The purpose of this in vivo study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography.
Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels.
Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries.
The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

This study aimed to evaluate the effectiveness of deep convolutional neural networks (CNNs) for diagnosis of interproximal caries in pediatric intraoral radiographs. A total of 500 intraoral radiographic images of first and second primary molars were used for the study. A CNN model (Resnet 50) was applied for the detection of proximal caries. The diagnostic accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under ROC curve (AUC) were calculated on the test dataset. The diagnostic accuracy was 0.84, sensitivity was 0.74, and specificity was 0.94. The trained CNN algorithm achieved AUC of 0.86. The diagnostic CNN model for pediatric intraoral radiographs showed good performance with high accuracy. Deep learning can assist dentists in diagnosis of proximal caries lesions in pediatric intraoral radiographs.

This study retrospectively analyzed the effect of clinical factors on the outcomes of REP(regenerative endodontic procedure). Patients who received the REP using triple antibiotic paste due to trauma or fracture of dens evaginatus from February, 2011 to January, 2020 were included in the study. Finally, 57 teeth in 54 patients were selected.
Investigated clinical factors were as follows: intentional bleeding, etiology, and root development stage. Treatment outcomes evaluated were as follows: improvement of subjective symptoms, changes in the periapical lesion, and the amounts of root development after REP. To compensate for differences in angulation and position between repeated radiographic examinations, images were aligned by Turboreg plugin. To evaluate the amounts of root development, apical diameter, root area, and root length were measured by ImageJ software.
Among the aforementioned factors, intentional bleeding had no significant effect on treatment results. Regarding the etiology, the increase in the root area and the root length was significantly less in trauma cases than in dens evaginatus fracture cases. Considering root development stage, more immature teeth presented more increase in the root area.

Children with an intellectual disability often demonstrate lack of cooperation during dental treatment and require behavioral management. A child with mild intellectual disability can be managed adequately using restraints and medication. However, in cases of profound intellectual disability, dental treatment under general anesthesia is usually required. In cases where the patient is an intellectually disabled child who has intellectually disabled parents, it is difficult to evaluate the patient's preoperative condition and to obtain consent for treatment under general anesthesia. Furthermore, they are unable to respond to emergencies after treatment. Therefore, dental treatment should be performed under general anesthesia with hospitalization for children with an intellectual disability. This case presents the dental treatment of an intellectually disabled child, who has intellectually disabled parents, and who required general anesthesia and hospitalization.
Anesthesia, General* ; Child ; Dental Care for Disabled ; Disabled Children* ; Emergencies ; Hospitalization ; Humans ; Intellectual Disability ; Parents*

Chronic infantile neurological cutaneous articular (CINCA) syndrome periodically causes fever along with inflammation in multiple organs. Patients with this condition are vulnerable to dental problems due to systemic inflammation. For uncooperative patients, general anesthesia has been widely used to control negative behavior. However, caution should be exercised when administering general anesthesia in these patients because this syndrome is pro-inflammatory. The present case report describes the clinical considerations of the dental treatment of an uncooperative child with CINCA syndrome who was treated under general anesthesia.
Anesthesia, General ; Child ; Cryopyrin-Associated Periodic Syndromes ; Dental Caries ; Fever ; Humans ; Inflammation

The aim of this study was to obtain the traceability of the software used to analyze lateral cephalometry and to calculate the uncertainty of the measurements. Furthermore, this study aimed to provide a basis for obtaining standard references for measurement values for orthodontic treatment in children.Cephalometric data were collected from 100 children diagnosed with class I malocclusion between the ages 6 to 13 years who visited the pediatric dentist at Seoul National University Dental Hospital. To ensure traceability, a phantom device was created. Correction values were calculated by measuring the length and angle of the phantom device using the software. Type A uncertainty was calculated by obtaining the standard deviation of cephalometric measurements of 100 persons and the standard error of repeated measurements. Determination of the type B uncertainty was induced by minimum resolution and the position of the head. Using these, the combined standard uncertainty was obtained and the expanded uncertainty was calculated.The results of this study confirm that the currently used software has high accuracy and reliability. Furthermore, the uncertainty of orthodontic measurements in Korean children aged 6 to 13 years was calculated, and distribution range for class I malocclusion with 95% confidence interval was suggested.
Cephalometry ; Child ; Dentists ; Head ; Humans ; Malocclusion ; Seoul ; Uncertainty

Pre-eruptive intracoronal resorption (PEIR) is a developmental defect in the crown of a pre-eruptive tooth. The purpose of this study was to investigate the relationship between the size of the pre-eruptive buccal pit radiolucency, which is suspected as PEIR on a panoramic radiography, and the need for restoration after the eruption of a mandibular first molar.The experimental group included 35 mandibular first molars, in which lesions requiring definite restoration were observed during eruption. The control group consisted of 64 sound mandibular first molars after eruption. The sex, age, tooth position, tooth formation stage, size of the pre-eruptive buccal pit radiolucency, and restoration methods in the experimental group and control group were examined.Compared with the control group, the experimental group showed a statistically significant difference in the size of the buccal pit before eruption. The buccal pit size for predicting the need for restoration was further examined by receiver operating characteristic curve analyses, and the area under the curve was 0.813 ± 0.047.If radiolucency is observed at the buccal pit of the mandibular first molar before eruption, periodic observations and post-eruption examinations are required.
Crowns ; Molar ; Radiography, Panoramic ; ROC Curve ; Tooth

The purpose of this study was to analyze the ratio and rate of apical closure when inducing root growth of necrotic immature permanent teeth using alternative triple antibiotics. 24 permanent teeth in the treatment group and 27 premolars in the control group were retrospectively studied using periapical radiographs for more than 300 days after the first visit. The difference in the growth rate between the two groups was statistically compared using the Mann-Whitney test at a significance level of 0.05. There were no statistically significant differences between the two groups in the first month and during months 1 – 3, 3 – 6, and 6 – 12. After 12 months, the cumulative rate of decrease in the apical foramen width in the treatment group was 50.59% and that in the control group was 71.82%, which revealed a significant difference between the two groups. There were significant differences in the rates of decrease in the apical foramen width after 3, 6 months, and later period in the treatment group, respectively. The cumulative rate of increase in the root dentin area presented no statistically significant differences between the treatment group and control group during the entire period of examination.
Anti-Bacterial Agents ; Bicuspid ; Dentin ; Retrospective Studies ; Tooth Apex ; Tooth

The practice pattern of pediatric dentistry has been changing for the last several decades. This change might be influenced by several factors such as development in dental materials and socioeconomic changes. The purpose of this study was to analyze the changing trends of patient distribution and treatment pattern of pediatric dentistry.Patient distribution and practice trends from 2006 to 2015 at the department of pediatric dentistry of Seoul National University Dental Hospital were reviewed. From 2006 to 2015, the proportion of new patient increased from 12.49% to 20.56%. The average age of new patients decreased. In 2006, restorative treatment had highest percentage, followed by preventive treatment, orthodontic treatment, surgical treatment, and pulp treatment. In 2015, preventive treatment had highest percentage, followed by restorative treatment, orthodontic treatment, surgical treatment and pulp treatment Frequency of general anesthesia increased more than 5 times for last 10 years. The proportion of insurance treatment decreased until 2009, and after 2010 it increased steadily.
Anesthesia, General ; Dental Materials ; Humans ; Insurance ; Pediatric Dentistry ; Seoul

Root resorption of the permanent maxillary incisors can occur due to ectopic eruption of the permanent canines. Severe root resorption threatens the long-term survival of the affected incisors. The aim of the present study was to identify risk factors for root resorption of the maxillary incisors associated with impacted maxillary canines. In the present study, we retrospectively analyzed the Cone-Beam Computed Tomography (CBCT) scans of 65 children and adolescents with ectopically erupting maxillary canines (total of 88 impacted canines). Root resorption of central incisors was significantly associated with the mesiodistal position and root development of the adjacent canine. Root resorption of lateral incisors was significantly associated with sex, age, and the buccolingual and vertical position of the adjacent canine. However, enlargement of the dental follicle was not significantly associated with root resorption of adjacent incisors. Although incisor resorption is difficult to diagnose and predict, our findings suggest that changes in the dental follicles of the erupting maxillary canines do not cause resorption of the adjacent permanent incisors. CBCT should be utilized to ensure early diagnosis of impacted canines and precise evaluation of incisor root resorption.
Adolescent ; Child ; Cone-Beam Computed Tomography ; Dental Sac ; Early Diagnosis ; Humans ; Incisor ; Retrospective Studies ; Risk Factors ; Root Resorption ; Tooth, Impacted