Diagnostic predictability of self-reported questionnaire for periodontitis / 대한구강보건학회지

OBJECTIVES: The present study aimed to evaluate the validity of a set of self-reported questionnaires for periodontitis for estimating the prevalence of chronic adult periodontitis in the Korean population. METHODS: The questionnaire is comprised of a total of 14 questions with four summarized concepts including self-diagnosis of oral status, subjective signs related to oral health, smoking and drinking status, and use of auxiliary oral hygiene devices including scaling. The predictiveness of the measures from these self-reported questions was assessed by logistic regression modeling using receiver operating characteristic (ROC) statistics, sensitivity, and specificity. RESULTS: The sensitivity, specificity, and AUC including all questions were 0.571, 0.768, and 0.781, respectively; the sum of sensitivity and specificity was 1.34. To gain robustness, a simplified predictive model was built with six questions. Its results were 0.536, 0.817, and 0.762 for sensitivity, specificity, and AUC, respectively. The sum of sensitivity and specificity was found to be 1.35. CONCLUSIONS: The self-reported questionnaire for periodontitis showed considerable validity, but further study is required to provide optimal validity and predictability.

Comparing the efficacy of a high pressure spray oral hygiene appliance and a sonic vibration toothbrush in reducing dental plaque / 대한구강보건학회지

OBJECTIVES: This study aims to compare home care dental devices for their dental plaque removal ability. METHODS: A single blinded randomized crossover clinical study design was used to measure plaque index (Turesky Modification Quigley-Hein Plaque Index). RESULTS: All 3 groups showed a statistically significant decrease in the plaque index after usage (P<0.001). In manual tooth-brushing group, the teeth on the right dental arch showed a greater decrease in the plaque index than on the left arch (P=0.041). All appliances showed greater plaque reduction in the upper right posterior teeth than in the lower right posterior teeth (P=0.009, 0.004, 0.007). CONCLUSIONS: The results of this study support development of more effective oral hygiene appliances and emphasis on oral hygienic education.

A change in the regional disparity based on the national insurance coverage of dental sealant in Korea / 대한구강보건학회지

OBJECTIVES: In 2002, the Ministry of Health and Welfare initiated a national sealant program (NSP) in public health centers in order to promote oral health among children in rural areas as well as among children with low socio-economic status in urban areas. However, this program was terminated in 2009 and substituted with the national insurance coverage of sealants (NICS). The aim of this study is to evaluate the impact of the change from NSP to NICS on regional inequality. METHODS: Based on data obtained from the 2010 and 2012 Korea National Oral Health surveys conducted, we analyzed the average number of permanent teeth with sealants (mean sealant) on the first molars and the prevalence of active dental caries in permanent teeth (D rate), segregated by region, in 8-year-old children. Analyses were performed using SPSS 21.0 (SPSS Inc., Chicago, IL, USA) after taking into consideration the complex design of the samples. RESULTS: The D rate of rural children was higher than that of those in metropolitan and city areas. Compared to the 2010 data on the mean sealants on the first molars, a 14.4% and 48.1% increase was observed in the mean sealants in children in the metropolis and in cities in 2012, respectively. However, this number decreased by 7.5% only in the rural areas. CONCLUSIONS: Accessibility to dental services was limited in the rural areas as compared than in other areas; this result is based on the fact that the D rate in rural areas was higher than that in other areas. The NSP has decreased this regional inequality with regard to the accessibility to dental services. However, it was suggested that the mean sealant on the first molars was reversed due to a change from NSP to NICS.

Validity and reliability of a questionnaire for evaluating periodontal disease / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to develop a self-administered questionnaire survey to determine its validity and reliability as well as to improve the instructions for measurement of periodontal disease during oral examination for reliably calculating the prevalence of periodontal disease. METHODS: The data obtained was analyzed using SPSS 20.0 and the WINSTEPS program that employs the Rasch model to evaluate validity and reliability of the instrument. RESULTS: We developed a self-administered questionnaire survey consisting of 14 questions based on NHANES. We confirmed the reliability by testing and re-testing the questionnaire survey using selfadministered methods. The average Kappa index obtained was 0.73, which indicated a relatively high reliability. CONCLUSIONS: Reliability and validity of the self-administered assessment tool for periodontal disease developed for the local situation/circumstances of Korea is suitable to be applied for oral examination of a large population. Moreover, the questionnaire survey for periodontal disease could be used to acquire data for constructing a database for oral health policy development.

The relationship between radiological features and clinical manifestation and dental expenses of keratocystic odontogenic tumor

PURPOSE: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. MATERIALS AND METHODS: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. RESULTS: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. CONCLUSION: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.

Development of a National Oral Health Screening Program / 대한구강보건학회지

The National Health Screening program has been implemented in Korea since 1980. First, we had searched recent scientific evidences and verified the accuracy of the data on target oral diseases. In order to determine the validity, we searched scientific bibliographic data and concluded that dental caries and periodontal disease were major oral problems. Second, we developed new improved forms for National Oral Health Screening. To improve these forms, we reviewed previous forms and gathered expert opinions. The new forms were consistent with the examination forms given to all age groups, and information on oral health conditions, dental education needs, and post-treatment care was included in the modified forms. We then designed manuals for dentists, which contained information on the screening criteria as well as consultation and patient education guidelines. The manuals were divided into three parts, including explanation of the screening criteria, standard of the decision, and education and consultation guidelines. By using these new and modified National Oral Health Screening forms, we expect an improvement in the National Oral Health Screening Program and enhancement in the oral health condition of patients.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

PURPOSE: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. MATERIALS AND METHODS: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. RESULTS: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. CONCLUSION: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

Effects of pH and titratable acidity on the erosive potential of acidic drinks / 대한구강보건학회지

No abstract available.

Reasons for extraction of permanent teeth in Korea / 대한구강보건학회지

OBJECTIVES: The object of this study was to determine the reasons for tooth extractions of permanent teeth in Korea. METHODS: 2009 National patient samples (NPS) data were obtained for patients from the Health Insurance Review and Assessment (HIRA). We conducted a frequency analysis of the reasons for 93,176 permanent teeth extraction. RESULTS: Overall, periodontal disease was the most frequent reason for tooth extraction (54.9%), followed by dental caries (38.4%). The males lost more teeth, due to periodontal disease than the females. In the below 30 age groups, caries was the main reason for tooth extraction. However, periodontal disease was remarkably increasing in those aged that were 30 year old and over. CONCLUSIONS: Most of the permanent teeth are extracted, due to caries and periodontal disease. Furthermore, there has been no efficient way of prevention for periodontal disease in public health activities, which targeted the population of the middle age group. Such method might be required.

Expert's opinions on the National Oral Health Examination evaluation system / 대한구강보건학회지

OBJECTIVES: The Delphi study was performed in Korea to develop a consensus opinion for the quality improvement in National oral health examination, and to obtain a basic data on how to improve the evaluation system of the National health examination. METHODS: Consensus was developed through two rounds of assessment in September and October, 2011. Seven professors and six dentists, recommended by Korean Dental Associations, were chosen as the Delphi experts. The Delphi questionnaire collected data in the following categories; management of facilities, preparation before oral screening, notice, certification of human resource, preservation of oral screening sheets, charge for oral screening, notification of agreement with using oral screening data, and the notification of oral screening results. To develop new criteria, the additional delphi questionnaire collected data in the following categories; human resource for dental screening, relevancy of instruments and facilities, a dental screening process. Respondents were asked to indicate their level of agreement with the questionnaire statements on a scale from 0 to 9 (0 indicating total disagreement and 9 indicating total agreement). The mean, coefficient of variation, median and agreement level were calculated. Agreement level was calculated by the proportion of respondents who chose more than 7. Consensus was considered to be defined when the agreement level was more than 45% in each section. RESULTS: Consensus was achieved in every criterion except for management of facilities, charge for oral screening and notification of agreement with using oral screening data. In new criteria, consensus was achieved in every criterion except for human resource for dental screening. CONCLUSIONS: Experts for the National Oral Health Examination in Korea achieved a consensus on certain aspects of the evaluation system of the National Oral Health Examination. It is needed to consider an improvement of the evaluation criteria on the National Oral Health Examination program.

Risk factors for dental caries incidence in children's permanent teeth: four-year follow-up study / 대한구강보건학회지

OBJECTIVES: The aim of this study was to analyze the related factors to dental caries incidence and increments of DMFT index in children's permanent teeth. METHODS: The subjects were 249 elementary school children at the baseline survey. At the four-year follow-up survey, number of subjects reduced to 141. In the first year, all subjects submitted the responses of questionnaire composed of demographic variables and oral health behaviors. They also received oral examination and tests of salivary excretion rate, salivary buffer capacity, Dentocult(R) SM and Dentocult(R) LB. In the first to fourth follow-up year, they received oral examinations. The relation of oral health-related factors with caries incidence and increments of DMFT and DMFS index was analyzed by chi-square test, ANOVA, logistic regression analysis and generalized linear model analysis using Poisson distribution. RESULTS: At four-year follow-up survey, subjects whose Dentocult(R) SM was 2 or higher compared to subjects whose Dentocult(R) SM was 1 or less and subjects whose Dentocult(R) LB was 2 or higher compared to subjects whose Dentocult(R) LB was 1 or less had higher DMFT index increments. In DMFT index increments, the adjusted odds ratio of subjects whose dfs index of primary molars was 11 and more was 4.30 compared to subjects whose dfs index of primary molars was 0 adjusted for gender, daily frequency of toothbrushing and eating between meal, mother's job, oral health education, salivary excretion, salivary buffer capacity and Dentocult(R) SM test. CONCLUSIONS: It was suggested that the caries incidence and increments of DMFT index in permanent teeth should be highly associated with salivary lactobacillus count and dfs index of primary molars.

Theory of X-ray microcomputed tomography in dental research: application for the caries research / 대한치과보존학회지

Caries remains prevalent throughout modern society and is the main disease in the field of dentistry. Although studies of this disease have used diverse methodology, recently, X-ray microtomography has gained popularity as a non-destructive, 3-dimensional (3D) analytical technique, and has several advantages over the conventional methods. According to X-ray source, it is classified as monochromatic or polychromatic with the latter being more widely used due to the high cost of the monochromatic source despite some advantages. The determination of mineral density profiles based on changes in X-ray attenuation is the principle of this method and calibration and image processing procedures are needed for the better image and reproducible measurements. Using this tool, 3D reconstruction is also possible and it enables to visualize the internal structures of dental caries. With the advances in the computer technology, more diverse applications are being studied, such automated caries assessment algorithms.

Assessment of antero-posterior skeletal relationships in adult Korean patients in the natural head position and centric relation / 대한치과교정학회지

OBJECTIVE: This study aimed to verify the intra-individual reproducibility of the natural head position (NHP) in adult Korean patients in the centric relation (CR) position and to prove the inter-individual variability of the Frankfurt horizontal (FH) plane and sella-nasion (SN) line compared to the true horizontal line (THL). In addition, the study aimed to investigate the correlations between linear measurements from A-point and B-point to the nasion true vertical line (NTVL) and angular measurements from A-point and B-point to the SN line. METHODS: Two lateral cephalograms were taken of 116 subjects (23 males, 93 females) with CR wax bites in a NHP at a one-week interval. RESULTS: Method errors of three variables and intraclass correlation coefficients of six parameters proved the intra-individual reproducibility of NHP (p 0.05), but it was clinically variable (SD 3.89degrees) on the inter-individual level. Conversely, the angle of the SN line to the THL was significantly different from 7degrees (p < 0.05). Very low correlation was found between the linear measurements and angular measurements of A-point and B-point (p < 0.01). CONCLUSIONS: The NTVL could be a useful reference line for assessing the antero-posterior position of the maxilla and mandibleof Korean adult patients in NHP and CR.

Application of 0.2% hyaluronic acid gel in oral surgical wound: A randomized double-blind study

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.

Application of 0.2% hyaluronic acid gel in oral surgical wound: A randomized double-blind study

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.