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Prognosis of the Apical Fragment of Root Fractures after Root Canal Treatment of Both Fragments in Immature Permanent Teeth

Jaesik LEE ; Soonhyeun NAM

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):123-130. doi:10.5933/JKAPD.2018.45.1.123

In the root fracture, pulp necrosis tends to involve only the coronal fragment, while the pulp in the apical fragment remains vital. The prognosis of endodontic treatment of the apical fragment is poor due to the possibility of overfilling of the space between the fragments and difficulty in removing necrotic tissue.In the present cases, endodontic treatment of the apical fragment of root fracture was performed. However, in reendodontic treatment, resistance was felt at the fracture site and access to the root canal in the apical fragment was difficult. Therefore, the calcium hydroxide was periodically exchanged only in the coronal fragment without further treatment in the apical fragment and the canal of the coronal fragment was finally filled with Gutta-percha.Regular observation revealed no radiologic complications in the apical fragment. In some cases, we can observe good healing pattern such as absorption of calcium hydroxide and pulp canal obliteration of apical fragment in the long term.
Absorption ; Calcium Hydroxide ; Dental Pulp Cavity ; Dental Pulp Necrosis ; Gutta-Percha ; Prognosis ; Tooth

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Oral Features in a Child with Noonan Syndrome : A Case Report

Inkyung HWANG ; Yeonju LEE ; Dohee SIM ; Yonjoo MAH

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):115-122. doi:10.5933/JKAPD.2018.45.1.115

Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders.An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance.This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.
Child ; Growth and Development ; Heart Defects, Congenital ; Hemostasis ; Humans ; Incidence ; Incisor ; Male ; Noonan Syndrome ; Overbite ; Prevalence ; Pulmonary Valve Stenosis ; Root Resorption ; Tooth ; Tooth, Impacted ; Traction

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Dental Treatment in a Patient with CINCA Syndrome under General Anesthesia

Ji Min LEE ; 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.2018;45(1):109-114. doi:10.5933/JKAPD.2018.45.1.109

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

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Pharyngeal Airway Dimensions in Skeletal Class II Young Adolescents : Cephalometric Study

Minkyoung CHEON ; Sunmi YANG ; Jaehwan KIM ; Seonmi KIM ; Namki CHOI

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):98-108. doi:10.5933/JKAPD.2018.45.1.98

This study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of the patients with skeletal class II division 1 or division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group (79 for pre-peak, 40 for peak, 40 for post-peak). Total 159 lateral cephalograms (70 for skeletal class I, 51 for skeletal class II, division 1, and 38 for skeletal class II, division 2) were selected.The growth of anteroposterior dimension of the pharyngeal airway were statistically significant among growth periods. The dimension for the nasopharyngeal and oropharyngeal airway space was the smallest in the division 1 skeletal class II group followed by class II division 2 and skeletal class I.
Adolescent ; Humans

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Penetration and Microleakage Assessment of Flowable Resin Applied on Carious Fissure Following Various Fissurotomy Techniques

Seok KWON ; Sangho LEE ; Nanyoung LEE ; Meongkwan JIH ; Youngmi YOON

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):90-97. doi:10.5933/JKAPD.2018.45.1.90

The purpose of this study was to evaluate the effect of fissurotomy on the penetration and microleakage of flowable resins for carious fissures. A total of 250 extracted premolars with early fissure caries were selected and divided into five groups according to the fissurotomy; no fissurotomy (n = 50), fissurotomy with Fissurotomy® original bur (n = 50), fissurotomy with Fissurotomy® Miro NTF bur (n = 50), fissurotomy with SF104R tapered diamond bur (n = 50), fissurotomy with 1/2 round carbide bur (n = 50). Two types of flowable resins (UniFil®Flow, Filtek®Flow) were used as sealing materials. All samples were sectioned and observed using a stereoscopic microscope after thermocycling and immersing in methylene blue solution. The adaptation of flowable resin to the fissure wall was observed using scanning electron microscopy. The penetration of flowable resin into the carious fissure was significantly increased by fissurotomy, which also decreased microleakage. Fissure preparation using different burs showed a significantly different in penetration, but did not show any difference in microleakage. Unifil®Flow showed better penetration than Filtek®Flow, but there was no significant difference in microleakage. Fissurotomy can be used to increase the penetration of flowable resin into carious fissures and decrease microleakage.
Bicuspid ; Dental Instruments ; Methylene Blue ; Microscopy, Electron, Scanning

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Antimicrobial Effect on Streptococcus mutans in Photodynamic Therapy using Different Light Source

Jaeyong KIM ; Howon PARK ; Juhyun LEE ; Hyunwoo SEO ; Siyoung LEE

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):82-89. doi:10.5933/JKAPD.2018.45.1.82

In a photodynamic therapy, the difference of antibacterial capacity was compared according to the type of source of light when the same quantity of energy is irradiated.After S. mutans is formed in planktonic state and biofilm state, erythrosine diluted to 40 µM was treated for 3 minutes, and as the type of light source, Halogen, LED, and Plasma arc were used, which were irradiated for 30 seconds, 15 seconds and 9.5 seconds, respectively.After the completion of the experiment, CFU of each experiment arm was measured to compare the photodynamic therapeutic effects according to each condition.The CFU of each experiment arm had no statistically significant difference.Under the same quantity of energy, the photodynamic therapeutic effect can be said to be the same regardless of types of light source, which is a useful result in the clinical field with various light irradiators.
Arm ; Biofilms ; Erythrosine ; Photochemotherapy ; Plankton ; Plasma ; Streptococcus mutans ; Streptococcus ; Therapeutic Uses

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A Retrospective Statistical Study on Sedation Cases in Department of Pediatric Dentistry at Dankook University Dental Hospital for 5 Years

Changhyun PARK ; Jisun SHIN ; Jongsoo KIM ; Jongbin KIM

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):75-81. doi:10.5933/JKAPD.2018.45.1.75

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

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Lateral Cephalometric Measurements of Class I Malocclusion Patients with Uncertainty

Ji Min LEE ; Ji Soo SONG ; Hong Keun HYUN ; Young Jae KIM ; Jung Wook KIM ; Ki Taeg JANG ; Sang Hoon LEE ; Hojae KIM ; Hyo Min CHO ; Teo Jeon SHIN

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):65-74. doi:10.5933/JKAPD.2018.45.1.65

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

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Relationship between Pre-Eruptive Buccal Pit Radiolucency and Restoration in Mandibular First Molar

Seo Hyun JUNG ; Ji Soo 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.2018;45(1):57-64. doi:10.5933/JKAPD.2018.45.1.57

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

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A Morphometric Study of Primary Anterior Zirconia Crowns in Korean Tooth Models

Jungha PARK ; Sangho LEE ; Nanyoung LEE ; Myoungkwan JIH

Journal of Korean Academy of Pediatric Dentistry.2018;45(1):41-56. doi:10.5933/JKAPD.2018.45.1.41

The purpose of this study was to provide clinical recommendations for restoration with selection of the most similar zirconia crown by 3-dimensional analysis of the shape of the maxillary primary central and lateral incisors in Korean individuals and prefabricated zirconia crowns.The average shape of the sound maxillary primary central and lateral incisors in 300 children was reproduced by 3-dimensional scanning. Zirconia crowns of 4 manufacturers (NuSmile ZR® Crown, Cheng Crowns®, Kinder Krowns®, and EZ Pedo® Crown) were scanned 3-dimensionally, and coordinates for comparison of the shape were measured to evaluate the similarity between the teeth and crowns. The most similar crowns were selected by comparing the mesiodistal length, crown height, crown shape ratio, distance between the same coordinates of a tooth and crown, the radius of curvature of the labial surface, and the volume.As a result of analysis, Cheng Crowns® size 3 and NuSmile ZR® Crown size 2 were the most similar crowns in the maxillary primary central and lateral incisors, respectively. Scanning the inner surface of the crowns and evaluating the amount of tooth reduction required suggested that an overall lesser amount of tooth reduction compared to that presented by the manufacturer's guidelines should be performed.
Child ; Crowns ; Humans ; Incisor ; Radius ; Tooth

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