The aim of this study is to investigate visual exploration of children and adolescents during dental treatment by examining time ratio of eye opening in various age groups.
This study reviewed 5 - 15 year-old patients who visited the department of pediatric dentistry of Yonsei University Dental Hospital from March to October 2018. Restorative treatment or sealant application was done by one pediatric dentist. A trained observer used 2 stopwatches to measure total treatment time and time of open eye. Average ratios of eye opening were calculated and compared.
60 patients were investigated, with 15 patients in each age group. Average ratio of eye opening increased as age decreased (p < .001). The average of 13 - 15 year-olds was significantly shorter than that of children younger than 12 years (p < .005).
This study indicated that children have higher rates of eye opening during dental treatment than adolescents.

The clinical manifestations of nervous system involvement in systemic lupus erythematosus (SLE) are highly diverse and their pathogenic mechanisms are incompletely understood. Neuropsychiatric SLE (NPSLE) poses difficulty in making the proper diagnosis, especially in circumstances where its initial symptoms are diffuse neuropsychiatric symptoms. We describe a 43-year old woman who exhibited a myoclonic jerk of the abdominal wall, followed shortly by acute confusion, which was attributed to SLE. Therapy with high dose corticosteroids completely reversed the symptoms. Myoclonus can be an anticipatory symptom of diffuse neurologic dysfunction in patients with NPSLE.
Abdominal Wall ; Adrenal Cortex Hormones ; Central Nervous System ; Female ; Humans ; Lupus Erythematosus, Systemic ; Lupus Vasculitis, Central Nervous System ; Myoclonus ; Nervous System ; Neurologic Manifestations

The first permanent molars play a key role in maxillofacial development and occlusion. The purpose of this study is to investigate the characteristics and development stages of first molars with delayed eruption, and to evaluate their associations with congenital missing teeth. Eight-year-old patients who had delayed eruption in their first molars were classified into 75 patients with physical barriers and 77 patients without physical barriers. The development stages of the first and second molars in the delayed area were analyzed using Nolla method from the panoramic radiographs. The relationship between congenital missing teeth and delayed area was also investigated. Delayed eruption of first molars were more common in the maxilla alone. With the presence of physical barriers, male patients showed higher frequency in unilateral cases, while female patients had higher bilateral cases when there was no physical barrier. Delayed development of first molars were observed in delayed eruption area. In the absence of physical barriers, adjacent second molars were also developed slowly and the incidence of congenital missing teeth was high in delayed area. If first molars with delayed eruption are observed, clinical and radiographical follow-ups are necessary for the evaluation of their developmental stages and congenital missing teeth.

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into ‘general background of the respondents’, ‘the awareness on national health insurance (NHI) and DHI’, ‘the awareness on DHI pertaining to pediatric dentistry’, ‘issues that need improvement on DHI pertaining to pediatric dentistry’, ‘DHI claims’, and ‘the roles of KAPD in DHI’. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

This study aimed to investigate a quantitative analysis of the anatomical characteristics of the maxillary supernumerary lateral incisor and its relationship with lateral incisors. Forty-four supernumerary lateral incisors from 43 patients were evaluated for analyzing the position, shape, direction, and relationship between the supernumerary lateral incisor and the normal lateral incisors, using cone-beam computed tomography (CBCT). To compare the size of crown, the mesiodistal width was measured and the Nolla stage was used for evaluating the degree of root development to compare tooth maturity. The supernumerary lateral incisors were in the normal direction at a rate of 90.9%, and in a supplemental shape at a rate of 84.1%. The supernumerary lateral incisor was smaller in size compared to the adjacent lateral incisor and opposite lateral incisor (p < .0001). There was no statistically significant difference in the development stage of root. Based on these results, the supernumerary lateral incisor is similar with the lateral incisor, but has a difference in the size of crown. It is necessary to distinguish the supernumerary lateral incisor from the lateral incisor precisely to reduce clinical complications.

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and osttreatment(T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this studyindicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.

The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children’s facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject’s compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children’s facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.

The first dental visit is recommended at the time of the eruption of the first tooth and no later than 12 months of age. However, even before the age of 1, children can visit the dental hospital for various reasons. The purpose of this study was to analyze the reasons for the dental visit of infant. From January 2006 to December 2015, medical records of infants who visited the Department of Pediatric Dentistry of Kyung Hee University were analyzed. The total number of patients was 419 (238 males and 181 females). The reasons for the dental visits were trauma (47.5%), nataleonatal tooth (19.8%), dental caries (8.1%), teething problem (4.3%), abnormal frenum (3.6%), soft tissue swelling (3.6%), Bohn’s nodule (3.3%), cleft lip and palate (2.9%), gingival neoplasm (1.9%), tongue ulceration (1.7%), oral examination (1.4%), enamel hypoplasia (1.2%) and abnormal temporomandibular joint sound (0.7%). According to this study, there were various oral diseases that could occur in infants. Since infants are usually cared by caregivers, pediatricians, and obstetricians, education of oral diseases of infants is needed to manage the oral symptoms properly.

The primary maxillary second molars usually have three roots. However, an additional root located mesiopalatally is occasionally observed. This study aimed to determine the relationship between a mesiopalatal root of primary maxillary second molars and an abnormal eruption pattern of maxillary second premolars. The study was performed on cone beam computed tomography images taken from 916 children who visited the Dental Hospital of Kyung Hee University from 2010 to 2018. 744 serial cross-sectional cone beam computed tomography images were evaluated. The overall incidence of the mesiopalatal root of primary maxillary second molars was 3.2% (n = 24) and the abnormal eruption pattern of maxillary second premolars was 19.2% (n = 143). Especially, patients with the mesiopalatal root of primary maxillary second molars were significantly more likely to have the abnormal eruption pattern on maxillary second premolars (p = 0.000). The odds of the abnormal eruption pattern of maxillary second premolars with the mesiopalatal root of primary maxillary second molars was about 13 times higher than those without. The eruption pattern of the permanent successor should be carefully observed and treated if the mesiopalatal root of primary maxillary second molar is existent.

The purpose of this study is to evaluate the effect of the spread of a new type of coronavirus infection (COVID-19) on the mental state in school-age children and parents focusing on the aspects of sleep disorders and depression. A questionnaire survey was conducted for 123 parents and 108 school-age children who visited Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong from April 2, 2020 through April 25, 2020, via the direct writing method. Participants were assessed with Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD)-7, Center for Epidemiology Scale for Depression. Logistic regressions were used with a level of significance of 5%.
The prevalence of GAD, depression, and poor sleep in parents were 34.1%, 17.1% and 44.7%, respectively. The prevalence of GAD in children was 20.4%.
Logistic regression showed that stress from Emergency Alert Messages about COVID-19 was associated with GAD and depression in parents. In children, the degree of emotional change after COVID-19 was associated with GAD.
This study confirmed that there was a change in the psychological status of children and guardians due to the epidemic of coronavirus disease-2019, and it would be necessary to consider their psychological status during dental treatment.