• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.587-597
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• 2004

Over the past 20 years, great strides have been made in research regarding the mechanisms involved in the progression of carious lesions, but new equipment and research tools need to be developed to continue these advancements in caries research. Various methods have been applied to reduce the incidence of carious lesions, which have led to a significant decrease in the number of occlusal caries, but a concurrent increase in the proportion of proximal carious lesions. New diagnostic equipment has been developed to detect early stage carious lesions, and these have demonstrated excellent laboratory results and show promise in clinical applications. The research presented here examines the efficacy of the newly developed $DIFOTI^{TM}$ system in detecting proximal carious lesions compared to traditional intraoral exam and bitewing radiography, possible problems or deficiencies of using the system in clinic, possible improvements that can be made to the system, and the efficacy of detecting early, reversible carious lesions that can be remineralized by preventative fluoride applications. The subject pool consisted of 23 grammer school age patients just prior to entering the mixed dentition phase. Each patient was given a thorough oral examination, radiographic examination consisting of bitewing radiographs of the posterior teeth, and $DIFOTI^{TM}$ examination of the anterior and posterior teeth. Each examination was carried out two times by two examiners, and the data were statistically analyzed. The results are as follows: 1. The mean alpha value of reliability test of the visual oral examination was as follows; occlusal surface was 0.8470. mesial surface was 0.6430, distal surface was 0.5727. lingual surface was 0.2807 and distal surface was 0.2339. When the examination was limited to posterior teeth, the mean alpha value was as follows; occlusal surface was 0.8577, distal surface was 0.8211, lingual surface was 0.7728, buccal surface was 0.7152 and mesial surface was 0.6782. 2. The alpha value of reliability test of the radiographic analysis of carious lesions of the occlusal, mesial, and distal surfaces was 0.8500. 3. The alpha value of reliability test of the $DIFOTI^{TM}$ diagnostic analysis of carious lesions of the occlusal, buccal, lingual, mesial, and distal surfaces was determined to be 0.7917. 4. The $DIFOTI^{TM}$ diagnostic system was found to be the most accurate means of detecting occlusal, buccal, and lingual surface carious lesions (p<0.05), while mesial and distal proximal carious lesions were most accurately assessed using bitewing radiography (p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.30-37
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• 2009

Early enamel caries is commonly remineralized by the patient‘s improved oral hygiene or fluoridation, however the result is clinically unreliable. As an alternative, we tried to seal the lesions with low-viscosity light-curing resin. The aim of the present study was to search the proper methods of the adequate pretreatment prior to applying adhesive resin on natural proximal caries lesions. Thirty nine extracted deciduous molar teeth showing proximal early caries lesion were used for this study. They were divided into 5 groups : Group 1; only carefully cleaned with water, group 2; etched with 15% HCl for 15s, group 3; etched with 35% phosphoric acid for 15s, group 4; etched with 35% phosphoric acid for 30s, and group 5; cleaned with 0.5% NaOCl. Following results were obtained by evaluating with SEM and CLSM after applied with adhesive resin. 1. As a result of SEM evaluation, group 2 showed clearly removed surface layer, group 3,4 showed partially removed surface layer irregularly, group 5 showed slightly removed surface layer. 2. Group 2 showed the deepest infiltration depth, followed by group 4, group 3, group 5, group 1 and besides group 5, other groups showed significantly deep infiltration depth. (p < 0.01) In conclusion, the best methods of the adequate pretreatment on natural proximal caries lesion for deep infiltration of adhesive resin was to etch with 15% HCl for 15s.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.16-24
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• 2001

The purpose of this study was to evaluate the specificity, sensitivity, and diagnostic power of caries activity test using laser fluorescence. The subjects of this study were 50 children of $7\sim9$ years old. Fluorescence from initial carious lesion of teeth illuminated by an argon laser(480nm) was observed and photographed with barrier filter. Visual examination for the dDfFtT rate and Streptococcus mutans colony counting was done to evaluate correlation with caries activity test using laser fluorescence. Data analysis was accomplished by Axelsson's method. The results from the present study can be summarized as follows: 1. There was positive correlation $(\gamma=0.48)$ between laser fluorescence test and Streptococcus mutans count. And also positive correlation $(\gamma=0.39)$ exists between laser fluorescence test and dDfFtT rate (P<0.01). 2. Positive correlation $(\gamma=0.27)$ between Streptococcus mutans colony count and dDfFtT rate was found(P<0.05). 3. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of laser fluorescence test were 44.4%, 85.7%, and 87.8%. 4. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of S. mutans colony counting were 77.8%, 92.9%, 84.8%. 5. When S. mutans colony counting was defined to standard testing method, sensitivity, specificity and diagnostic power of laser fluorescence test were 40.0%, 84.8%, 95.1%. In regard to above results, laser fluorescence test considered to be accurate and reliable method for determining caries activity because of it's close relationship with caries susceptibility test and caries experience measurements. And it was also considered to be practical because it would be simple, inexpensive, and time saving method.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.461-466
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• 2016

Dental caries is an important dental disease among children and adolescents that can continue for a lifetime. Early detection of dental caries in deciduous dentition is significant because it can influence the permanent teeth. It is also critical to prevent dental caries by performing fluoride treatment and pit-and-fissure sealant for high-risk children. Various methods have been developed for the early detection of dental caries; however, many studies are still seeking to discover more effective methods. In general, visual examination and radiographic images are used, but these techniques have several limitations such as errors and radiation exposure. In this study, clinical application of the newly developed DIAGNOcam caries identification device and its possible applications were examined. DIAGNOcam was applied to diagnose dental caries in the posterior teeth of patients in the Department of Pediatric Dentistry, and it was confirmed that it could be used to detect proximal caries, the margin of restoration, and the extent of dental caries lesions.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.210-216
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• 2002

Air abrasion technology can prepare enamel and dentin for bonding, similar to etching by acidic gels and solutions. Longer treatment can excavate pit and fissures, preparing the tooth for immediate placement of bonded resin materials. Although not appropriate for every clinical situation, the air abrasive technology minimizes heat, vibration and bone-conducted noise associated with conventional means of caries removal since the cutting is accomplished by air pressure. Also, patients treated with the air-abrasion technology rarely request anesthesia. Air abrasion technology was more effective in treating early carious lesions and stains compared to lesions where caries had already progressed to produce soft dentin and the strong air stream and noise caused by the evacuation system was a major discomfort to pediatric patients, and the experience and skillfulness of clinician should be required for accurate and proper tooth preparation.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.102-107
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• 2009

In clinical pediatric dentistry, we have many chances to encounter the white spot like incipient enamel lesions on the mesial surfaces of the 1st molars with direct vision, especially just after the 2nd primary molars were exfoliated. But it was thought highly desirable to assess if these lesions are properly and effectively managed yet. This study aims at surveying the prevalence of incipient lesions on the mesial surfaces of the 1st molars in children through direct observation and examining the suitability of adhesive sealing on them as a pilot trial in searching for their proper management. 1. Among the 124 mesial surfaces of the 1st molars examined, 34% were sound, 53% had incipient carious lesions and 13% had cavitated lesions. 2. In the sectional views of the specimens, 20% showed microleakage after thermo-cycling and it was thought not recommendable as a permanent method. Therefore in order to effectively fight against the incipient caries lesions in children‘s permanent teeth, it was thought proper not to rely on any one method, but to perform reinforcing oral hygiene and promotion of remineralization in combination with therapeutic sealing which is stronger in short-term sealing effect. Although therapeutic sealing has been considered as the core in minimally invasive concept to treat the white spot lesions, its long-term clinical trials have not been suggested. Continuous research is strongly required for making this approach to acquire permanent nature, especially in regards of proper pretreatment and high molecular materials deeply penetrable into enamel.

• Journal of dental hygiene science
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• v.13 no.2
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• pp.182-190
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• 2013

Composition of oral microbial flora is suggested to play a role in the maintenance of oral health. Among them, Streptococcus mutans plays an essential role in the formation of dental plaque and it is being noticed as incipient infective bacteria of dental caries. The purpose of this study was to prepare the basic data about distribution of Streptococcus mutans detected from saliva by measuring colony density. It is well known that smoking as well as drinking is a factor of dental caries, however there are few investigations about distribution of Streptococcus mutans either smoking or drinking. The materials of this study were collected from students of dentistry college with general characteristics obtained by self-administered questionnaires. Students were asked to gently chew the paraffin to get saliva for 1 minute. Bacitracin disc in the culture medium was activated for 15 minutes, and then sample was incubated in the activated medium at $37^{\circ}C$ incubator for 48 hours. Streptococcus mutans colonization per 1 ml saliva was measured by the number of criteria. The severe levels of dental caries activity were significantly increased in the case of smoking (from 5.6% to 10%) or drinking (form 0% to 7%), respectively. Also, dental caries activity increased according to smoking and drinking periods longer. However, using the SPSS analytical process (Mann-Whitney's U), no significant differences were observed between the smoking and the non-smoking or the drinking and non-drinking, respectively. These results obtained from dental caries activity of saliva suggest that distribution of Streptococcus mutans following smoking or drinking can be used as a significant information for oral health.

• Restorative Dentistry and Endodontics
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• v.33 no.5
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• pp.481-492
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• 2008

The purpose of this study is to observe and compare the remineralization tendencies of artificially demineralized enamel by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 36 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 3 days in order to produce dental caries artificially that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffered remineralization solution of three different degrees of saturation (0.25, 0.30, 0.35) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope $({\times}100)$. The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were determined. In conclusion, in the group with the lowest degree of saturation, remineralization occurred thoroughly from the surface to the subsurface lesion, whereas in the groups with greater degree of saturation showed no significant change in the subsurface lesion, although there was corresponding increase in the remineralization width on the surface zones.

• The korean journal of orthodontics
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• v.31 no.6 s.89
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• pp.567-578
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• 2001

To investigate the difference of Texture exhibited on interproximal enamel surface with each different stripping method and the susceptibility of proximal enamel to demineralization after stripping and the application of a topical fluoride go] and sealant, one hundred human premolars, which were Previously extracted for orthodontic reasons were evaluated by means of Scanning electron microscopy and laser fluorescence. The results were as follows : 1. No matter what the initial stripping instrument was the furrows that resulted from all the stripping methods were not completely removed by careful polishing. 2. Among the enamel surfaces that were treated with three different initial abrasive instruments, followed by the same polishing method (Sof-$Lex^{(r)}$ disks), the enamel surfaces that were treated with 700 crosscut carbide bur showed the smoothest surfaces. 3. The stripped teeth, no matter what the initial stripping instrument was, were less resistant to initial demineralization than untreated teeth. But no difference in caries susceptibility according to differently stripped methods was found (p<(0.001). 4. Teeth treated with APF-gel or sealant were mote resistant to demineralization than those treated without other treatment after stripping (p<0.001). 5. Comparing groups treated with APF-gel to groups treated with sealant, the former was more resistant to demineralization than the tatter (p<0.05). In conclusion, enamel surfaces that were stripped jnterproximally were less resistant to demineralization even though various attempts were made to produce smooth, self-cleaning enamel surfaces. Therefore, additional treatment-sealant or calcifying/ fluoridating solution To the stripped enamel surfaces is recommended.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.202-209
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• 2011

Current treatment concept of dental caries has been changed, because it has been proved that it is a preventable disease. The philosophy has been changed from purely restorative treatment to preventive caries control. Therefore the methods or criteria of oral examination has been changed. The clinician have to detect not only cavitation, but also the lesion of non-cavitation stage. International Caries Detection and Assessment System II (ICDAS II) was developed recently, which is a new criteria of classification of dental caries. This system was based on the current concept of prevention, early detection and patient-centered management of caries. Therefore this philosophy is in accord with the perspective of pediatric dentistry. The purpose of this article is to introduce this system for oral examination of children.