The aim of this study was to analyze the changes and improvements in symptoms of sleep-disordered breathing (SDB) using semi-rapid maxillary expansion (SRME) in children with narrow maxilla and SDB symptoms. Subjects were 15 patients with sleep disorder (apnea-hypopnea index, AHI ≥ 1) and narrow maxillary arch between 7 and 9 years of age. Before the SRME was applied, all subjects underwent pediatric sleep questionnaires (PSQ), lateral cephalometry, and portable sleep monitoring before expansion (T0). All subjects were treated with SRME for 2 months, followed by maintenance for the next 3 months. All subjects had undergone PSQ, lateral cephalometry, and portable sleep monitoring after expansion (T1). Adenoidal-nasopharyngeal ratio (ANR), upper airway width and hyoid bone position were measured by lateral cephalometry. The data before and after SRME were statistically analyzed with frequency analysis and Wilcoxon signed rank test. As reported by PSQ, the total PSQ scale was declined significantly from 0.45 (T0) to 0.18 (T1) (p = 0.001). Particularly, snoring, breathing, and inattention hyperactivity were significantly improved (p = 0.001). ANR significantly decreased from 0.63 (T0) to 0.51 (T1) (p = 0.003). After maxillary expansion, only palatopharyngeal airway width was significantly increased (p = 0.035). There was no statistically significant difference in position of hyoid bone after expansion (p = 0.333). From analysis of portable sleep monitoring, changes in sleep characteristics showed a statistically significant decrease in AHI and ODI, and the lowest oxygen desaturation was significantly increased after SRME (p = 0.001, 0.004, 0.023).In conclusion, early diagnosis with questionnaires and portable sleep monitoring is important. Treatment using SRME will improve breathing of children with SDB.
Cephalometry ; Child ; Diagnosis ; Early Diagnosis ; Humans ; Hyoid Bone ; Maxilla ; Oxygen ; Palatal Expansion Technique ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Snoring

The object of this study is to introduce a novel method of foreheadplasty. The new foreheadplasty can lower the anterior hairline and results in reduction of the vertical forehead length and mid-face lift can be performed at the same time. A 54 year-old female who had a long forehead visited the clinic for rejuvenation of the mid-face. The authors performed dual-vector foreheadplasty and were able to lower the anterior hairline by the advancement of the posterior scalp flap. Mid-face lift was performed by elevation of the malar fat pads. The surgical results were analyzed by measuring the length of the forehead before and 2 years after the surgery. Medical photographs were taken at the same period. The preoperative length of the forehead was 75.5 mm and decreased to 63.0 mm after the surgery. The shortened forehead was well maintained even 2 years after the operation (63.3 mm). The patient suffered from partial sensory loss of the parietal region but resolved simultaneously after 2 months. No other complications, such as, hypertrophic scarring, infection, prolonged inflammation and alopecia occurred. In conclusion the dual-vector foreheadplasty is a relatively simple and safe way to lower the anterior hair line with the elevation of the mid-face.
Adipose Tissue ; Alopecia ; Cicatrix, Hypertrophic ; Female ; Forehead ; Hair ; Humans ; Inflammation ; Rejuvenation ; Rhytidoplasty ; Scalp

PURPOSE: A barbed suture used in flexor tenorrhaphy can maintain prolonged strength despite absorption of the suture material and allows knotless repair with tendon-barb adherence along the suture's entire length. The purpose of this study was to evaluate the strength of the tendon and its histologic analysis after tenorrhaphy using barbed sutures. METHODS: Forty-two New Zealand rabbits were used in this study and were divided into experimental and control groups. In the experimental group, knotless repair of the tendons was performed using absorbable barbed sutures. In the control group, a 4-stranded double-modified Kessler tenorrhaphy was performed using non-absorbable monofilament sutures. The force to failure for each tendon was measured immediately after tendon repair and at 1 week, 4 weeks, and 8 weeks after the repair. Microscopic analysis of the tendons was performed at 1 week, 4 weeks, and 8 weeks after their repair. RESULTS: Eight weeks after tendon repair, the force to failure value of the rabbits in the experimental group (144.02+/-10.21 N) was significantly higher than that of the rabbits in the control group (125.26+/-8.75 N) (p=0.032). The difference in the value during the periods was not statistically significant. Histologic findings showed increased foreign body reaction in the tendons of the experimental group and sustained inflammation in those of the control group. CONCLUSION: With respect to load to failure and the degree of inflammation, the use of absorbable barbed suture resulted in better tendon repair than the conventional non-absorbable suture.
Absorption ; Calcaneus ; Foreign-Body Reaction ; Inflammation ; Rabbits ; Sutures ; Tendon Injuries ; Tendons

The aim of this study was to evaluate the association between various predicting tools and Apnea-Hypopnea Index (AHI) to identify children with sleep disordered breathing (SDB). From 5 to 10 years old who came for orthodontic counseling, 61 children, whom had lateral cephalograms, pediatric sleep questionnaire (PSQ) records, and portable sleep monitoring results, were included in this study. A total of 17 measurements (11 distances and 6 angles) were made on lateral cephalograms. The measurements of lateral cephalograms, PSQ scales and portable sleep monitoring results were statistically analyzed. 49 of 61 (80%) patients showed AHI > 1, which suspected to have SDB and their mean AHI was 2.75. In this study, adenoid size (A/N ratio), position of the hyoid bone from mandibular plane, gonial angle, and PSQ scale were related to a higher risk of pediatric SDB. Also, oxygen desaturation index (ODI) and snoring time from sleep monitoring results were statistically significant in children with SDB using Mann-Whitney test (p ＜ 0.05).
In conclusion, evaluation of hyoid bone position, adenoidal hypertrophy, gonial angle in lateral cephalogram, and PSQ scale was important to screen out potential SDB, especially in children with frequent snoring.

The purpose of this study was to investigate trends in dental sedation of Korean children and adolescents.
A retrospective study was conducted on patients under 20 years of age who received dental treatment under sedation using National Health Insurance Service-National Sample Cohort Database from 2002 to 2015. Based on the 1 million standard data, there were 436 cases of dental treatment under sedation in 2002, but 4002 cases in 2015, showing a trend increasing every year. The 3 - 5 year old group accounted for the largest portion (54.2%), while the 6 - 8 year old group increased recently. Nitrous oxide inhalation sedation is the most commonly used, accounting for 45.9% in 2002, but increased to 89.5% in 2015. Combination of nitrous oxide inhalation sedation, chloralhydrate and hydroxyzine was the most common, accounting for 5.7% in 2002, but decreased to 2.9% in 2015.
There is a trend to use the sedation method more safely and in a way that reduces side effects.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, autosomal recessive disorder; affected patients are characterized by inability to feel pain and to sweat over the entire body, as well as by mental retardation. Because, in the oral examination, no specific findings on soft or hard tissue may be found except possible lesions due to self-mutilation, early recognition and diagnosis are essential for these patients. Pediatric dentists must be aware of the clinical manifestations and treatment considerations related to uncontrolled body temperature, tactile hyperesthesia and lack of pain reflex. In this case report, dental management of CIPA was suggested by presenting a 6-year follow-up of young patient.
Body Temperature ; Dentists ; Diagnosis ; Diagnosis, Oral ; Follow-Up Studies ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Hyperesthesia ; Hypohidrosis ; Intellectual Disability ; Pain Insensitivity, Congenital ; Reflex ; Sweat

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018.Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2(nd) referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2(nd) referral was relatively delayed with increased ratio of ‘during treatment’.These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Child ; Dental Clinics ; Dentists ; Electronic Health Records ; Female ; Humans ; Intellectual Disability ; Jeollabuk-do ; Minor Surgical Procedures ; Outpatients ; Pediatric Dentistry ; Referral and Consultation

The aim of this study was to determine the prevalence and incidence and evaluate the current status of dental treatment of Amelogenesis imperfecta (AI) and Dentinogenesis imperfecta (DI) in South Korea. The data was based on National Health Insurance Service (NHIS)-National Sample Cohort Database (2002 - 2015) and Jeonbuk National University (JBNU) Dental Hospital (2011 - 2020).
The NHIS data analysis showed prevalence of AI and DI were 11.6 and 2.4 per 100,000 people, respectively. The annual incidence of AI and DI for 2013 - 2015 were 2.2 and 0.5 per 100,000. There were no statistically significant differences regarding the number of visits, the reimbursable cost among AI, DI patients and others.
In the patient analysis of the JBNU dental hospital, proportion of the reimbursable and non-reimbursable cost for AI patients were 12.1% and 87.9%, while DI patients accounted for 18.6% and 81.4%.

The aim of this study was to investigate difference of child's dental fear and agreement between parent/child dyads according to parental rearing style.The subjects were 801 children aged 8 and 11-year old and their parents in Jeonju city. The parents were asked to answer a questionnaire which included four parental rearing style and the Children's Fear Survey Schedule - Dental Subscale(CFSS-DS) at home. Also, the CFSS-DS was completed by 8 and 11 years old children in a classroom.Authoritative, permissive, authoritarian and neglectful parenting styles were 53.4%, 45.8%, 0.2% and 0.6% respectively. Authoritative and permissive parents reported 5.7 and 7.5 points higher than dental fear scores reported by their children. At 8 years old, children of authoritative parents were significantly 3.9 points higher than them of permissive parents(p = 0.002). Also, parent/child dyads showed moderate agreement assessing dental fear at aged 8.Parenting styles are related to children's dental fear, and especially 8-year-old girls in authoritative parenting styles have the highest dental fear. However, as age increased, the impact of parental styles on children's dental fear decreased.
Appointments and Schedules ; Child ; Dental Anxiety ; Female ; Humans ; Jeollabuk-do ; Parenting ; Parents

The most common cause of mouth breathing is obstacles caused by mechanical factors in upper airway. Mouth breathing could be consequently pathological cause of sleep-disordered breathing. Sleep-disordered breathing in children can cause growth disorders and behavioral disorders. The purpose of this study was to investigate relationship between upper airway and sleep-disordered breathing in children with mouth breathing.Twenty boys between 7 – 9 years old who reported to have mouth breathing in questionnaire were evaluated with clinical examination, questionnaires, lateral cephalometric radiographs, and portable sleep testing. This study assessed apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) for the evaluation of sleep-disordered breathing and was done to investigate the correlation between these values and the upper airway width measured by lateral cephalometric radiographs.There was no significant correlation with the size of the tonsils (p = 0.921), but the adenoid hypertrophy was higher in the abnormal group than in the normal group (p = 0.008). In the classification according to AHI and ODI, retropalatal and retroglossal distance showed a statistically significant decrease in the abnormal group compared to the normal group (p = 0.002, p = 0.001). As AHI and ODI increased, upper airway width tended to be narrower. This indicates that mouth breathing could affect the upper airway, which is related to sleep quality.
Adenoids ; Child ; Classification ; Growth Disorders ; Humans ; Hypertrophy ; Mouth Breathing ; Mouth ; Oxygen ; Palatine Tonsil ; Sleep Apnea Syndromes