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Journal Central

Previous studies to elucidate the etiology of cyclosporine(Cs)-induced gingival overgrowth in children have not completely excluded all factors that may cause differences among individuals. This study examined the effect of cyclosporine on the metabolism of type 1 collagen(CoL-I) in experimental models that controlled the effects of biological variations on individuals. Five 5-week-old male Sprague-Dawley rats were administered Cs by gastric feeding for 6 weeks. Gingival specimens were harvested from the mandibular posterior area before beginning Cs administration and at 2, 4, and 6 weeks thereafter. Gingival fibroblasts were cultured from all the 20 biopsies collected from the gingiva. Half of the fibroblasts collected prior to the Cs administration were designated as Control. The other half of the fibroblasts were treated with Cs in vitro and called in vitro test group(Tt). The fibroblasts collected 2, 4, and 6 weeks after the Cs administration were called in vivo test groups : T2, T4, T6, respectively. Immunofluorescence microscopy was used to detect CoL-I in all the fibroblasts. CoL-I was analyzed at both the gene and protein expression levels by real-time polymerase chain reaction and western blotting. Changes in CoL-I before and after Cs treatment were evaluated from the gingiva of each rat. There was no significant difference in gene expression of CoL-I in the control and test groups. CoL-I protein expression levels of fibroblasts increased in in vitro Cs treatment for each individual, and also increased in in vivo Cs treatment. In this study, the experimental method that control biological variations that can occur due to differences among individuals was useful. Subsequent studies on other factors besides CoL-I and in-depth studies in humans are needed.

This study aimed to investigate the effects of learning with role-playing on student satisfaction and achievement regarding behavior management teaching in pediatric dentistry. 93 students were divided into 19 groups and randomly assigned to role-play as a doctor, patient, parent, assistant, or narrator. Their performances were evaluated by the instructor and the satisfaction survey was conducted. All participants took the written test and were asked to compare lecture and role-playing with regard to the effectiveness of learning. Statistical analysis was performed with Mann-Whitney U test, Independent T-test, and Kruskal-Wallis test. 68 students (73.1%) who believed that the role-playing was more helpful than lecture showed higher level of satisfaction than students who believed lecture was more helpful. But there were no differences in the tutor evaluation score and the written test scores. Participants in the patient management scenario showed higher level of descriptive question scores of the written test and tutor evaluation score than those who participate in the parent management scenario. There were no differences between the role groups. Role-playing may help students to become more interested and participatory in learning behavior management. The level of satisfaction may differ by the design and content of the scenario.

This study aimed to evaluate surface morphology and resin tag penetration of resin infiltration into primary anterior teeth after enamel deproteinization with sodium hypochlorite (NaOCl) prior to phosphoric acid (H3PO4) etching. Ninety primary anterior teeth with non-cavitated caries lesion were devided five groups according to enamel pretreatment as follows, group Ⅰ-15% hydrochloric acid (HCl) 2min. ; group Ⅱ-5.25% NaOCl 1min., 35% H3PO4 1min. ; group Ⅲ-5.25% NaOCl 2min., 35% H3PO4 1min. ; group Ⅳ-5.25% NaOCl 1min., 35% H3PO4 2min. ; group Ⅴ-5.25% NaOCl 2min., 35% H3PO4 2min. Fifteen teeth were examined etched surface structure using field emission-scanning electron microscope. Seventy five teeth were infiltrated with resin, maximum penetration depth and percentage penetration were analysed using dual fluorescence confocal microscopy. As the application time of NaOCl increased, ratio of enamel type Ⅰ, Ⅱ were increased. Percentage penetration (PP) was higher in group Ⅴ than group Ⅱ, Ⅲ (p < 0.05). PP of group Ⅳ, Ⅴ did not show any differences. Non-cavitated caries of primary anterior teeth can be treated with resin infiltration. Enamel deproteinization with NaOCl prior to 35% H3PO4 etching could be an alternative of 15% HCl etching in resin infiltration.

The aim of this study was to evaluate the effect of etching time and bonding agents on bond strength of sealant applied to the occlusal surface of primary molars. Forty non-carious exfoliated human primary molars were included in the study. The teeth were randomly divided into 4 groups for measurement. For group Ⅰ, no acid etching treatment was used. For group Ⅱ, Ⅲ, and Ⅳ, acid etching gels were applied on the occlusal surface for 15, 30, and 60 seconds, respectively. Each group was divided into 2 subgroups; one group was treated with bonding agents on the enamel while the other was not. Microtensile bond strength was evaluated using a universal testing machine. There were no statistically significant differences in bond strength with varying duration of etching among groups. The results revealed that the use of bonding agents prior to application of fissure sealant increased the bond strength(p ＜ 0.05). It could be concluded that etching time greater than 15 seconds does not significantly enhance the bond strength, but the use of bonding agents as an intermediate layer between the primary molar and fissure sealant would be beneficial in increasing the bond strength.

The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.

The aim of this study was to evaluate the shear bond strength of three luting cements and to identify the effect of thermocycling. Zirconia discs were made similar to the inner surface of a preformed pediatric zirconia crown (NuSmile® ZR crown: ZRCr). The similarity between the zirconia discs and the inner surface of a ZRCr was confirmed by scanning electron microscope. Three luting cements were KetacTM Cem Permanent Glass Ionomer Luting Cement (KGI), RelyXTM Luting Plus Cement (RLP), RelyXTM Unicem Self-Adhesive Universal Resin Cement (RUR). Three luting cements were bonded according to the manufacturer's instructions for 60 zirconia discs and 60 dentin of primary teeth. Total of 120 specimens were divided into two subgroups: One was not aged, and the other was tested with 5500 thermocycling. Shear bond strength was measured using a universal testing machine, and the fracture patterns were observed with SEM. On the zirconia discs and the dentin of primary teeth, shear bond strength of RUR was higher than that of KGI and RLP, and there were statistically significant differences by cement type. The shear bond strength differences for RUR were not statistically significant depending on thermocycling.

Children need regularly dental check-ups after dental treatment because there are a lot of changes of oral conditions such as tooth exfoliation and eruption, occlusion, and recurrence of dental caries. The purpose of this study is to determine the factors that affect the follow-up pattern after dental treatment under conscious sedation. Patients who were treated under sedation at the department of pediatric dentistry of Ewha Womans University Mokdong Hospital from 2009 to 2013 were included in this study. The final samples comprised of 562 patients that were classified into 4 groups according to the number of visits during 3 years. The chi-square test was used to determine the factors affecting regular follow-up. There were statistically significant differences between each treatment groups and factors such as the change of doctor, overall treatment time, the number of treated teeth under sedation, restorative treatment, minor operation, and preventive treatment (p < 0.05). This study identified factors that affect regular follow-up after dental treatment under conscious sedation. It is recommended to educate the importance of regular check-ups to parents who are less likely to return.

The purpose of this study was to investigate the cause of eruption disturbance in the maxillary central incisor and establish the effective treatment plan by analyzing the vertical distance, angulation of long axis and root development of the tooth with eruption disturbance using the cone-beam CT. The average age of 134 patients diagnosed with unilaterally impacted maxillary central incisor was 7.9 years old and the male was 2.1 times higher than the female. The most common cause of eruption disorder was physical obstruction, especially mesiodens and odontoma. Of the teeth with unilateral eruption disorder, 78 cases erupted spontaneously and 56 cases erupted non-spontaneously after removal of physical obstruction. The possibility of spontaneous or non-spontaneous eruption in the unilaterally impacted maxillary central incisor depended on several factors, such as vertical distance, angulation of long axis and root development of unerupted tooth. The spontaneous eruption of the impacted maxillary cental incisor was most frequent at the angulation of long axis of 50 to 90 degrees, which is similar to the angulation of long axis of the normally erupted maxillary central incisor. In addition, the spontaneous eruption period of impacted maxillary central incisor was more influenced by the vertical distance than the angulation of long axis and the root development. Most of the teeth that showed non-spontaneous eruption had orthodontic traction, and these teeth were usually erupted within about 12 months. The period treated with orthodontic traction was no statistical significance with the vertical distance, the angulation of long axis, and the root development. This study will provide information on the cause of unilaterally impacted maxillary cental incisor and help to establish the future treatment plan.

The purposes of this study were to evaluate microleakage of Biodentine, one of the tricalcium silicate based pulpcapping materials, and to compare the shear bond strength between composite resin and Biodentine with different setting times. For microleakage evaluation, 70 bovine teeth were used. Cavities were formed on the labial surfaces and filled with Biodentine. The teeth were divided into seven groups, each consisting of 10 teeth. The specimens were prepared by applying the composite resin on the upper side after different setting times. To evaluate shear bond strength, 210 acrylic resin blocks with central grooves were prepared, and the grooves were filled with Biodentine. The acrylic resin blocks were divided into seven groups of 30 specimens each, and the specimens were prepared by applying the composite resin on the upper side after different setting times. In samples with setting time of 24 hours or longer period, the microleakage between composite resin and Biodentine was reduced significantly while the shear bond strength increased to offset the polymerization shrinkage of the composite resin. Setting Biodentine for more than 24 hours before composite resin restoration would lead to more favorable clinical result.

Periogen is a new caries activity test using real-time polymerase chain reaction. The aim of this study was to assess the validity of Periogen by evaluating the correlation with dmft, dmfts indices and comparing with Cariview and caries risk assessment tool (CAT). 83 children under 6 participated in this study. Dmft, dmfts indices and CAT were collected through an examination of oral health status. Plaque samples for Periogen and Cariview were collected and manipulated according to the manufactures’ instructions. The correlation coefficient of Periogen, Cariview and CAT with the dmfts index were 0.38, 0.56 and 0.66 in each (p < 0.01). The sensitivity of Periogen, Cariview and CAT were 43%, 76% and 95% and specificity were 80%, 72% and 74% respectively. Area under curve under the receiver operating characteristic curves in each method indicated 0.69, 0.81 and 0.85. CAT and Cariview were more effective in evaluation the risk of dental caries than Periogen so far. To be used Periogen clinically, more improvements for higher validity were needed.

A salivary testing instrument has an advantage that the method is simple and can be performed in a short time. However, it is necessary to verify the factors that affect the reliability of the result, because the device is easy to use and even saliva collection is simple. The aim of this study was to compare the difference of the test results according to the measurement time in order to analyze the time factor of the external variable among the factors that may affect the measurement results of the salivary testing instrument. The relationship between the measured values of the salivary testing instrument to identify the internal variables was analyzed. Saliva was collected from 20 randomly selected patients regardless of age, sex, or diseases. The mean age was 46.6 years, 10 males and 10 females. The saliva collected was directly measured with the salivary testing instrument as group I. The saliva samples were placed in air in a paper cup for 10 minutes, and then measured as group III. Then group I was remeasured after 30 minutes and assigned as group II. Group III was remeasured after 30 minutes and called as group IV. As a result, all of the cariogenic bacteria, acidity, buffer capacity, blood, leukocyte, protein and ammonia, except buffer capacity, showed statistically significant changes in group II and IV. This means that the reliability of the test results is poor if the measurement time is not observed. Cariogenic bacteria were correlated with leukocyte and protein, buffer capacity was related to acidity, protein, and protein was related to buffer capacity and leukocyte. In conclusion, the result according to the measurement time as the external variable was different, which means that time must be strictly monitored when testing saliva. It is also necessary to take into account the relevance of the correlations between the internal variables and the clinical data.

Although the frequency of composite resin restoration in children is gradually increasing, there are insufficient researches about the rate of composite resin repair in children. The purpose of this study was to evaluate the repair rate of composite resin restorations in the permanent first molar in children under 12 years old. This study retrospectively analyzed 169 children treated with composite resin restoration in the permanent first molar from May 2014 to April 2015. According to the location of the tooth, the repair rate was higher in the mandible than maxilla and in the left than right. In the classification of restoration, the repair rate was the highest in the class II cavity, and the repair rate was the lowest in the restoration of the occlusal surface only. Repair rate in two years was 14.8%, and repair hazard ratio decreased with age. The most common reason of composite resin restoration replacement was the secondary caries (74.1%). Within the limits of study, the repair rate of children was higher than that of adult due to the characteristics of children. Therefore, dentists should understand these characteristics and try to reduce the repair rate of composite resin composite restorations.

Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

Turner syndrome (TS) is a chromosomal disorder caused by monosomy of the X chromosome, with complete or partial absence of the second sex chromosome. Anomalies of root morphology have been found to occur more often in patients with TS, which make endodontic treatment challenging and requires special handling. The patients with TS may also have systematic problems such as cardiac or renal malformations, so in treating these patients it is important for clinicians not only to be aware of the characteristic intraoral findings, but also to make the patients have regular dental check-ups to prevent oral complications in advance. An 12-year-old girl who had been diagnosed with TS at the age of 10 years was referred due to discomfort in the bilateral mandibular premolar regions. Dens evaginatus and taurodontism were detected in all the mandibular premolars characteristically. The bilateral mandibular first premolars had three roots and the bilateral mandibular second premolars had periapical lesion with two roots. Due to the complexity of the root canal anatomy, root canal treatment were completed with a dental microscope to ensure adequate visualization. After 2 years of regular follow-up examinations, there were no clinical sign or symptom associated with the teeth, and no periapical lesion, was found. This case report describes the characteristic oral features and dental management of TS patients.

The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.