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    Approaches of General and Specialist Dentists to Deep Caries Management: A Cross-Sectional Study from Turkey
    (Univ Indonesia, Fac Dentistry, 2021) Delikan, Ebru; Erturk-Avunduk, Ayse Tugba; Aksu, Seckin
    Objective: To determine the differences in treatment strategies and material preferences for deep dentine carious lesions (DDCLs) management among general and specialist dentists. Methods: Dentists working in universities, oral and dental health centers, or private practice were administered a 14-item web-based questionnaire regarding demographic and occupational characteristics, approaches to DDLCs, pulp capping methods, and preferences for restorative materials. The data were examined using descriptive statistical analysis and Pearson's chi-square tests. Results: The study enrolled 298 general and 265 specialist dentists among whom 67.1% were female and 73.3% were aged 25 to 35 years. Total excavation and permanent restoration of DDCLs were the commonly preferred treatments (67.0%), although the pediatric dentists tended toward selective caries removal in these lesions. Mineral trioxide aggregate was used more regularly by the pediatric dentists and endodontists. The pediatric dentists exhibited statistically significantly lower preference for canal treatment than general dentists and endodontists as treatment option for mature teeth with DDCLs (p<0.05). Conclusion: Conservative treatment approaches and material preferences of specialists and general dentists in DDCLs are generally different. The age of dentists, the time since their graduation, place of work and the number of patients they have seen daily may affect the approaches and preferences.
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    Effect of topical fluoride applications on residual monomer release from resin-based restorative materials
    (BMC, 2023) Delikan, Ebru; Erturk-Avunduk, Ayse Tugba; Karataş, Özcan; Sacmaci, Serife
    Background: The effects of topical fluoride applications on the release of monomer ingredients from resin-based dental materials by immersion in various extraction solutions are unclear. The aim of this study was to determine the effect of topical fluorides (APF and NaF) on the elution of residual monomers (Bis-GMA, TEGDMA, UDMA, and HEMA) from resin-based materials. Methods: Ninety specimens were prepared, 30 bulk-fill composite resin, 30 nanohybrid universal composite resin, and 30 polyacid-modified composite resin (compomer). These were randomly divided into three groups based on fluoride application procedures. Each specimen was kept in 75% ethanol solution, and residual monomers released from materials were analyzed using high-performance liquid chromatography (HPLC) after 10 min, 1 h, 24 h, and 30 days. The groups were compared using the Mann Whitney U and Kruskal Wallis tests. Measurements were analyzed using the Friedman and Wilcoxon signed-rank tests. Results: Fluoride applications generally had no considerable effect on the amount of residual monomer released from resin-based restorative materials. The amount of monomer release after topical APF application was similar to the release in the control group and was lower than the release in the NaF group. The release of monomers from the resin-based material used in the study did not approach toxic levels at the applied time intervals. The compomer released lower amounts of monomer than other resin-based materials. Conclusions: Fluoride applications do not increase monomer release from resin-based restorative materials. However, compomers should be employed by clinicians due to their lower monomer release compared to other resin restorative materials. The release of monomers from all the resin-based materials did not approach toxic levels at the applied time intervals.
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    Effect of whitening concepts on surface roughness and optical characteristics of resin-based composites: An AFM study
    (Wiley, 2024) Erturk-Avunduk, Ayse Tugba; Delikan, Ebru; Cengiz-Yanardag, Esra; Karakaya, Izgen
    The aim of this study was to evaluate the effects of various whitening agents on the surface roughness and optical characteristics of different types of resin composite restorations. Fifty specimens were prepared for each resin [G-ae nial Posterior (GP), SonicFill-2 (SF), Solidex (SDX), and Nova Compo HF (NC)]. Following baseline color and surface roughness (Ra) measurements, the specimens were randomly divided into 5 groups (n = 10/group) according to whitening concepts: control (distilled water), in-office bleaching [OB-(Opalescence Boost)], at-home bleaching [HB-(Opalescence PF)], whitening toothpaste [WT-(Signal White Now)], and whitening mouthwash [WM-(Listerine Advanced White)]. ?E-00, ?TP00, and ?WID values were calculated before and after the whitening procedure with a spectrophotometer using the CIEDE2000 formula. Surface roughness measurements were repeated. The surface topography was determined using atomic force microscopy. Two-and three-way analyses of variance and Tukey's post-hoc test were performed, with p < 0.05 regarded as indicative of significance. No significant differences were detected among the resin composite materials in terms of the ?E-00 values (p > 0.05). Color change of all resin materials was above the AT threshold (>1.8) and the PT threshold (>0.8). All restorative materials presented acceptable (AT<2.62) TP00 values. Solidex specimens demonstrated the lowest W-ID values compared to the other composites. There were significant differences among the whitening procedures with respect to ?E-00, ?TP00, and W-ID values (p < 0.001). SF/WT combination showed the highest and clinically unacceptable ?E-00 values. The highest roughness values were observed in the SDX specimens and the combination of SDX/OB. The effect of whitening agents on the optical characteristics and surface roughness of restorative materials depends on the type of material, agent, and time.
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    Evaluation of the quality of YouTube™ videos about pit and fissure sealant applications
    (Wiley, 2023) Erturk-Avunduk, Ayse Tugba; Delikan, Ebru
    Aim: To evaluate the content and quality of YouTube (TM)? videos about pit and fissure sealant application. Methods: The keywords fissure sealant and pit and fissure sealant were used to search for YouTube (TM)? content, after the first 300 video results were evaluated. Considering the exclusion criteria, a final sample of 110 videos was obtained, which were analysed in terms of the number of views, duration in minutes, the number of subscribers, the total number of likes and dislikes, the number of comments, days elapsed since upload, the interaction index, and the viewing rate. Global Quality Scoring (GQS) index was also used as a second evaluation method and videos were classified according to the quality of information that it contained as follows: good, moderate, and poor. Results: Most of the videos were uploaded by dentists/specialists. Among them, 14 videos had good quality, 63 were of moderate quality, and 33 were poor informative. The good-quality videos had statistically significantly higher interaction index and viewing rates, and the majority of the videos had a GQS-2 score. The viewing rate was positively correlated with duration and the number of views, likes and dislikes, comments, and subscribers. Conclusion: There is considerable variability in the scientific accuracy and quality of health information on the Internet. While there are videos that provide sufficient health information, there are also videos that contain insufficient or even incorrect information. Dental care professionals should be aware of misinformation found on YouTube (TM)? and ensure that patients always have access to accurate and reliable information.
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    In-vitro Evaluation of Topical Fluoride on the Optical Properties, Surface Texture, and Hardness of Restorative Materials
    (Int Soc Fluoride Research, 2024) Delikan, Ebru; Erturk-Avunduk, Ayse Tugba; Karataş, Özcan
    Purpose: This study aims to evaluate the interactions of fluoride-containing gels and varnishes on the optical properties and surface texture of composite resins, compomers, and bulk-fill composite resins. Thus, it seeks to address the current gap in the literature regarding the effect of fluoride agents on bulk-fill restorative materials. Methods: Using Teflon moulds, 50 specimens of 6 mm diameter and 2 mm thickness were produced for each of the G-ae nial Posterior, FiltekTM One Bulk-Fill and Dyract-XP materials. Baseline color and surface roughnesss measurements of the specimens were performed. The specimens were subjected to the following applications: Study groups (Topex NaF gel, Topex APF gel, ProShield varnish, and MI varnish with RECALDENTTM) and Control group (distilled water). Color and surface roughness measurements were repeated after the application period. The surface microhardness of the specimens (study groups and control group) was measured using Vickers microhardness tester. Statistical analyses, including two-way analyses of variance (comparison of color, whiteness and microhardness parameters) and three-way analyses of variance (comparison of surface roughness parameter), and Pearson's correlation test (the relationship between surface roughness and color change and surface roughness), were applied. Results: The restorative material significantly (p-value<0.001) influenced the color changes (Delta E00), with the FiltekTM One Bulk-Fill/Topex APF gel interaction yielding the highest Delta E00 average value (2.1 +/- 1.15). Materials and fluoride agents exerted significant effects on the Whiteness Index (Delta WID) for Dentistry (pvalue<0.001). Dyract-XP displayed lower initial surface roughness (1.05 +/- 1.38), with all materials exhibiting comparable values after fluoride treatment. Microhardness varied among the materials, with FiltekTM One Bulk-Fill having the highest total value (65.39 +/- 2.67) and G-ae nial Posterior having the lowest total (42.97 +/- 3.32) value. When considering the interaction of restorative materials, fluoride treatment, Topex APF gel-treated G-ae nial Posterior showed the lowest (40.56 +/- 1.78) microhardness, whereas FiltekTM One Bulk-Fill showed the highest (65.06 +/- 1.88) values. Conclusions: Topical fluoride agents induce alterations in the color, roughness, and hardness of restorative materials, depending on the material type, fluoride agent, and duration of application.
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    The Effects of Mouthwashes on the Color Stability of Resin-Based Restorative Materials
    (Univ Costa Rica, Fac Odontologia, 2021) Erturk-Avunduk, Ayse Tugba; Aksu, Seckin; Delikan, Ebru
    Objective: This study investigated the effects of three types of mouthwash on the color stability of three resin-based restorative materials (nanohybrid resin composite, sonic-activated bulk-fill material, and compomer). Materials and Methods: To this end, 120 cylindrical disc specimens were prepared and polished, after which they were incubated in distilled water for 24 hours for post-polymerization. The baseline color values of each specimen were measured with a spectrophotometer, then the specimens were randomly divided into four groups. Following immersion in the mouthwashes for 24 hours, the specimens were rinsed with distilled water and dried before the color measurement was repeated. The values of color change (Delta E-00) were subsequently calculated. A two-way analysis of variance and Duncan's post hoc multiple comparison tests were conducted to determine statistically significant differences among the restorative materials. Results: All samples showed discoloration after immersion, albeit some instances of discoloration were imperceptible. In this respect, a statistically significant difference was found among the restorative materials and mouthwashes (p<0.05). Imperceptible Delta E-00 values were derived on the nanohybrid resin composite and compomer, but perceptible and acceptable Delta E-00 values were detected on the sonic-activated bulk-fill materials (p<0.05). The clinically unacceptable discoloration was observed on the sonic-activated bulk-fill composite immersed in Listerine (R). Conclusions: Clinicians should make recommendations based on the potential staining capacity of mouthwashes prescribed for daily use in restorative materials. In this way, the need for renewal of restorations due to discoloration could be avoided.