KJC Korea
Journal Central

Dental erosion is a complex disease of multifactorial etiology with high risk of loss of tooth structure, which still has not been appropriate interest. The aim of this study was to assess the prevalence and risk indicators of dental erosion in Korean school children. A cross-sectional survey was performed on 664 children aged 8~9 years. Data concerning gender, types of caregiver, dietary habits, oral hygiene habits and parental knowledge were obtained from a questionnaire,which was answered by the parents of the children. Association between erosion and the factors were statistically analyzed with chi-squared test and independent t-test at a significance level of 0.05. Dental erosion was present in 242 children. In carbonated drinks, dental erosion was significantly associated with preference, frequency of consumption and the ingestion method (p ＜ 0.05). In fruit juices, dental erosion was significantly associated with preference and frequency of consumption (p ＜ 0.05), but no significant associations were found with the ingestion method (p ＞ 0.05). There were no significant associations between dental erosion and gender, type of caregiver, oral hygiene habits and parental knowledge (p ＞ 0.05). In conclusion, it was considered that motivation to be followed by practice is important as well as education for prevention of dental erosion.

The prevalence and interest of dental erosion seems to be rising in children all over the world. Thus, This study was performed to investigate the prevalence and severity of dental erosion in the primary molars at terminal stage nearing exfoliation, and associated risk factors. An examination was performed on 788 children using modified Linkosalo & Markkanen system, and questionnaires were gained. Association between dental erosion and the risk factors were statistically analyzed with chi-squared test and logistic regression analysis at a significance level of p < 0.05. As a result, 213 children (27%) showed dental erosion, and the mandibular left first primary molar was the most influenced tooth. According to the analysis of risk factors, frequent intake of carbonated drinks and fruit juices showed significant development of erosion (p <0.05), and using straw for drinking fruit juices showed significant a reduction of erosion (p < 0.05)

In growing children it is frequently found that dental maturation is strongly influenced by the growth rate of maxilla or mandible. If there is evidence to prove this, it might be utilized as a criterion in the early diagnosis of skeletal malocclusion, even before the object's real skeletal features are yet revealed. The purpose of this study was to find out if the difference of dental maturation in over-grown mandible in children with skeletal Class III has any relationship with some skeletal features of mandible. 50 patients in Hellman dental age IIIA with normal occlusion and Class III malocclusion of mandibular overgrowth type respectively were selected as study objects. The age estimation was performed on maxillary and mandibular teeth, eruption rate of the 2nd molars of each group have been measured on panoramic radiography,and the differences in dental age of the upper and lower jaw were analyzed under Demirijian's method. The results were as follows:The difference of dental age of maxillary and mandibular teeth between the two groups was 0.66 and 1.20years respectively, with a higher difference in the experimental group (p < 0.05). The difference of eruption rate of the maxillary and mandibular second molar was not found between two group (p >0.05).

General anesthesia or sedation is an essential for a successful dental treatment for the disabled. The aim of this study is to assess the patients who had dental management under general anesthesia or sedation at Chungnam dental clinic for the disabled, who received dental treatment under general anesthesia, sevoflurane sedation and intravenous sedation from January, 2011 to September 2012. Of the 426 patients studied, 389patients received dental care under general anesthesia, 20 patients received dental care under sevoflurane sedation and 17 patients received dental care under intravenous sedation. The Rate of general anesthesia was higher than that of sevoflurane sedation, intravenous sedation. Sevoflurane sedation is a useful method for short time treatment such as traumatic pediatric patients. Intravenous sedation is an option for patients who had anxiety and fear such as dentally disabled patients. Sevoflurane or intravenous sedation not only gradually reduces the use of general anesthesia but also useful methods themselves for the dentally disabled.

Maxillary canines are the most commonly impacted or ectopically erupted teeth. If we find the abnormality of maxillary canines early, we can manage it reasonably and systematically. If we cannot see the spontaneous normalization at the periodic recall, primary canine extraction will be the next treatment choice. However, if the primary canine is extracted too early, the extraction socket will be filled with hard bone and then the eruption pathway can be locked. So it is more beneficial to extract the primary canine at the period about 6 months before the normal canine eruption time. The next treatment plan can be surgical and orthodontic approaches before the root apical closure of the impacted canine. Sometimes, surgical extraction and further prosthetic procedure can be needed for a severely malposed impacted canine or badly resorpted incisor. This is the case of the idiopathic mesial movement of impacted maxillary canines.

Ectopic eruption of the first permanent molar is an abnormal positioning of this tooth, causing a premature resorption of the distal surface of the second primary molar. It occurs in approximately 3~4% of the population and the maxillary arch is usually affected. While 66% of ectopically erupting permanent molars are corrected spontaneously without treatment (i.e. a reversible type), active treatment is necessary for irreversible ectopic eruption cases. The treatment modalities have been divided into two categories: interproximal wedging and distal tipping. Interproximal wedging is indicated for minimal impaction and when the impaction is severe, distal tipping techniques are required. Although much has been written about treatment modalities on unilateral ectopic eruption of the first permanent molar, few reports mention bilateral ectopic eruption cases. In this report, two cases of bilateral ectopic eruption of the first permanent molars in young patients are presented. We describe the use of a modified bilateral Halterman appliance for correction of these cases and the clinical results were satisfactory.

In an intra-alveolar root fracture (IARF) of a primary tooth with severe mobility and displacement , extraction and periodic-follow-up is the choice of recommended treatments because of the fear of aspiration of the mobile tooth and the possibility of damage in the permanent succeeding tooth. However, repositioning and splinting are presented as a fresh proposal recently. In case of extracting a primary incisor, many problems occur; esthetic problems; functional problems such as pronunciation and mastication; space loss; and psychological and social problems. Therefore, the best treatment is conservation of the primary tooth. The aim of this report was to suggest the conservative treatment of an Intra-alveolar root fracture of the primary central incisors with severe mobility and displacement based on two cases that describe the diagnoses,treatments and follow-ups (mean period: 27-month). All cases have been treated by reduction and immobilization by resin wire splint (RWS) (mean period: 6-week). Both cases were followed up until the successors were erupted. There have been no complications such as pain, pulp necrosis, periapical lesion, displacement of permanent tooth germ, eruption disturbance and etc.

The term‘ triple tooth’is used to describe a rare dental abnormality in which three teeth appear to be joined. The literature contains many reports of joined primary teeth; most cases have involved, however, the joining of two teeth, and only rarely three teeth. Triple tooth has clinical problems such as dental caries, esthetic problems,malocclusions, and periodontal problems. Therefore, it may require multi-disciplinary approach. The present study describes rare case of triple tooth between maxillary primary central and lateral incisors and a supernumerary tooth. An one-year, eleven-month old girl was seen for evaluation of swelling in the labial gingiva above a right maxillary triple tooth. She experienced traumatic dental injury in that area three weeks ago. Intraoral examination revealed an abscess and fistula in the region of the triple tooth. A radiographic examination showed that right lateral incisor was missing. Endodontic treatment and composite resin restoration was performed on the triple tooth. After follow-ups of 7 months period, there were no marked complications.

Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol 3~3.5 μg/mL. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.

Early childhood caries prevalence has increased significantly in children ages 2~5 years. ECC disproportionately affects lower socioeconomic and minority groups, is a predictor for future decay, but is preventable and manageable. Caries risk assessment systematically derives a patient’s caries risk and is important during an infant oral health visit beginning at age 1. Information obtained through a risk assessment can guide a disease management care path tailored to an individual’s age and risk to effectively treat and manage one’s caries disease process.