Byung-Jai Choi

Incidence and relationship of an additional root in the mandibular first permanent molar and primary molars

OBJECTIVES The mandibular first permanent and primary molars occasionally have an additional root located distolingually. This study aimed to determine the incidences of an additional root in these molars and their relationship. STUDY DESIGN This study involved 4050 children for whom periapical radiographs of the mandibular molar area were available. The incidence of an additional root for each molar was calculated and the pattern of concurrent additional roots in different molars was also investigated. RESULTS Additional roots were present in 33.1%, 27.8%, and 9.7% of the first permanent, second primary, and first primary molars, respectively. When an additional root was present in a primary molar, the probability of the posterior adjacent molar also having an additional root was greater than 94.3%. CONCLUSION The presence of an additional root in a primary molar can be used to predict the presence of an additional root in molars posterior to it.

Comparative gene expression analysis of the human periodontal ligament in deciduous and permanent teeth.

There are histological and functional differences between human deciduous and permanent periodontal ligament (PDL) tissues. The aim of this study was to determine the differences between these two types of tissue at the molecular level by comparing their gene expression patterns. PDL samples were obtained from permanent premolars (n = 38) and anterior deciduous teeth (n = 31) extracted from 40 healthy persons. Comparative cDNA microarray analysis revealed several differences in gene expression between the deciduous and permanent PDL tissues. These findings were verified by qRT-PCR (quantitative reverse-transcription–polymerase chain reaction) analysis, and the areas where genes are expressed were revealed by immunohistochemical staining. The expressions of 21 genes were up-regulated in deciduous relative to PDL tissues, and those of 30 genes were up-regulated in permanent relative to deciduous PDL tissues. The genes that were up-regulated in deciduous PDL tissues were those involved in the formation of the extracellular matrix (LAMC2, LAMB3, and COMP), tissue development (IGF2BP, MAB21L2, and PAX3), and inflammatory or immune reactions leading to tissue degradation (IL1A, CCL21, and CCL18). The up-regulated genes in permanent PDL tissues were related to tissue degradation (IL6 and ADAMTS18), myocontraction (PDE3B, CASQ2, and MYH10), and neurological responses (FOS, NCAM2, SYT1, SLC22A3, DOCK3, LRRTM1, LRRTM3, PRSS12, and ARPP21). The analysis of differential gene expressions between deciduous and permanent PDL tissues aids our understanding of histological and functional differences between them at the molecular level.

Comparative Gene-Expression Analysis of the Dental Follicle and Periodontal Ligament in Humans

The human dental follicle partially differentiates into the periodontal ligament (PDL), but their biological functions are different. The gene-expression profiles of the dental follicle and PDL were compared using the cDNA microarray technique. Microarray analysis identified 490 genes with a twofold or greater difference in expression, 365 and 125 of which were more abundant in the dental follicle and PDL, respectively. The most strongly expressed genes in the dental follicle were those related to bone development and remodeling (EGFL6, MMP8, FRZB, and NELL1), apoptosis and chemotaxis (Nox4, CXCL13, and CCL2), and tooth and embryo development (WNT2, PAX3, FGF7, AMBN, AMTN, and SLC4A4), while in the PDL it was the tumor-suppressor gene WIF1. Genes related to bone development and remodeling (STMN2, IBSP, BMP8A, BGLAP, ACP5, OPN, BMP3, and TM7SF4) and wound healing (IL1, IL8, MMP3, and MMP9) were also more strongly expressed in the PDL than in the dental follicle. In selected genes, a comparison among cDNA microarray, real-time reverse-transcription polymerase chain reaction, and immunohistochemical staining confirmed similar relative gene expressions. The gene-expression profiles presented here identify candidate genes that may enable differentiation between the dental follicle and PDL.

The Effect of Nano-Sized β-Tricalcium Phosphate on Remineralization in Glass Ionomer Dental Luting Cement

This study aimed to evaluate the anticariogenic and remineralization effects of the glass ionomer dental luting cement containing nano-β-TCP in vitro. The β-Tricalcium Phosphate (β-TCP) are the components of dental enamel and bone mineral as biological apatites. In addition, β-TCP contains a significant amount of calcium and phosphate, which can promote remineralization of enamel subsurface lesions in animal and human. RelyXTM glass ionomer cement(3M/ESPE, USA) was used as dental luting cement. Film thickness, setting time, and compressive strength was measured for each group of pure glass GIC, 15% nano-β-TCP GIC. Human molars were prepared in box-shaped cavities that were filled with the GIC with and without the 15% nano-β-TCP were placed in 25ml of pH 5.0 acid buffer for 4 days at 37°C. After 4 days, longitudinal sections (1007m) were obtained through the center of each restoration. The sections were analyzed using a scanning electronic microscope (SEM) and confocal laser scanning microscopy (CLSM) to identify the change in the enamel surface. A significant difference in the CLSM images between pure GIC and nano-β-TCP-GIC. CLSM allows the demineralized surface layers of sound enamel to be visualized down to approximately 100 μm. The pure GIC specimens had a relatively thick fluorescent layer. On the other hand, the fluorescent layer of the nano-β-TCP-GIC specimens were thinner. The SEM images of micro surfaces demonstrate that nano-β-TCP-GIC is less rough than pure GIC. Therefore, the addition of nano-β-TCP enhanced protection against acid demineralization and promoted remineralization of enamel surface.

Shh signaling is essential for rugae morphogenesis in mice

Palatal ridges, or rugae palatinae, are corrugated structures observed in the hard palate region. They are found in most mammalian species, but their number and arrangement are species-specific. Nine palatal rugae are found in the mouse secondary palate. Previous studies have shown that epithelial Shh signaling in the palatal ridge plays an important role during rugae development. Moreover, Wnt family members, including LEF1, play a functional role in orofacial morphogenesis. To explore the function of Shh during rugae development, we utilized the maternal transfer of 5E1 (anti-Shh antibody) to mouse embryos. 5E1 induced abnormal rugae patterning characterized by a spotted shape of palatal ridge rather than a stripe. The expression patterns of Shh and Shh-related genes, Sostdc1, Lef1 and Ptch1, were disrupted following 5E1 injection. Moreover, rugae-specific cell proliferation and inter-rugae-specific apoptosis were affected by inhibition of Shh signaling. We hypothesize that the altered gene expression patterns and the change in molecular events caused by the inhibition of Shh signaling may have induced abnormal rugae patterning. Furthermore, we propose a reaction–diffusion model generated by Wnt, Shh and Sostdc1 signaling. In this study, we show that Sostdc1, a secreted inhibitor of the Wnt pathway, is a downstream target of Shh and hypothesize that the interaction of Wnt, Shh and Sostdc1 is a pivotal mechanism controlling the spatial patterning of palatal rugae.

Microscopic analysis of molar–incisor malformation

OBJECTIVE Molar-incisor malformation (MIM) is a newly discovered type of dental anomaly that involves a characteristic root malformation of the permanent first molars. The aim of this study was to reveal the microstructure of MIM teeth in order to determine their origin. STUDY DESIGN Four MIM teeth were extracted from a 9-year-old girl due to severe mobility. The detailed microstructure of the teeth was determined by examinations with micro-computed tomography (micro-CT), hematoxylin and eosin (H&E) staining, immunohistochemical staining, and scanning electron microscopy to reveal the detailed microstructure. RESULTS Micro-CT and H&E staining revealed the pulpal floor comprising three layers: upper, middle, and lower. Amorphous hard tissues and hyperactive cells were observed in the middle layer of the pulpal floor, and the cells stained positively for dentin sialoprotein and osteocalcin, but not for collagen XII. CONCLUSION The results of the present study imply that MIM-affected molars probably result from inappropriate differentiation of the apical pulp and dental follicle.

The Distribution of Patients and Treatment Trends in the Department of Pediatric Dentistry, Yonsei University Dental Hospital for Last 5 Years

The aim of this study was to investigate changes in treatment patterns within pediatric dentistry departments by analyzing the distribution of patients and treatment trends. To that end, treatment charts based on electronic medical records (EMR) from the Yonsei University Dental Hospital from 2008 to 2012 were collected and analyzed. The results showed a decrease in the number of new patients and patients cared for by non-specialists, while the number of foreign patients has increased. The under 2 years-old group accounted for a large portion of new patients. Dental caries, dental trauma, and malocclusion ranked as the top complaints. In terms of restoration treatment, the proportion of patients receiving composite resin, amalgam, and sealant has decreased, whereas self-curing glass ionomer and preventive resin restoration have increased. Single-visit endodontic treatment has been increasing, with a decreasing trend in multi-visit endodontic treatment. The rate of conservative pulp treatment, such as pulp capping and pulpotomy, has increased. For reducing patient anxiety, treatments under sedation have increased, especially with the use of nitric oxide. This investigation into the latest treatment trends and patient characteristics is expected to help pediatric dentists to make appropriate treatment plans.

Distinctive Genetic Activity Pattern of the Human Dental Pulp between Deciduous and Permanent Teeth

Human deciduous and permanent teeth exhibit different developmental processes, morphologies, histological characteristics and life cycles. In addition, their pulp tissues react differently to external stimuli, such as the pulp sensitivity test, dental trauma and pulp therapy materials. These suggest differences in gene expression and regulation, and in this study we compared gene-expression profiles of the human dental pulp from deciduous and permanent teeth. Pulp tissues from permanent premolars and deciduous molars aged 11–14 years were extirpated and mRNA was isolated for cDNA microarray analysis, and quantitative real-time PCR (qPCR). Other teeth were used for immunohistochemical analysis (IHC). Microarray analysis identified 263 genes with a twofold or greater difference in expression level between the two types of pulp tissue, 43 and 220 of which were more abundant in deciduous and permanent pulp tissues, respectively. qPCR analysis was conducted for eight randomly selected genes, and the findings were consistent with the cDNA microarray results. IHC confirmed that insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) was broadly expressed in deciduous dental pulp tissue, but minimally expressed in permanent dental pulp tissue. Immunohistochemical analysis showed that calbindin 1 (CALB1), leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5), and gamma-aminobutyric acid A receptor beta 1 (GABRB1) were abundantly expressed in permanent predentin/odontoblasts, but only minimally expressed in deciduous dental pulp tissue. These results show that deciduous and permanent pulp tissues have different characteristics and gene expression, suggesting that they may have different functions and responses to therapies focused on pulp or dentin regeneration.

Correlation between Caries Experience and New Colorimetric Caries Activity Test in Children

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Physical and Adhesive Properties of Cyanoacrylate-Based β-TCP Composites

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