Essentials of Dentistry (Essent Dent) is a peer-reviewed, open access, online-only journal published by İstanbul University-Cerrahpaşa. Essentials of Dentistry is a continuously published journal in English. The journal has moved to continuous publication by volume from Volume 4.
Pleomorphic Adenoma of the Hard Palate: A Case Report
Pleomorphic adenoma is the most common benign salivary gland neoplasm; the majority of these tumors arise in the parotid gland and rarely in the minor salivary glands. The objective is to assess clinical and radiological results, leading to a planned excisional biopsy under local anesthesia with a minimally invasive approach. The report aims to validate diagnostic accuracy and discuss broader clinical implications, emphasizing the significance of accurate diagnosis and the role of minimally invasive procedures in managing pleomorphic adenoma (PA) in minor salivary glands. A 29-year-old ASA I male patient was referred to the clinic with a 5-year history of a painless mass in the hard palate. Based on clinical and radiological examinations, an excisional biopsy was planned under local anesthesia. The operation was performed with a minimally invasive approach. Histopathological examination identified a diagnosis of PA, consistent with clinical and radiological evaluation. Pleomorphic adenoma of the minor salivary gland is a relatively rare pathology. The complete excision of the tumor is a definitive treatment protocol for these cases. Cite this article as: Eren Y, Öztürk Muhtar M, Emes Y, Olgaç V, Aybar B. Pleomorphic adenoma of the hard palate: A case report. Essent Dent. 2025, 4, 0007, doi: 10.5152/EssentDent.2025.25007.
The Application of Morinda citrifolia (noni) as An Alternative Herbal Product in Dentistry
Abstract: Morinda citrifolia, also referred to as noni, is a plant used to treat a variety of diseases. Noni fruit helps treat bacterial infections because of its antifungal, antibacterial, analgesic, anti-inflammatory, antioxidative, and immunomodulatory properties. The noni plant has been used in dentistry more often in recent years. It is effective as a mouth rinse for periodontal diseases, an irrigant in endodontics, and an agent that inhibits caries, and it is increasingly preferred over synthetic alternatives due to its reduced side effects and greater cost-effectiveness.
From Design to Integration: The Impact of Custom-Made Subperiosteal Implants in Oral Surgery
Abstract: Subperiosteal implants have been utilized in oral surgery for several decades, with varying degrees of success and clinical outcomes. This review article closely examines the current state of custom-made subperiosteal implants, exploring their advantages, limitations, and the emerging technologies that are actively shaping their future development and clinical application. The use of these specialized implants has evolved over time, incorporating advancements in materials, fabrication techniques, and surgical protocols to address the unique anatomical challenges faced by patients with limited bone volume or quality. Despite the inherent complexities involved in their design and placement, subperiosteal implants have shown promise as an alternative treatment option for individuals with inadequate bone density or volume to support traditional endosseous implants. Through continued research and refinement of the underlying technologies, the future of custom-made subperiosteal implants holds the potential to provide more effective and predictable solutions for patients in need of oral rehabilitation. Cite this article as: Gedik B, Kundakçıoğlu A. From design to integration: the impact of custom-made subperiosteal implants in oral surgery. Essent Dent. 2025; 4, 0006, doi: 10.5152/EssentDent.2025.25006.
Prevalence and Etiology of Dental Ankylosis in Primary Teeth
Abstract: Dental ankylosis is a condition characterized by abnormal fusion of the cementum of the tooth with the surrounding alveolar bone, leading to the loss of the periodontal ligament (PDL). This fusion disrupts the normal tooth eruption process, especially in primary teeth, and prevents them from reaching the correct occlusal plane. The exact cause of ankylosis in primary teeth is not fully understood and is the subject of ongoing research. However, it is believed to be multifactorial, including potential contributing factors such as trauma, genetic predisposition, bone disorders, systemic diseases, and infections. Research shows that ankylosis predominantly affects the first lower primary molars, with secondary ankylosis sometimes occurring due to traumatic events. Following the first lower primary molars, the first upper primary molars, second lower primary molars, and second upper primary molars are also frequently affected. Infra-occlusion is approximately 10 times more common in the mandible than in the maxilla and often occurs bilaterally. Clinically, ankylosed teeth cannot be exposed to post-eruption movements and can remain fixed in the infra-occlusion position. The severity of infra-occlusion can vary from mild to complete retention. Histological examinations of ankylosed teeth reveal that resorbed root areas may be replaced by both cementum and bone, establishing a direct connection between the tooth and the surrounding bone. In addition, PDL remnants may be present despite fibrosis and reduced cell number. Treatment goals for infra-occluded primary molars with successive teeth include facilitating the natural eruption of the permanent tooth while protecting the affected tooth and surrounding gum and bone tissue. The goals in the treatment of ankylosed teeth are to preserve the affected tooth as much as possible, protect adjacent tissues, prevent interference with normal growth, enable orthodontic interventions, preserve the aesthetic appearance, and restore normal function.
Root Canal Configuration of Mandibular Incisors in Turkish Population: An Analysis Using Vertucci’s Classification with CBCT
Background: The root canal anatomy of mandibular incisors is complex and often unpredictable, posing challenges for endodontic treatment. Insufficient knowledge of canal morphology may result in missed root canals and treatment failures. This study aimed to evaluate the prevalence and variation of Vertucci root canal configurations in mandibular incisors within a Turkish population. Methods: A total of 2400 mandibular central and lateral incisors were collected for analysis. Initially, radiovisiography (RVG) images were employed to determine the number of canals. Teeth identified with 2 canals (n=348) were further examined using cone beam computed tomography (CBCT) for detailed morphological assessment. A chi-square test was used to evaluate the distributions of various tooth types. The significance level was set at P < .05. Results: The most frequently observed root canal configuration was Vertucci type I (85.5%), followed by type III (13%), and type II (1%). Types V and VI were rarely encountered. A chi-square goodness-of-fit test demonstrated statistically significant differences in the distribution of canal types (P < .001). Type III canals were more likely to have an oval shape, complicating the shaping and obturation processes. Conclusion: In the Turkish population, the mandibular incisors predominantly exhibit Vertucci type I and type III configurations. Cone beam computed tomography has been established as an effective imaging modality for assessing root canal complexity. Clinicians should be aware of anatomical variations, especially cases with 2 canals that may converge at the apex to ensure successful endodontic outcomes. Further studies with larger sample sizes are recommended to validate these findings. Cite this article as: Özçelik İ, Çiftçioğlu E. “Root canal configuration of mandibular incisors in Turkish population: an analysis using Vertucci’s classification with CBCT”. Essent Dent. 2025, 4, 0053, doi: 10.5152/EssentDent.2025.25053.
Are YouTube Videos on Root Canal Retreatment Reliable Sources of Information?
Background: The objective of this study is to systematically evaluate the quality, reliability, and patient education potential of YouTube videos addressing root canal retreatment, and to investigate the interrelationships among the assessment tools applied. Methods: The first 200 videos retrieved using the keyword “retreatment” on the YouTube platform up to March 2025 were screened according to predefined inclusion criteria, and a total of 58 videos were included in the study. Video content was assessed using the Global Quality Scale (GQS), the Modified DISCERN tool, and a usefulness score. Additionally, parameters such as video duration, like ratio, interaction index, and view rate were analyzed. Statistical analyses included the Mann–Whitney U test, independent samples t-test, and Spearman correlation analysis. Results: The mean scores of the evaluated videos were low for the Global Quality Scale (1.88 ± 0.92), Modified DISCERN (2.26 ± 1.02), and usefulness score (2.50 ± 1.14). None of the videos were classified as having high content quality. A strong positive correlation was found between video duration and both GQS (r=0.487, P < .001) and usefulness score (r=0.361, P=.005). Additionally, a moderate negative correlation was observed between the interaction index and the number of days since the video was uploaded (r=–0.53, P < .001). Conclusion: Most YouTube videos of root canal retreatment are characterized by low content quality and reliability. This poses a risk of exposing patients to inaccurate or insufficient information. It is essential for healthcare professionals to produce and recommend scientifically grounded, high quality, and reliable content to support patient education effectively. Cite this article as: Tavşan O, Ongun SK. Are YouTube videos on root canal retreatment reliable sources of information? Essent Dent. 2025, 4, 0058, doi: 10.5152/EssentDent.2025.25058.
Expression of CD56 in Human Tooth Germ, Adenomatoid Odontogenic Tumor, and Ameloblastic Fibroma
Background: Odontogenesis is a multistage process involving interaction between ectodermally derived odontogenic epithelium and neural crest–derived ectomesenchyme. CD56 is a neural cell adhesion molecule with sparse information regarding its expression in tooth germs. Therefore, the purpose of this study is to evaluate the immunohistochemical expression of CD56 in adenomatoid odontogenic tumor (AOT), ameloblastic fibroma (AF), and odontogenic myxoma (OMYX) and to compare the staining pattern with the human tooth germs for histogenetic relationship. Methods: Archival paraffin-embedded tissue blocks of 4 human tooth germs (one in bud stage, 4 in bud-to-cap transition stage, 3 in early bell stage, and 2 in late bell stage), 13 AOT, 4 AF, and 10 OMYX were evaluated by routine sections and immunohistochemistry with the CD56 marker. Immunohistochemical reaction was assessed semi-quantitatively. Results: Positive CD56 staining was observed on one side of the epithelium of the tooth bud and in the outer enamel epithelium with a rim of positive reaction in the dental follicle. Other components of the tooth germ were negative. Only certain tumor cells in AOT and AF reacted to CD56 while OMYX did not react. Conclusion: This study demonstrates the expression pattern of CD56 in human tooth germs where the outer enamel epithelium adopts cell-fate decisions early in development. Thus, the histogenetic correlation of cells positive for CD56 in AOT and AF implies that they are linked to the dental lamina and/or outer enamel epithelium while the lack of CD56 expression in the mesenchymal component of AF and OMYX is inconsistent with neural crest–derived mesenchyme participation. Cite this article as: Ponniah I, Mathirat A. Expression of CD56 in human tooth germ, adenomatoid odontogenic tumor, and ameloblastic fibroma. Essent Dent. 2025, 4, 0034, doi: 10.5152/EssentDent.2025.24034.
Awareness of Dental Students Studying at Different Universities in Hepatitis B and Hepatitis C Infection Control
Background: This study aims to evaluate and compare the knowledge, attitudes, and behaviors of dental students from 2 different universities regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infection control through a questionnaire-based study. Methods: A total of 242 fourth- and fifth-year dental students from 2 universities participated in this study. A 15-question survey assessing their knowledge, attitudes, and behaviors related to hepatitis B and C was administered. Data analysis was performed using SPSS 29, with statistical significance set at P < .05. Results: It was observed that 65.7% (n=159) of the students participating in the study were female and 34.3% (n=83) were male. It was observed that 51.2% (n=124) of the students were in the fourth grade and 48.8% (n=118) were in the fifth grade. The scores of the fourth grade students studying at Kahramanmaraş Sütçü İmam University were found to be statistically significantly higher than the fifth grade students (P=.001). Fourth grade students from Kahramanmaraş Sütçü İmam University scored considerably lower on knowledge questions than did fourth grade students from Marmara University (P=.044). The scores of the fourth grade students from Kahramanmaraş Sütçü İmam University on the behavior questions were statistically significantly higher than those of the fourth grade students from Marmara University (P=.012). Conclusion: The study indicates that while dental students have a high level of knowledge about hepatitis B and C, their attitudes and behaviors require further improvement. Ongoing education is essential to ensure compliance with infection control standards. Cite this article as: Öner Talmaç AG, Keser G, Namdar Pekiner FM, Ziyanak S. Awareness of dental students studying at different universities in hepatitis B and hepatitis C infection control. Essent Dent. 2025, 4, 0014, doi: 10.5152/EssentDent.2025.25014.
Evaluation of the Information Quality of Chatbot Technologies About Root Canal Treatment
Background: This study aims to evaluate the quality of information provided by artificial intelligence (AI)-based chatbot technologies regarding root canal treatment. ChatGPT-4 (OpenAI Inc.), Google Gemini (Google LLC), and Microsoft Copilot (Microsoft Corporation) were assessed for the accuracy, reliability, and scope of their responses. Methods: Twenty frequently asked questions about root canal treatment were compiled from online sources and refined by endodontic experts. These questions were posed to the 3 chatbots, and responses were collected twice to evaluate reliability. Answers were scored using a 5-point Likert scale based on a modified Global Quality Score for accuracy and completeness. Statistical analyses, including Pearson correlation coefficients and Fisher’s exact tests, were conducted to evaluate the validity and reliability of the responses. Results: ChatGPT provided the longest responses (mean word count: 250) but did not include citations. Copilot offered concise responses (mean word count: 120) with consistent citations, while Gemini provided moderate-length answers (mean word count: 230) with limited references. Regarding dentist recommendations, ChatGPT suggested consulting a dentist in 16 of 40 responses, Copilot in 12, and Gemini in 38. At the high validity threshold, Gemini achieved a 100% validity rate, outperforming ChatGPT and Copilot. Reliability analysis showed high correlation coefficients for all chatbots: Gemini (1.0), Copilot (0.95), and ChatGPT (0.93). Conclusion: Artificial intelligence-based chatbots show strong potential for providing patient education on root canal treatment. Gemini demonstrated superior reliability and validity, highlighting the importance of robust training datasets. However, inaccuracies and limitations in chatbot responses underline the need for continuous evaluation and improvement of these technologies to ensure they are reliable and clinically useful tools in healthcare. Cite this article as: Sarkan C, Haznedaroglu F. Evaluation of the information quality of chatbot technologies about root canal treatment. Essent Dent. 2025, 4, 0031, doi: 10.5152/EssentDent.2025.24031.
A Comparative Analysis of Collagen Fiber and Adipose Content in the Connective Tissue Procured from Different Harvesting Sites Using Different Harvesting Techniques: A Cross-Sectional Study
Background: Soft tissue augmentation procedures using connective tissue grafts (CTGs) produce varied outcomes due to differences in the histological composition of grafts from different sites and techniques. This study aimed to compare the histologic composition of CTG harvested by de-epithelization vs. a single-incision technique from the palate. Methods: Forty-five subjects (aged 25-45) scheduled for mucogingival surgeries were divided into 3 groups: Group I (de-epithelialized free gingival graft), Group II (maxillary tuberosity graft), and Group III (single-incision technique). A 2 x 2 mm tissue sample was taken from the antero-superior part of the graft and analyzed using hematoxylin & eosin or Picrosirius red staining to assess collagen and adipose content under a polarizing microscope. Results: Preoperative donor site thickness was greater in Group II than in Groups I and III (P < .001). Collagen area and bundle thickness were significantly higher in Group I compared to Groups II and III (P < .05, P < .001). Adipose tissue content was higher in Group III. Epithelium remnants were observed in 66.67%, 80%, and 13.3% of Groups I, II, and III, respectively (P < .05). Conclusion: Fibrous tissue content was higher in superficial mucosal tissues, while deeper palatal tissues showed more adipose tissue. Cite this article as: Narayan I, Baron TKA, Shah R, Thomas R, Cheruvathoor JG, Gowda TM. A comparative analysis of collagen fiber and adipose content in the connective tissue procured from different harvesting sites using different harvesting techniques: A cross-sectional study. Essent Dent. 2025, 4, 0012, doi: 10.5152/EssentDent.2025.25012.
Battery Levels of a Light Emitting Diode Unit Affects the Properties of Various Flowable Composites
Background: The battery levels may affect the light intensity of light-emitting diode (LED) curing units which can, indeed, directly influence the various properties of composite resins that are polymerized by light activation. Thus, this study aimed to evaluate the effect of battery levels of a cordless LED unit on the various properties of composite resins polymerized by light activation. Methods: Firstly, the light intensity of the cordless LED unit (Elipar Deep Cure, 3M ESPE) was individually checked and 88 composite discs with the dimensions of 8 × 4 mm were prepared from 2 universal (Estelite Palfique [Tokuyama]; Nova Compo HF [Imicryl Dental]) and 2 bulkfill composites (Tetric N-Ceram Bulk [Ivoclar Vivadent]; Beautifil-Bulk Flowable [Shofu]). The polymerization process was obtained at different battery levels: high level (HL, 100%), and low level (LL, 10%). The parameters evaluated included the degree of conversion (DC), color, and top/bottom microhardness scores. Data were statistically analyzed, with significance set at P < .05. Results: The composite materials tested in this study exhibited significantly different scores across the parameters evaluated (P < .05). However, aside from the DC, the changes in color and the top/bottom microhardness scores were only numerically significant. The LL battery level for all tested composites demonstrated a significantly lower DC compared to the HL samples (P < .05). Conclusion: The varying battery levels of the cordless LED curing unit affect the DC of the tested composites. Therefore, it is essential to routinely check the battery levels of LED units to ensure adequate light intensity during the polymerization process. Cite this article as: Yıldırım Bilmez Z, Berkman M, Ozan G. Battery levels of a light emittıng diode unit affects the properties of various flowable composites. Essent Dent. 2025; 4, 0030, doi: 10.5152/EssentDent.2025.24030.
Exploring Gender and Age Differences in Oral Health: Insights from Panoramic Radiographs in a Retrospective Study
Background: The primary objective of this study was to assess the influence of age and gender on changes in oral health, specifically focusing on the variations in the number of decayed, missing, and restored teeth (DMFT) over time. Methods: Panoramic radiographs from 2410 individuals aged 18-88 years were assessed using the DMFT index. The numbers of decayed (D), missing (M), and restored (F) teeth were recorded at 2 distinct time points. The total DMFT score was calculated for each individual, considering the quadrants and left/right sides of the mouth. Changes in DMFT scores were analyzed across various age groups and between genders. Due to the non-parametric data, statistical analyses were performed using Quade's Rank ANCOVA test to control for covariates such as time, age, and gender, and to evaluate group differences independently. Post-hoc analyses were performed to further explore the impact of demographic variables (P < .05). Results: The analysis, which compared genders irrespective of age, revealed significant differences in all quadrants concerning the number of decayed, missing, and restored teeth, as well as the DMFT scores, between men and women, with changes observed over time (P < .05). Similarly, statistical significance was found among different age ranges (P < .05). Additionally, within each age group, gender effects were observed (P < .05). When considering score changes for the whole mouth (left and right sides together) there was no statistical significance between genders regarding D (P=.349) and F (P=.645) scores. Conclusion: The median DMFT score increased over time, and there is a direct association with gender and age. Cite this article as: Kerimova Köse L, Müdüroğlu Adıgüzel R, Güngör S, Arhun N. Exploring gender and age differences in oral health: insights from panoramic radiographs in a retrospective study. Essent Dent. 2025; 4, 0022, doi: 10.5152/EssentDent.2025.25022.
Awareness of Medication-Related Osteonecrosis of the Jaw Among Dentistry Students: A Multicenter Survey Study
Background: This cross-sectional study aimed to evaluate the awareness of fourth- and fifthyear dental students from three Turkish universities (Sakarya, Uşak, and Tokat Gaziosmanpaşa Universities) regarding bisphosphonates (BPs), medication-related osteonecrosis of the jaws (MRONJ), and related issues, as well as to identify potential improvements in their education. Methods: A survey consisting of 16 multiple-choice and 1 open-ended question was used to assess students’ knowledge of BPs, MRONJ, and their educational preferences. Categorical variables were analyzed using chi-square and Fisher’s exact tests. Comparisons between educational years were made with t-tests or Mann–Whitney U tests, and differences among faculties were evaluated with one-way ANOVA or Kruskal–Wallis tests. Results: A total of 382 students participated: 217 fourth-year and 165 fifth-year students, with a mean age of 22.84 ± 0.94 years. Fifth-year students had significantly more knowledge about BPs (P=.000) and listed their university as the primary source of information (P=.000). They also had a better understanding of BP active substances (P=.038) and MRONJ definitions (P=.001) than fourth-year students. Conversely, fourth-year students were less aware of diseases treated by BPs (P=.038) and appropriate patient approaches for MRONJ (P < .001). Uşak University students outperformed others in recognizing BP indications and active substances (P < .001). Overall, 64.3% of participants felt inadequate in evaluating MRONJ risk and treatment, while 88.48% expressed a desire for further education, with 34.91% requesting more clinical training. Conclusion: The findings indicate that students feel underprepared in managing MRONJ cases, highlighting the need for enhanced clinical and theoretical training. Cite this article as: Erdil A, Sami Demirsoy M, Çolak S, İğneci M, Başal A. Awareness of medication-related osteonecrosis of the jaw among dentistry students: a multicenter survey study. Essent Dent. 2025; 4, 0003, doi: 10.5152/EssentDent.2025.25003.
Retrospective Analysis of the Prevalence of External Root Resorption in the Adjacent Mandibular Second Molar Due to Impacted Mandibular Third Molar Using Cone-Beam Computed Tomography
Background: This study aimed to investigate the distribution of impaction positions and depths of mandibular third molars (MTMs) and their association with the frequency and severity of external root resorption (ERR) in adjacent mandibular second molars (MSMs) using cone-beam computed tomography (CBCT). Additionally, the study explored the potential risks posed by third molar characteristics in the development of resorption and analyzed the specific localization and severity of detected resorption cases. Methods: This study analyzed data from 247 patients, involving 400 teeth, who were admitted to Çanakkale Onsekiz Mart University Faculty of Dentistry. Patients with impacted MTMs and clear CBCT images showing the relationship between the impacted third molar and the adjacent second molar were included. The severity of ERR was categorized into 4 levels: non-resorptive, mild, moderate, and severe, based on the Ericson classification. The direction and depth of impaction were assessed using Winter’s and Pell-Gregory’s classifications, respectively. Cohen’s kappa statistic was used to evaluate observer agreement, and relationships between variables were analyzed using the chi-square test (P < .05). Results: External root resorption was identified in 20.5% of the examined teeth. The majority of resorption cases (75.6%) were localized in the cervical region. Mandibular third molars with mesioangular (28.7%) and horizontal (33.3%) positions were associated with a higher risk of causing ERR. Additionally, impacted MTMs at a median depth demonstrated the highest rate of ERR, with a prevalence of 23.4%. Conclusion: Impacted MTMs frequently cause ERR of adjacent MSMs, particularly when the third molars are in mesioangular or horizontal positions and at median depth. Cone-beam computed tomography is a valuable tool for the early diagnosis and treatment planning of ERR. Cite this article as: Eren İ, Ata GC, Eren H. Retrospective analysis of the prevalence of external root resorption in the adjacent mandibular second molar due to impacted mandibular third molar using cone-beam computed tomography. Essent Dent. 2025; 4, 0018, doi: 10.5152/EssentDent.2025.25018.
Evaluation of Calcium Hydroxide Removal from Simulated Internal Resorption Cavities by Different Irrigation Techniques
Background: Calcium hydroxide (CH) is a material that is very difficult to remove, especially in complex root canal anatomies and pathologic formations such as internal root resorption (IRR). The purpose of this study is to compare ultrasonic and sonic irrigation activation systems, as well as XP-endo Finisher, in terms of their efficiency in removing 2 forms of CH from simulated IRR cavities. Methods: Fifteen human maxillary central incisors were used for this study. The teeth were cut from their crowns to standardize the root lengths at 15 mm. After preparing root canals, the roots were split into 2 halves vertically using a diamond disc, and artificial resorption cavities were prepared 5 mm above the root apex. Two forms of CH were applied into the root canals and resorption cavities. Tested methods were manual irrigation, XP-endo Finisher, EDDY, and passive ultrasonic activation (PUI). After the experiments, samples were evaluated under a stereomicroscope at ×20 magnification and scored via pixel count. Results: Residual CH was observed in all samples after experiments. Passive ultrasonic activation revealed the best median scores, yet there was no significant difference between PUI and EDDY (P > .05). Passive ultrasonic activation was statistically superior to XP-endo Finisher (P < .05). Passive ultrasonic activation, EDDY, and XP-endo Finisher revealed superior results compared to manual irrigation (P < .05). There was no significant difference between CH prepared with distilled water and its injectable form (UltraCal XS) in terms of removability from simulated IRR cavities. Conclusion: None of the tested methods was able to remove CH completely from the simulated internal root resorption cavities. Cite this article as: Kürkçü O, Haznedaroğlu F, Kutlu Basmacı G. Evaluation of calcium hydroxide removal from simulated internal resorption cavities by different irrigation techniques. Essent Dent. 2025; 4, 0013, doi: 10.5152/EssentDent.2025.24013.
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Assessment of Periapical Index Scores Among Individuals Presenting with Painful Pulpal Involvement of Tooth
Background: The aim of this study was to assess the periapical index scores among individuals presenting with painful pulpal involvement of tooth. Methods: A cross-sectional study was conducted among individuals visiting the dental outpatient department of Tribhuvan University Teaching Hospital, Kathmandu, Nepal with suspected painful endodontic lesions. Intraoral periapical radiographs were taken, and periapical conditions were assessed using periapical index scores. Data were analyzed in the Statistical Package for Social Sciences version 20.0 software (IBM Corp.; Armonk, NY, USA). Mean, standard deviation, frequency, and percentage were calculated according to the nature of the data. A chi-square test was done to determine the association between different characteristics and periapical involvement. Results: Most of the study participants (284, 74%) complained of dental pain, followed by pain and swelling both (50, 13%). On oral examination, 61 (15.9%) had the presence of a draining sinus, and 182 (47.4%) had tenderness on percussion of the same tooth. The majority of them (230, 59.9%) had a normal periapical bony structure. Some (36, 9.4%) had changes in bone structure with some diffuse mineral loss, and very few (2, 0.5%) had severe apical periodontitis with exacerbating features. Periapical involvement was significantly higher in older adults (P=.039), those with a draining sinus (P < .001), intraoral swelling (P=.001), and lymph node involvement (P < .001). Conclusion: The findings of this study concluded that most of the individuals complaining of pain in their tooth due to pulpal involvement had normal apical bony structure and very few had severe apical periodontitis with exacerbating features. Periapical involvement was significantly associated with age, draining sinus, intraoral swelling, and lymph node involvement. Cite this article as: Dahal S, Acharya N, Niroula D, Poudel P. Assessment of periapical index scores among individuals presenting with painful pulpal involvement of tooth. Essent Dent. 2025, 4, 0027, doi: 10.5152/EssentDent.2025.24027.
Comparison of Different Aperture Values in Dental Photography in Terms of Depth of Field, Sharpness, Diffraction, and Chromatic Aberration: A Preliminary Study
Background: Dental photography is a crucial tool in modern dentistry, used for documentation, communication, and education. This preliminary study aimed to determine the optimal aperture range for dental photography, considering depth of field, sharpness, diffraction, and chromatic aberration. Methods: A Nikon D7500 camera with a Tokina AT-X M100 PRO D 100 mm F2.8 macro lens was used to capture images of a dental model. Photographs were taken at various aperture values ranging from f/3.3 to f/32. A survey was conducted with 14 dentists to evaluate the images for depth of field, sharpness, and diffraction. Results: About 36% of participants considered f/13 as the lowest acceptable aperture value for adequate depth of field. Regarding diffraction, 50% of responses indicated that diffraction became clearly visible at aperture values of f/22 and above. Conclusion: There is no clear consensus on aperture values that provide sharp photographs while maintaining sufficient depth of field in dental photography. The findings suggest that lower aperture values than those traditionally recommended may provide better image quality by reducing diffraction effects. Further research is needed to explore alternative techniques such as focus stacking or the use of tilt-shift lenses to overcome the limitations of depth of field and diffraction in dental photography. Cite this article as: Yünük OA, Demirci M, Tuncer S, Yünük M, Tekçe N. Comparison of different aperture values in dental photography in terms of depth of field, sharpness, diffraction, and chromatic aberration: a preliminary study. Essent Dent. 2025; 4, 0029, doi: 10.5152/EssentDent.2025.24029.
The Effects of Saliva Characteristics and Oral Hygiene Habits on Dental Health: Evaluation with DMFT Index
Background: The World Health Organization (WHO) has identified oral health as an important public health priority. Dental caries is a common health problem worldwide, and the DMFT (Decayed, Missing, Filled Teeth) index is an effective measurement tool for evaluating this issue. This study examines the relationship between oral hygiene habits, saliva characteristics, and the DMFT index among first-year students at Burdur Mehmet Akif Ersoy University Faculty of Dentistry. Methods: 56 dentistry students were included in the study. Clinical examinations determined the DMFT values of the participants. Saliva samples were collected using the stimulated saliva method, and pH, buffering capacity, and flow rate were measured. In addition, a questionnaire was administered to question the students’ oral hygiene habits and nutritional behaviors. The data were analyzed with SPSS software, and P < .05 was considered significant. Results: Women’s mean DMFT value was lower than men’s; however, no significant difference was observed (P > .05). Men’s salivary flow rate was significantly higher (P < .05). An essential and negative correlation was found between DMFT and salivary pH value (P < .05). A negative correlation was observed between tooth brushing frequency and DMFT. However, this relationship was not significant (P > .05). Conclusion: Regular tooth brushing, dental flossing, and adequate hydration are essential for oral health. Properties of saliva, such as pH and buffering capacity, are effective in preventing dental caries, and the DMFT index is a vital tool for evaluating these relationships. The study emphasizes the effects of oral hygiene habits and biological factors on oral health. Cite this article as: Küçükyıldız EN, İşiner B. The effects of saliva characteristics and oral hygiene habits on dental health: evaluation with DMFT index. Essent Dent. 2025, 4, 0008, doi: 10.5152/EssentDent.2025.25008.
Evaluation of the Effects of Different Polishing Techniques on the Optical and Mechanical Properties of Resin-Based Restorative Materials
Background: In screw-retained implant-supported prostheses, restorative materials seal screw access holes, requiring mechanical stability and aesthetic integration. Their effectiveness depends on surface properties, influenced by polishing techniques, which impact clinical success. However, limited research has examined how different polishing protocols affect their optical and mechanical properties. This study evaluated the color change, surface roughness, and hardness of resin-based restorative materials after one-step, two-step, and multi-step polishing. Methods: Ninety disk-shaped specimens (10 × 2 mm) were prepared from Stark Bulk Fill Composite (SBF), Zenchroma One Shade Universal Composite (ZOS), and Ruby CompNano Composite (RCN) materials. The specimens were divided into 3 subgroups based on polishing techniques (n=10): Group 1, one-step polishing; Group 2, two-step polishing; and Group 3, multi-step polishing. Initial color, translucency, hardness, and roughness measurements were conducted, followed by repeat measurements. Data were analyzed using two-way ANOVA with a significance level of P < .05. Results: Ruby CompNano exhibited the highest color stability among the tested materials, while one-step polishing resulted in more discoloration. Translucency values were unaffected by the materials and polishing procedures but decreased after coffee immersion. Multi-step polishing produced the smoothest surfaces, whereas surface roughness increased in the one- and two-step groups. Hardness values decreased across all groups after immersion, except for the OneShade Universal Composite, where multi-step polishing maintained hardness. Conclusion: Multi-step polishing techniques were found to be more effective in minimizing surface roughness and preserving color stability and hardness, with the Ruby CompNano composite being the material with the highest color stability Cite this article as: Tosun B, Uysal N, Yanıkoğlu N. Evaluation of the effects of different polishing techniques on the optical and mechanical properties of resin-based restorative materials. Essent Dent. 2025; 4, 0016, doi: 10.5152/EssentDent.2025.25016.
Effect of Mouth Rinses Used for Covid-19 Prevention on the Color Stability of Composite Resins
Background: The aim of this study was to investigate the effect of different mouth rinses on the color stability of microhybrid (Opallis (OP), FGM) and nanohybrid (Estelite Sigma Quick (ESQ), Tokuyama) composite resins, which are recommended to be used before dental procedures to prevent the spread of severe acute respiratory syndrome coronavirus 2. Methods: Forty specimens of each composite resin, A2 shade, were prepared and immersed in mouth rinses containing 0.2% chlorhexidine (CHX), 1% povidone-iodine (PVP-I), and 1.5% hydrogen peroxide for 1 minute daily, followed by reincubation in artificial saliva for 28 days. Color measurements were recorded at baseline, 7, 14, and 28 days using a spectrophotometer, and color differences (ΔE00) were calculated to assess color stability. A 2-way ANOVA and Duncan test were used for statistical analysis. Results: The color stability of both composite resins was significantly affected by the mouth rinses. The microhybrid composite (OP) exhibited greater color changes compared to the nanohybrid composite (ESQ). After 14 and 28 days, the ΔE00 values of OP samples exposed to Andorex, Batiqon, and Dermosept exceeded the clinically unacceptable threshold (ΔE00 > 1.8). In contrast, the nanohybrid composite resin showed lower color change, remaining below the clinical acceptability threshold throughout the study period. Conclusion: Mouth rinses, particularly those containing CHX and PVP-I, caused significant and clinically unacceptable color changes in composite resin restorations over time. The study suggests that the prolonged use of these mouth rinses in patients with composite resin restorations should be carefully considered to avoid undesirable aesthetic outcomes. Cite this article as: Çam M. Effect of mouthrınses used for COVID-19 prevention on the color stability of composite resins. Essent Dent. 2025; 4, 0002, doi: 10.5152/EssentDent.2025.25002.
Effect of Layer Thickness on Conversion Degree and Microhardness of Bulk-Fill Composites
Background: This study aimed to evaluate the effect of layer thickness on the conversion degree and microhardness of low- and high-viscosity bulk-fill composite resins. Methods: Six different bulk-fill composite resins, SDR (Dentsply), Sonic Fill (Kerr), X-tra Fil (Voco), Beautifil Bulk Restorative (Shofu), Beautifil Bulk Flowable (Shofu), and Filtek Bulk Fill Flowable (3M ESPE) were tested. Disc-shaped samples (7 mm diameter, 2 and 4 mm thickness, n=4 per group) were prepared and polymerized using an LED (Light-Emitting Diode) curing unit (Elipar S10, 3M ESPE). After 24 hours at 37°C, the degree of conversion was analyzed using Fourier Transform Infrared Spectroscopy (FTIR)- Attenuated Total Reflectance (ATR) (Perkin Elmer Spectrum Two), and microhardness was measured using a Knoop hardness tester (Buehler MMT-3 Digital Microhardness Tester). Data were analyzed using Shapiro-Wilk, ANOVA, Tukey’s HSD, and Pearson correlation with SPSS 26.0V (IBM SPSS Corp.; Armonk, NY, USA). Results: No significant difference in bottom/top surface hardness ratio was observed in 2 mm samples (P > .05). However, at 4 mm, a statistically significant difference was found among the composite groups (P= .003). SDR had the highest hardness ratio (0.87 ± 0.04), while Beautifil Bulk Restorative (BBR) had the lowest (0.68 ± 0.08). The highest degree of conversion at both thicknesses was in SDR (65.13 ± 2.00 at 2 mm, 62.90 ± 2.30 at 4 mm), whereas X-tra Fil had the lowest (41.25 ± 13.57 at 2 mm, 39.25 ± 6.75 at 4 mm). In BBR, conversion at 2 mm was significantly higher than at 4 mm (P=.004). Cite this article as: Kütük Ömeroğlu M, Ertaş E. Effect of layer thickness on conversion degree and microhardness of bulk-fill composites. Essent Dent. 2025; 4, 0024, doi: 10.5152/EssentDent.2025.25024.
Evaluation of the Practice Differences Between Dentists in Fixed Prosthesis Procedures
Background: Fixed prostheses are widely used in the rehabilitation of missing teeth. The success of these restorations depends on various factors, including impression techniques, gingival retraction, interocclusal records, and temporary prosthesis fabrication. This study aimed to evaluate the knowledge, attitudes, and practice variations among dentists in Türkiye regarding fixed prosthesis procedures. Methods: This study was conducted via an online survey. The questionnaire consisted of 14 questions covering demographic characteristics and fixed prosthodontic procedures, including gingival retraction, impression materials, interocclusal records, and temporary prosthesis fabrication. Statistical analyses were performed using IBM SPSS (IBM SPSS Corp.; Armonk, NY, USA, Version 23.0), with a significance level of P < .05. Results: A total of 152 dentists participated, of whom 61.8% were female and 38.2% were male. Gender did not significantly influence material or technique selection (P > .05), whereas educational background and professional experience significantly affected the choice of impression materials (P < .05). Condensation silicone was the most preferred impression material (54.6%), and wax was the most frequently used interocclusal record material (75.8%). Additionally, 94.7% of dentists fabricated temporary prostheses, with the indirect technique being the most preferred. Conclusion: Significant variations were observed in material and technique selection, particularly based on education and experience. While younger dentists showed a higher preference for modern materials, experienced practitioners relied more on conventional techniques. Cite this article as: Bilgi Özyetim E, Yıldırım G, Güven MÇ. Evaluation of the practice differences between dentists in fixed prosthesis procedures. Essent Dent. 2025; 4, 0035, doi: 10.5152/EssentDent.2025.25035.
Effect of Different Irrigation Activation Methods on the Dentinal Tubule Penetration of Dyed Sodium Hypochlorite: Rhodamine B vs. Fluorescein Sodium Salt
Background: This study aimed to observe the penetration of sodium hypochlorite (NaOCl) into the dentinal tubules (DTs) with confocal laser scanning microscopy (CLSM) using fluorescein sodium salt (FSS) and Rhodamine B. Methods: Six groups of 120 freshly extracted human maxillary central incisors were randomly divided. Both FSS and Rhodamine B were used in 3 groups (n: 20): control group, sonic irrigation (SI), and passive ultrasonic irrigation (PUI). The irrigation solution amounts and total duration were the same in all groups. Using CLSM, transverse sections (2-, 4-, and 6 mm distances to the root apex) were examined. Both the percentage (%) and maximum depth (µm) of NaOCl penetration were calculated. Results: There was no statistically significant difference in penetration percentage (PP) and maximum depth of penetration (MPD) between Rhodamine B and FSS (P=.635, and P= .869, respectively). The maximum PP of NaOCl was seen in the 6-mm sections across all groups, including both Rhodamine B and FSS. In the same sections with 2 dyes, however, no statistically significant changes were seen between the irrigation groups. In the SI and PUI groups, a significantly higher MPD was detected with Rhodamine B in 4-mm sections than 2-mm sections. The SI group exhibited significantly more MPD than control group in the 4-mm section with Rhodamine B and FSS. Conclusion: The FSS can be safely used in penetration studies into the DT. The SI and PUI did not significantly enhance the irrigation solution’s penetration into the DT compared to conventional endodontic irrigation. Cite this article as: Yalçın TY, Gökyay SS. Effect of different irrigation activation methods on the dentinal tubule penetration of dyed NaOCl: rhodamine B vs. fluorescein sodium salt. Essent Dent. 2025; 4, 0037, doi: 10.5152/EssentDent.2025.25037.
The Effect of Aqueous Okra (Abelmoschus esculentus L.) Extract on Human Periodontal Ligament Fibroblast Cells Viability: A Pilot Study
Background: The aim of this pilot research was to assess the cell viability activity of different concentrations of aqueous okra (Abelmoschus esculentus L.) extracts on human periodontal ligament fibroblast (hPDLF) cells. Methods: Aqueous okra extract was prepared for the experiments, and the content of the extract was analyzed by high-performance liquid chromatography (HPLC). For the purpose of treating cells, the aqueous okra extract was prepared in 7 different concentrations (0.125, 0.187, 0.25, 0.375, 0.5, 0.75, and 1 mg/mL). To assess cell viability, cells were seeded in 96-well plates on 4 occasions for each concentration. The cells were treated with aqueous okra extract for a period of 24 hours. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay protocol was employed for the purpose of evaluating cell viability. The data were subjected to statistical analysis using the GraphPad Prism statistical software. A P-value of less than .05 was considered statistically significant. Results: Analysis using HPLC showed the existence of rutin, 4-hydroxybenzoic acid, and syringic acid in the extract. The MTT test revealed no significant difference in the viability of hPDLF cells between the control and aqueous okra extract-treated groups (P > .05). Conclusion: The outcomes of this research demonstrate that aqueous okra extract has a similar effect on the viability of hPDLF cells at different concentrations. This suggests the need for further studies in which okra is prepared at varying concentrations, dissolved in different solvents, and followed over longer time intervals. Cite this article as: Tosun UU, Aydın ST, Baykara D, et al. The effect of aqueous okra (Abelmoschus esculentus L.) extract on human periodontal ligament fibroblast cells viability: A pilot study. Essent Dent. 2025, 4, 0033, doi: 10.5152/EssentDent.2025.25033.
Effect of Gastric Acid on Surface Roughness and Color Stability of 3D-Printed Permanent Resins
Background: In dentistry, 3-dimensional (3D) printed permanent resin materials are widely used due to their durability and aesthetic versatility. However, their response to acidic environments, such as exposure to gastric acid in conditions like gastroesophageal reflux, is not yet fully understood. This study investigates the impact of simulated gastric acid on the color stability and surface roughness of 3D-printed permanent resin materials. Methods: A total of 60 specimens (n= 15 in each group) were prepared as disc-shaped specimens using 4 different 3D-printed permanent resins: VarseoSmile TriniQ (VST), Crowntec (CR),C&B Ceramic Resin (CB), and Permanent Crown (PB). The specimens were exposed to a simulated gastric acid solution (pH 1.2) at 37°C for 18 hours, and color change (ΔE) was measured by a spectrophotometer, and surface roughness (Ra) was measured by a contact profilometer. Results: After gastric acid exposure, color change (ΔE) in all groups remained within clinically acceptable limits (ΔE <3.3). However, significant differences in surface roughness were observed depending on the material type. The CB group showed higher surface roughness compared to the other groups (P < .05). Conclusion: The 3D-printed permanent resins maintained color stability under gastric acid exposure, while surface roughness varied depending on the material composition. These findings highlight the importance of material selection, especially for patients with acidic oral environments. Cite this article as: Dinçer G, Şeşen P. Effect of gastric acid on surface roughness and color stability of 3D-printed permanent resins. Essent Dent. 2025, 4, 0042, doi: 10.5152/EssentDent.2025.25042.
ChatGPT-4 Omni’s Accuracy in Multiple-Choice Dentistry Questions: A Multidisciplinary and Bilingual Assessment
Background: This study evaluated the performance of ChatGPT-4 Omni (ChatGPT-4o) in answering multiple-choice questions from the Dentistry Specialty Examination (DUS), a nationwide exam conducted in Türkiye, assessing knowledge in basic medical and clinical dentistry sciences. Additionally, it examined performance variations based on question language (Turkish vs. English). Methods: The dataset included 1504 unique questions from publicly available DUS exams (2012-2021) categorized into Basic Medical Sciences (n= 514) and Clinical Dentistry Sciences (n= 990). Each question was presented to ChatGPT-4o in both Turkish and English, generating 3008 responses. Accuracy was determined using the official answer key. McNemar’s test compared accuracy between languages, while chi-square and Bonferroni post-hoc tests assessed differences across disciplines. Results: ChatGPT-4o showed significantly higher accuracy for English questions (87.8%) than Turkish questions (84.0%) (P < .001). In Basic Medical Sciences, accuracy was significantly higher for English questions in Anatomy (P = .004) and Physiology (P = .039), while Biochemistry achieved 100% accuracy in both languages. In Clinical Dentistry Sciences, English responses were significantly more accurate in Periodontology (P = .013), Endodontics (P = .003), and Pediatric Dentistry (P = .005), whereas Turkish responses performed better in Maxillofacial Radiology (P = .013). The highest error rates were in Prosthetic Dentistry (20.1%) for English and Endodontics (18.3%) for Turkish. Conclusion: ChatGPT-4o demonstrated high accuracy in DUS exam questions, with English responses generally outperforming Turkish ones. Performance varied across disciplines, indicating potential language-based limitations. These findings highlight large language models (LLMs)’ potential for dental education while underscoring the need for improvements in language processing and discipline-specific knowledge. Cite this article as: Dündar Sarı MB, Sezer B. ChatGPT-4 Omni’s Accuracy in Multiple-Choice Dentistry Questions: A Multidisciplinary and Bilingual Assessment. Essent Dent. 2025, 4, 0029, doi: 10.5152/EssentDent.2025.25029.
Knowledge and Attitudes of Dental Patients Toward Botulinum Toxin Treatment
Background: This study aims to evaluate the knowledge, attitudes, and perceptions of patients applying to a dental faculty for treatment regarding botulinum toxin. Methods: The study was conducted at the İstanbul Yeni Yüzyıl University Faculty of Dentistry Hospital and included a total of 139 patients. A 3-section questionnaire was used: (1) demographic data, (2) knowledge of Botox, and (3) attitudes toward Botox applications. The data were analyzed using IBM SPSS 23.0, and the Kruskal-Wallis test, Dunn’s test, Mann-Whitney U test, Chi-square test, and Fisher’s Exact tests were applied. Results: Among the participants, 67.6% were female, 32.4% were male, and 70.6% were between 18 and 44 years old. Only 15.1% of the participants correctly answered the question “What Is Botox?.” While 75.5% of the participants stated that Botox is used for cosmetic purposes, their knowledge of its therapeutic applications was limited. Additionally, 20.9% of participants reported being aware of the side effects of Botox, while 33.1% stated that they had considered undergoing Botox treatment. 12.9% of the participants had previously undergone Botox procedures, with 72.2% receiving it for aesthetic reasons and 27.8% for medical purposes. Conclusion: The results of the study indicate that patients have insufficient knowledge regarding the therapeutic uses of botulinum toxin. Participants predominantly perceive Botox as a cosmetic procedure and have limited awareness of its medical benefits. Furthermore, a significant portion of participants believe that Botox procedures can only be performed by plastic surgeons and dermatologists, demonstrating low awareness of the competency of dentists in administering such treatments. This study highlights the need to increase patient awareness regarding both the aesthetic and therapeutic uses of Botox.
Is There a Difference Between Dental Measurements on Conventional Plaster Models and Digital Models?Background: Comparison of dental measurements between conventional plaster models and digital models. Methods: The sample consisted of 41 final models from
Background: Comparison of dental measurements between conventional plaster models and digital models. Methods: The sample consisted of 41 final models from the archive of the Department of Orthodontics, Faculty of Dentistry, Ordu University. Mesiodistal tooth widths, intercanine and intermolar arch widths, and Bolton tooth size discrepancies were evaluated on both plaster and digital models. Digital models were obtained by scanning the plaster models using 3Shape Trios 3 Move+ and iTero Lumina scanners. The resulting standard triangle language files were imported into OrthoAnalyzer software for measurement. Tooth widths on plaster models were measured using a digital caliper. All measurements were performed by a single examiner. To assess the intra-observer reliability, a second set of measurements was taken from a random subset of models, and intraclass correlation coefficients were calculated. Data from the 3 groups were analyzed using the Kruskal–Wallis and Dunn tests. A P-value <.05 was considered statistically significant. Results: Significant differences were found in the mesiodistal widths of several teeth, including the upper right first molar, canine, and lateral incisor; upper left second premolar and canine; lower right second premolar, first premolar, central and lateral incisors; and lower left first and second premolars and first molar. Mandibular intercanine and intermolar widths also showed significant differences. Digital measurements were generally larger than those from plaster models. No significant differences were observed between the 2 digital systems, or in total and anterior Bolton analyses. Conclusion: Despite some discrepancies between manual and digital methods, digital models provided consistent and clinically reliable measurements. Cite this article as: Alpaydın MT, Alpaydın T, Erzayın B. Is there a difference between dental measurements on conventional plaster models and digital models? Essent Dent. 2025, 4, 0019, doi: 10.5152/EssentDent.2025.25019.
Effect of Thickness of Resin Matrix Ceramics on Polymerization of Resin Cements
Background: This study aimed to assess how the thickness of resin matrix ceramics (RMC) impacted the microhardness of the underlying resin cement. Methods: Three types of RMC were analyzed: polymer infiltrated ceramic, resin nano ceramic, and nano ceramic. Every ceramic block had sections 0.5, 1, and 1.5 mm thick and 8 mm in diameter. Nine groups, each containing 10 RMC discs (n = 10), were produced by combining all the parameters. Central-holed stainless steel that was 6 mm in diameter and 0.5 mm deep was used for applying translucent light-cured luting resin. The resin cement underwent polymerization in direct contact with the RMC. Under a 50 g load and a 15-second indentation duration, Vickers measurements were taken from the underside of the resin cement specimens using 3 distinct indentation locations. The average of the 3 measurements for each specimen was utilized to determine the Vickers hardness value. The data were analyzed using two-way ANOVA and Tukey post hoc tests. Results: In the case of resin cements with underlying thicknesses of 0.5 mm and 1 mm, the groups GC Cerasmart and Vita Enamic demonstrated significantly higher average microhardness in comparison to the Lava Ultimate group (P < .05). Compared to the GC Cerasmart and Vita Enamic groups, the Lava Ultimate group’s mean microhardness of the resin cements for a thickness of 1.5 mm was significantly lower (P < .05). Conclusion: Resin matrix ceramics thickness and type had a significant effect on microhardness values in all kinds of RMC. Cite this article as: Göktepe B, Çelik E, Gönüldaş F. Effect of thickness of resin matrix ceramics on polymerization of resin cements. Essent Dent. 2025, 4, 0052, doi: 10.5152/EssentDent.2025.25052.
Comparison of the Presence and Frequency of Pulp Stones in Mandibular Teeth with Panoramic Radiography and Cone Beam Computed Tomography Images: A Retrospective Study
Background: This study aimed to evaluate and compare the diagnostic effectiveness of cone beam computed tomography (CBCT) and panoramic radiography in detecting pulp stones in mandibular teeth and investigate the relationship between pulp stone prevalence and demographic variables. Methods: This retrospective study analyzed a total of 1947 mandibular teeth from 150 patients (80 males, 70 females) using both CBCT and panoramic radiography images. Teeth were categorized into 4 anatomical groups: incisors, canines, premolars, and molars. The presence of pulp stones was assessed by a calibrated observer for each imaging modality. Chi-square tests were employed to determine statistical significance (P < .05) in detection rates between imaging modalities and across demographic variables. Results: Cone beam computed tomography demonstrated significantly greater sensitivity in the detection of pulp stones compared to panoramic radiography, particularly in molars (27.3% vs. 8.7%) and anterior teeth, where panoramic radiography frequently failed to detect pulp stones. A statistically significant difference in pulp stone prevalence was observed in the canine group, with higher detection rates in females than males (11.4% vs. 1.3%, P=.009). The CBCT demonstrated superior sensitivity (94.1%, 95% CI: 89.2%-97.3%) compared to panoramic radiography (31.7%, 95% CI: 24.8%-39.4%) for pulp stone detection, with specificity values of 100% for both modalities. Conclusion: Cone beam computed tomography is significantly more effective than panoramic radiography for detecting pulp stones in mandibular dentition, offering enhanced diagnostic capability, particularly in complex anatomical regions. While sex may influence pulp stone prevalence in specific tooth groups, age does not appear to be a determining factor within the examined cohort. Cite this article as: Eren İ, Şahin YN. Comparison of the presence and frequency of pulp stones in mandibular teeth with panoramic radiography and cone beam computed tomography images: A retrospective study. Essent Dent. 2025, 4, 0075, doi:10.5152/ EssentDent.2025.25075.
Influence of Preparation Height on Digital Impression Trueness: A Comparative Study of 2 Intraoral Scanners
Background: This study aims to evaluate the effect of crown preparation height on the trueness of intraoral scanners (IOS) by comparing 2 different scanners at varying preparation heights. Methods: A typodont model was prepared with a chamfer finish line at 2 different crown heights (7 mm and 5 mm). A laboratory scanner (E1, 3Shape, Copenhagen, Denmark) was used to obtain a reference scan. Intraoral scanners, Trios 3 (3Shape, Copenhagen, Denmark) and iTero Element 5D Plus (Align Technologies, San Jose, USA), were used for digital impressions. Ten scans were taken for each preparation height per scanner, resulting in a total of 40 scans. The trueness was assessed using Geomagic Control X software by calculating root mean square (RMS) error values between IOS scans and the reference model. Statistical analysis was performed using IBM SPSS v29. An independent sample t-test was applied (α=0.05). Results: The iTero scanner exhibited significantly lower RMS values (0.040 ± 0.005 mm) compared to the Trios 3 scanner (0.049 ± 0.006 mm, P < .001), indicating higher overall trueness. The Trios 3 scanner showed a significant difference in trueness between 5 mm (0.051 ± 0.005 mm) and 7 mm (0.046 ± 0.006 mm) preparations (P=.043), demonstrating improved trueness with greater preparation height. In contrast, the iTero scanner maintained consistent trueness across both preparation heights (P=.451). Conclusion: The trueness varies depending on the intraoral scanner used. Crown height is a factor that affects trueness depending on the scanner. Cite this article as: Özden YE, Yılmaz Z, Özkurt Kayahan Z, Kazazoğlu E. Influence of preparation height on digital impression trueness: a comparative study of 2 intraoral scanners. Essent Dent. 2025, 4, 0030, doi:10.5152/EssentDent.2025.25030.
A Comparative Analysis of the Sources and Levels of Stress Among Dental Students at State and Foundation Universities
Background: The aim of this study was to examine the stress levels and the primary sources of stress among fourth- and fifth-year dental students receiving clinical education at state and foundation universities in Türkiye. Methods: A total of 198 fourth and fifth-year dental students from Çanakkale Onsekiz Mart University and Beykent University, enrolled in the 2024-2025 academic year, participated in this study. The Modified Dental Stress Questionnaire (DES), consisting of 30 questions, was administered to the participants to identify the sources of stress. The responses were evaluated using a 4-point Likert scale, ranging from not stressful (1 point) to very stressful (4 points). The obtained data were statistically analyzed (P < .05). Results: The participants were 71.2% female and 28.8% male; 59.1% were studying at state universities, and 40.9% at foundation universities. The internal consistency of the scale was found to be highly reliable with a Cronbach’s alpha coefficient of 0.928. The total DES score of state university students was found to be significantly higher compared to foundation university students (P=.004). A significant difference was found between state and foundation universities for 13 different items on the stress scale (P < .05). Conclusion: It was observed that dental students experience high levels of stress, with stress levels being higher among students at state universities. These findings highlight the need for identifying effective strategies to reduce stress and developing different approaches based on the type of university. Cite this article as: Ayan G, Işik HY, Sariyilmaz E. A comparative analysis of the sources and levels of stress among dental students at state and foundation universities. Essent Dent. 2025, 4, 0048, doi:10.5152/EssentDent.2025.25048.
Analyzing the Posts on YouTube and Instagram Concerning Endocrowns: Characteristics, Quality, and Content
Background: Quick and easy access to Instagram and YouTube makes them exceptional platforms that can easily convey health information to the public and mislead people as a result of misinformation in post content. The aim was to examine the quality and content of “Endocrown”- related posts on Instagram and YouTube social media platforms. Methods: Instagram and YouTube searches were conducted by researchers using the keywords “endocrown” and “endocrowns.” Along with the descriptive features of the posts, their content, quality, and reliability were evaluated according to the utility score, Global Quality Scale (GQS), and modified DISCERN (mDISCERN) score. Results: A total of 203 Instagram posts were included in the study, of which 5% were of high quality and exhibited high content reliability. Among the 182 YouTube posts, 8% and 18% were of high quality and exhibited high content reliability, as determined by mDISCERN and GQS, respectively. A positive correlation was detected between the utility score, mDISCERN, and GQS scores (P < .001). Additionally, the utilization of rubber dams in the posts uploaded by dentists is significantly less than that of specialists (P < .001). Conclusion: The investigation revealed that the majority of endocrown-related content on YouTube and Instagram posts was of substandard quality and lacked reliability. It is recommended that the quantity, quality, and reliability of Instagram and YouTube posts about “Endocrown” be increased. Cite this article as: Abat VH, Özkan K. Analyzing the posts on YouTube and Instagram concerning endocrowns: characteristics, quality, and content. Essent Dent. 2025, 4, 0039, doi: 10.5152/EssentDent.2025.25039.
Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0/
Evaluating the Quality of YouTube Videos on Dental Implants: A Methodological Approach
Background: Patients frequently use the internet and video-sharing platforms to obtain health-related information. YouTube is a commonly preferred tool for patient education because of its audiovisual format, accessibility, and lack of subscription requirements. Patients awareness of dental implants is crucial, and knowledge gaps are common. This study aimed to evaluate the quality of Turkish YouTube videos on dental implants and to assess their potential usefulness as educational tools for patients. Methods: Using the keyword “diş implantı” (dental implant), identified via Google Trends as the most searched term by the public, a search was conducted on YouTube on May 1, 2025. Of the first 200 videos listed, 58 met the inclusion criteria and were analyzed. The videos were evaluated using a usefulness score (0-9) and the Global Quality Scale (GQS, 1-5). The observer scored each video based on 9 content domains. Statistical analyses were performed using the KruskalWallis tests, one-way ANOVA, and Spearman correlation ( P < .05). Results: The mean usefulness score was 3.28 ± 1.68, and the mean GQS was 2.48 ± 0.89. Of all the videos, 48.3% were rated as moderate, 39.7% as poor, and only 12% as good. TV channel videos had the highest usefulness scores. A strong and positive correlation was observed between usefulness scores and GQS (rs = 0.712, P < .001). Conclusion: The overall quality of YouTube videos on dental implants was moderate. To improve patient awareness, the number of high-quality videos prepared by dental professionals should increase. Cite this article as: Özkan E. Evaluating the quality of YouTube videos on dental implants: A methodological approach. Essent Dent. 2025, 4, 0063, doi: 10.5152/EssentDent.2025.25063.
Comparative Radiopacity Evaluation of Dental Materials Used in Vital Pulp Therapy
Background: Radiopacity is an essential property of pulp capping materials, enabling accurate radiographic diagnosis and differentiation from dental tissues. This study compared the radiopacity of 15 dental materials used in vital pulp therapy of primary and permanent teeth with each other and with enamel and dentin. Methods: Eight calcium silicate-based, 6 glass ionomer-based, and 1 calcium hydroxide-based material were tested. Forty-five disk-shaped specimens (8 mm diameter, 2 mm thickness) were prepared according to manufacturers’ instructions. Radiographs were obtained using digital radiography with enamel, dentin sections, and a 9-step aluminum (AI) wedge. Mean gray values were converted to equivalent AI thickness (mm Al) using calibration curves. Data were analyzed using 1-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: Significant differences in radiopacity were found among materials (P < .001). Bio-C Repair and NeoPutty MTA showed the highest mm Al values, while Amalgomer and Zirconomer had the lowest. Ionofil U, Glass Liner, Theracal LC, Calcimol LC, Amalgomer, and Zirconomer had radiopacity lower than both primary and permanent enamel. Conclusion: All calcium silicate-based materials met the ISO 6876 threshold of ≥3 mm Al. However, the radiopacity of Amalgomer and Zirconomer was lower than that of dentin and below acceptable clinical standards. Cite this article as: Sarimehmetoglu N, Ozdemir B. Comparative radiopacity evaluation of dental materials used in vital pulp therapy. Essent Dent. 2025, 4, 0059, doi:10.5152/EssentDent.2025.25059.
Copyright (c) 2025 Attribution-NonCommercial 4.0 International CC BY-NC 4.0 Deed https://creativecommons.org/licenses/by-nc/4.0/deed.en
An Investigation of Prevalence, Awareness, and Oral Findings of Bruxism in Students at the Faculty of Dentistry
Background: The present study investigated the prevalence, awareness, and oral findings of bruxism in dental students and the relationship between social factors and perceived stress. Methods: A total of 118 students (74 females, 44 males) aged between 18 and 29 years studying at the Faculty of Dentistry, Burdur Mehmet Akif Ersoy University, were included in this study. The students were asked to complete a questionnaire composed of demographic and bruxism- related items. The Basic Erosive Wear Examination (BEWE) index was used to determine the extent of wear of the teeth, and the Perceived Stress Scale was used to understand the stress levels of the students. Results: The rate of bruxism awareness and actual occurrence of bruxism was 27.12% and 31.3%, respectively. There was a statistically significant correlation between the BEWE scores and the father’s education level, family structure, teeth clenching habit, and pain in the joint area and face (P < .05). Furthermore, there was a statistically significant difference between perceived stress and family income, family disciplinary status, noise from the jaw joint, pain in the teeth, joints, and facial area, and teeth clenching habit, and these complaints affected the quality of life (P < .05). Conclusion: Bruxism was found to be prevalent among the dental students who participated in this study. It should be taken into consideration that the presence of bruxism may be associated with elevated stress levels and higher BEWE scores. Cite this article as: Öğünç A, Tunç H. An investigation of prevalence, awareness, and oral findings of bruxism in students at the faculty of dentistry. Essent Dent. 2025, 4, 0028, doi:10.5152/EssentDent.2025.25028.
Randomized Controlled Trials in Dentistry
Abstract: Randomized Controlled Trials (RCTs), acknowledged as a source of evidence regarding the feasibility of an initiative, are considered secondary level evidence for decisions in practice. However, they are also recognized as a fundamental source for systematic reviews and meta-analyses, which constitute primary-level evidence. Conducting an RCT requires a comprehensive understanding of study design, necessitating researchers to be well-versed in concepts such as PICO question, randomization, statistical tests, sample size calculation, bias, and protocol entries. Considering and adhering to the fundamental concepts of design, coupled with meticulous reporting, can facilitate the demonstration of the actual effects of interventions and the presentation of results with significant evidential value. Despite the ongoing evolution of RCTs over time, systematic deficiencies persist. This review addresses the methodology of RCTs. Cite this article as: Bahçeci DN, Saygılı S, Kasımoğlu Y. Randomized controlled trials in dentistry. Essent Dent. 2025; 4, 0001, doi: 10.5152/EssentDent.2025.24001
Animal-Assisted Therapy in Dentistry: A Review
Abstract: Animal-assisted therapy (AAT) is considered a beneficial method to improve children’s and adolescents’ mental and physical health, especially in medical settings. It is a recent phenomenonin dentistry as an advanced behavioral management technique to reduce anxiety. It is generally applied in children, patients with known dental phobia, patients who cannot benefit from other behavior management techniques such as those with autism spectrum disorder or Down syndrome, and patients who are not appropriate for sedation or general anesthesia. The aim of AAT in dentistry is reducing anxiety toward dental procedures and improving patient satisfaction. The interest of humans in animals comes from the fact that primitive human survival depended in part on animals in the environment, which is correlated with the biophilia hypothesis. When animals are in a peaceful state, especially dogs, the situation can signal safety, security, and a sense of well-being for both humans and animals. Dogs are appropriate therapy animals for dentistry because they have developed human-like social skills during their domestication over time. They are sensitive to human posture, attentional situations, and emotions. This review aims to investigate and summarize the use of AAT in dental care. Various articles in the literature were reviewed. The main results indicate that AAT is an effective method for controlling anxiety in dental settings, but further investigations and studies should be performed to determine definitive results. Cite this article as: Mutlu B, Keskin M, Kasımoğlu Y. Animal-assisted therapy in dentistry: a review. Essent Dent. 2025; 4, 0022, doi: 10.5152/EssentDent.2025.24022.
Understanding the Psychological and Sociological Effects of Molar Incisor Hypomineralization: A Scoping Review of Current Evidence
Molar incisor hypomineralization (MIH) is a dental condition characterized by enamel opacities, discoloration, and structural fragility, which can significantly affect individuals’ psychological and sociological well-being. In affected teeth, post-eruptive enamel breakdown often occurs, resulting in structural deficiencies that increase dentin hypersensitivity and hinder effective oral hygiene maintenance. This compromised hygiene can, in turn, elevate the risk of dental caries and periodontal disease, necessitating more frequent dental interventions. Over time, these challenges may contribute to the development of dental anxiety and behavioral management difficulties. Moreover, MIH can lead to functional limitations, such as masticatory difficulties and speech impairments. The impact of MIH extends beyond its physical symptoms, especially during childhood and adolescence, potentially resulting in significant psychosocial consequences. Enamel discoloration and loss of structure may cause aesthetic concerns, reduced self-esteem, and social withdrawal. Given the multifaceted effects of MIH, early diagnosis and individualized treatment strategies are essential for mitigating both its physical and psychosocial burdens, ultimately improving the overall quality of life of affected individuals. This scoping review aims to comprehensively evaluate, based on current scientific evidence, the functional and specific psychosocial impacts of MIH. Cite this article as: Aydoğdu T, Sezer B. Understanding the psychological and sociological effects of molar incisor hypomineralization: A scoping review of current evidence. Essent Dent. 2026, 4, 0050, doi:10.5152/EssentDent.2025.25050.
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