1.Color Matching of Single-Shade Composite Resin by Various Pulp Capping Materials in Anterior Teeth
Sohyun PARK ; Jongsoo KIM ; Jongbin KIM ; Mi Ran HAN ; Jisun SHIN ; Joonhaeng LEE
Journal of Korean Academy of Pediatric Dentistry 2024;51(2):176-184
This study aimed to compare color matching between single-shade composite resin-restored teeth with various pulp capping materials and the dentin surrounding the restoration through instrumental analysis and visual evaluation of the color difference. Fifty maxillary right central incisor acrylic resin teeth were prepared with standardized Class III cavities on the proximal surfaces. These teeth were divided into five groups: restored with single-shade composite resin only; Ultra-Blend™ plus followed by single-shade composite resin; TheraCal PT™ followed by single-shade composite resin; Endocem® MTA premixed followed by single-shade composite resin; and Well-root PT™ followed by single-shade composite resin. The color difference (ΔEab*) between the restored area and the center of the resin teeth was measured using a spectrophotometer. No significant color difference was observed in groups restored with only single-shade composite resin, Ultra-Blend™ plus, and TheraCal PT™. The visual evaluation revealed that Ultra-Blend™ plus exhibited the best color matching score, whereas the Endocem® MTA premixed and Well-root PT™ groups showed significantly lower color matching scores than the single-shade composite resin-only group. When opting for single-shade composite resin usage for anterior tooth restorations with the aim of reducing chair time, pulp capping materials UltraBlend™ plus and TheraCal PT™ provide esthetically pleasing results.
2.Enhancing the Physicochemical Properties of Sodium Iodide-based Root Canal Filling Material with Lanolin Incorporation
Hye Shin PARK ; Jongsoo KIM ; Joonhaeng LEE ; Jisun SHIN ; Mi Ran HAN ; Jongbin KIM ; Yujin KIM ; Junghwan LEE
Journal of Korean Academy of Pediatric Dentistry 2024;51(2):140-148
This study aimed to enhance the physicochemical properties of sodium iodide-based root filling materials, particularly solubility. In earlier developmental stages, the iodoformcontaining paste exhibited high antibacterial efficacy but failed to meet only the solubility requirement among the ISO 6876 criteria. Therefore, this study focused on enhancing the physicochemical properties of the paste under development, particularly centering on reducing its solubility. Four experimental groups were established, including three control group. The previously developed D30 paste was named the Oil 33 group, and the control group was named the Vitapex® group. The Oil 50 group, in which the oil content was increased, and the Oil 45L group, in which lanolin was incorporated. The physical properties (solubility, pH, flowability, and film thickness) of the four pastes were evaluated according to the ISO 6876 standards. No significant differences were observed between the Oil 45L and Vitapex® groups in any of the physical property evaluations. While the Oil 33 and Oil 50 groups met the ISO 6876 standards for flowability and film thickness, the Oil 45L group met all the physical properties. However, reducing the overall oil content may be necessary to enhance the antimicrobial properties. The result of the physicochemical experiments showed that the Oil 45L group with the newly formulated composition and incorporated lanolin exhibited low solubility meeting the ISO 6876 standard of ≤ 3%. We were able to develop a paste with more stable solubility than previous iodide-based root-filling materials. Therefore, the oil content must be further adjusted to improve its antimicrobial properties. If other physical properties also meet the ISO 6876 standards and demonstrate excellent results in cytotoxicity tests, this root filling material could potentially replace existing options.
3.Comparative Analysis of the Physical and Biochemical Properties of Light-cure Resin-modified Pulp Capping Materials
Tae Gyeom KIM ; Jongsoo KIM ; Joonhaeng LEE ; Jisun SHIN ; Mi Ran HAN ; Jongbin KIM ; Yujin KIM ; Jae Hee PARK
Journal of Korean Academy of Pediatric Dentistry 2024;51(2):149-164
This study compared the solubility, water absorption, dimensional stability, release of various ions (hydroxyl, calcium, sulfur, strontium, and silicon), and cytotoxicity of lightcured resin-modified pulp-capping materials. Resin-modified calcium hydroxide (Ultrablend™ plus, UBP), light-cured resin-modified calcium silicate (TheraCal LC™, TLC), and dual-cure resin-modified calcium silicate (TheraCal PT™, TPT) were used. Each material was polymerized; solubility, 24-hour water absorption, and 30- day dimensional stability experiments were conducted to test its physical properties. Solubility was assessed according to the ISO 6876 standard, and 24 hours of water absorption, 30 days of dimensional stability were assessed by referring to the previous protocol respectively. Eluates at 3 and 24 hours and on 7, 14, and 28 days were analyzed according to the ISO 10993-12 standard. And the pH, Ion-releasing ability, cell proliferation rate, and cell viability were assessed using the eluates to evaluate biochemical characteristics. pH was measured with a pH meter and Ion-releasing ability was assessed using inductively coupled plasma atomic emission spectrometry (ICP-AES). Cell proliferation rate and cell viability were assessed using human dental pulp cells (hDPCs). The former was assessed by an absorbance assay using the CCK-8 solution, and the latter was assessed by Live and Dead staining. TPT exhibited lower solubility and water absorption than TLC. UBP and TPT demonstrated higher stability than TLC. The release of sulfur, strontium, calcium, and hydroxyl ions was higher for TLC and TPT than for UBP. The 28-day release of hydroxyl and silicon ions was similar for TLC and TPT. TLC alone exhibited a lower cell proliferation rate compared to the control group at a dilution ratio of 1 : 2 in cell proliferation and dead cells from Live and Dead assay evaluation. Thus, when using light-cure resin-modified pulp-capping materials, calcium silicate-based materials can be considered alternatives to calcium hydroxide-based materials. Moreover, when comparing physical and biochemical properties, TPT could be prioritized over TLC as the first choice.
4.Trends in behavioral management techniques for dental treatment of patients with autism spectrum disorder: a 10-year retrospective analysis
Gahee SON ; Sohee OH ; Jaehee LEE ; Saeromi JUN ; Jongbin KIM ; Jongsoo KIM ; Joonhaeng LEE ; Miran HAN ; Jisun SHIN
Journal of Dental Anesthesia and Pain Medicine 2024;24(3):187-193
Background:
Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years.
Methods:
This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022.
Results:
The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N2O-O2 sedation. The most common age group for sedation or general anesthesia was 6–9 years, with a higher prevalence in males than in females. Notably, N2O-O2 and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia.
Conclusion
This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N2O-O2 sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.
5.Trends of conscious sedation in the Department of Pediatric Dentistry at the Dankook University Dental Hospital for 11 Years
Sohyun PARK ; Jongbin KIM ; Jongsoo KIM ; Joonhaeng LEE ; Miran HAN ; Jisun SHIN
Journal of Dental Anesthesia and Pain Medicine 2023;23(5):265-271
Background:
Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years.
Methods:
This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital.
Results:
Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged <4 years tended to decrease, while that of children aged >5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females.
Conclusion
Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.
6.pH, Ion Release Capability, and Solubility Value of Premixed Mineral Trioxide Aggregates
Seolah BACK ; YuJi JANG ; Junghwan LEE ; Joonhaeng LEE ; Jisun SHIN ; Jongbin KIM ; Miran HAN ; JongSoo KIM
Journal of Korean Academy of Pediatric Dentistry 2022;49(4):379-391
The current study aimed to compare the pH, solubility value, and ion release capability of premixed mineral trioxide aggregates (MTAs) versus conventional pulp capping materials before and after setting. The following materials were used: resin-modified calcium silicate cement (TheraCal LC®, TLC), resin-modified calcium hydroxide cement (Ultra-BlendTM plus, UBP), and 2 kinds of premixed MTA (Endocem MTA® premixed regular 〔EMPR〕 and Well-RootTM PT 〔WRP〕). The specimens of each material were prepared before and after setting and were immersed in distilled water. The materials’ pH and solubility value were assessed. Next, three kinds of ion (calcium, sulfide, and strontium) released by pulp capping materials were evaluated via inductively coupled plasma atomic emission spectrometry. In the after-setting group, the pH of TLC and UBP decreased. However, the pH of the premixed MTAs increased with time. TLC released a higher concentration of strontium ion compared with the other materials. Meanwhile, EMPR released a significantly high concentration of sulfide ion (p < 0.05). In the after-setting group, the 2 kinds of premixed MTAs released a significantly higher concentration of calcium ion compared with the other materials (p < 0.05). In the after-setting group, EMPR had a significantly low solubility value (p < 0.05). The Kruskal-Wallis test, followed by the Mann-Whitney U test with Bonferroni correction, was used in statistical analysis. In conclusion, resin-modified calcium silicate cement, modified calcium hydroxide cement, and the 2 kinds of premixed MTAs had an alkaline pH and low solubility value and they released various concentrations of ions after setting.
7.Characterization of Odontoblasts in Supernumerary Tooth-derivedDental Pulp Stem Cells between Passages by Real-Time PCR
Sangeun JI ; Sol SONG ; Joonhaeng LEE ; Jongbin KIM ; Jongsoo KIM
Journal of Korean Academy of Pediatric Dentistry 2021;48(3):291-301
The aim of this study is to compare the properties of odontoblast gene of early passage cells and late passage cells derived from impacted maxillary supernumerary teeth.
Impacted supernumerary teeth with maxilla were extracted from 12 patients (8 males, 4 females) between 6 - 9 years old without medical history. Real-time polymerase chain reaction (PCR) was conducted to compare characterization of odontoblast cell in the 3rd and 10th passage, and between with bone inducing additive group and without additive group. Genes for odontoblasts characteristics are osteonectin (ONT), alkaline phosphatase (ALP), osteocalcin (OCN), dentin matrix protein 1 (DMP-1) and dentin sialophosphoprotein (DSPP).
The level of gene expression was in a decreasing order of ONT, ALP, OCN, DMP-1 and DSPP in the 3rd passage, and in decreasing order of ONT, DMP-1, OCN, ALP, and DSPP in the 10th passage in the undifferentiation and differentiation group. The order of ONT, DMP-1, and OCN did not changed. ALP and DMP-1 were switched in order.
ALP and DMP-1 may be used as important markers for differentiating between the 3rd passage and 10th passage cells.
Considering that supernumerary tooth was extracted young age and the time required to cultured 10th passage was short, supernumerary tooth can be considered a useful donor site of dental pulp stem cells.
8.Antibacterial Effect on Enterococcus Faecalis and Physical Properties of Chitosan Added Calcium Hydroxide Canal Filling Material
Sol SONG ; Yu-Jin KIM ; Jung-Hwan LEE ; Joonhaeng LEE ; Jisun SHIN ; Jongbin KIM
Journal of Korean Academy of Pediatric Dentistry 2021;48(2):198-208
The aim of this study was to evaluate the antibacterial effect on Enterococcus Faecalis and physical properties of chitosan added calcium hydroxide canal filling material.
Low, medium, high molecular weights of chitosan powder were mixed with calcium hydroxide canal filling material. Also, for each molecular weight group, 1.0, 2.0, 5.0 wt% of chitosan powder were added. An overnight culture of E. faecalis was adjusted to 1 × 106 CFU/ml. For test of antibacterial effect, three different molecular weights of 2.0 wt% chitosan and three different concentrations of high molecular weight chitosan were mixed with calcium hydroxide canal filling material. The absorbance of plates was analyzed using spectrophotometer at 570 nm with a reference wavelength of 600 nm. Physical properties such as flow, film thickness and radiopacity were examined according to ISO 6876 : 2012.
All molecular weight type of chitosan containing material showed inhibitory effect against E. faecalis growth compared to non-chitosan added calcium hydroxide canal filling material group (p < 0.05). High molecular weight chitosan containing material showed the most antibacterial effect. Also, the antibacterial effect decreased as the incorporated amount of chitosan decreased (p < 0.05). Every molecular weight group of material containing chitosan had a tendency for reduced flow and radiopacity, increased film thickness according to amount of chitosan. Low molecular weight of 1.0 wt% chitosan addition did not show any significant difference of physical properties compared to conventional calcium hydroxide canal filling material.
In conclusion, for reinforcement of antibacterial effect against E. faecalis and for favorable physical properties, 2.0 wt% of chitosan adding is recommended. Considering its antibacterial effect of chitosan, further studies are required for clinical application of chitosan in endodontics and pediatric dentistry.
9.Effect of Sodium Fluoride Varnish and Potassium Iodide on Remineralization Efficacy of Silver Diamine Fluoride
Kunho LEE ; Junyong AHN ; Jong Soo KIM ; Miran HAN ; Joonhaeng LEE ; Jisun SHIN
Journal of Korean Academy of Pediatric Dentistry 2021;48(4):467-475
The purpose of this study was to compare the effect of sodium fluoride(NaF) varnish and potassium iodide(KI) on remineralization efficacy of silver diamine fluoride(SDF) by measuring microhardness and evaluating surface morphology by scanning electron microscope(SEM).
Artificial caries lesions were induced on extracted primary molars and vickers microhardness was measured. Specimens were randomly separated into 4 groups for treatment. The specimens in group I were treated with SDF, group II with NaF varnish after SDF, group III with KI after SDF and group IV with distilled water. After 8 days of pH cycling, vickers microhardness was measured and difference before and after treatment was calculated. For SEM, 2 samples were evaluated respectively after enamel polishing, lesion formation and after pH cycling.
Group III showed highest increase in microhardness. Group I showed higher increase in microhardness than Group II but without statistical difference. Group IV showed lowest increase in microhardness value among 4 groups.
On SEM image, group I, II and III showed smoother and less irregular surface compared to group IV. Amorphous crystal pellicles were observed in group III.
In conclusion, SDF, SDF and NaF, SDF and KI groups showed smoother surface and increase in microhardness suggesting the possibility that remineralization effect might take place in oral conditions. In addition, in limited conditions of this study, applying NaF varnish after SDF did not increase the remineralization efficacy of SDF while KI significantly increased the remineralization efficacy of SDF. However, additional study considering various conditions that might affect demineralization and remineralization in clinical situations need to be conducted.
10.Difference in Bonding Strength of RMGIC according to Type of Hemostatic Agent in Primary Tooth
Seolah BACK ; Joonhaeng LEE ; Jongbin KIM ; Miran HAN ; Jong Soo KIM
Journal of Korean Academy of Pediatric Dentistry 2021;48(4):460-466
The purpose of this study was to compare the effect of the hemostatic agent containing aluminum chloride with hemostatic agent containing ferric sulfate on the shear bond strength of resin-modified glass ionomer cement(RMGIC) to dentin in primary tooth.
Twenty extracted non-carious human primary teeth were collected in this study. The specimens were cut to expose dentin and polished. The specimens were randomly seperated into 3 groups for treatment; group I: polyacrylic acid(PAA), RMGIC; group II: aluminum chloride, PAA, RMGIC; group III: ferric sulfate, PAA, RMGIC
Ten specimens from each group were subjected to shear bond strength test.
The mean shear bond strength of each group was as follows: 10.07 ± 1.83 MPa in Group I, 7.62 ± 0.78 MPA in group II, 5.23 ± 0.78 MPa in group III. There were significant differences among all groups(p < 0.001).
In conclusion, both aluminum chloride hemostatic agent and ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC to dentin. And ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC more than the aluminium chloride hemostatic agent.

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