• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.45-49
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• 2019

Bartter syndrome is an inherited renal tubular disorder characterized by hypokalemia, hypochloremic metabolic alkalosis, hyperreninemia, hyperprostaglandinism, and normal blood pressure. Bartter syndrome is classified by neonatal and classic type. Clinical manifestation of Bartter syndrome considered in dental treatment include tendency to dehydration, vomiting and erosion, attrition and abrasion of the teeth. A 2-year-4 month old boy with Bartter syndrome type III was referred to the Seoul National University Dental Hospital for dental evaluation and treatment. He showed hypokalemic hypochloremic metabolic alkalosis and had been treated with indomethacin and potassium chloride. He had hypocalcified teeth with or without multisurface caries lesions in all dentition and the erosion of maxillary teeth was detected. Dental procedure under general anesthesia was scheduled due to multiple caries and his medical condition. The dental procedure was successfully performed. This case suggests that electrolyte imbalances need to be treated prior to dental treatment and complete coverage restoration is necessary to protect the eroded teeth. An appropriate management plan for the patients with Bartter syndrome should include considerations of the need for close interaction with the pediatrician for pre- and post-operative care. General anesthesia may be recommendable to manage the patients having multiple caries with Bartter syndrome.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.74-78
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• 2019

Atypical teratoid rhabdoidal tumor(AT/RT) is a rare and fast-growing tumor usually diagnosed in childhood. Routine magnetic resonance imaging(MRI) assessment of AT/RT patients is done to detect metastatic tumors and recurrent lesions. The purpose of this case report is to present a case about caries treatment of a 3-year-8-month old female patient with AT/RT under general anesthesia. A 3-year-8-month old patient with AT/RT visited Seoul National University Dental Hospital for caries treatment. At the first dental visit, she was receiving chemotherapy. Multiple caries were observed from clinical and radiographic examination. The dental procedure was successfully performed under general anesthesia. Patients with brain tumor may take routine MRI to detect metastatic tumors and recurrent lesions. Dentists should take into consideration of possible dislodgement of restoration by ferromagnetic properties and artifact formation on MRI image. Ready-made zirconia crowns can be a good restoration option for such patients.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.60-64
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• 2019

Swyer-James syndrome (SJS), also known as Swyer-James-MacLeod syndrome and unilateral hyperlucent lung syndrome, is rare acquired pulmonary disorder develops secondary to infectious etiologies in early childhood. Viral respiratory infection such as adenoviruses or Mycoplasma pneumoniae in infancy or early childhood rarely cause Swyer-James syndrome. It is generally characterized on radiographs by a unilateral small lung with hyperlucency and air trapping on expiration. In many cases unaffected lung tissue functions normally, compensating for affected lung portion. Preoperative assessment is needed to determinate individual's pulmonary function. A 4-year-old boy with Swyer-James syndrome visited Seoul National University Dental Hospital Department of pediatric dentistry for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions on deciduous teeth. Considering patient's underling disease, age, and level of cooperation, dental treatment under general anesthesia was scheduled. Dental treatment was done with composite resin and stainless-steel crown. Since ventilation of Swyer-James syndrome patients was diminished because of airway obstruction, close monitoring of ventilation is necessary during dental treatment. Considering pulmonary pathology, general anesthesia rather than sedation is recommended when special behavior management is required for dental treatment. Swyer-James syndrome patients can tolerate general anesthesia and surgery well, according to several reports.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.65-69
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• 2019

Wolf-Hirschhorn syndrome(WHS) is a congenital disorder caused by deletions of the short arm of chromosome 4. The most common characteristics are mental and growth retardation, dietary disorder and craniofacial features with a characteristic 'Greek warrior helmet' appearance. The dental characteristic of WHS includes delayed development, tooth agenesis, clefts, microdontia, taurodontism, and severely worn dentition. The purpose of this case report is to describe the dental treatment of a patient with WHS. 3-year-old boy with WHS visited the Seoul National University Dental Hospital for dental treatment. He had difficulty with nasotracheal intubation because of craniofacial anomalies and also had poor oral hygiene due to a limitation of mouth opening and dietary disorder. Due to his airway problem, behavior management and severity of dental conditions, dental treatment was performed under general anesthesia. This case suggests general anesthesia can be chosen with WolfHirschhorn syndrome patients to safely care for their dental problems.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.23-28
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• 2019

People with intellectual disabilities (ID) usually have poor oral health status and are susceptive to have more caries than general populations. Even when the patients get regular dental treatment, their dental conditions are usually not good for some additional factors. In this presentation, we show dental follow-up care of two patients who have multiple caries. The first case is a 16-year-old boy who has a unilateral facial paralysis with ID. As the lack of controlling of the muscles resulted in interfering with the self-cleansing, it would be associated with a higher incidence on the affected side. Endodontic treatment and caries treatment as restoration was performed. Due to loss of posterior occlusal support on right side, we planned to recover the right posterior relationship by full coverage restorations. In second case, a 20-year-old boy has been on a long-term follow up. Caries treatment, periodontal treatment, and prosthetic treatment were performed under several times of general anesthesia. He has been treated more than 8 years and gets a regular check at 1-month intervals, however, high dental caries susceptibility has been retained. These cases present that dentists should perform more aggressive treatment and be involved in providing better maintenance of patients with intellectual disabilities with multiple caries in adolescence. In other words, it is necessary to suggest a customized preventive strategy for patients with ID.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.65-75
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• 2022

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.45-56
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• 2022

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.3
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• pp.264-273
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• 2022

Due to the development of properties of adhesive materials currently used in dentistry, the bonding ability between the brackets and the tooth enamel has been greatly improved. In general, in situations where cooperation can be obtained, adhesion of the orthodontic bracket through the conventional three-step process can show excellent bonding strength. However, if it is difficult to expect patient cooperation, as in the pediatric dentistry area, or if moisture isolation is not properly performed, the binding strength that does not reach the expected effect. As a result, various products that simplify the process for adhesion are being developed. The aim of this study was to evaluate and compare the shear bonding strength between the conventional 3-step adhesion system, self-etching primer system and one-step adhesion system that reduces the priming process. A total of 60 human maxillary, mandibular premolars were prepared. Group I (control group) were followed conventional 3-step bonding process. Group II were conditioned with self-etching primer. Group III were etched with 37% phosphoric acid and brackets were bonded with self-priming adhesive. The resultant shear bond strength of each group was measured and an adhesive remnant index (ARI) was recorded. The mean shear bond strength of group I, II, III were 14.69 MPa, 11.21 MPa and 12.21 MPa respectively. Significant differences could only be found between group I, II and group I, III (p < 0.05). The ARI indicated no significant difference among all groups.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.368-378
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• 2022

The purpose of this study was to analyze the accessibility to dental facilities and the differences in chief complaints of new patients who visited Pusan National University Dental Hospital. We collected information from electronic medical records for 1,820 new patients. The accessibility was analyzed by measuring the distance from the patient's house to the dental facilities. The distance was categorized into 10 km sections, and the presence or absence of a local pediatric dental clinic within 10 km of the patient's house was also categorized. As the distance between the house and Pusan National University Dental Hospital increased, the proportion of patients who visited for dental caries decreased, and orthodontic treatment increased. Dental caries accounts for 27.9% of less than 10 km and 20.5% over 30 km. Orthodontic treatment accounts for 25.4% within 10 km and 27.3% more than 30 km away. The presence or absence of a local pediatric dental clinic within 10 km did not significantly affect the distribution of chief complaints. This study can be used as basic research data to establish effective treatment measures that can improve the physical and geographical accessibility of patients visiting pediatric dentistry.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.149-157
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• 2022

The aim of this study was to evaluate the effects of erythrosine-mediated photodynamic therapy (PDT) on Streptococcus mutans biofilm recovery by counting its colony-forming units (CFUs) and via confocal laser scanning microscopy analysis at different time points following PDT. In PDT, photosensitizer was an erythrosine. S. mutans ATCC25175 biofilms were irradiated using an LED curing light. Chlorhexidine (CHX) was used as positive control. After each antimicrobial treatment, samples were cultured to allow biofilm recovery. Viability was measured by calculating the CFU counts after treatment and after every 3 hours for up to 24 hours. Immediately after treatment, the PDT and CHX groups showed equally significant decreases in S. mutans CFU counts compared to the negative control. After 12 hours of reculture, the PDT group showed no significant difference in the decrease in CFU count compared to the negative control, whereas the CHX group showed significantly lower CFU counts throughout the 24-hour period. Erythrosine-mediated PDT can effectively inhibit S. mutans biofilm formation. However, biofilm recovery occurred earlier in the CHX group after PDT. This study provides insights into the clinical effectiveness of PDT in preventing dental caries.