Taesung Jeong

The evaluation of resin infiltration for masking labial enamel white spot lesions

OBJECTIVE The aim of this study was to clinically assess the effectiveness of masking white spot enamel lesions using a resin infiltration technique that was recently developed to arrest incipient caries in a micro-invasive concept. METHODS Twenty teeth with a Developmental Defect of Enamel (DDE) and 18 teeth with Post-orthodontic Decalcification (POD) were selected and treated with resin infiltration. Standardized photographs were taken before, immediately after, and 1 week after treatment and were analysed using image analysing software to calculate the ΔE values. The results were classified into three groups: completely masked, partially masked, and unchanged. RESULTS Among the 20 teeth with DDE, five teeth (25%) were classified as completely masked, whereas seven (35%) and eight teeth (40%) were partially masked and unchanged, respectively. Among the 18 teeth with POD, 11 teeth (61%) were completely masked, six teeth (33%) were partially masked, and one tooth (6%) was unchanged. In some teeth, the result was more improved after 1 week than immediately after infiltration. CONCLUSION The masking effect was dramatic in some cases but not in others. The long-term colour stability of the result should be followed up through continuous clinical and scientific studies.

FAM83H mutations cause ADHCAI and alter intracellular protein localization.

Mutations in a family with sequence similarity 83 member H (FAM83H) cause autosomal-dominant hypocalcification amelogenesis imperfecta (ADH CAI). All FAM83H ADHCAI-causing mutations terminate translation or shift the reading frame within the specific exon 5 segment that encodes from Ser287 to Glu694. Mutations near Glu694 cause a milder, more localized phenotype. We identified disease-causing FAM83H mutations in two families with ADHCAI: family 1 (g.3115C>T, c.1993 C>T, p.Q665X) and family 2 (g.3151C>T, c.2029 C>T, p.Q677X). We also tested the hypothesis that truncation mutations alter the intracellular localization of FAM83H. Wild-type FAM83H and p.E694X mutant FAM83H fused to green fluorescent protein (GFP) localized in the cytoplasm of HEK293T cells, but the mutant FAM83H proteins (p.R325X, p.W460X, and p.Q677X) fused to GFP localized mainly in the nucleus with slight expression in the cytoplasm. We conclude that nuclear targeting of the truncated FAM83H protein contributes to the severe, generalized enamel phenotype.

Survey of Sedation Practices by Pediatric Dentists

The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children`s behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + (67.6%), CH + Hx + Mida submucosal administration (SM) + (29.7%), and Mida IM + (23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient`s safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Dental Caries Status of 14-16 Year Old Adolescents in Yangsan Area

Although adolescents usually show peculiar aspects in oral health status, there have been not so many studies about it, while there have been innumerable studies for children. This study aimed at evaluating the prevalence of dental caries of adolescents in Yangsan in Republic of Korea, detecting its contributing factors, and distinguishing the high-risk group by epidemiological mass survey. Besides, the significance including early caries lesion in diagnosis criteria was assessed with minimal invasive concept. This survey was performed on 1,371 adolescents aged 14 to 16 in Yangsan as subject examinees by a single trained examiner. The dental caries status was checked by oral examination at schools and questionnaire survey was accompanied for some relevant risk factors. The data were analyzed to yield the results as follows: Regarding the caries experience, the DMFT score by WHO criteria with ECL including or not was 4.79 and 3.97 respectively. In both the criteria, female showed higher values and that of high-risk group was almost twice compared with whole examinees by Sic Index. About pit & fissure sealed rate, it revealed the tendency that the more sealed teeth, the lower DMFT values. Among the studied risk factors, only the habit of brushing before going to bed showed positive relationship ( p < 0.05).

THE DENTAL MATURATION OF MAXILLA IN CHILDREN WITH ANTERIOR CROSSBITE OF MAXILLARY UNDERGROWTH TYPE

In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p

LITERATURE REVIEW OF INTERNATIONAL CARIES DETECTION AND ASSESSMENT SYSTEM II TO ORAL EXAMINATION FOR CHILDREN

Current treatment concept of dental caries has been changed, because it has been proved that it is a preventable disease. The philosophy has been changed from purely restorative treatment to preventive caries control. Therefore the methods or criteria of oral examination has been changed. The clinician have to detect not only cavitation, but also the lesion of non-cavitation stage. International Caries Detection and Assessment System II (ICDAS II) was developed recently, which is a new criteria of classification of dental caries. This system was based on the current concept of prevention, early detection and patient-centered management of caries. Therefore this philosophy is in accord with the perspective of pediatric dentistry. The purpose of this article is to introduce this system for oral examination of children.

THE RISK INDICATORS OF DENTAL EROSION IN 8- AND 9-YEAR-OLD SCHOOLCHILDREN IN YANGSAN

Dental erosion is a complex disease of multifactorial etiology with high risk of loss of tooth structure, which still has not been appropriate interest. The aim of this study was to assess the prevalence and risk indicators of dental erosion in Korean school children. A cross-sectional survey was performed on 664 children aged 8~9 years. Data concerning gender, types of caregiver, dietary habits, oral hygiene habits and parental knowledge were obtained from a questionnaire, which was answered by the parents of the children. Association between erosion and the factors were statistically analyzed with chi-squared test and independent t-test at a significance level of 0.05. Dental erosion was present in 242 children. In carbonated drinks, dental erosion was significantly associated with preference, frequency of consumption and the ingestion method (p 0.05). There were no significant associations between dental erosion and gender, type of caregiver, oral hygiene habits and parental knowledge (p > 0.05). In conclusion, it was considered that motivation to be followed by practice is important as well as education for prevention of dental erosion.

THE CHARACTERISTICS OF RESIN INFILTRATED INCIPIENT CARIOUS LESIONS

The concept of resin infiltration which was born in an innovative philosophy to arrest the incipient caries. However, the structural changes of resin infiltrated lesions have not yet explained completely. The liquid resin might contribute not only to maximizing the penetration but to deteriorating physical stability. This study was performed to examine some physical and histological features of resin infiltrated incipient carious lesions. With the specimen of resin infiltrated lesions, microhardness by nanoindentation in depth profile, morphology of resin tags were revealed after HCl dissolution, and degree of microleakage were assessed. The percentage of microhardness of surface layer and lesion body of untreated specimen to sound enamel was 64.6% and 24.6% respectively, while that of resin-infiltrated lesions was 72.1%, showing significant difference (p on the average. Among 20 specimens for microleakage assessment, 13 specimens showed no leakage while 5 and 2 showed leakage into outer and inner half of lesion respectively. It was thought the infiltrant resin penetrates deeply and homogeneously into lesion body and improves its hardness with relatively good physical stability.

ANTERIOR ESTHETIC RESIN RESTORATION OF INTELLECTUALLY DISABLED CHILD WITH OLIGODONTIA : A CASE REPORT

Intellectual disability is accompanied by a high incidence of congenitally absent teeth and supernumerary teeth, and is observed more frequently than are disorders of location and order during delayed eruption, when accompanied by other symptoms. Furthermore, it is associated with a higher occurrence of dental anomalies such as conical teeth, microdontia, and amelogenesis imperfecta. As it is difficult to obtain adequate cooperation from patients with intellectual disabilities, physical restraint and conscious sedation using medication and general anesthesia can be considered. Reshaping of conical teeth with resin composite may be helpful to rehabilitate patients with oligodontia and a conical tooth shape. Diagnostic wax-up and a silicone matrix formed the basis for the successful reconstruction of the anterior teeth. This case describes the treatment of a patient with intellectual disability who had oligodontia and conical-shaped incisors. Under general anesthesia, the patient was treated using direct composite resin restoration.

An Evaluation Study for Satisfaction of Symposium for Dental Sedation

The Korean Academy of Pediatric Dentistry (KAPD) organized the Committee on Sedation, Education and Research to establish appropriate guidelines in dental sedation and to help to the safety of dental sedation of society members through continuous education. The purpose of this study was to try to evaluate the satisfaction rating of the society members of the sedation symposium and BLS course that was held during the KAPD annual congress in 2015. The committee created a questionnaire to target the KAPD members who participated in the annual congress. The questionnaire was given to the 143 total members and were carried out based on the satisfaction evaluation of the symposium. The 23 total members who participated in the BLS course, reported satisfactory evaluations of the BLS course. Both the symposium and BLS courses confirmed a high level of satisfaction from the KAPD members. In addition, the committee learned about the future direction of the education offered by the KAPD the members wish for it to take. KAPD will endeavor to consistently provide advanced education and the systematic training program of emergency management situation for KAPD members.