Saliva is an important body fluid in the oral cavity containing lots of biomarkers, whose inherent micro-ecosystem holds significant value for early diagnosis and monitoring of oral diseases. Simultaneously, saliva has particular advantages, such as ease of sampling, painless and non-invasive collection, and suitability for repeated sampling, making it highly appropriate for surveillance and follow-up of diseases. In a series of studies conducted by the research group for preventive dentistry in Peking University School and Hospital of Stomatology, we compared different segments of saliva and those samples collected via different sampling methods using proteomic/peptidomic and microbiomic technologies to explore the stability of saliva samples. Besides, the significance of applying representative salivary biomarkers in early prevention and control of representative oral diseases (e.g. dental caries, periodontal diseases) and systemic conditions (e.g. type 2 diabetes mellitus, chronic kidney disease) was confirmed as well.
Humans ; Saliva/chemistry* ; Dental Caries/diagnosis* ; Biomarkers/analysis* ; Periodontal Diseases/diagnosis* ; Mouth Diseases/diagnosis* ; Proteomics/methods* ; Diabetes Mellitus, Type 2/diagnosis* ; Microbiota ; Renal Insufficiency, Chronic/prevention & control*

Immature permanent teeth refer to those that have erupted but have not yet formed and matured in terms of shape and structure. The characteristics of their disease onset and treatment methods are different from those of ordinary permanent teeth. Children with special healthcare needs often lack the capacity to cooperate during routine dental procedures, making treatment under general anesthesia (GA) the preferred option. With social advancements, the demand for pediatric dental GA has considerably increased. This study discuss the treatment strategies for immature permanent teeth under GA, including diagnosis, therapeutic principles, key considerations, and clinical approaches for dental caries, pulpitis periapical periodontitis, etc.
Child ; Humans ; Anesthesia, General ; Dental Caries/diagnosis* ; Dentition, Permanent ; Periapical Periodontitis/therapy* ; Pulpitis/therapy*

OBJECTIVES: This study aimed to compare the salivary biochemical indices between caries-free individuals and those with early childhood caries (ECC), and construct a saliva-based caries diagnostic model by analyzing the correlation between salivary biochemical indices and caries severity. METHODS: A total of 120 children aged 4-6 years were selected and divided into two groups: individuals with ECC (C group, RESULTS: The NO CONCLUSIONS Salivary biochemical indices can contribute to the diagnosis and risk assessment of ECC.
Child ; Child, Preschool ; Dental Caries/diagnosis* ; Dental Caries Susceptibility ; Humans ; Saliva

OBJECTIVE: To develop a software based on "UniDental" system which is a virtual reality dental simulation system and applied to undergraduate majoring in stomatology to improve the ability of identifying caries. METHODS: A software was developed applying to identify virtual dental caries based on UniDental system. In the software, a virtual dental caries model was designed and carious tissue was separated to 3 layers by the depth. The stiffness was the same within each layer which was increasing gradually layer by layer. The roughness was also the same within each layer which was decreasing gradually layer by layer. Sixty-four participants in pre-clinical stage of the class of 2014 majoring in stomatology from Peking University School of Stomatology were trained with the software. During the training, the students should probe on the virtual dental carious tissue layer by layer and feel the difference of vertical stiffness and horizontal roughness of each layer by using a handpiece with realistic force feedback. After training, a questionnaire survey was conducted to evaluate the software including a score of 1-5 for haptic fidelity of stiffness and roughness and their relevant gradient and benefit of improving the ability of identifying caries, choosing the preferred training method. The data were statistically analyzed using Kruskal-Wallis test. RESULTS: The median of subjective evaluation scores of the proposed metrics were all "4", demonstrating that the software operated above medium fidelity. The stiffness scores of all 3 layers were statistically significant (P < 0.05) on the stiffness gradient score. The roughness scores of the 1st and 2nd layers were statistically significant (P < 0.05) on the roughness gradient score. The training was helpful to improve the ability of identifying caries (median was 4). The scores of all 3 layers stiffness and relevant gradient were statistically significant (P < 0.05) on the score of benefit of improving the ability of identifying caries. 90.4% of the participants preferred the traditional extracted teeth training method. CONCLUSION The virtual reality dental simulation system was helpful to improve students' ability of identifying caries. It couldn't replace the traditional extracted teeth training method by now, it should be used as a supplement to the traditional training method.
Clinical Competence ; Computer Simulation ; Dental Caries/diagnosis* ; Dental Caries Susceptibility ; Humans ; Simulation Training ; User-Computer Interface ; Virtual Reality

The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.
Anesthesia, General ; Dental Caries ; Diagnosis ; Diagnosis, Oral ; Hematology ; Humans ; Inpatients ; Oral Health ; Pediatric Dentistry ; Referral and Consultation ; Rehabilitation ; Tooth Mobility

The modern era of microbial genome analysis began in earnest in the 2000s with the generalization of metagenomics and gene sequencing techniques. Studying complex microbial community such as oral cavity and colon by a pure culture is considerably ineffective in terms of cost and time. Therefore, various techniques for genomic analysis have been developed to overcome the limitation of the culture method and to explore microbial communities existing in the natural environment at the gene level. Among these, DNA fingerprinting analysis and microarray chip have been used extensively; however, the most recent method of analysis is metagenomics. The study summarily examined the overview of metagenomics analysis techniques, as well as domestic and foreign studies on disease genomics and cluster analysis related to oral metagenome. The composition of oral bacteria also varies across different individuals, and it would become possible to analyze what change occurs in the human body depending on the activity of bacteria living in the oral cavity and what causality it has with diseases. Identification, isolation, metabolism, and presence of functional genes of microorganisms are being identified for correlation analysis based on oral microbial genome sequencing. For precise diagnosis and treatment of diseases based on microbiome, greater effort is needed for finding not only the causative microorganisms, but also indicators at gene level. Up to now, oral microbial studies have mostly involved metagenomics, but if metatranscriptomic, metaproteomic, and metabolomic approaches can be taken together for assessment of microbial genes and proteins that are expressed under specific conditions, then doing so can be more helpful for gaining comprehensive understanding.
Bacteria ; Colon ; Dental Caries ; Diagnosis ; DNA Fingerprinting ; Generalization (Psychology) ; Genes, Microbial ; Genome, Microbial ; Genomics ; Human Body ; Metabolism ; Metabolomics ; Metagenome ; Metagenomics ; Methods ; Microbiota ; Mouth

The purpose of this study was to compare the validity of Cariview®, a new colorimetric caries activity test, with CRT® bacteria, a conventional bacterial culture method. In addition, this study assesses the correlation between the dental caries experience and activity between mothers and their children.34 pairs of mothers and their children under the age of 6 years participated in this study with informed consent. After filling out a questionnaire and oral examination, the two caries activity tests above were performed on each subject.In the results, Cariview® scores were statistically significant with children's caries experience (r = 0.598, p <0.01) and showed higher correlation than CRT® bacteria scores. Cariview® scores showed statistically significant correlation with the number of decayed teeth in both mothers and children (p <0.05). In both Cariview® and CRT® bacteria tests, there was no statistically significant correlation between caries experience and caries activity (p > 0.05).Cariview® colorimetric test will be clinically useful for predicting future caries risk and establishing a preventative strategy in pediatric dentistry.
Bacteria ; Child ; Dental Caries ; Diagnosis, Oral ; Humans ; Informed Consent ; Methods ; Mothers ; Pediatric Dentistry ; Tooth

Deep neck infections (DNIs) are mainly caused by dental caries, tonsillitis, and pharyngitis; however, DNIs can also occur after head and neck trauma. A 79-year-old male patient underwent a craniectomy due to an acute subdural hematoma. The patient was unconscious and continued to have a fever, but no clear cause was found. On postoperative day 9, he suddenly showed redness and swelling on the anterior neck. Enhanced computed tomography of the pharynx revealed tracheal necrosis and an abscess in the surrounding area. An incision and drainage were performed and Enterobacter aerogenes and E. faecalis were identified. The infection was controlled after antibiotic treatment. High endotracheal tube cuff pressure was suspected as the cause of the tracheal infection. Although DNIs are difficult to predict in patients who cannot report their symptoms due to unconsciousness, prevention and rapid diagnosis are important, as DNIs have serious side effects.
Abscess ; Aged ; Brain Injuries* ; Brain* ; Dental Caries ; Diagnosis ; Drainage ; Enterobacter aerogenes ; Fever ; Head ; Hematoma, Subdural, Acute ; Humans ; Intubation, Intratracheal ; Male ; Neck ; Necrosis ; Palatine Tonsil ; Pharyngitis ; Pharynx ; Tonsillitis ; Unconsciousness

PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.
Calculi ; Dental Caries ; Dental Clinics ; Diagnosis ; Diagnosis, Oral ; Humans ; Inflammation ; Mass Screening ; National Health Programs ; Radiography, Dental ; Radiography, Panoramic ; Root Caries ; Sensitivity and Specificity ; Survival Rate ; Tooth ; Tooth Loss

PURPOSE: The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. MATERIALS AND METHODS: Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a 100×90-mm field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of α=.05. RESULTS: Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant (P>.05). CONCLUSION: Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.
Area Under Curve ; Cone-Beam Computed Tomography* ; Dental Caries ; Dentin ; Diagnosis ; ROC Curve ; Tooth ; Tooth, Deciduous*