1.Detecting of Proximal Caries in Primary Molars using Pen-type QLF Device
Hyejin CHO ; Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Jung-Wook KIM ; Ki-Taeg JANG ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2021;48(4):405-413
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.
2.Detection of Proximal Caries Lesions with Deep Learning Algorithm
Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2022;49(2):131-139
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.
3.Clinical Factors Affecting the Results of Regenerative Endodontic Procedure
In-Ki KIM ; Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Young-Jae KIM ; Jung-Wook KIM ; Ki-Taeg JANG
Journal of Korean Academy of Pediatric Dentistry 2021;48(4):449-459
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.
4.Dental treatment under general anesthesia in an intellectually disabled child with intellectually disabled parents.
Jeong Hwa HAN ; Hong Keun HYUN ; Young Jae KIM ; Jung Wook KIM ; Ki Taeg JANG ; Chong Chul KIM ; Sang Hoon LEE ; Teo Jeon SHIN
Journal of Dental Anesthesia and Pain Medicine 2016;16(3):213-216
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*
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Child
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Dental Care for Disabled
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Disabled Children*
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Emergencies
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Hospitalization
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Humans
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Intellectual Disability
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Parents*
5.Characteristics of Intravenous Midazolam Sedation with Nitrous Oxide in Pediatric Dental Treatment
Hyuntae KIM ; Ji-Soo SONG ; Hong-Keun HYUN ; Young-Jae KIM ; Jung-Wook KIM ; Ki-Taeg JANG ; Sang-Hoon LEE ; Teo Jeon SHIN
Journal of Korean Academy of Pediatric Dentistry 2020;47(1):53-61
Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment.
The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records.
Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil.
Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.
6.Regional Distribution and Practice Pattern of Pediatric Dental Clinics in Korea
Jong Kyun CHAE ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Sang-Hoon LEE ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2020;47(1):44-52
The number of pediatric dental clinics has been increasing due to the development of dentistry and changes in public awareness of professional dental care for children. The purpose of this study was to investigate the present status of pediatric dental clinics in Korea in several respects, including regional distribution.
There were 343 pediatric dental clinics (1.91%) among 17,917 dental clinics in Korea. 248 out of 343 private practitioners were board certified pediatric dentists. Of 248 board certified pediatric dentists, 25 displayed the specialty in their clinics’ name. Gyeonggi occupied largest share of the total pediatric dental clinics in Korea, followed by Seoul and Busan. Gangnam-gu occupied largest share of the total pediatric dental clinics in Seoul. Out of all pediatric dental clinics in Korea, 78.7% was run by only one dentist. 90.9% of pediatric dental clinics didn’t do night clinic on weekdays and 26.5% was open until after 15:00 on Saturday.
7.Association between Developmental Anomalies of Permanent Lateral Incisors and Tooth Eruption Disturbances
Minji KIM ; Jisoo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Young-Jae KIM ; Jung-Wook KIM ; Sang-Hoon LEE ; Ki-Taeg JANG
Journal of Korean Academy of Pediatric Dentistry 2020;47(2):128-139
The purpose of this study was to examine the prevalence of developmental anomalies of permanent lateral incisor and eruption disturbances and analyze the association between two components. Panoramic radiographs of 3984 patients (aged 5 to 13 years) who visited the Department of Pediatric Dentistry of Seoul National University Dental Hospital between November 2016 and October 2017 were screened.
The prevalence of developmental anomalies of permanent lateral incisors was 10.2%. The most common developmental anomalies were congenitally missing teeth(66.1%), followed by peg lateralis(33.5%). The prevalence of eruption disturbances was 16.5%. Among the patient with developmental anomalies of permanent lateral incisors, associated eruption disturbances were appeared on 31.1% of patients. Peg lateralis(p < 0.001), underdeveloped lateral incisors(p < 0.001) and dens invaginatus(p = 0.004) were associated significantly with eruption disturbance of permanent teeth. Eruption disturbance in patients with peg lateralis and dens invaginatus was most prevalent in maxillary canine. For patients with underdeveloped lateral incisor, eruption disturbance of maxillary central incisor was most frequent.
It is important for patients with developmental anomalies of lateral incisors to detect associated eruption disturbance early through regular checkup. Diagnosis and treatment plan in view of such relationships is important in order to treat appropriately at the optimal time.
8.Lateral Cephalometric Measurement of Skeletal Class III malocclusion Patients with Uncertainty
Young Jae SUNG ; Ji-Soo SONG ; Hong-Keun HYUN ; Young-Jae KIM ; Jung-Wook KIM ; Ki-Taeg JANG ; Sang-Hoon LEE ; Teo Jeon SHIN
Journal of Korean Academy of Pediatric Dentistry 2020;47(4):416-426
The purpose of this study was to calculate uncertainty of orthodontic measurement in skeletal class III malocclusion children using lateral cephalometry analysis software which obtained traceability in previous study. Using this data, standard reference of measurement value for skeletal class III malocclusion was obtained.
Lateral cephalometric data was collected from 144 children who visited Pediatric Dentistry from 2017 to 2020 for orthodontic treatment. Orthodontic measurement was analyzed with software which obtained traceability. Type A evaluation of uncertainty and type B evaluation of uncertainty was calculated to obtain combined standard uncertainty and expanded uncertainty. Standard reference of skeletal class III children was compared to standard reference of skeletal class I children.
Distribution range for skeletal class III malocclusion children aged 6 to 10 with 95% confidence interval was provided using calculated uncertainty of orthodontic measurement value.
9.The Effect of Silver Diamine Fluoride on Salivary Biofilm
Meekyung SEO ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Sang-Hoon LEE ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2020;47(4):406-415
Silver diamine fluoride (SDF) is an effective and efficient agent for arresting dental caries. It can be useful in treating children with behavioral or medical limitations. The purpose of this study was to evaluate the antimicrobial effect of SDF by using salivary biofilm.
Pellicle-like saliva coated structure was prepared by using unstimulated saliva. For developing cariogenic biofilm, Streptococcus mutans was added to the mixture of pooled saliva and inoculated into a saliva coated glass or chamber. SDF was applied to cariogenic biofilm to evaluate the antimicrobial effect of SDF. As time passed, total bacteria and S. mutans were reduced after application of SDF (p < 0.000). Confocal laser scanning microscope also showed the increment of the ratio of dead cell.
As a result of experiment using enamel and dentin of primary teeth, it was confirmed that the growth of cariogenic biofilm was inhibited when the SDF was treated (p = 0.029 each).This study showed excellent anti-microbial effect of SDF. And anti-caries effect in clinical practice can be expected.
10.Retrospective study on three-dimensional characteristics of mesiodens using CBCT in pediatric dentistry
GiYoun RYU ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Sang-Hoon LEE ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2021;48(1):77-94
The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019.
The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient’s age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications.
These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.