KJC Korea
Journal Central

The objectives of this study were to evaluate oral health status of children in multicultural families and compare oral health behaviors of multicultural mothers with those of ordinary Korean families. The mothers’social characters, oral health behaviors and oral health status of children were investigated so that the data from this study can be utilized in developing programs for oral health care promotion especially designed for multicultural families. The subjects were 135 pairs of multicultural mothers and their children who participated in the community programs in suburban areas of Ik-san city and 168 pairs of ordinary Korean mothers and their children residing in Ik-san city. The results were as follows :1. The dft index and dfs index of multicultural subjects were 4.17 and 6.67, respectively, while ordinary Korean subjects were found to have 2.69 and 4.63(p<0.05). 2. The frequency of tooth brushing per day of children from multicultural families was lower than that of children from ordinary Korean families(p<0.01). 3. The ratio of practice of oral health behaviors of mothers from multicultural families was lower than that of mothers from ordinary Korean families(p<0.01). Tooth brushing instructions were the most frequently carried out by multicultural mothers, which was followed by teaching the importance of oral health, restriction of carbohydrates, and dental check-ups. Significant correlations were not detected between mothers’oral health behaviors and children’s dental caries experiences(p>0.05).

The purpose of this study was to evaluate the attitude and knowledge level of a group of elementary school teachers in management of traumatic dental injury. The sample consisted of 231 elementary school teachers in Jeon-Buk province, and data was collected by means of a self-administered questionnaire. The questionnaire surveyed the teachers’general information, attitude on the dental trauma education, knowledge of management of tooth fracture, luxation, avulsion and tooth storage media. Only 15.2% of the teachers had received dental first aid treatment education, but 97% were favorable to receiving education. Although there were differences among the questions, insufficient knowledge and awareness of the management of traumatic dental injury were shown in the majority of teachers. It is recommended that education strategies and programs for improving the awareness of immediate management of traumatic dental injuries are necessary for elementary school teachers in Jeon-Buk province.

The aim of this in vitro study was to evaluate the effectiveness of experimental 2.26% fluoride-polyvinyl alcohol (F-PVA) tape in inhibition of enamel demineralization using enamel surface microhardness (SMH) analysis and scanning electron microscopy (SEM) examination. Enamel specimens (n=60) randomly assigned to four groups: control group, F-PVA tape group, fluoride varinish (F-varnish) group, casein phosphopeptide-amorphous calcium phosphate (CPP-ACFP) group. After topical application, pH-cycling was processed. Then, SMH was measured and the percentage loss of surface microhardness (%SML) was calculated. For the SEM examination, five sample specimens in each group were treated and the morphologic character was evaluated. After pH-cycling, the SMH values of the enamel specimens of F-PVA tape and F-varnish group were significantly higher than that of CPP-ACFP group, there was no significant difference between F-PVA tape and Fvarnish group. With SEM examination, enamel surfaces in the F-PVA tape group and F-varnish group showed numerous spherical and ovoid crystals formed on the enamel surface were also observed. The density of crystals was higher than that of both control group and CPP-ACFP group. F-PVA tape is effective in inhibition of enamel demineralization. Also, F-PVA tape’s inhibition of enamel demineralization is comparable to that of F-vanish and greater than that of CPP-ACFP.

The purpose of this study was to evaluate the accuracy and reproducibility of measuring the size of unerupted permanent tooth via cone beam computed tomography(CBCT). Ten children were scanned with dental CBCT,and 3-dimensional reconstruction of the dentitions were generated CBCT. Mesio-distal dimension and buccolingual dimension of the teeth were made directly on the model with a high-precision digitalcaliper and on the CBCT by using three-dimensional dental imaging software. Reliability and accuracy were assessed by using intraclass correlation and paired t-tests. (p<0.05)The results were as follows :1. Intraclass correlations were above 0.9 for Both the CBCT and the model measurements, showinghigh reliability. 2. Although there were high correlation values(r=0.91) between CBCT and model messurement methods,comparisons between the CBCT and model messurement methods showed a statistically significant difference(p<0.05). 3. The CBCT measurements tended to slightly underestimate by 0.2 mm. But, the systematic difference of CBCT measurements were clinically acceptable Therefore, CBCT measurement method can be used to measure the size of unerupted teeth in a sufficiently accurate way.

Whenever pediatric dentists choose the preformed stainless steel crowns for restoration of primary molars, we usually prefer the crown forms that most fit to the abutment teeth. Despite some previous reports on significant ethnic difference in the size and shape of tooth crowns in primary dentition, only the imported products have been available to date, which might show some discrepancy with tooth anatomy of Korean. However, a domestic product of preformed stainless steel crown has been marketed recently that is expected to show more accurate fit to the primary tooth of Korean. To investigate the morphological characteristics of primary molars of Korean children, their mesiodistal and buccolingual diameters from the dental casts of 263 children in Pusan and Kyungsangnamdo province were measured by digital calipers. The measured data were compared with those of the three types of preformed stainless steel crowns(3M ESPE Stainless Steel Primary Molar Crown, Kids Crown, Sankin Anatom Primary Crown) by statistical processes with regression analysis. The results were as follows:1. In every primary molar crown of three brands, the bucco-lingual width to mesio-distal width ratio (MD-BL ratio) showed higher values compared with those of natural teeth. 2. While the products of 3M ESPE and Shinhung showed similar features, those of Sankin showed some difference from both, and these difference was more marked in mandibular primary molars. 3. The nearer is the mesio-distal width of the crown to the average, the better was the adaptation of the preformed crown, and the reverse was true. 4. The teeth which revealed more discrepancy between preformed crown and natural tooth were upper and lower first primary molars.

The objective of this study was to assess the effect of salivary contamination on shear bond strength of pit and fissure sealant using several bonding agents by means of applying saliva at different stages of treatment. 56 teeth were randomly divided into one of seven groups (8 per group): (Group A, B) acid etching; (Group C,D, E) Adper^TM Single Bond after acid-etching; (Group F, G) Adper^TM Prompt L-pop. Saliva was applied to teeth surface of B, D, E, and G groups for 10 seconds. Especially, group D was contaminated after acid-etching and group E was contaminated with saliva after adhesive application. After light curing, all of the specimens were thermocycled and the shear bond strength tests were performed. The results were as follows. 1. In generally performed pit and fissure sealant group, shear bonding strength significantly differently reduced when was contaminated by saliva (p<0.05). However the group that was applied with bonding agent during pit and fissure sealant procedure, there were no significant differences in the kind of bonding agents nor the stage of contamination. 2. In group that was not contaminated by saliva during pit and fissure sealant treatment, Adper^TM Single Bond yielded the highest bonding strength but there were no significant differences. 3. The failure pattern on the debonded surfaces shows that most specimens from groups using bonding agents showed cohesive failures while most specimens from groups that didn’t use bonding agents showed adhesive failures.

Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney,brain and musculoskeletal system, and occurs predominantly in males. The patient with Lowe syndrome is characterized with congenital cataracts, glaucoma, prominent forehead, thin and sparse hair, mental and growth retardation, muscular hypotonia, renal dysfunction, and metabolic bone disease. We have experienced a 10-year-old boy with Lowe syndrome who had poor oral hygiene and trouble for teeth brushing. To manage his behavior and systemic metabolic disorder, sedation was performed during dental care. Excessive calculus formation in this patient is caused by both medication and lack of ability to maintain oral hygiene. The dental management of those patients has to be focused on prevention due to difficulties in dental treatment and dangers of general anesthesia for the Lowe syndrome.

Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. Dilacerations are estimated to occur in 3% of all permanent dentitions. However, the etiology of dilaceration is not yet fully understood. Traumatic injury to the deciduous predecessors and ectopic development of the tooth germ are the two commonly cited causes of this anomaly. The involved tooth is usually the maxillary central incisor and it also shows high prevalence of impaction. At first, We tried to do surgical exposure with orthodontic traction but to no avail. After then surgical repositioning of the dilacerated tooth was performed. Finally, Satisfactory results were obtained at the end of treatment,with improvement in dental esthetics and fuctional aspects.

In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases,regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also,platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.

Dens invaginatus is a developmental anomaly resulting in a deepening or invagination of the enamel organ into the dental papilla prior to calcification of the dental tissues. The most widely used classification of dens invaginatus is the system described by Oehler categorizes invaginations into three classes as determined by how far they extend radiographically from the crown into the root. Oehler’s classification type III is that the invagination extends through the root and communicates with the periodontal ligament. There is usually no communication with the pulp. In Type III lesions, any infection within the invagination can lead to an inflammatory response within the periodontal tissues giving rise to a‘ peri-invagination periodontitis’. In the cases presented here, we treated two patients who were refered for ‘peri-invagination periodontitis’on maxillary lateral incisor with Oehler’s type III invagination by different approaches each, and they have shown satisfactory outcomes. Although there are several approaches to the management of dens invaginatus, the most important objective is to preserve the health of the pulp, which can be achieved by early diagnosis and the prophylactic treatment regardless of severity. When disease has developed, decision has to be made whether to treat the invagination and the pulp separately.

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia,cold compression and adequate medication shoud be done.

Revacularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revasculization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also,when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline,was applied on the immature first permanent molar infected by caries.

Although the stainless steel crowns have been recognized as the most effective and durable form of restoration for primary molars, they have been regarded by many dentists as having definite demerits such as invasive nature of procedural complexity and behavioral aspects of children. As an alternative to conventional technique of stainless steel crown restoration, the Hall technique was first introduced in 1988, which is characterized by just pushing the pre-contoured, cement filled crown form onto the abutment molar with no local anesthesia, no caries removal, no tooth preparation. According to several reports,this can slow, arrest, or even reverse the progress of caries. In addition, its atraumatic feature gives less discomfort and stress to children than conventional one, which is thought excellent especially in younger children. Also, It has been reported to be effective and acceptable to dentist, child patients and their parents. In this case study, three children with age of 4 years 5 months, 4 years 10 months, 6 years 4 months were treated with stainless steel crowns using Hall technique on first primary molar respectively. The teeth were free from pulpal, periapical pathology. After follow up of about 3 to 6 months period, the results showed clinically successful outcomes without any marked complication in pulp, tooth or soft tissue till now. But, it should be kept in mind that this technique is not proper to every child, every carious molar, or every dentist. Thorough distinction of indicated cases and continuous follow-up check is highly required. Conclusively, Hall technique might be an effective and realistic minimally invasive alternative for the carious primary molars especially in younger or disabled children, despite potential doubts on its efficacy and some definite limitations.

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the pat-terns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized,in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally,as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future-oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.