Eruption disturbances of the mandibular first molars can cause multiple problems in occlusal development although they are extremely rare. Early diagnosis and treatment are very important to prevent complications associated with eruption disturbances. The present case report describes the treatment of two cases of eruption disturbances of the mandibular first permanent molar. A fixed appliance composed of a cantilever spring with mandibular second deciduous molar as an anchor tooth was used to tract the impacted mandibular first permanent molar. The success of both cases shows that this novel traction appliance can be used to induce the eruption of an impacted mandibular first permanent molar within a short time in patients with intact mandibular second deciduous molar as an anchor tooth.

Sleep-disordered breathing (SDB) induces dysfunction of the orofacial muscles, leading to morphologic alteration of the face and dental malalignment. Early diagnosis and treatment of SDB is required in pediatric patients to ensure normal facial growth. Myofunctional therapy (MFT) is a modality for the treatment of SDB and prefabricated appliances can be used. Herein 2 cases of malocclusion with SDB, in which MFT with a prefabricated appliance was used for orthodontic treatment, have been described. SDB was diagnosed based on clinical symptoms taken by interview and home respiratory polygraphy. In both cases, SDB was improved using prefabricated appliance for MFT. However, resolution of crowding depended on the degree of crowding.
Child ; Crowding ; Early Diagnosis ; Humans ; Malocclusion ; Muscles ; Myofunctional Therapy ; Sleep Apnea Syndromes

This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars.Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian' s method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated.Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency.Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.
Adolescent ; Busan ; Child ; Compensation and Redress ; Dental Clinics ; Humans ; Malocclusion ; Masks ; Maxilla ; Methods ; Molar ; Orthopedics ; Puberty ; Retrognathia ; Retrospective Studies

This study was performed to evaluate clinical use of laser fluorescence (LF) to identify early childhood caries lesions suitable for applying resin infiltration.20 exfoliated primary molars with proximal caries were selected and cut buccolingually cross the central pit for regarding the mesial and distal surfaces respectively. 27 specimens corresponding to ICDAS code 1 and 2 were selected and the LF values were measured. When infiltrant resin was applied, double staining for microscopy detection has done simultaneously. Tooth samples were sliced with 0.7 mm thick. The maximum lesion depth, maximum penetration depth, and average penetration rate were measured from the confocal scanning laser microscope image. Pearson correlation analysis was performed.The intraclass correlation coefficient of LF values shows excellent agreement. LF values had positive correlation with penetration rate, but not lesion depth and penetration depth. Significant correlation between LF readings and penetration rate was verified in deep enamel caries and dentin caries except shallow enamel caries.Infiltrant resin could penetrate with a higher rate and LF values could be increased in more active caries lesions. In assessing radiologically similar caries lesion, laser fluorescence might be useful for identifying caries activity.
Dental Enamel ; Dentin ; Fluorescence ; Microscopy ; Molar ; Reading ; Tooth ; Tooth, Deciduous

This study was aimed to assess the new trial for minimal cavity preparation in composite restoration combined with resin infiltration, focusing at application sequence.32 human primary molars with early carious lesions around small cavity were selected and randomly divided into two groups, according to the sequence of cavity preparation (P), composite filling (F) and resin infiltration (I) as IPF and PFI group. Each group was assessed about amount of tooth reduction, features of resin infiltration, and marginal leakage around restoration.Amount of tooth reduction evaluated using micro-CT was decreased compared with the original lesion size in both groups. Features of resin infiltration were verified under confocal laser scanning microscopy. In both groups, infiltrant resin was found on all around the composite and maintained in spite of extent of decalcification even after artificial caries induction. Marginal micro leakage assessed with silver nitrate immersion and micro-CT was found more frequently in PFI group.The technique combining resin infiltration and composite restoration might ensure better adhesion prognosis as applied by the sequence of resin infiltration, cavity preparation, and composite filling. This new trial was thought meaningful in minimizing the cavity size and contributing to minimal invasive dentistry.
Dentistry ; Humans ; Immersion ; Microscopy, Confocal ; Molar ; Prognosis ; Silver Nitrate ; Tooth

This study was performed to evaluate the restoration combined with resin infiltration (RI) of early cavitated smooth surface caries lesion in terms of microleakage. Flowable resin and resin-modified glass ionomer cement (RMGIC) were compared. Sound 20 extracted 3rd molars were divided into 2 groups randomly. Artificial decalcified lesion was induced. Cavities were prepared on the mesial and distal surfaces, and randomly set as experimental and control group. RI was applied to the experimental group before cavity restoration. The control group was restored without RI. In group I and II, flowable resin and RMGIC was used for restoration respectively. After thermocycling and silver nitrate immersion, microleakage was assessed by μ-CT. Depth of microleakage was lower in experimental group than control group only in group II (p = 0.05). Microleakage depth was lower in group II than group I in both xperimental and control groups (p = 0.05). RI pretreatment before restoration of early cavitated caries lesions might reduce the microleakage and help long-term maintenance of restoration. In this study, RMGIC was less polymerization shrinkage. Restoration with RMGIC after RI pretreatment reduced the microleakage of the restoration compared to the flowable resin.

Lesch-Nyhan syndrome is a rare X-linked, recessively inherited disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. This syndrome is characterized by 3 major features: neurological dysfunction, hyperuricemia, and cognitive and behavioral disturbances (e.g., self-mutilation, which begins at 2 to 3 years of age). Uncontrollable self-mutilation begins with biting of the perioral tissues and extends into patterns such as finger biting and head hitting. This report describes the case of a 31-month-old boy who was diagnosed with Lesch-Nyhan syndrome with severe lip injuries caused by self-mutilative behaviors. The behaviors were blocked with a semi-fixed lip bumper for a short period. The device was applied to the patient on the day of the visit without the requirement for an oral impression. It was easy to manage oral hygiene and adjust the device because it was detachable by clinicians and guardians. Therefore, a semi-fixed lip bumper may be useful as an interim appliance to block self-mutilative behaviors in children with Lesch-Nyhan syndrome.

The purpose of this retrospective study was to evaluate the survival rate by comparing Class II restoration using flowable resin composite with stainless steel crown in primary molars.
Electronic medical records and radiographs of 1,504 primary molars with proximal caries of 590 patients from June 2015 to August 2019 were analyzed. With the collected data, survival analysis was performed using the Kaplan-Meier method.
The 1-year survival rate of flowable resin composite in the primary molar was 98.5%, 3-year survival rate was 87.7%, and mean survival time was 39 months. There was no statistically significant difference between flowable resin composite and stainless steel crown (p = 0.896).
Within the limits of this study, Class II restoration using flowable resin composite can be considered a promising option for the treatment of proximal caries in primary molars.

This study aimed to analyze the preoperative factors of immature first molars treated with vital pulp therapy and to find out their correlation in pediatric patients. From May 2014 to January 2020, 523 patients and 1,242 immature first molars were investigated. Factors including age, sex, tooth location, Molar-incisor hypomineralization (MIH), caries cavity location, and history of previous restoration were evaluated. As a result of the study, the vital pulp therapy group had 5.56 times more MIH, 3.39 times more mesial cavities, and 8.73 times more distal cavities. In order to avoid vital pulp therapy in immature first molar, early diagnosis and active management of MIH and preventive treatment of mesial and distal caries are necessary after its immediate eruption.

The purpose of this study was to investigate the prevalence and characteristics of pre-eruptive intracoronal radiolucencies (PEIR) from panoramic radiographs in Korean children and adolescents.
This study examined panoramic radiographs of 3,000 patients aged between 5 and 14 years old who visited ten dental hospitals in Korea. The age and gender of the patients, the tooth type, the number of intracoronal radiolucent lesions, and the location and size of the lesions were recorded.
The overall prevalence of patients with PEIR was 2.5%. The difference in the presence of PEIR between both genders was not significant. Within each tooth type, the mandibular first molar showed highest prevalence of PEIR (29.6%). The central part of the crown was the most frequently observed location of PEIR (56.8%). The size of the PEIR lesions was mostly limited to less than one-third of the thickness of coronal dentin.