KJC Korea
Journal Central

The aim of this study is to compare the differences of the demineralization resistance of resin infiltration and 1.23% acidulated phosphate fluoride in bovine teeth with artificial caries. We applied 1.23% Acidulated phosphate fluoride (APF) gel and Icon® caries infiltrant on the artificial bovine enamel carious lesion and then demineralized all samples. The depth of demineralization was measured by using Confocal Laser Scanning Microscope (CLSM) and observed the roughness and irregularity of the enamel was observed by Scanning Electron Microscope (SEM). In this experiment with demineralization resistance on smooth artificial carious lesion, less depth of demineralization, roughness, and irregularity of enamel was observed in APF gel and Icon® group than in the control group. There was no significant difference between the depth of demineralization of 1.23% APF gel and Icon® caries infiltrant group. However, resin infiltration is beneficial as less roughness and irregularity was observed on the enamel surface than when 1.23% APF gel is applied.

The aim of this study was to understand the roles of Sonic Hedgehog (SHH) signaling during tooth root and periodontium formation. In this study, we generated the dental mesenchyme-specific Smoothened (Smo) activated/ inactivated mice with the activity of Cre recombinase under the control of osteocalcin promoter. In the Smo activated mutant molar sections at the postnatal 28 days, we found extremely thin root dentin and widened pulp chamber. Picrosirius red staining showed loosely arranged fibers in the periodontal space and decreased cellular cementum with some root resorption. Immunohistochemical staining showed less localization of matrix proteins such as Bsp, Dmp1, Pstn, and Ank in the cementum, periodontal ligament, and/or cementoblast. In the Smo inactivated mutant mouse, there was not any remarkable differences in the localization of these matrix proteins compared with the wild type. These findings suggest that adequate suppressing regulation of SHH signaling is required in the development of tooth root and periodontium.

Sedation is a useful behavior management technique for dental patients who may be uncontrollable or have medical problems. The aim of this study is to investigate the changes in patterns of sedative treatments in pediatric dentistry by analyzing the distribution of patients and used sedative agents. Patients and sedative agents were reviewed based on the electronic medical records (EMR) of the department of pediatric dentistry in Yonsei University Dental Hospital from 2011 to 2016. The number of patients who were treated under sedation generally increased. Male received more sedation treatment than female by 2014, and they became similar from 2015. The treatment percentage of patients with systemic disease decreased in 2013, remained constantly afterwards. The ratio of sedative treatment for the age 4 - 5 and age 6 - 10 generally increased, while that of the age 0 - 2 and older than age 11 decreased. The ratio of the age 3 remained steady. Nitrous oxide was the most frequently used sedative agent. The use of benzodiazepine increased while the use of chloral hydrate decreased. Although the use of sedation has expanded, multidimensional approaches for ensuring safety have been less focused. Therefore, it is necessary to explore further studies for the safety and efficacy of the use of sedation.

The purpose of this study was to compare the validity of Cariview®, a new colorimetric caries activity test, with CRT® bacteria, a conventional bacterial culture method. In addition, this study assesses the correlation between the dental caries experience and activity between mothers and their children. 34 pairs of mothers and their children under the age of 6 years participated in this study with informed consent. After filling out a questionnaire and oral examination, the two caries activity tests above were performed on each subject. In the results, Cariview® scores were statistically significant with children’s caries experience (r = 0.598, p < 0.01) and showed higher correlation than CRT® bacteria scores. Cariview® scores showed statistically significant correlation with the number of decayed teeth in both mothers and children (p < 0.05). In both Cariview® and CRT® bacteria tests, there was no statistically significant correlation between caries experience and caries activity (p > 0.05). Cariview® colorimetric test will be clinically useful for predicting future caries risk and establishing a preventative strategy in pediatric dentistry.

Behavior management of the child constitutes an important part of pediatric dentistry. The majority of children can be treated with adequate behavior management. However, some children who have extensive dental problems or mental, physical disabilities cannot cooperate. So, the need for general anesthesia as a special method of behavior management has increased recently. This study analyzes the records of patients who received dental treatment under general anesthesia. The 1378 cases of 1322 patients under 18 years of age, who received dental treatment under general anesthesia in department of pediatric dentistry at the Seoul National University dental hospital, from October, 2011 to December, 2015 were included. In this study, male (60.9%) was more than female (39.1%). The mean age of patients was 5.9 years and age from 5 to 9 years was the most frequent (56.0%). The primary dental treatment which patients received was dental caries treatment (51.1%), followed by surgical treatment (42.2%). The dental treatment under general anesthesia has many advantages including of performing a lot of treatments at once, producing good quality of treatment, and reducing the number of visits. General anesthesia may be a useful method of behavior management.

Resin infiltration has been used as a treatment option for the management of early caries lesions recently. However, the etching procedure with hydrochloric acid might be somewhat stressful for the clinicians due to safety problem especially for young children, leading to less utility. This study aims at searching for some alternative surface pretreatment methods of resin infiltration for the early caries lesions in primary anterior teeth by comparing penetration depth of various methods. No significant difference was found in penetration ratio between etched surface with 15% hydrochloric acid and 35% phosphoric acid. However, the penetration ratio was significantly higher in groups pretreated either with dental pumice or abrasive metal strip (p < .05). By the result of this study, etching with phosphoric acid as an alternative of hydrochloric acid was thought clinically acceptable as a pretreatment method for resin infiltration in early caries lesions for primary anterior teeth. It was notable that surface conditioning with dental pumice or metal strip before etching was effective in increasing the penetration. This procedural modification might be much more correspondent with minimally invasive concept and hopefully contribute to increased safety and utility in pediatric dentistry.

The objective of this study was to compare the shear bonding strength of zirconia after cleaning the crown contaminated by saliva or blood and determine the effect of thermocycling. 180 specimens were embedded in acrylic resin. 20 Specimens in the positive control group were bonded with resin cement without contamination. 20 Specimens in the negative control group were washed with water for 20 seconds and then dried for 10 seconds. 120 Specimens contaminated by saliva or blood were cleaned by using three cleaning methods: 37% phosphoric acid gel, commercial cleanse, and 2.5% NaOCl. All samples were bonded with resin cement and divided into two subgroups: One was not aged, and the other was tested with 30,000 thermocycling. In both groups contamination by saliva and blood, no statistically significant difference was not found in control, groups cleansed by commercial cleanser and 2.5% NaOCl. When the groups cleansed with water and 37% phosphate gel were compared with the control, significantly low shear bond strength was shown. Thermocycling group showed statistically significantly low shear bond stress compared to the groups without thermocycling. When zirconia was contaminated by saliva or blood, its original shear bond strength could be obtained if it was cleaned with commercial cleanser or 2.5% NaOCl.

The purpose of this study is to analyze the cariogenicity of vitamin supplements for children by the Caries Potentiality Index (CPI), pH drop capacity, proliferation rate of Streptococcus mutans . Four vitamin supplements were selected - Noma (NM), Cenovis Kids (CK), Animal Parade (AP), and Character Vitamin (CV). CPI value decreased in the order of AP, CV, CK, and NM. Initial values of all experimental groups showed acidity below pH 7.0. Analysis of the colony forming units of Streptococcus mutans showed that NM and CV resulted a higher proliferation rate (p < 0.05) than CK and AP (p < 0.05). Bacterial activity of the control group was lower than other groups when observed with a confocal laser scanning microscope. Considering the bacterial activity and acidity of vitamin supplements, it is necessary to pay close attention when children taken the vitamin supplements for their oral health.

Root resorption of the permanent maxillary incisors can occur due to ectopic eruption of the permanent canines. Severe root resorption threatens the long-term survival of the affected incisors. The aim of the present study was to identify risk factors for root resorption of the maxillary incisors associated with impacted maxillary canines. In the present study, we retrospectively analyzed the Cone-Beam Computed Tomography (CBCT) scans of 65 children and adolescents with ectopically erupting maxillary canines (total of 88 impacted canines). Root resorption of central incisors was significantly associated with the mesiodistal position and root development of the adjacent canine. Root resorption of lateral incisors was significantly associated with sex, age, and the buccolingual and vertical position of the adjacent canine. However, enlargement of the dental follicle was not significantly associated with root resorption of adjacent incisors. Although incisor resorption is difficult to diagnose and predict, our findings suggest that changes in the dental follicles of the erupting maxillary canines do not cause resorption of the adjacent permanent incisors. CBCT should be utilized to ensure early diagnosis of impacted canines and precise evaluation of incisor root resorption.

The practice pattern of pediatric dentistry has been changing for the last several decades. This change might be influenced by several factors such as development in dental materials and socioeconomic changes. The purpose of this study was to analyze the changing trends of patient distribution and treatment pattern of pediatric dentistry. Patient distribution and practice trends from 2006 to 2015 at the department of pediatric dentistry of Seoul National University Dental Hospital were reviewed. From 2006 to 2015, the proportion of new patient increased from 12.49% to 20.56%. The average age of new patients decreased. In 2006, restorative treatment had highest percentage, followed by preventive treatment, orthodontic treatment, surgical treatment, and pulp treatment. In 2015, preventive treatment had highest percentage, followed by restorative treatment, orthodontic treatment, surgical treatment and pulp treatment Frequency of general anesthesia increased more than 5 times for last 10 years. The proportion of insurance treatment decreased until 2009, and after 2010 it increased steadily.

The purpose of this study was to analyze the ratio and rate of apical closure when inducing root growth of necrotic immature permanent teeth using alternative triple antibiotics. 24 permanent teeth in the treatment group and 27 premolars in the control group were retrospectively studied using periapical radiographs for more than 300 days after the first visit. The difference in the growth rate between the two groups was statistically compared using the Mann- Whitney test at a significance level of 0.05. There were no statistically significant differences between the two groups in the first month and during months 1 - 3, 3 - 6, and 6 - 12. After 12 months, the cumulative rate of decrease in the apical foramen width in the treatment group was 50.59% and that in the control group was 71.82%, which revealed a significant difference between the two groups. There were significant differences in the rates of decrease in the apical foramen width after 3, 6 months, and later period in the treatment group, respectively. The cumulative rate of increase in the root dentin area presented no statistically significant differences between the treatment group and control group during the entire period of examination.

In this study, total fluoride (TF) in commercial toothpastes for children in Korea was evaluated and compared with the fluoride concentration declared by the manufacturer (Declared F). Additionally, total soluble fluoride (TSF) was evaluated and compared with TF. Ten toothpastes were coded with letters to allow blind analysis. For evaluation of TF, each toothpaste was homogenized in deionized water. For evaluation of TSF, each toothpaste was centrifuged and then, the supernatant of the sample was evaluated. Fluoride concentrations were assessed using a fluoride electrode coupled to an ion analyzer. Only one toothpaste showed lower TF concentration than Declared F. In all toothpastes, TSF was similar to the TF.

The purpose of this study is to compare the properties of dental pulp and periodontal ligament stem cells from extracted supernumerary teeth by quantitative real-time PCR. Impacted supernumerary teeth in the maxillary anterior region were extracted. Dental pulp and periodontal ligament cells were collected from extracted supernumerary teeth on the same day. After isolation and culture of cells, compare characterization of them by using qRT-PCR. Primer sequences for odontoblasts are ONT, ALP, OCN, DMP-1 and DSPP. On dental pulp group, ONT has the largest quantity of gene expression, followed by OCN, ALP, DMP-1 and DSPP. On periodontal ligament group, ONT has the largest quantity of gene expression, followed by OCN, ALP, DSPP and DMP- 1. Analysis of quantitative gene expression data using relative quantification showed that the expression of all genes decreased in periodontal ligament cells. Dental pulp and periodontal ligament stem cells from supernumerary teeth have the properties of odontoblasts. Considering that properties, supernumerary teeth were considered a useful donor site of dental pulp and periodontal ligament stem cells.

Dental avulsion, defined as the complete displacement of a tooth from the alveolar bone with consequent loss of the blood and nerve supply, was reported as one of the most severe dental injuries. Avulsion can cause tissue ischemia, which leads to pulp necrosis. Apexification is a conventional treatment method that induces an apical calcified barrier in immature roots with pulp necrosis. However, root development characterized by an increase in the root thickness and length cannot be achieved by apexification. The purpose of this case report was to describe the radiographic and clinical outcomes of regenerative endodontic treatment for the avulsed and necrosed permanent tooth with an immature root after replantation in a 5-year-old girl; the treatment was performed using a mixture of ciprofloxacin, metronidazole and cefaclor, CollaTape and Biodentine.

Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span. A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oralrehabilitation with a removable partial denture was initiated. Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development. Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.