: A modified three-part questionnaire comprised of questions regarding demographic data, attitude and knowledge about dental trauma was distributed to 328 teachers (public schools:164/private schools:164). The results of the questionnaire were expressed as frequency distributions. Statistical analysis was performed by version 20.0 of the SPSS statistics software. Results: The average correct knowledge score was 4.96 out of 10. Two individual predictors significantly improved the respondents’ knowledge: being more than 50 years old age (p=0.001) and more than 15 years teaching experience group (p

Abstract Background ENAM mutations cause autosomal dominant or recessive amelogenesis imperfecta (AI) and show a dose effect: enamel malformations are more severe or only penetrant when both ENAM alleles are defective. Methods Whole exome sequences of recruited AI probands were initially screened for mutations in known AI candidate genes. Sanger sequencing was used to confirm sequence variations and their segregation with the disease phenotype. The co‐occurrence of ENAM and LAMA3 mutations in one family raised the possibility of digenic inheritance. Enamel formed in Enam+/+Ambn+/+, Enam+/−, Ambn+/−, and Enam+/−Ambn+/− mice was characterized by dissection and backscattered scanning electron microscopy (bSEM). Results ENAM mutations segregating with AI in five families were identified. Two novel ENAM frameshift mutations were identified. A single‐nucleotide duplication (c.395dupA/p.Pro133Alafs*13) replaced amino acids 133‐1142 with a 12 amino acid (ATTKAAFEAAIT*) sequence, and a single‐nucleotide deletion (c.2763delT/p.Asp921Glufs*32) replaced amino acids 921‐1142 with 31 amino acids (ESSPQQASYQAKETAQRRGKAKTLLEMMCPR*). Three families were heterozygous for a previously reported single‐nucleotide ENAM deletion (c.588+1delG/p.Asn197Ilefs*81). One of these families also harbored a heterozygous LAMA3 mutation (c.1559G>A/p.Cys520Tyr) that cosegregated with both the AI phenotype and the ENAM mutation. In mice, Ambn+/− maxillary incisors were normal. Ambn+/− molars were also normal, except for minor surface roughness. Ambn+/− mandibular incisors were sometimes chalky and showed minor chipping. Enam+/− incisor enamel was thinner than normal with ectopic mineral deposited laterally. Enam+/− molars were sometimes chalky and rough surfaced. Enam+/−Ambn+/− enamel was thin and rough, in part due to ectopic mineralization, but also underwent accelerated attrition. Conclusion Novel ENAM mutations causing AI were identified, raising to 22 the number of ENAM variations known to cause AI. The severity of the enamel phenotype in Enam+/−Ambn+/− double heterozygous mice is caused by composite digenic effects. Digenic inheritance should be explored as a cause of AI in humans.

Aim: Although there are many materials that can be used for retrograde filling in surgical endodontics, none of them can be regarded as an ideal material yet. The purpose of this study was to compare the surface topography of three different root-end filling materials. Methods: 36 extracted single rooted human incisor teeth were cleaned and decoronated to standardized 10 mm root lengths. The root segments were prepared and 2 mm apical resection were performed. The samples were randomly separeted to three groups (Group A: Ca(OH)2, Group B: MTA Angelus, Group C: ProRoot MTA), each comprised of 12 roots. Materials were placed as 2 mm apical barriers and obturated with guttapercha and AH-Plus sealer. Each group dimidiated two subgroups (A1,A2,B1,B2,C1,C2). Groups A1,B1,C1 were stored in normal saline (NS), groups A2,B2,C2 were stored in neutral phosphate buffer saline (NPBS) solution and samples were incubated at 370C for 2 weeks. Stereomicroscope (32X) was used to photograph the root-end filling. Results: All specimens demonstrated white crystals formation and sediment over the root-end filling materials and on the superficial border of the root-end cavities’ wall as a white plague. A2,B2,C2 samples have more crystal sediment on root-end fillings than samples A1,B1,C1. Dissolution and corrosion were observed in groups A1, A2. Conclusions: The results of this study revealed that calcium hydroxide is more resorbable than MTA Angelus and ProRoot MTA. The crystals formation and precipitation were observed in neutral phosphate buffer saline solution was more than normal saline solution for all groups as a hydroxiapatite crystals.

Objectives: Mouth opening capacity is often regarded as one of the important parameters for evaluating the function of the temporomandibular joint (TMJ) and masticatory muscle status. A reduced mouth opening capacity may be one of the first clinical signs of TMJ involvement. The purpose of this study was to create age related percentiles for the maximal interincisal distance (MID) of healthy children. Methods: The patients admitted for routine dental examinations to Istanbul University Faculty of Dentistry, Department of Pedodontics were included in this study. The interincisal measurements were performed with metallic calliper and also malocclusions were recorded for all children. Oneway Anova test, Tukey HDS test, Tamhane’s T2 test and Student t test were used for statistical analysis. Results: The study population comprised of 1059 (569 males, 490 females), 3-to 15-year-old (mean age 8.82±3.06) children. The mean score of maximal inter-incisal distance was found 33.24±5.54 for females; 33.32±5.71 for males. There was no statistically significant difference according to gender (p=0.815; p>0.05). The mean score of maximal inter-incisal distance was found 28.63±4.34 for 3-5 years; 33.52±4.84 for 6-11 years; 37.35±5.52 for 12-15 years children. Statistically significant differences were found between age groups (p: 0.001; p

Objectives: The purpose of this study was to evaluate the accuracy of conventional radiography, intraoral digital radiovisiography and electronic apex locator in determining the working length of root canals in primary teeth (in-vivo) and to compare the results with scanning electron microscopy measurements (ex-vivo). Materials and Methods: This study was conducted on 50 primary molar teeth. Standard endodontic access cavity preparations were prepared and the actual length was calculated by calibrated investigators. Working lengths were determined by using conventional radiography, RVG and apex locator in a total of 116 root canals. After the extraction of the teeth, each canal length was determined by using SEM. Data were analysed statistically by using Oneway Anova, Tukey HDS, Student t test and Bonferroni tests. Results: The mean root length measurements with conventional radiography were significantly higher than apex locator, RVG and SEM. The accuracy of apex locator and RVG were higher than conventional radiography in determining the working length in primary teeth. Conclusions: The electronic apex locators provide an acceptable level of accuracy in determining root canal length in primary teeth. Clinical Relevance: The purpose of this study was to evaluate the accuracy of conventional radiography, intraoral digital radiovisiography and electronic apex locator in determining the working length of root canals in primary teeth and,to compare the results with scanning electron microscopy measurements.

Amelogenesis imperfecta is a group of rare inherited disorders that affect tooth enamel formation, quantitatively and/or qualitatively. The aim of this study was to identify the genetic etiologies of two families presenting with hypomaturation amelogenesis imperfecta. DNA was isolated from peripheral blood samples obtained from participating family members. Whole exome sequencing was performed using DNA samples from the two probands. Sequencing data was aligned to the NCBI human reference genome (NCBI build 37.2, hg19) and sequence variations were annotated with the dbSNP build 138. Mutations in MMP20 were identified in both probands. A homozygous missense mutation (c.678T>A; p.His226Gln) was identified in the consanguineous Family 1. Compound heterozygous MMP20 mutations (c.540T>A, p.Tyr180* and c.389C>T, p.Thr130Ile) were identified in the non-consanguineous Family 2. Affected persons in Family 1 showed hypomaturation AI with dark brown discoloration, which is similar to the clinical phenotype in a previous report with the same mutation. However, the dentition of the Family 2 proband exhibited slight yellowish discoloration with reduced transparency. Functional analysis showed that the p.Thr130Ile mutant protein had reduced activity of MMP20, while there was no functional MMP20 in the Family 1 proband. These results expand the mutational spectrum of the MMP20 and broaden our understanding of genotype-phenotype correlations in amelogenesis imperfecta.

Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.

Dyskeratosis congenital (DC) is a rare condition characterized by reticulate skin hyperpigmentation, mucosal leukoplakia, and nail dystrophy. More serious features are bone marrow involvement with pancytopenia and a predisposition to malignancy. The purpose of this case report is to describe the oral and dental findings in children with DC syndrome. A 10-year-old male diagnosed with DC was admitted because of extensive caries and toothache. Inadequate oral hygiene and extensive caries were observed in oral examination of the patient. Plaque accumulation was seen in gingival border of maxillary teeth. Papillary atrophy on the tongue was observed. Short and blunted roots of mandible incisors and upper and lower molars were determined on the radiographic examination. Dryness on the lips and commisuras, ectropion on his eyes, and epiphora were observed. Hematologic tests were performed and showed aplastic anemia at the age of 2. At the age of 4, the bone marrow transplantation was performed. Dermatological findings occurred after the bone marrow transplantation. The skin of the patient was thin, dry, and wrinkled in some areas. He had palmoplantar hyperkeratosis and syndactylia on his fingers. Endodontic treatment procedures were applied and other extensive caries are still being restored. The patient will be given full preventive care during regular follow-up. Oral hygiene was improved to the optimum level.

Amelogenesis imperfecta (AI) is a group of inherited conditions featuring isolated enamel malformations. About 5% of AI cases show an X-linked pattern of inheritance, which are caused by mutations in AMELX. In humans there are two, non-allelic amelogenin genes: AMELX (Xp22.3) and AMELY (Yp11.2). About 90% of amelogenin expression is from AMELX, which is nested within intron 1 of the gene encoding Rho GTPase activating protein 6 (ARHGAP6). We recruited two AI families and determined that their disease-causing mutations were partial deletions in ARHGAP6 that completely deleted AMELX. Affected males in both families had a distinctive enamel phenotype resembling "snow-capped" teeth. The 96,240 bp deletion in family 1 was confined to intron 1 of ARHGAP6 (g.302534_398773del96240), but removed alternative ARHGAP6 promoters 1c and 1d. Analyses of developing teeth in mice showed that ARHGAP6 is not expressed from these promoters in ameloblasts. The 52,654 bp deletion in family 2 (g.363924_416577del52654insA) removed ARHGAP6 promoter 1d and exon 2, precluding normal expression of ARHGAP6. The male proband of family 2 had slightly thinner enamel with greater surface roughness, but exhibited the same pattern of enamel malformations characteristic of males in family 1, which themselves showed minor variations in their enamel phenotypes. We conclude that the enamel defects in both families were caused by amelogenin insufficiency, that deletion of AMELX results in males with a characteristic snow-capped enamel phenotype, and failed ARHGAP6 expression did not appreciably alter the severity of enamel defects when AMELX was absent.

There is evidence for a genetic component in caries susceptibility, and studies in humans have suggested that variation in enamel formation genes may contribute to caries. For the present study, we used DNA samples collected from 1,831 individuals from various population data sets. Single nucleotide polymorphism markers were genotyped in selected genes (ameloblastin, amelogenin, enamelin, tuftelin, and tuftelin interacting protein 11) that influence enamel formation. Allele and genotype frequencies were compared between groups with distinct caries experience. Associations with caries experience can be detected but they are not necessarily replicated in all population groups and the most expressive results was for a marker in AMELX (p=0.0007). To help interpret these results, we evaluated if enamel microhardness changes under simulated cariogenic challenges are associated with genetic variations in these same genes. After creating an artificial caries lesion, associations could be seen between genetic variation in TUFT1 (p=0.006) and TUIP11 (p=0.0006) with enamel microhardness. Our results suggest that the influence of genetic variation of enamel formation genes may influence the dynamic interactions between the enamel surface and the oral cavity.

The aim of this study was to evaluate the Vector system in comparison to the conventional technique in cavity preparation. Four extracted primary teeth with no restorations and similar fissure carious lesions and four permanent teeth extracted for orthodontic reasons were used. Class I preparations were made provided that the caries depth remained within the dentin limits. Two teeth were treated with an aerator, the other two had carious tissue removed with the Vector system. Prepared cavities were evaluated with scanning electron microscopy for the surface roughness of the dentine and enamel and for the carious tissue removal efficiency. This pilot study determined that it is possible to remove carious tissue and perform cavity preparation with the Vector system. According to this preliminary evaluation of surface quality, a cavity prepared with the Vector treatment system, allows for a slicker floor, and a more regular enamel-dentine line than that prepared with an aerator. However, the Vector system requires a longer treatment time which we believe may be a negative point, especially for young patients.