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Clinical Management and Short-term Prognosis of Molar-Incisor Malformation Affected Patients: Case Reports

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):121-130. doi:10.5933/JKAPD.2022.49.1.121

Molar-incisor malformation (MIM) is a newly reported dental anomaly with molar root deformity and incisor crown defects. MIM-affected teeth may cause severe pain with no apparent tooth caries. Since the affected molars clinically appear normal, radiographs are recommended for accurate diagnosis on the first visit. Since MIM-affected patients are in mixed dentition, timely and appropriate interventions are needed to avoid unnecessary pain and complicated clinical issues. This report was written to describe two patients who had MIM in early mixed dentition and report their 2-year follow-ups.

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Minimally Invasive Techniques for the Treatment of Mucoceles in Young Patients: A Case Series

Jongsung KIM ; Gimin KIM ; Jaesik LEE ; Hyunjung KIM ; Soonhyeun NAM

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):113-120. doi:10.5933/JKAPD.2022.49.1.113

Oral mucocele is a common exophytic lesion resulting from the accumulation of saliva due to pathological changes in the minor salivary glands. It is typically asymptomatic and painless and characterized by semipermeable, fluctuant nodules. General treatment methods for mucocele include surgical excision, marsupialization, cryosurgery, and steroid injection. This case report presents the treatment of oral mucocele using micro-marsupialization and a tying method as minimally invasive techniques rather than surgical treatment. Based on this case report, it is suggested that micro-marsupialization and the tying method can be used as alternative methods for the treatment of oral mucocele infants and children with behavioral control problems.

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Fracture Resistance of Incisal Tooth Fragment reattached with different Materials and Preparation

Jongsung KIM ; Gimin KIM ; Jaesik LEE ; Hyunjung KIM ; Soonhyeun NAM

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):104-112. doi:10.5933/JKAPD.2022.49.1.104

The purpose of this study is to analyze the fracture resistance of reattached tooth according to the resin materials and tooth preparation type under physiological conditions.
Uncomplicated crown fracture in the oblique direction was reproduced on the extracted 64 anterior teeth. Depending on the composite resin material, reattachment was performed using a flowable resin and a packable resin. Depending on retentive forms, reattachment was performed using simple reattachment, 1.0 mm × 1.0 mm labial chamfer bevel, 1.0 mm × 1.0 mm lingual chamfer bevel and 1.0 mm × 1.0 mm circumferential bevel. A load was applied to the palatal surface of the tooth using a universal testing machine at an angle of 125 degree, which is the interincisal angle of normal children. Under the masticatory pressure condition, fracture resistance of lingual chamfer groups was 28.28 ± 7.41 MPa and 27.54 ± 4.45 MPa, which was significantly higher than those of simple reattachment groups, 17.21 ± 5.87 MPa and 20.10 ± 6.00 MPa, in both flowable and packable resin groups.
When considering the lingual force similar to masticatory pressure, the fragment retention was significantly improved when the lingual chamfer was formed compared to the simple reattachment. Clinicians may consider the design of the lingual chamfer in order to improve fracture resistance to masticatory pressure during fragment reattachment.

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Analysis of the Characteristics of First Permanent Molars with Delayed Eruption

Hosun LEE ; Koeun LEE ; Misun KIM ; Okhyung NAM ; Hyo-Seol LEE ; Sungchul CHOI

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):95-103. doi:10.5933/JKAPD.2022.49.1.95

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.

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Comparative Validation of the Mixed and Permanent Dentition at Web-Based Artificial Intelligence Cephalometric Analysis

Sunhahn SHIN ; Donghyun KIM

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):85-94. doi:10.5933/JKAPD.2022.49.1.85

This retrospective study aimed to evaluate the difference in measurement between conventional orthodontic analysis and artificial intelligence orthodontic analysis in pediatric and adolescent patients aged 7 - 15 with the mixed and permanent dentition.
A total of 60 pediatric and adolescent patients (30 mixed dentition, 30 permanent dentition) who underwent lateral cephalometric radiograph for orthodontic diagnosis were randomly selected. Seventeen cephalometric landmarks were identified, and 22 measurements were calculated by 1 examiner, using both conventional analysis method and deep learning-based analysis method. Errors due to repeated measurements were assessed by Pearson’s correlation coefficient. For the mixed dentition group and the permanent dentition group, respectively, a paired t-test was used to evaluate the difference between the 2 methods.
The difference between the 2 methods for 8 measurements were statistically significant in mixed dentition group: APDI, SNA, SNB, Mandibular plane angle, LAFH (p < 0.001), Facial ratio (p = 0.001), U1 to SN (p = 0.012), and U1 to A-Pg (p = 0.021). In the permanent dentition group, 4 measurements showed a statistically significant difference between the 2 methods: ODI (p = 0.020), Wits appraisal (p = 0.025), Facial ratio (p = 0.026), and U1 to A-Pg (p = 0.001).
Compared with the time-consuming conventional orthodontic analysis, the deep learning-based cephalometric system can be clinically acceptable in terms of reliability and validity. However, it is essential to understand the limitations of the deep learning-based programs for orthodontic analysis of pediatric and adolescent patients and use these programs with the proper assessment.

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Impact of COVID-19 on Dental Trauma in Korea

Donghyun SON ; Yoon LEE ; Jihun KIM

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):76-84. doi:10.5933/JKAPD.2022.49.1.76

The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service’s Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed.
Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply.
After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

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Assessment of the Caries Detection Ability of Quantitative Light-induced Fluorescence (QLF) in Primary Teeth in vitro

Kyung Hyun CHO ; Chung-Min KANG ; Hoi-In JUNG ; Tae Yang LEE ; Je Seon SONG

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):65-75. doi:10.5933/JKAPD.2022.49.1.65

The aim of this study was to evaluate QLF (quantitative light-induced fluorescence) technology for the caries detection in primary teeth and validate the relationships between the cavity volume of carious lesions and QLF analysis results. Total 125 tooth surfaces include 53 occlusal surfaces, and 72 proximal surfaces were investigated with the portable QLF device for detection of dental caries in primary molars. Micro-CT radiograph was also performed to classify carious lesions and calculate the cavity volume. QLF showed good accuracy and reliability (sensitivity 0.75 - 0.94, specificity 0.82 - 0.95, and AUROC 0.88 - 0.98) for the caries detection in primary teeth except ΔR average results of proximal caries which showed relatively low values. Statistically significant relationships were found between ΔF average, QS-Index and the cavity volume according to Spearman rank-order correlation coefficients (r = 0.805 - 0.832, p < 0.001). QLF detection method would be a harmless and reliable way for children to diagnose dental caries without the concern about radiation exposure.

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Intraoral Scan for Virtual Skull-Dentition Hybrid Images of Young Patients

Joohee LEE ; ByoungEun YANG ; Hyelim LEE

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):57-64. doi:10.5933/JKAPD.2022.49.1.57

Additional dentition images are needed because the dentitions are distorted in cone-beam computed tomography (CBCT) due to streak artifacts and non-uniformity of the x-ray beam.
The purpose of this study is to evaluate the feasibility of improving the dentition image of CBCT scan with intraoral scanner instead of plaster models.
Maxilla images from plaster models, two intraoral scanners, and CBCT of 20 patients aged 12 to 18 were used in this study. With one of the intraoral scanners, the full arch was scanned by three segments and combined into a complete full arch. Virtual skull-dentition hybrid images from intraoral scanners were superimposed with the images from plaster models to evaluate the coordinate value difference and distance at reference points.
The results showed that the coordinate value difference and distance were smallest with segmented intraoral scan, which showed only 2 ㎛ distance. Intraoral scan may provide good dentition images for virtual skull-dentition images.

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Changes of Occlusion following the Placement of Preformed Metal Crown to the Permanent First Molar in Children and Adolescents

Jiwoong KIM ; Nanyoung LEE ; Myeongkwan JIH ; Sangho LEE

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):45-56. doi:10.5933/JKAPD.2022.49.1.45

The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization.
The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan Ⅲ was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted.
In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment.
In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.

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Correlation of Left Mandibular Third Molar Development and Chronological Age

Min Sun SONG ; Chung-Min KANG ; Je Seon SONG ; Hyung-Jun CHOI ; Seong-Oh KIM

Journal of Korean Academy of Pediatric Dentistry.2022;49(1):35-44. doi:10.5933/JKAPD.2022.49.1.35

The aim of this study is to evaluate the development of the left mandibular third-molar development with modified Demirjian method and its relation to chronological age.
A total of 1653 digital panoramic radiographs of healthy individuals aged between 7 and 23 years who visited Yonsei University Dental hospital were selected. The developmental status of the left mandibular third molars was assessed using dental maturity scoring proposed by Demirjian et al. The mean age of the first appearance of mineralization, complete crown formation, and complete root formation were around 9, 14, 21 years respectively. Statistically significant differences between males and females in the development stage of D and G were revealed that crown formation and root length completion were attained earlier in males than in females. There was significant positive relationship between age and third molar development in both sexes, and new formula was presented to estimate age of children and adolescents based on their developmental stages of third molars.
In this study, the use of left mandibular third molar as a developmental marker is appropriate, and age estimation can be attained with dental maturity stage.

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