In the root fracture, pulp necrosis tends to involve only the coronal fragment, while the pulp in the apical fragment remains vital. The prognosis of endodontic treatment of the apical fragment is poor due to the possibility of overfilling of the space between the fragments and difficulty in removing necrotic tissue.In the present cases, endodontic treatment of the apical fragment of root fracture was performed. However, in reendodontic treatment, resistance was felt at the fracture site and access to the root canal in the apical fragment was difficult. Therefore, the calcium hydroxide was periodically exchanged only in the coronal fragment without further treatment in the apical fragment and the canal of the coronal fragment was finally filled with Gutta-percha.Regular observation revealed no radiologic complications in the apical fragment. In some cases, we can observe good healing pattern such as absorption of calcium hydroxide and pulp canal obliteration of apical fragment in the long term.
Absorption ; Calcium Hydroxide ; Dental Pulp Cavity ; Dental Pulp Necrosis ; Gutta-Percha ; Prognosis ; Tooth

This study analyzed the longevity of preformed metal crowns (PMCs) in first permanent molars and evaluated factors influencing their survival during a long-term follow-up period. In all, 115 first permanent molars treated with PMCs between June 2008 and June 2018 were retrospectively analyzed. The overall combined success rate for the study group was 84.3%. The 5-year survival rate was 82.8%. Multivariate Cox regression analyses identified distal cavities and mandibular PMC placement as risk factors for restoration failure. Careful placement of PMCs at the final try-in stage augments the longevity of the crown.

This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N2O/O2 in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables.
The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects.
It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.

Dilacerations generally involve central incisors; most often maxillary incisors rather than their mandibular counterparts. The clinical features of dilaceration include non-eruption of the responsible tooth or prolonged retention of the deciduous predecessor tooth. In Case 1, the tooth showed a dilaceration at the boundary between the crown and the root, more laterally rather than labiolingually. In Case 2, the dilacerated tooth showed a crown dilaceration with a relatively normal orientation of the dental root. In both cases, no significant space losses for eruption were observed. Moreover, it seems that unlike the maxilla with the palate, the mandibular anterior teeth are limited to show severe displacement.
From these cases, it is suggested that if a mandibular permanent incisor shows a crown dilaceration or lateral dilaceration at the boundary between the crown and the root, there is a relatively high probability of spontaneous eruption of the dilacerated tooth.

Dentinogenesis imperfecta (DI) is a hereditary disorder of dentinal defect. It is generally inherited as a single autosomal dominant trait. DI usually affects both the primary and permanent dentition. Affected teeth have various types of discolorations, rapid destruction of the dentin, and severe attrition. In radiologic view, the affected teeth have bulbous crowns, short roots and narrow or closed pulp chambers. The treatment objective is to prevent additional attrition and recover the vertical dimension of occlusion.The aim of this report was to present the long-term prognosis in 15 years in a pair of siblings. Both the patients had DI with tooth attrition and discoloration. Different treatment procedures were used, depending on the difference in the timing of intervention. The first patient saved most of his teeth. The second patient had all of her teeth extracted. This report could be helpful for early diagnosis and overall treatment of DI.

The purpose of this study was to investigate the characteristics related to the musculoskeletal disorders in pediatric dentists and general dentists. This study was conducted based on the survey results of a total of 109 dentists who have been working for the last year. Forty - three pediatric dentists and 66 general dentists were surveyed through online survey tool. Both pediatric dentists and general dentists mainly complained of musculoskeletal disorders in the neck, shoulders, wrists, and back. Most pediatric dentists usually suffered from back pain due to their unbalanced posture while giving dental treatments. Pediatric dentists in sedative treatment felt more pain in particular part of their body, such as neck and shoulder. Regular exercise and stretching for the prevention of musculoskeletal disorder have been shown to mainly relieve pain in the back but no other parts in their body.

In children, large odontogenic cysts affect adjacent anatomical structures as well as displace developing permanent teeth. Odontogenic cysts are treated via enucleation or marsupialization. This case reports a 5-year-old boy and a 10-year-old boy who have not only displaced 3 or more permanent teeth but also elevated the maxillary sinus floor due to the large size of the cyst in the maxillary anterior region. In both cases, marsupialization was selected to minimize complications. After marsupialization, a customized acrylic obturator, window opening, and orthodontic traction for eruption guidance were gradually attempted, and it showed a good prognosis, so we report these cases.

The purpose of this study was to compare factors causing stress in pediatric and general dentists when treating pediatric patients and to evaluate their overall occupational stress level. A total of 191 dentists participated in the online survey, consisting of 66 pediatric dentists and 125 general dentists. The questionnaire was conducted using Google Form. Both groups were stressed due to poor cooperation of patient and caregiver, uncertain prognosis of treatment, and low cost of pediatric dental treatment. The pediatric dentists felt relatively high stress due to poor cooperation from caregivers and an uncertain prognosis of treatment (p < 0.05). Overall occupational stress was high in both groups in the order of patient, time, job environment, and income-related stress, and the degrees of pediatric dentists were lower than general dentists. Among the 3 sub-factors of occupational burnout, more than 98% of both groups showed burnout in “depersonalization”, and more than 69% of both groups showed burnout in “emotional exhaustion”. Both groups showed a low burnout rate in “reduced sense of accomplishment” and pediatric dentists showed a higher sense of accomplishment than general dentists (p < 0.05). This study showed that both groups were under high occupational stress due to various factors, and efforts were required to relieve stress.

Antibiotic use in the dental field, especially in pediatric dentistry, should be carefully considered, taking into account resistance and side effects. This review aims to provide a general overview of antibiotic use and dosage in pediatric dentistry. Indications for antibiotic prescription include symptoms of systemic infection such as fever (≥ 38°C), lymphadenitis (cervical lymph node swelling and tenderness), facial swelling (especially spreading around the eyes), cellulitis, soft tissue infections (risk of deep infection and sepsis), severe localized infection or high risk of infection after invasive dental procedures such as acute pulpitis, severe periapical abscess spreading to soft tissues, persistent or worsening infection despite drainage, and prophylactic antibiotic use in immunocompromised patients. Antibiotic use for simple dental caries, no signs of infection after root canal treatment, prophylactic use after simple tooth extraction, and viral infections is unnecessary. The first-choice antibiotic in dentistry is amoxicillin; its dosage should be adjusted according to the infection symptoms and body weight in children. Furthermore, amoxicillin-clavulanate, clindamycin, metronidazole and azithromycin can be prescribed depending on the type of infection and the patient’s allergies. Excessive and inappropriate antibiotic use can contribute to antibiotic resistance. Pediatric dentists should receive continuous education and stay updated on periodic revisions to antibiotic use and dosage guidelines.

Antibiotic use in the dental field, especially in pediatric dentistry, should be carefully considered, taking into account resistance and side effects. This review aims to provide a general overview of antibiotic use and dosage in pediatric dentistry. Indications for antibiotic prescription include symptoms of systemic infection such as fever (≥ 38°C), lymphadenitis (cervical lymph node swelling and tenderness), facial swelling (especially spreading around the eyes), cellulitis, soft tissue infections (risk of deep infection and sepsis), severe localized infection or high risk of infection after invasive dental procedures such as acute pulpitis, severe periapical abscess spreading to soft tissues, persistent or worsening infection despite drainage, and prophylactic antibiotic use in immunocompromised patients. Antibiotic use for simple dental caries, no signs of infection after root canal treatment, prophylactic use after simple tooth extraction, and viral infections is unnecessary. The first-choice antibiotic in dentistry is amoxicillin; its dosage should be adjusted according to the infection symptoms and body weight in children. Furthermore, amoxicillin-clavulanate, clindamycin, metronidazole and azithromycin can be prescribed depending on the type of infection and the patient’s allergies. Excessive and inappropriate antibiotic use can contribute to antibiotic resistance. Pediatric dentists should receive continuous education and stay updated on periodic revisions to antibiotic use and dosage guidelines.