Trends of conscious sedation in the Department of Pediatric Dentistry at the Dankook University Dental Hospital for 11 Years

Background@#Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years. @*Methods@#This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital. @*Results@#Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged 5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females. @*Conclusion@#Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.

A Retrospective Study on the Effect of Pulp Treatment on the Exfoliation of Primary Teeth / 대한소아치과학회지

The aim of this study was to retrospectively analyze the effects of pulp treatment on exfoliation of primary teeth and its related factors. In this study, 167 teeth of 97 patients aged 6 months to 12 years who were treated with pulp treatment at Dankook Dental Hospital were selected, and information related to pulp treatment and tooth loss was collected. The included subjects were 72 primary anterior teeth (43.1%) and 95 primary posterior teeth (56.9%), of which 56 were males (57.7%) and 41 females (42.3%). The mean follow-up period was 106.1 ± 38.7 months, and the mean age at pulp treatment was 34.8 ± 15.4 months for primary anterior teeth and 69.1 ± 25.1 months for primary posterior teeth. Unilaterally pulpectomized teeth were significantly exfoliated earlier than the same tooth on the opposite side (p 0.05). Pulpectomized teeth were lost earlier, an average of 7.8 months for primary anterior teeth and 8.5 months for primary posterior teeth. Early loss of the primary tooth can lead to space loss and premature eruption of the successor, so this can be considered when planning or performing treatment of the primary tooth.

Primary Diffuse B-cell Lymphoma of Uterine Cervix: A Case Report

Primary diffuse large B-cell lymphoma (DLBCL) of the female genital tract is a rare case. It is hard to diagnose DLBCL of the uterine cervix before surgery because it is often misdiagnosed as cervical myoma or cervical squamous cell carcinoma. Here, we report a case of cervical DLBCL misdiagnosed as a cervical myoma. A 48-year-old premenopausal woman was referred to the gynecology department due to abnormal uterine bleeding with a normal Papanicolaou smear. The initial diagnosis according to ultrasound and computed tomography was a cervical myoma. She had undergone a hysterectomy with bilateral salpingectomy. The final diagnosis was cervical DLBCL and she was referred to the department of hematology for treatment with Rituximab combined chemotherapy. After six courses of chemotherapy, complete remission was reached. At a 2-year follow-up, the patient is alive without interval change.

Characterization of Odontoblasts in Supernumerary Tooth-derivedDental Pulp Stem Cells between Passages by Real-Time PCR / 대한소아치과학회지

The aim of this study is to compare the properties of odontoblast gene of early passage cells and late passage cells derived from impacted maxillary supernumerary teeth.Impacted supernumerary teeth with maxilla were extracted from 12 patients (8 males, 4 females) between 6 - 9 years old without medical history. Real-time polymerase chain reaction (PCR) was conducted to compare characterization of odontoblast cell in the 3rd and 10th passage, and between with bone inducing additive group and without additive group. Genes for odontoblasts characteristics are osteonectin (ONT), alkaline phosphatase (ALP), osteocalcin (OCN), dentin matrix protein 1 (DMP-1) and dentin sialophosphoprotein (DSPP). The level of gene expression was in a decreasing order of ONT, ALP, OCN, DMP-1 and DSPP in the 3rd passage, and in decreasing order of ONT, DMP-1, OCN, ALP, and DSPP in the 10th passage in the undifferentiation and differentiation group. The order of ONT, DMP-1, and OCN did not changed. ALP and DMP-1 were switched in order. ALP and DMP-1 may be used as important markers for differentiating between the 3rd passage and 10th passage cells. Considering that supernumerary tooth was extracted young age and the time required to cultured 10th passage was short, supernumerary tooth can be considered a useful donor site of dental pulp stem cells.

The prevalence of taurodontism in primary molar and correlation with permanent first molar / 대한구강보건학회지

Objectives@#The purpose of this study was to investigate the prevalence of permanent first molar taurodontism and identify the correlation between primary molars and permanent first molar taurodontism. @*Methods@#Among the 10,113 children who underwent panoramic radiography at a dental hospital from January 2010 to December 2019, 685 children (404 boys, 281 girls) were included in this study. @*Results@#Six children (0.8%) and 98 children (14.1%) showed taurodontism of the primary molars and permanent first molar, respectively. All of the children with taurodontism in the primary molars had at least one taurodontism in the permanent first molars. @*Conclusions@#Early diagnosis of taurodontism in primary molars might allow dentists to make treatment plans in accordance with tooth development.

The prevalence of taurodontism in primary molar and correlation with permanent first molar / 대한구강보건학회지

Objectives@#The purpose of this study was to investigate the prevalence of permanent first molar taurodontism and identify the correlation between primary molars and permanent first molar taurodontism. @*Methods@#Among the 10,113 children who underwent panoramic radiography at a dental hospital from January 2010 to December 2019, 685 children (404 boys, 281 girls) were included in this study. @*Results@#Six children (0.8%) and 98 children (14.1%) showed taurodontism of the primary molars and permanent first molar, respectively. All of the children with taurodontism in the primary molars had at least one taurodontism in the permanent first molars. @*Conclusions@#Early diagnosis of taurodontism in primary molars might allow dentists to make treatment plans in accordance with tooth development.

Comparison of Cariogenic Characteristics between Fluoride-sensitive and Fluoride-resistant Streptococcus mutans / 대한소아치과학회지

The aim of this study is to compare cariogenic characteristics of fluoride-sensitive Streptococcus mutans [fluoride-sensitive (FS) S. mutans ] and fluoride-resistant Streptococcus mutans [fluoride-resistant (FR) S. mutans] in the presence of sucrose, and to evaluate its effect on cariogenic biofilm formation. S. mutans ATCC 25175 was continuously cultured in trypticase soy broth (TSB) containing NaF (70 ppm) for 40 days to generate FR S. mutans . FS and FR S. mutans were inoculated in TSB with or without 2% sucrose, and optical density and pH were measured every hour. An oral biofilm was formed using saliva bacteria and analyzed through confocal laser scanning microscopy and CFU count. Finally, the expression of glucosyltransferases genes of both S. mutans was investigated through RT-PCR. FR S. mutans exhibited slower growth and lower acidogenicity in the presence of sucrose compared to FS S. mutans . Both cariogenic and single species biofilm formation was lower in the presence of FR S. mutans , along with reduced number of bacteria. FR S. mutans showed significantly low levels of gtfB, gtfC, and gtfD expression compared to FS S. mutans . On the basis of results, FR S. mutans may be less virulent in the induction of dental caries.

Validity, Reliability and Reproducibility of Space Analysis using Digital Model taken via Model Scanner and Intraoral Scanner: An In vivo Study / 대한소아치과학회지

The purpose of this study is to evaluate validity, reliability and reproducibility of tooth width (TW), arch length (AL) and arch length discrepancy (ALD) measured on a digital model taken via 3-dimensional model scanner and intraoral scanner compared to a plaster model.A total of 30 patients aged 12 to 18 were eligible for the study. 3 types of models were acquired from each patient: a conventional plaster model (P), a model scanned digital model (MSD) taken via Freedom UHD® and an intraoral scanned digital model (ISD) taken via CS3600® in-vivo. The reliability of TW and AL in each group was evaluated using Pearson’s correlation coefficient, while the reproducibility was evaluated with intraclass correlation coefficient. The validity of space analysis was assessed by paired t-test.As a result, all measurements of P, MSD and ISD groups showed favorable reliability and reproducibility. Most of measurements for space analysis in MSD group and TW in ISD group also presented high validity. AL and ALD presented statistically significant difference between P and ISD group. The validity of measurements of space analysis in ISD group was short in doubt to valid, but clinically acceptable. Both MSD and ISD are clinically acceptable to use for space analysis but clinician should be aware that errors can be found using a digital model.

Fluoride Release and Recharge Properties of Several Fluoride-Containing Restorative Materials / 대한소아치과학회지

The aim of the study is to compare the fluoride release and recharge properties of glass ionomer cements and ‘alkasite’.Specimens of two glass ionomer cements (Fuji Ⅸ GP and Riva Self Cure), ‘alkasite’ restorative material (Cention N) and composite resin (FiltekTM Z350XT) were prepared. The fluoride release of each specimen was measured for 28 days. Thereafter, 1.23% acidulated phosphate fluoride (APF) gel was applied to experimental groups. No treatment was performed on control groups. The fluoride release was measured for additional 7 days to evaluate the fluoride recharge properties of each materials.The fluoride release was highest in Riva Self Cure, followed by Fuji Ⅸ GP, Cention N (p < 0.05). Fluoride release of Cention N was measured to be approximately 49% of Fuji Ⅸ GP’s. After the application of 1.23% APF gel, increases in fluoride release were observed in Riva Self Cure, Fuji Ⅸ GP and Cention N (p < 0.05). Fluoride recharge was observed in Cention N as well as in glass ionomer cements. Further studies are required to evaluate the anti-cariogenic properties of Cention N at clinical conditions.

Fracture Strength and Translucency of CAD/CAM Zirconia Crown for Primary Anterior Tooth / 대한소아치과학회지

The purpose of this study is to evaluate the validity of primary anterior zirconia crown made with Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) technology by analyzing fracture strength and translucency parameter.Zirconia crown was designed with CAD software, using 3D scanned data of #61 tooth model. Crown fabrication was performed with CAM machine using zirconia block. Zirconia crowns were divided into 3 groups according to thickness(0.3, 0.5, and 0.7 mm), and fracture strength was compared with 1.0 mm thickness of resin strip crown. The compressive force was applied with universal testing machine at 30° along the incisal edge at increments of 1 mm/min. For translucency evaluation, 0.3, 0.5, and 0.7 mm thickness of zirconia specimens were fabricated and translucency was measured with spectrophotometer.Among zirconia groups, there was a significant increase in fracture strength as thickness increased (p Thin primary anterior zirconia crown can be designed and fabricated according to individual needs by using CAD/CAM. Restoration with thin crown would reduce the amount of tooth reduction, risk of pulp exposure, and make more esthetic restoration possible.

Comparison of Microhardness and Compressive Strength of Alkasiteand Conventional Restorative Materials / 대한소아치과학회지

The aim of this study was to compare compressive strength and microhardness of recently introduced alkasite restorative materials with glass ionomer cement and flowable composite resin. For each material, 20 samples were prepared respectively for compressive strength and Vickers microhardness test. The compressive strength was measured with universal testing machine at crosshead speed of 1 mm/min. And microhardness was measured using Vickers Micro hardness testing machine under 500 g load and 10 seconds dwelling time at 1 hour, 1 day, 7 days, 14 days, 21 days and 35 days. The compressive strength was highest in composite resin, followed by alkasite, and glass ionomer cement. In microhardness test, composite resin, which had no change throughout experimental periods, showed highest microhardness in 1 hour, 1 day, and 7 days measurement. The glass ionomer cement showed increase in microhardness for 7 days and no difference was found with composite resin after 14 days measurement. For alkasite, maximum microhardness was measured on 14 days, but showed gradual decrease.

Dental Management in a Patient with Glanzmann’s Thrombasthenia : A Case Report / 대한소아치과학회지

Glanzmann’s thrombasthenia (GT) is a rare, autosomal recessive inherited congenital disorder, characterized by impaired blood coagulation due to platelet dysfunction. It was first reported by the pediatrician Glanzmann in 1918. GT affects both males and females, and it is more common in regions of the Middle East, India, and France, where intermarriage is common. It has an incidence of about 1 in 1,000,000 people. In South Korea, according to the Division of Rare Diseases, Korea Centers for Disease Control and Prevention, around 200 cases have been reported in 2018. Clinical symptoms include petechia, ecchymosis, epistaxis, and gingival bleeding. The spontaneous loss of deciduous teeth can result in excessive bleeding with that blood transfusion should be considered. Preventing hemorrhages and hemostasis are most important factors in dental treatment. Local bleeding can be controlled by compression, but platelet transfusion can be required by prolonged bleeding. Pediatric dentists can minimize the gingival bleeding by control of the oral hygiene to prevent gingivitis and dental caries. The importance of oral hygiene and periodic recall check-up should be emphasized. During dental treatment, the examination and the treatment plan of patient should be modified to prevention of hemorrhages carefully. A 6-year-old girl with GT was referred for the treatment of dental caries, and resin restoration was performed under nitrous oxide inhalation sedation. After treatment, compression was required for the bleeding control.

Comparison of Prevention Methods against Enamel Demineralization adjacent to Orthodontic Bracket Using Fluoride / 대한소아치과학회지

As a common side effect of fixed orthodontic treatment, demineralization of the enamel adjacent to the bracket and band occurs in patients with poor oral hygiene. The purpose of this study was to investigate what is the most effective method to prevent demineralization around the fixed orthodontic appliance among various methods using fluoride. 80 extracted bovine incisors with a healthy surface were classified into four groups as experimental materials: (Group I) Control group, (Group II) V varnish™, (Group III) Tooth Mousse Plus®, (Group IV) Vanish™ XT. After treatment for each group, mineral loss and Vickers surface microhardness were measured at 0, 30, 60 and 90 days after demineralization in artificial carious solution. Mineral loss was the lowest in group IV, followed by group II and group III, which showed a significant difference. The surface microhardness was the lowest in group IV, followed by group II and group III, which showed a significant difference. Through this study, group IV showed the best effect to prevent enamel demineralization around the bracket. Group III showed significant prevention of enamel demineralization compared with the control group, but the effect was less than that of the other groups.

Characterization of Human Dental Pulp Cells from Supernumerary Teeth by Using Flow Cytometry Analysis / 대한소아치과학회지

The aim of this study was to analyze cells from human dental pulp tissue of impacted supernumerary teeth as stem cells with flow cytometry. Human dental pulp cells from 15 supernumerary teeth were identified their characteristics as stem cells by expression of mesenchymal stem cell markers through flow cytometry analysis at passage 3 and passage 10. Cluster of differentiation (CD) 73, CD 90, CD 34, CD 45 and STRO-1 cell surface markers were used to figure out characteristics of dental pulp stem cells from supernumerary teeth. At passage 3, the cell population showed positive expression of CD 73, CD90 and STRO-1, lacked expression of CD 34 and CD 45. At passage 10, CD 73, CD 90 and STRO-1 showed positive expression while CD 34 and CD 45 showed negative expression. This study indicated that dental pulp stem cells of supernumerary teeth had the properties of mesenchymal stem cells at both early and late passage. Impacted supernumerary teeth could be considered as a noble source of stem cells because of rapid growth and maintaining characteristics of stem cells until late passage.

Comparison of the Rate of Demineralization of Enamel using Synthetic Polymer Gel / 대한소아치과학회지

Carbopol® 907 used as surface protecting agent in White's method is the one of the artificial caries lesion producing solution was discontinuing of production. New surface protecting material to substitute of Carbopol® 907 was required.The author prepared an artificial caries lesion producing solution as follows White's method with Carbopol® 907 and also another artificial caries lesion producing solution with Carbopol® 2050®.96 flattened and polished enamel samples were immersed in a demineralizing solution of 0.1 mol/L lactic acid, 0.2% carboxyvinylpolymer and 50% saturated hydroxyapatite for 1, 2, 3, 4, 5, 6, 7, 9, 11, 15, 18 and 20 days. All samples from each group were subjected to polarized microscopy observed and image analysis for measuring the lesion depth.From the review of polarized images, the artificial caries lesion producing solution using Carbopol® 907 and Carbopol® 2050 can produced an artificial caries that was very similar to natural caries characters.From the regression analysis of the lesion depth produced by the artificial caries lesion producing solution using Carbopol® 907 and Carbopol® 2050, Carbopol® 2050 estimate as Y = 9.8X + 8.0 and Carbopol® 907 was Y = 8.4X − 0.4. R square value of Carbopol® 2050 and Carbopol® 907 was 0.965 and 0.945 respectively.The rate of demineralization by the artificial caries lesion producing solution using Carbopol® 2050 was faster than that of Carbopol® 907. And R square value of Carbopol® 2050 and Carbopol® 907 were very high and it means that the lesion depth was very high coefficient to demineralization period.

Gene Expression of Supernumerary Dental Pulp Related to the Subculture Speed: A Pilot Study / 대한소아치과학회지

The purpose of this study was to investigate the odontoblast gene expression related to the subculture speed of supernumerary dental pulp stem cells (sDPSCs). The stem cell is undifferentiated cells which has the ability to differentiate into various cells. Specific stimulation or environment induces cell differentiation, and these differentiation leads to bone or muscle formation.20 sDPSCs were obtained from 20 children under aseptic condition. During the culture through the 10th passage, the third passage cells which showed short subculture period and 10th passage cells which showed long subculture period were earned. Each cell was divided into differentiated group and non-differentiated group. Quantitative real-time polychain reaction (q-RT-PCR) was performed for each group. The genes related to odontoblast differentiation, Alkaline Phosphatase (ALP), Osteocalcin (OCN), Osteonectin (ONT), Dentin sialophosphoprotein (DSPP) and Dentin matrix acidic phosphoprotein 1 (DMP-1), were measured.Differentiated cells showed more gene expression levels. Undifferentiated cells showed higher gene expression level in 10th passages but differentiated cells showed higher gene expression level in 3rd passages. Cells that showed faster subculture period showed relatively lower gene expression level except for OCN and DSPP.

Correlation between Fluoride Release, Microhardness and Solubility of High viscosity Glass Ionomers / 대한소아치과학회지

This study was to measure and compare the amount of fluoride, microhardness and solubility of high viscosity glass ionomer and resin-reinforced glass ionomer during 84 days.Fuji IX GP EXTRA, Fuji IX GP, Fuji II LC and Filtek™ Z350XT stored in deionized water for 84 days to measure fluoride release, microhardness and solubility.As a result of measurement of fluoride release, all the glass ionomers showed the highest amount of fluoride release on day 1 and gradually decreased. Fuji IX GP EXTRA showed the highest amount of fluoride release and cumulative release. And Fuji IX GP and Fuji II LC showed no significant difference. Microhardness measurements showed that all experimental groups decreased 1 day after exposure to water. After 84 days, microhardness showed no significant difference between Fuji IX GP EXTRA and Fuji IX GP, and Fuji II LC was the lowest. In the solubility measurement, Fuji IX GP EXTRA, Fuji IX GP, and Fuji II LC increased rapidly to 21 days. After 21 days, there was no significant difference in the three groups. As a result, short term fluoride release affects solubility and microhardness, but long term fluoride release has no correlation.Through this study, the amount of fluoride, microhardness, and solubility of various glass ionomers were evaluated, and these properties could be applied clinically.

Characteristics of Supernumerary Tooth-derived Pulp Cells during Long-term Culture / 대한소아치과학회지

This study was conducted to investigate the characteristics of subculture times in the early, middle, and late passages by measuring the time under subculture until it was judged that the supernumerary tooth-derived pulp stem cells (sDPSCS) were no longer proliferating. Three supernumerary teeth from two healthy six-years old boys were extracted and stem cells were obtained from the pulp tissue. This was called SNT1 (supernumerary tooth 1), SNT2, and the supernumerary tooth from another child was named SNT3. SNT1 and 2 were subcultured at the same time and SNT3 was subcultured a little faster. The mean time of complete subculture was 3.6 ± 1.1 days. Total passages were cultured up to 23.3 ± 0.6 and took 83 days. These were divided into three groups based on the passage. The increase rate of time taken in subculture between group I and group II was 11.9%, but the rate between group II and group III was 28.6%, which was 2.4 times increased. The time taken between passages during long-term subculture up to 22 passages shows a regressive pattern y = 0.1169x + 2.25 and y = 0.1169x + 2.0. In conclusion, the passage time of SPSCs increased in late passages, and it shows a similar pattern.

A Novel Method to Study the Effects of Cyclosporine on Gingival Overgrowth in Children / 대한소아치과학회지

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.

Cariogenicity of Vitamin Supplements for Children / 대한소아치과학회지

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.