Effectiveness of the Invisalign Mandibular Advancement Appliance in Children with Class II Division 1 Malocclusion / 치위생과학회지

Background@#This study aimed to determine the skeletal and dental effects in pediatric and adolescent Korean patients with ClassII Division 1 malocclusion treated using the Invisalign Mandibular Advancement (MAⓇ ) appliance. @*Methods@#The study included patients aged 6 to 18 years who received orthodontic treatment with the MAⓇ appliance for Class II Division 1 malocclusion at the Department of Pediatric Dentistry, Wonkwnag University Daejeon Dental Hospital, between July 1, 2018, and December 31, 2021. The treatment group consisted of 20 patients, 10 boys and 10 girls. The control participants were also 10 boys and 10 girls. Lateral cephalometric radiographs were taken before and after treatment, and 41 measurements of skeletal and dental changes were measured and analyzed using the V-CephTM 8.0 (Osstem Implant). All analyses were performed using SPSS software (IBM SPSS for Windows, ver 26.0; IBM Corp.), and statistical significance was tested using paired and independent samples t-tests for within-group and between-group comparisons, respectively. @*Results@#The patients in the treatment group showed significant decreases in ANB (A point, Nasion, B point), maxillary protrusion,maxillary anterior incisor labial inclination, and maxillary protrusion after treatment. However, when compared with the growth changes observed in the control group, only ANB and maxillary protrusion decreased, with no significant differences in SNA, SNB, and mandibular length. @*Conclusion@#Collectively, the results of this study confirm that the use of MAⓇ appliance in pediatric and adolescent Korean patients with Class II Division 1 malocclusion results in a reduction of anteroposterior skeletal and dental disharmony.

Effects of a Prefabricated Functional Orthodontic Appliance on Children with Class II Division 1 Malocclusion / 치위생과학회지

Background@#This study aimed to evaluate the effect of a prefabricated functional appliance (MyobraceⓇ ) on skeletal, dental, and soft tissue components in children with Class II, division 1 malocclusion. @*Methods@#Thirteen patients with Class II, division 1 malocclusion (9 girls and 4 boys; mean age, 8.2±0.9 years at the start and 9.3±1.0 years at the end of the treatment) were treated with MyobraceⓇ for a mean period of 12.9±4.0 months. Patients were instructed to use the appliance daily for 1 hour and overnight while sleeping. A control group of 10 patients with untreated Class II, division 1 malocclusion (3 girls and 7 boys; mean age, 9.0±1.6 years at the start and 10.4±2.1 years at the end of the observation) was included to eliminate possible growth effects. The mean observation period for this group was 17.7±11.2 months. Lateral cephalograms were taken at the start and end of the treatment, and findings from 41 measurements were analyzed using the V-CephTM program. The mean and standard deviation of cephalometric measurements were analyzed using paired and independent sample t-tests. @*Results@#The treatment group showed significant changes in SNB, ANB, maxillary protrusion, ramus height, proclination of upper anterior teeth, interincisal angle, overjet, and upper lip protrusion compared with the control group. However, only decrease in ANB, maxillary protrusion, overjet, upper lip protrusion, and increase in interincisal angle were significantly higher in the treatment group than in the control group. @*Conclusion@#The prefabricated functional appliance induced skeletal, dentoalveolar, and soft tissue changes, resulting in a significant reduction in anteroposterior discrepancy.

Silver Diamine Fluoride Compound for Dental Caries and Its Characterisation Using Microscopic Computed Tomography and Nanoindentation / 치위생과학회지

Background@#In our study, a silver diamine fluoride (SDF) compound for the treatment of dental caries was synthesized to characterize its remineralization activity upon direct application to deciduous teeth. This study aimed to use microscopic computed tomography (microCT) and nanoindentation to evaluate whether SDF composite application could effectively arrest dental caries in five exfoliated primary molars. @*Methods@#Carious teeth were extracted and visually examined using quantitative photofluorescence devices (Qraycam and QraypenTM). After performing microCT, the SDF composite was applied to the teeth according to the manufacturer’s instructions. The researchers exchanged and precipitated the irritant saliva once daily for 1 week. The teeth were sectioned longitudinally through the centers of the mesial and distal surfaces, embedded, polished, and measured using nanoindentation. Thereafter, microCT was repeated. Statistical analyses were performed using GraphPad Prism software. @*Results@#Following SDF composite application, a remineralized layer was observed on microCT images, and the hardness increased when measured using nanoindentation. We found that demineralized enamel presented with an increased number of irregular crystals in the deep carious lesion group compared with those in the shallow carious lesion group, resulting in a rougher surface. @*Conclusion@#The SDF composite may be used for remineralization of early caries and cessation of advanced caries in primary molars.

Antimicrobial Persistence of Silver Diamine Fluoride and Silver Fluoride against Streptococcus mutans

Purpose@#To evaluate the antimicrobial persistence of silver diamine fluoride (SDF) and silver fluoride (AgF) on Streptococcus mutans. @*Materials and Methods@#An in vitro experiment was conducted to observe changes in the diameter of the inhibition zone of various materials, including AgF (Riva Star Aqua™ step 1; SDI), potassium iodine (Riva star aqua™ step 2;SDI), Fluor protector® (FP, Ivoclar Vivadent), SDF (Riva star™ step 1; SDI), Ampicillin (Sigma-Aldrich), Amphotericin B (Nexstar) and negative control on S. mutans.Result: SDF, AgF and FP exhibited significant antimicrobial persistence over the 4 weeks period (P<0.05). At day 28, the diameter of inhibition zone was larger in SDF than in AgF. @*Conclusion@#SDF and AgF have significant antibacterial durability against bacteria commonly associated with dental caries, with the antimicrobial effect lasting for at least 4 weeks. Further clinical studies are needed to validate these findings in vivo.

Characteristics and Risk Factors of High Caries Risk Group in 12-year-old Children Using Data from the 2015 Children’s Oral Health Survey / 대한소아치과학회지

The purpose of this study was to examine the characteristics of the high caries risk group of 12-year-old children in Korea. Oral health status and interview data were collected from 23,089 children aged 12 years who participated in the 2015 Korean Children’s Oral Health Survey. Subjects were classified into high-risk and low-risk groups according to the Significant caries (SiC) index, and the influence of each variable was analyzed. As a result of the study, the SiC index of the high-risk group was 5.08, which was about 9.6 times higher than the lowrisk group. The risk factors associated with the high-risk group were in the order of the number of sealant teeth, dental treatment demand for the past year, perceived oral health status, gender, region, frequency of snack intake per day, and use of oral hygiene aids. In order to improve the oral health of children, appropriate preventive treatment and oral health education should be carried out with reference to the items indicated as risk factors in the high-risk group of dental caries.

Application of New Appliances for Management of Growing Class III Malocclusion Child: Comparazation Case Reports / 치위생과학회지

The purpose of this comparison of case reports is to introduce the results of the application of new devices for the management of growing Class III malocclusions in children. Two 8-year-old boys had a chief complaint of anterior crossbite. Anterior crossbite correction using a tandem traction bow appliance (TTBA) or a Carriere Motion 3D Class III appliance with a Transforce appliance was planned. By comparing cephalometric radiographs before and after treatment, changes in skeletal growth and incisor inclination to the Frankfort horizontal (FH) plane could be measured. Both devices increased SNA and ANB angles, N –| Pg-A, U1 to SN, and U1 to FH. Both appliances improved facial features and resolution of anterior crossbite. The TTBA and Carriere Motion 3D Class III appliance had similar effects when applied as early treatment for growing mesio-occlusions and anterior crossbite in two boys. However, long-term outcome assessments and well-designed comparative studies are still required.

Verification of the Korean Version of the Dental Fear Survey

BACKGROUND: Although studies on dental fear in relation to sex and age have been conducted, there have been few nationwide studies particularly on the youth sector. In addition, no validity and reliability verifications have been implemented for new research groups on the Korean version of the Dental Fear Survey (K-DFS). Therefore, this study aimed to apply the K-DFS developed in a previous study on Korean youth to draw conclusions on dental fear among the youth.METHODS: This study used the K-DFS, a Korean translation of Kleinknecht's Dental Fear Survey for elementary school, middle school, and high school students. This study selected 2,161 young people of various ages as participants and increased the validity of the research results by expanding nationwide the scope of the study area.RESULTS: Differences in fear levels according to sex were higher in boys fear behavior scores than in girls' regarding dental treatment (P < 0.05). Students with dental fear had higher scores on items associated with dental treatment and fear of dental stimuli compared with students without dental fear (P < 0.05). Differences were observed among the three groups (P < 0.05). However, the results of logistic regression analysis showed no statistically significant differences for dental visits based on sex, grade, and other subcomponents (P > 0.05).CONCLUSION: By verifying the validity of the newly developed K-DFS, this research confirmed its utility as a dental fear questionnaire. Therefore, there can be no objection that the grounds for criticism have been established according to conventional wisdom. In the future, however, developing and studying the limits of K-DFS that overcome the factors of dental fear, especially pain, will help reduce dental fear in adolescents.

Investigation of the impact of dental fear on Child Oral Health Impact Profile scores

BACKGROUND: The Child Oral Health Impact Profile (COHIP) is a measure of oral health-related quality of life (OHRQoL) in children and adolescents. This study examined the impact of dental fear on the OHRQoL by comparing the COHIP scores of children with and without dental fear. METHODS: The OHRQoL in children and adolescents was measured using the Korean version of the COHIP. In total, 102 students (49 boys and 53 girls) filled in a questionnaire designed to evaluate dental fear and the OHRQoL in 2012 and 2014. RESULTS: In 2012, the group without dental fear showed higher COHIP scores than the group with dental fear; the difference between the two groups was statistically significant. In 2014, the same pattern was observed, but the difference was non-significant for all COHIP items other than those pertaining to social-emotional well-being. Comparison of COHIP scores according to changes in fear showed that the group with continuous dental fear showed significantly lower overall COHIP, negative COHIP, and low social-emotional wellbeing scores, than the group without continuous fear in 2012 and 2014. CONCLUSION: We expected children with dental fear to have poor oral health, affecting their OHRQoL; however, dental fear did not affect the OHRQoL.

Cytotoxicity of Various Calcium Silicate-based Materials with Stem Cells from Deciduous Teeth / 대한소아치과학회지

The purpose of this study was to compare and evaluate the cytotoxicity of 3 calcium silicate-based materials (CSMs) on stem cells from human exfoliated deciduous teeth (SHEDs). The powder of Retro MTA® (RM), EZ-Seal™ (EZ) and ENDOCEM Zr® (EN) was eluted with SHED culture media and then filtered. The SHEDs were cultured in the presence of the various concentrations of the eluate. To investigate the effect of the 3 CSMs on SHED proliferation, the MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay was performed. Flow cytometry analysis was also performed to identify any changes in the cellular phenotype. The absorbance values of the SHEDs cultured in the eluate of samples at a 10% concentration showed the following relation: RM > EN > EZ (p = 0.0439). However, the SHEDs maintained their mesenchymal phenotype regardless of product exposure. Although the 3 CSMs did not alter the SHED stem cell markers, EZ may be a less cytocompatible than RM and EN.

New treatment method for pain and reduction of local anesthesia use in deep caries

Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. Carie-care™, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of Carie-care™ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: ‘chemo-mechanical caries removal agent’, ‘dental caries’, ‘Carie-care’, ‘chemo-mechanical caries removal’, ‘chemo-mechanical caries excavation’, other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that Carie-care™ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

Esthetic Restoration of Deciduous Teeth Using Prefabricated Zirconia Crown in Children with Early Childhood Caries: A Report of Three Cases / 치위생과학회지

Early childhood caries is a widespread condition that requires attention; however, its treatment remains a challenge in terms of child behavior management. This study describes the usefulness of customized zirconia crowns for the restoration of deciduous teeth through the evaluation of some cases. Three cases are described: a 29-month-old girl who presented with severe early childhood caries affecting anterior tooth, a 50-month-old boy who presented with extensive caries of his anterior tooth, and 70-month-old girl who presented with extensive caries of his primary posterior dentition. These prefabricated, zirconium-based ceramic crowns (Nusmile™ NuSmile) are available in various sizes, shapes and colors. Before the treatment, radiographs and intraoral photographs were taken to evaluate the appropriateness of treatment. Our findings indicate that customized zirconia crowns may be appropriate for restoring the deciduous teeth. Further long-term clinical studies are required to clarify the usefulness of this restorative method.

Factors Affecting Dental Fear in Korean Adolescents

PURPOSE: The purpose of this study was to evaluate the dental fear experienced among Korean adolescents and to identify the relevant factors. MATERIALS AND METHODS: In order to compare the level of dental fear depending on the subjects' previous experience, descriptive statistical analysis was performed. Gender- and grade-dependent evaluation was performed according to the presence of their previous dental visit and dental fear. Subjective oral health status was also investigated. In order to determine the factors affecting dental fear, logistic regression analysis was performed. RESULT: Among the total of 333 subjects who had experienced dental fear, females were found to experience 1.766 times greater dental fear than males (P=0.007). The worse subjective perception of their oral health was associated with increase in the experience of dental fear by 1.245-fold (P=0.047). CONCLUSION: The dental fear was likely to be formed during the visit to the dentist's office or through previous experience of dental treatment. Therefore in order to reduce the fear associated with dental treatment in adolescents, establishemnt of a proper environment in the dental clinic and a patient management program are necessitated.

Anti-cariogenic Properties of α-Pinene, a Monoterpene in Plant Essential Oil

Dental caries is the most common chronic disease in the dental field. Streptococcus mutans (S. mutans) is the most important bacteria in the formation of dental plaque and dental caries. In a previous study, we confirmed that the essential oil of Chrysanthemum boreale has antibacterial activity against S. mutans. Alpha-pinene is one of the major chemical components of Chrysanthemum boreale essential oil. In the present study, we investigated the inhibitory effects of α-pinene on cariogenic properties such as growth, acid production, biofilm formation, and bactericidal activity on S. mutans. Alpha-pinene at a concentration range of 0.25-0.5 mg/mL significantly inhibited the growth of S. mutans and acid production of S. mutans. Biofilm formation was significantly inhibited at < 0.0625 mg/mL α-pinene, similar to the data from scanning electronic microscopy. Under confocal laser scanning microscopy, the bacterial viability was decreased by α-pinene in a dose-dependent manner. These results suggested that α-pinene may be a useful agent for inhibiting the cariogenic properties of S. mutans.

The relationship between subjective oral health and dental fear in Korean adolescents

BACKGROUND: This study is aimed to evaluate the level of fear and to reduce the overall fear, thereby enabling patients to receive treatment via timely visits. METHODS: In a survey conducted by 460 South Korean middle school students, we used 453 data that faithfully responded to the survey. Multiple regression analysis was conducted to investigate the factors influencing subjective oral health and dental fear. The significance level used for statistical significance was α = 0.05. RESULTS: The level of fear was higher for upper grade, female students. The factors affecting dental fear were higher for gingival bleeding and dental pain. Regarding factors for dental fear affecting subjective oral health, lower fear of puncture needle and tooth removal tool resulted in higher subjective oral health. CONCLUSION: The study found that adolescents had higher fear of dental care when they had gingival bleeding and tooth pain. Gingival bleeding is a symptom of early gingival disease and dental pain is likely due to advanced dental caries. These results suggested that it is necessary to have a program to reduce dental fear and anxiety as well as a program to prevent dental diseases through regular periodic screening and education.

Three-dimensional measurement of periodontal surface area for quantifying inflammatory burden

PURPOSE: Measurement of the root surface area (RSA) is important in periodontal treatment and for the evaluation of periodontal disease as a risk factor for systemic disease. The aim of this study was to measure the RSA at 6 mm below the cementoenamel junction (CEJ) using the Mimics software (Materialise, Leuven, Belgium). METHODS: We obtained cone-beam computed tomography (CBCT) data from 33 patients who had visited the Department of Oral and Maxillofacial Radiology of Dankook University Dental Hospital. The patients comprised 17 men and 16 women aged from 20 to 35 years, with a mean age of 24.4 years. Only morphologically intact teeth were included in our data. Because the third molars of the maxilla and mandible have a high deformation rate and were absent in some participants, they were not included in our research material. RESULTS: The CBCT data were reconstructed into 3-dimensional (3D) teeth models using the Mimics software, and the RSA at 6 mm below the CEJ was separated and measured using 3-Matic (Materialise). In total, 924 3D teeth models were created, and the area at 6 mm below the CEJ could be isolated in all the models. The area at 6 mm below the CEJ was measured in all teeth from the 33 patients and compared based on sex and position (maxilla vs. mandible). CONCLUSIONS: In this study, we demonstrated that it was feasible to generate 3D data and to evaluate RSA values using CBCT and the Mimics software. These results provide deeper insights into the relationship between periodontal inflammatory burden and systemic diseases.

Regenerative Endodontic Procedure in Korean Children and Adolescents: A Case Report / 치위생과학회지

Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.

Comparison between QraypenTM Imaging and the Conventional Methods of Visual Inspection and Periapical Radiography for Proximal Caries Detection in Primary Molars: An In Vivo Study / 치위생과학회지

The purpose of this study was to evaluate the efficacy of the newly-developed Qraypen™ (All In One Bio, Korea) system for the diagnosis of early proximal caries by comparing it with the conventional methods of visual inspection and periapical radiography. This study was carried out from July 2015 to April 2016 targeting 32 children aged 7~12 years who visited Y-Dental Clinic for school oral health examinations. Two investigators selected and examined a total of 153 primary molars that had not undergone restorative treatment. Comparisons were carried out between visual inspections, readings of posterior periapical radiography images, and readings of Qraypen™ images. This study revealed that the percentage of interproximal surfaces of primary molar teeth without caries incidence was 83.7% using Qraypen™ imaging and 84.9% using visual inspection and periapical radiography. The differences between the two methods were not statistically significant. Thus, Qraypen™ is expected to be a useful and convenient auxiliary diagnostic device that can facilitate the detection of hidden proximal caries in primary molars.

Study on the trends in Korean clinical practice guidelines development

BACKGROUND: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. METHODS: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. RESULTS: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. CONCLUSIONS: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes.

Developmental procedures for the clinical practice guidelines for conscious sedation in dentistry for the Korean Academy of Dental Sciences

BACKGROUND: Evidence-based clinical practice guidelines (CPGs) are defined as “statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations.” This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. METHODS: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs. Existing guidelines, relevant systematic reviews, policy documents, legislation, or other recommendations were reviewed and appraised. To supplement this information, key questions were formulated by the Guideline Development Group and used as the basis for designing systematic literature search strategies to identify literature that may address these questions. Guideline documents were evaluated through a review of domestic and international databases for the development of a renewing of existing conscious sedation guidelines for dentistry. Clinical practice guidelines were critically appraised for their methodologies using Appraisal of guidelines for research and evaluation (AGREE) II. RESULTS: A total of 12 existing CPGs were included and 13 recommendations were made in a range of general, adult, and pediatric areas. CONCLUSION: The clinical practice guidelines for conscious sedation will be reviewed in 5 years' time for further updates to reflect significant changes in the field.

Effect of the Ethanol Extract of Propolis on Formation of Streptococcus mutans Biofilm

Streptococcus mutans (S. mutans) is one of the most important bacteria in the formation of dental plaque and dental caries. S. mutans adheres to an acquired pellicle formed on the tooth surface, and aggregates with many oral bacteria. It initiates plaque formation by synthesizing glucan from sucrose, which is catalyzed by glucosyltransferases. Propolis is a resinous mixture produced by honeybees, by mixing saliva and beeswax with secretions gathered from wood sap and flower pollen. Bees prevent pathogenic invasions by coating the propolis to the outer and inner surface of the honeycomb. Propolis has traditionally been used for the treatment of allergic rhinitis, asthma and dermatitis. We investigated the inhibitory effects of propolis ethanol extract on biofilm formation and gene expression of S. mutans. The biofilm formation of S. mutans was determined by scanning electron microscopy (SEM) and safranin staining. We observed that the extract of propolis had an inhibitory effect on the formation of S. mutans biofilms at concentrations higher than 0.2 mg/ml. Real-time PCR analysis showed that the gene expression of biofilm formation, such as gbpB, spaP, brpA, relA and vicR of S. mutans, was significantly decreased in a dose dependent manner. The ethanol extract of propolis showed concentration dependent growth inhibition of S. mutans, and significant inhibition of acid production at concentrations of 0.025, 0.05, 0.1 and 0.2 mg/ml, compared to the control group. These results suggest that the ethanol extract of propolis inhibits gene expression related to biofilm formation in S. mutans