Williams syndrome is a rare congenital disorder with various physical abnormalities and characterized by facial, oral, and dental features. Individuals with Williams syndrome typically have eating disorders in the early childhood, which lead to prolonged night feeding. Prolonged night feeding is a risk factor for rampant dental caries. Williams syndrome is caused by the microdeletion of chromosome 7, resulting in elastin deficiency. Elastin is integral to cardiovascular health. Many patients with Williams syndrome have complex cardiovascular abnormalities that must be considered a part of dental management. Complications related to cardiovascular diseases may induce adverse effects such as dangerously elevated blood pressure. This may occur in patients during stressful dental treatment. In addition, characteristics of auditory hyperalgesia and anxiety disorders among patients with William syndrome, complicate receiving routine dental management. Therefore, dental treatment under sedation or general anesthesia may be preferable for patients with Williams syndrome; in particular, patients who are very uncooperative and/or needs extensive dental treatment. A thorough evaluation of each patient's physical condition is required before making decisions regarding dental treatment. Careful monitoring and preparation for emergencies are very important during and shortly after dental treatment under general anesthesia or sedation. Monitoring is critical until vital signs have stabilized and return to normal. A 28-month-old man diagnosed as having Williams syndrome, visited the Dental Hospital of OO University for the management of rampant dental caries. We reported on the management of this patient who had peripheral pulmonic stenosis, and received dental treatment under general anesthesia. We also reviewed the characteristics of Williams syndrome and discussed considerations for dental treatment under general anesthesia.
Anesthesia, General ; Anxiety Disorders ; Blood Pressure ; Cardiovascular Abnormalities ; Cardiovascular Diseases ; Child, Preschool ; Chromosomes, Human, Pair 7 ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dental Caries ; Eating ; Elastin ; Emergencies ; Humans ; Hyperalgesia ; Pulmonary Valve Stenosis ; Risk Factors ; Vital Signs ; Williams Syndrome

The purpose of this retrospective study was to evaluate the survival rate of composite resin restorations in permanent first molars in pediatric patients focusing on the influence of risk factors related to patients and teeth.172 patients (6 – 12 years old) who had their permanent first molars restored with composite resin from July 2010 to July 2012 were investigated. From the dental records, the influence of the risk factors on the survival of restorations was assessed. Location of teeth, classification of cavities, patients' age and caries risk were included as risk factors in this study. The caries risks of patients were evaluated by the value of the decayed-missing-filled teeth index with the records of patients taken at 5 years old.Among 354 restorations, 272 restorations retained and 82 restorations were replaced. The overall cumulative survival rate at 5 years was 73.9%. The main reason for replacement of restorations was secondary caries (81.7%). Patients with older age group and with lower caries risk group showed higher survival rate of restorations. No statistically significant influence was detected between the survival rates and the possible risk factors : location of teeth, patients' age and caries risk. The survival rate of restorations was significantly affected by the classification of the cavities (p = 0.002).
Classification ; Dental Records ; Humans ; Molar ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tooth

Molar-incisor malformation (MIM) is a new type of root anomaly reported recently. The characteristics of MIM are dysplastic root formations, constriction of pulp chambers and presence of calcified matrices at the level of cementoenamel junction in permanent first molars and primary second molars. In some cases, permanent maxillary incisors are also affected. The permanent first molars of the patient in this case report were affected with MIM. Generalized pulp stones were observed in overall primary dentition. Micro-computed tomography (micro-CT) imaging and scanning electron microscope-energy dispersive X-ray spectrometer analysis were performed on the extracted mandibular first molar and maxillary primary second molar of the patient. Micro-CT images revealed the discontinuity of enamel directly connected to an accessory canal of the root.

The aim of the study is to compare the fluoride release and recharge properties of glass ionomer cements and ‘alkasite’.
Specimens of two glass ionomer cements (Fuji Ⅸ GP and Riva Self Cure), ‘alkasite’ restorative material (Cention N) and composite resin (FiltekTM Z350XT) were prepared. The fluoride release of each specimen was measured for 28 days. Thereafter, 1.23% acidulated phosphate fluoride (APF) gel was applied to experimental groups. No treatment was performed on control groups. The fluoride release was measured for additional 7 days to evaluate the fluoride recharge properties of each materials.
The fluoride release was highest in Riva Self Cure, followed by Fuji Ⅸ GP, Cention N (p < 0.05). Fluoride release of Cention N was measured to be approximately 49% of Fuji Ⅸ GP’s. After the application of 1.23% APF gel, increases in fluoride release were observed in Riva Self Cure, Fuji Ⅸ GP and Cention N (p < 0.05). Fluoride recharge was observed in Cention N as well as in glass ionomer cements. Further studies are required to evaluate the anti-cariogenic properties of Cention N at clinical conditions.

Recently, sedation is routinely used in children who lacked cooperation in pediatric dental clinics. The purpose of this study is to analyze dental treatment cases in department of pediatric dentistry at Dankook University Dental Hospital associating with sedation during 5 years.From January 2011 to December 2015, information about dental treatment cases in department of pediatric dentistry was collected and reviewed. The information gathered included patient gender, age, sedation type, sedative agents, date of operation, and type of procedure.The proportion of treatment cases with conscious sedation for total treatment cases continued to decline until 2014. On the other hand, the incidence of general anesthesia increased gradually. The frequency of midazolam administration and nitrous oxide inhalation sedation increased recently. The use of conscious sedation was significantly decreased when the age of patient was 3 years or older. The frequency of general anesthesia was similar in all age groups. There was a tendency to perform treatment with deeper sedation when the patient was male than female, and when the pulp treatment was performed together with the restorative treatment than not performed. The frequency of re-treatment within 90 days after restoration treatment decreased as the depth of sedation increased.
Anesthesia, General ; Child ; Conscious Sedation ; Dental Clinics ; Female ; Hand ; Humans ; Incidence ; Inhalation ; Male ; Midazolam ; Nitrous Oxide ; Pediatric Dentistry ; Retrospective Studies ; Statistics as Topic

The purpose of this study was to investigate the odontoblast gene expression related to the subculture speed of supernumerary dental pulp stem cells (sDPSCs). The stem cell is undifferentiated cells which has the ability to differentiate into various cells. Specific stimulation or environment induces cell differentiation, and these differentiation leads to bone or muscle formation.20 sDPSCs were obtained from 20 children under aseptic condition. During the culture through the 10th passage, the third passage cells which showed short subculture period and 10th passage cells which showed long subculture period were earned. Each cell was divided into differentiated group and non-differentiated group. Quantitative real-time polychain reaction (q-RT-PCR) was performed for each group. The genes related to odontoblast differentiation, Alkaline Phosphatase (ALP), Osteocalcin (OCN), Osteonectin (ONT), Dentin sialophosphoprotein (DSPP) and Dentin matrix acidic phosphoprotein 1 (DMP-1), were measured.Differentiated cells showed more gene expression levels. Undifferentiated cells showed higher gene expression level in 10th passages but differentiated cells showed higher gene expression level in 3rd passages. Cells that showed faster subculture period showed relatively lower gene expression level except for OCN and DSPP.
Alkaline Phosphatase ; Cell Differentiation ; Child ; Dental Pulp ; Dentin ; Gene Expression ; Humans ; Odontoblasts ; Osteocalcin ; Osteonectin ; Pilot Projects ; Stem Cells

Carbopol® 907 used as surface protecting agent in White's method is the one of the artificial caries lesion producing solution was discontinuing of production. New surface protecting material to substitute of Carbopol® 907 was required.The author prepared an artificial caries lesion producing solution as follows White's method with Carbopol® 907 and also another artificial caries lesion producing solution with Carbopol® 2050®.96 flattened and polished enamel samples were immersed in a demineralizing solution of 0.1 mol/L lactic acid, 0.2% carboxyvinylpolymer and 50% saturated hydroxyapatite for 1, 2, 3, 4, 5, 6, 7, 9, 11, 15, 18 and 20 days. All samples from each group were subjected to polarized microscopy observed and image analysis for measuring the lesion depth.From the review of polarized images, the artificial caries lesion producing solution using Carbopol® 907 and Carbopol® 2050 can produced an artificial caries that was very similar to natural caries characters.From the regression analysis of the lesion depth produced by the artificial caries lesion producing solution using Carbopol® 907 and Carbopol® 2050, Carbopol® 2050 estimate as Y = 9.8X + 8.0 and Carbopol® 907 was Y = 8.4X − 0.4. R square value of Carbopol® 2050 and Carbopol® 907 was 0.965 and 0.945 respectively.The rate of demineralization by the artificial caries lesion producing solution using Carbopol® 2050 was faster than that of Carbopol® 907. And R square value of Carbopol® 2050 and Carbopol® 907 were very high and it means that the lesion depth was very high coefficient to demineralization period.
Dental Enamel ; Durapatite ; Lactic Acid ; Methods ; Microscopy ; Polymers

The aim of this study was to analyze cells from human dental pulp tissue of impacted supernumerary teeth as stem cells with flow cytometry. Human dental pulp cells from 15 supernumerary teeth were identified their characteristics as stem cells by expression of mesenchymal stem cell markers through flow cytometry analysis at passage 3 and passage 10. Cluster of differentiation (CD) 73, CD 90, CD 34, CD 45 and STRO-1 cell surface markers were used to figure out characteristics of dental pulp stem cells from supernumerary teeth. At passage 3, the cell population showed positive expression of CD 73, CD90 and STRO-1, lacked expression of CD 34 and CD 45. At passage 10, CD 73, CD 90 and STRO-1 showed positive expression while CD 34 and CD 45 showed negative expression. This study indicated that dental pulp stem cells of supernumerary teeth had the properties of mesenchymal stem cells at both early and late passage. Impacted supernumerary teeth could be considered as a noble source of stem cells because of rapid growth and maintaining characteristics of stem cells until late passage.
Dental Pulp ; Flow Cytometry ; Humans ; Mesenchymal Stromal Cells ; Stem Cells ; Tooth, Supernumerary

The aim of this study was to compare compressive strength and microhardness of recently introduced alkasite restorative materials with glass ionomer cement and flowable composite resin. For each material, 20 samples were prepared respectively for compressive strength and Vickers microhardness test. The compressive strength was measured with universal testing machine at crosshead speed of 1 mm/min. And microhardness was measured using Vickers Micro hardness testing machine under 500 g load and 10 seconds dwelling time at 1 hour, 1 day, 7 days, 14 days, 21 days and 35 days. The compressive strength was highest in composite resin, followed by alkasite, and glass ionomer cement. In microhardness test, composite resin, which had no change throughout experimental periods, showed highest microhardness in 1 hour, 1 day, and 7 days measurement. The glass ionomer cement showed increase in microhardness for 7 days and no difference was found with composite resin after 14 days measurement. For alkasite, maximum microhardness was measured on 14 days, but showed gradual decrease.

The purpose of this study is to evaluate the validity of primary anterior zirconia crown made with Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) technology by analyzing fracture strength and translucency parameter.
Zirconia crown was designed with CAD software, using 3D scanned data of #61 tooth model. Crown fabrication was performed with CAM machine using zirconia block. Zirconia crowns were divided into 3 groups according to thickness(0.3, 0.5, and 0.7 mm), and fracture strength was compared with 1.0 mm thickness of resin strip crown. The compressive force was applied with universal testing machine at 30° along the incisal edge at increments of 1 mm/min. For translucency evaluation, 0.3, 0.5, and 0.7 mm thickness of zirconia specimens were fabricated and translucency was measured with spectrophotometer.
Among zirconia groups, there was a significant increase in fracture strength as thickness increased (p < 0.05). The fracture strength of zirconia crown was significantly higher than resin strip crown in all groups (p < 0.05). Translucency parameter was highest in 0.3 mm group, and significantly decreased as thickness increased to 0.5 and 0.7 mm (p < 0.05).
Thin primary anterior zirconia crown can be designed and fabricated according to individual needs by using CAD/CAM. Restoration with thin crown would reduce the amount of tooth reduction, risk of pulp exposure, and make more esthetic restoration possible.