Personalized 3D-printed Titanium Cutting Guide and Prefabricated Osteosynthesis Plate for Mandibular Step Osteotomy to Treat Severe Mandibular Prognathism.

Mandibular step osteotomy, performed for mandibular prognathism, is a difficult and time-consuming procedure. Virtual computer surgery and computer-aided design & computer-aided manufacturing have demonstrated accurate results in orthognathic surgery, though not used for mandibular step osteotomy yet. In this study, the authors report the case of a 21-year-old man with severe mandibular prognathism, with a reverse overjet of 12 mm. Step osteotomy, a modified method of body osteotomy, was planned virtually and performed using 3-dimensional (3D) printed titanium surgical guides and osteosynthesis plates, using computer-aided design & computer-aided manufacturing. At the 6-month postoperative follow-up, there were no notable complications, and normal healing was observed. Each segment was stably in place with the prefabricated plates. The proximal segments were not sagged medially or laterally. With 3D-printed surgical guides and osteosynthesis plates, intraoperative complications, such as injury to adjacent teeth and nerves, could be avoided. They also showed reasonable accuracy and helped reduce operative time and improve outcomes. Unlike surgical guides made of resin/polyamide, titanium surgical guides can be made thinner, which can reduce the extent of detachment. They also did not undergo any deterioration during the operation. Cutting guides and prefabricated plates using virtual surgical planning and 3D printing have many advantages, including reduced preoperative preparation time and operative time, reduced incidence of intraoperative complications, and improved outcomes. However, limitations still exist and further studies are required.

Korean National Oral Health Survey Data on the Symmetry of Primary Dentition Surface Caries.

OBJECTIVES: This study evaluated the intraoral symmetry of dental caries in primary teeth as part of a study of caries patterns in primary dentition. STUDY DESIGN: The data for 4,800 5-year-old and 4,379 8-year-old children in this study were from the 2012 Korean national oral health survey. Pearson correlation coefficients of the decayed and filled surface (dfs) values ranged from 0.436 (lower primary canines) to 0.835 (upper primary central incisors) for the right and left primary teeth and from 0.084 (right primary central incisor) to 0.457 (left primary second molar) for the upper and lower primary dentition (P< 0.01). RESULTS: The upper and lower dfs values differed significantly (P< 0.05) when the right and left primary second molars were excluded. The left or right primary data without caries ranged from 56.4% (lower of first and second primary molars) to 99.7% (lower primary central incisors). The bilateral caries among cases with one or more in the right or left primary teeth ranged from 25.0% (lower lateral primary incisor) to 72.7% (upper primary central incisors). CONCLUSIONS: These results suggested that dental caries in primary teeth show bilateral symmetry and differences in the degree of symmetry according to the teeth set or surface set of the homologous teeth.

Caries Prevalence in Korean Children and Adolescents from 2000 to 2012.

OBJECTIVES: National oral health data is required to assess a population's oral health needs, monitor oral health, plan effective intervention community programs and health policies, and evaluate progress toward health objectives. The study aimed to estimate the prevalence, severity, and inequality in dental caries distribution among Korean young people. STUDY DESIGN: Trained, calibrated examiners at the Korea Ministry of Health & Welfare conducted epidemiological surveys in 2000, 2006, and 2012 during which dental caries were assessed according to World Health Organization (WHO) diagnostic criteria. Decayed, missing, and filled surface and tooth (DMFS/DMFT) indices were estimated. RESULTS: DMFT indices decreased in all regions between 2000 and 2012, with values of 3.3, 2.2, and 1.8 for 12-year-old children in 2000, 2006, and 2012, respectively. The prevalence of caries was higher among female versus male subjects and in rural versus urban areas. CONCLUSIONS: Despite the observed decrease in caries experience indicators in Korea, the caries prevalence remains considerably higher than that in European countries and than the targets set by WHO within the Health21 policy framework. Therefore, Korea apparently retains further potential for caries reduction. Community-based oral disease prevention programs are urgently needed to promote oral health.

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.

Dental fear & anxiety and dental pain in children and adolescents; a systemic review.

BACKGROUND: There are few previous studies investigating the relationship of dental fear and anxiety (DFA) with dental pain among children and adolescents. To address this issue, we examined the literature published between November 1873 and May 2015 to evaluate the prevalence of DFA and dental pain among children and adolescents, and their relationships with age and sex. METHODS: We performed a broad search of the PubMed database using 3 combinations of the search terms dental fear, anxiety, and dental pain and prevalence. A large proportion of the identified articles could not be used for the review due to inadequate end points or measures, or because of poor study design. Thirty-two papers of acceptable quality were identified and reviewed. RESULTS: We found that the prevalence of DFA was estimated to be 10%, with a decrease in prevalence with age. It was more frequently seen in girls, and was related to dental pain. CONCLUSIONS: We concluded that dental fear, anxiety, and pain are common, and several psychological factors are associated with their development. In order to better understand these relationships, further clinical evaluations and studies are required.

Reliability and validity of the Korean version of the Dental Fear Survey.

BACKGROUND: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey ( DFS ) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS ( K-DFS ) and test its reliability and validity. METHODS: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. RESULTS: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. CONCLUSIONS: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.

Use of three-dimensional computed tomography images in dental care of children and adolescents in Korea.

Advances in computed tomography (CT) technology - from traditional CT to cone beam (CB) CT - have benefitted both the dentists and their young patients. We therefore wanted to determine the prevalence of CBCT use in pediatric dentistry in Korea. Our first approach was to conduct an institutional survey to evaluate the use of CBCT for diagnosing and evaluating dental problems in pediatric patients. Our second approach was to review any articles published during 2002-2011 in the Journal of the Korean Academy of Pediatric Dentistry that described clinical use of CBCT. The journal articles surveyed indicated that there were three areas in which CBCT was most useful. The most prevalent use was for diagnosis and monitoring of the growth of cystomas and other tumors in the mouth. The second most common use of CBCT was localization of impacted teeth and evaluation of their relations with adjacent teeth. The third use was to observe supernumerary teeth and evaluate their relations with the roots of adjacent teeth. Compared with traditional CT, CBCT has shorter acquisition times and causes less radiation exposure to the patient. There are fewer side effects with CBCT because its accuracy allows minimally invasive treatment for such problems as impacted and supernumerary teeth.

Restoration of strip crown with a resin-bonded composite cement in early childhood caries.

Background. Early childhood caries is a widely prevalent disease throughout the world. It is necessary to treat this condition in early childhood; however, child behavior management may be particularly challenging during treatment. To overcome this challenge, we used Carigel to remove caries and RelyX Unicem resin cement for strip crown restoration. It not only has the desired aesthetic effect but is also more effective for primary teeth, which are used for a shorter period than permanent teeth are. Case Presentation. We report a case of three pediatric patients with early childhood caries, in whom caries was removed by using Carigel to avoid the risk of pulpal exposure associated with high-speed handpieces. Subsequently, aesthetic restoration was performed using strip crown with RelyX Unicem self-adhesive resin cement. Conclusion. RelyX Unicem has the following advantages: (1) not requiring have any special skills for the dentist for performing the procedure, (2) decreased occurrence of bubbles during injection of the cement, and (3) overall short duration of the procedure. Thus, it is appropriate for the treatment of pediatric patients whose behavior is difficult to manage. However, further studies are required in order to establish the use of RelyX Unicem as a stable restorative material in early childhood caries.