• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.91-95
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• 2009

The use of stainless steel crowns are indicated for restoration of primary or permanent molars with proximal dental caries, extensive dental caries, or previous pulp treatment with increased danger of tooth fracture. Stainless steel crowns were introduced by Humphrey in 1950. For their improved durability, longevity, and success rate, they have been strongly considered for restoring extensive and multi-surfaced dental caries of molars in pediatric dentistry. However, they also have shortcomings, such as possibility of pulpal exposure or damaging proximal surface of adjacent teeth. In addition, when oversized stainless steel crowns are used, eruption of the adjacent permanent teeth may be disturbed by their prominent margin. As a means to compensate the shortcomings of stainless steel crowns, use of orthodontics bands may be considered. It is an alternative restoration method, where an orthodontic band is placed on a tooth first and cavity is restored with filling material, such as composite resin, glass ionomer, or amalgam. The use of an orthodontic band is indicated for molar restoration with cervical dental caries, extensive dental caries, enamel hypoplasia, or previous pulp treatment. Because it requires shorter chair time compared to stainless steel crown, its application is very useful for children with poor behavior. However, restoration using an orthodontic band requires good oral hygiene after its application. This case report illustrates the conservative restoration of primary molars and permanent molars with extensive dental caries using orthodontic bands.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.377-387
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• 2006

The objective of this study was to evaluate the influence of multiple adhesive coatings on the thickness of hybrid and adhesive layer and shear bond strength(SBS) of self-etch adhesives and self-etch primer adhesives. The buccal or lingual crown dentin of extracted human molars was used. Self-etch adhesives or self-etch primer adhesives were applied 1, 2 and 3 times on the dentin before light curing. In another group adhesives were reapplied after light curing first layer. Treated surfaces were prepared to measure the thickness of hybrid and adhesive layer with SEM, and shear bond strength to dentin using an Instron machine. The following results were obtained : 1. The adhesive layers increased with the number of coatings(p<0.05) with all adhesives. Adpor Prompt L-Pop and Xeno III were significantly thinner than self-etch primer adhesives (p<0.05). 2. The thickness of hybrid layers increased with the number of coatings (p<0.05). 3. The shear bonding strength of Unifil Bond and Clearfill SE Bond were higher than Scotchbond Multipurpose Plus and Adpor Prompt L-Pop (p<0.05), and similar with Xeno III. 4. The shear bond strength increased significantly with the number of coatings in Adpor Prompt L-Pop(p<0.05), but decreased at 3 times in AdheSE Bond(p>0.05). 5. In Adpor Prompt L-Pop and Xeno III, the shear bond strength decreased when adhesives were reapplied after curing the first adhesive layer.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.96-100
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• 2016

Metachromatic leukodystrophy (MLD) is a progressive and degenerative neurological disease caused by a deficiency of the catabolic enzyme arylsulfatase A. Deficiency of arylsulfatase A results in accumulation of sulfatide in the white matter of the peripheral and central nervous system and it occurs demyelination as a result. The patient gradually goes through mental and motor failure. General symptoms of MLD include gait disturbance, mental deterioration, muscle rigidity and impaired swallowing. Inheritance of the disease is autosomal recessive. We report a dental caries treatment of a 3-year old boy with MLD. The patient underwent hematopoietic stem cell transplantation (HSCT) to slow the progression of the disease. He was suffered from difficulties of mastication and swallowing from the degenerative neurological symptom. He was ingesting food by both oral feeding and tubal feeding after he took percutaneous endoscopic gastrostomy (PEG). The cause of multiple caries was mainly presumed as patient's prolonged time of meal. The treatment was performed under general anesthesia considering patient's incompliance. Severely affected lower primary molars were treated with pulp treatment and restored with stainless steel crown. Others were restored with composite resin. There were no postoperative complications. MLD is life threatening progressive disease and also has an impact on unfavorable condition for oral health. Routine home oral care and periodic professional dental care should be emphasized to the caregiver of patient considering the susceptibility of dental caries. Not only the medical care, but periodic dental office visit would benefit the quality of life of the patient.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.82-86
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• 2016

Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome. A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination. Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely. Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.

• Restorative Dentistry and Endodontics
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• v.28 no.5
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• pp.378-384
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• 2003

This study evaluated the influence of a desensitizer(MS coat) on microtensile bond strength of different adhesives:a three-step adhesive(All-Bond 2), a two-step adhesive(Single Bond), a one-step adhesive(One-up Bond F). Non-caries extracted human molars were used. Dentin surface was obtained by horizontal section on mid-portion of crown using a water-cooled low speed diamond saw. Teeth were randomly divided into 6 group. AMO(MS coat + All Bond), SMO(MS coat + Single Bond)- and OMO(MS coat + One-up Bond F)-dentin surface were treated with 17% EDTA before bonded adhesive. AMX-, SMX- and OMX-dentin surface were bonded with All-Bond 2, Single Bond and One-up Bond F, respectively. with no previous treatment with MS coat and 17% EDTA. About 1cm high resin composite($Z-250^{TM}$) were incrementally build-up on the treated surface. The specimens for the microtensile test were serially sectioned perpendicular to the adhesive layer to obtain $0.7{\times}0.7mm$ sticks. 30 sticks were prepared from each group. After that. tensile bond strength for each stick was measured with Microtensile Tester at a 1mm/min crosshead speed. Fractured dentin surfaces were observed under the SEM. The results were statistically analysed by using a One-way ANOVA and Tukey's test(p<0.05). Value in MPa were: $AMO-44.35{\pm}13.21;{\;}SMO-39.35{\pm}13.32;{\;}OMO-31.07{\pm}10.25;{\;}AMX-49.22{\pm}16.38;{\;}SMX-56.02{\pm}13.35;{\;}OMX-72.93{\pm}16.19$. Application of MS coat reduced microtensile bond strengths of both Single Bond and One-up Bond F, whereas microtensile bond strengths of All-Bond 2 were not affected significantly.

• 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 Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.127-133
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• 2019

Purpose: The purpose of present study was to investigate fracture strength and mode of failure of endodontically treated teeth restored with metal cast post-core system, prefabricated fiber post system, and newly introduced polyetherketoneketone (PEKK) post-core system. Materials and methods: A total of 21 mandibular premolar were randomly grouped into 3 groups of 7 each according to the post material. Group A was for metal cast post core; Group B for prefabricated glass fiber post and resin core; and Group C for milled PEKK post cores. All specimens were restored with metal crown. The fracture strength of each specimen was measured by applying a static load of 135-degree to the tooth at 2 mm/min crosshead speed using a universal testing machine. After the fracture strength measurement, the mode of failure was observed. The results were analyzed using Kruscal-Wallis test and post hoc Mann-Whitney U test at confidence interval ${\alpha}=.05$. Results: Fracture resistance of PEKK post core was lower than those of cast metal post and fiber reinforced post with composite resin core. In the aspect of fracture mode most of the root fracture occurred in the metal post core, whereas the post detachment occurred mainly in the fiber reinforced post. In the case of PEKK post core, teeth and post were fractured together. Conclusion: It is necessary to select appropriate materials of post for extensively damaged teeth restoration and clinical application of the PEKK post seems to require more research on improvement of strength.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.5
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• pp.514-523
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• 2004

Statement of problem: All-ceramic restorations have been advocated for superior esthetics. Various post and core systems have been used to improve the strength of damaged teeth, but it is unclear whether they affect the final shade of finished all-ceramic restorations. Purpose: The influence of different types of post and core systems on light transmission through all-ceramic crowns was assessed by spectrophotometric analysis. Also the masking effect of different thickness of ceramic ingot was evaluated. Material and Methods : Forty-five sample disks (15mm in diameter) at several thickness(1.0, 1.5, 2.0mm) and value(shade 100, 200, 300) were made in heat pressed ceramic(IPS-Empress). Background specimens simulating gold-alloy cast posts(Type III casting gold alloy), metal posts(Ni-Cr casting alloy) and ceramic posts(CosmoPost) were fabrica-ted. Resin composite(Z250, A3 shade) was used as a tooth substrate reference. For each combination, the change in color was measured with a spectrophotometer. Readings were performed for 2 conditions (1) ability of ceramic to mask the core in relation to its thickness(1.0, 1.5, or 2.0mm) ; (2) influence of post and core types on the final color of the ceramic. Data were recorded according to the CIE $L^*a^*b^*$ systems and color difference($\Delta$E) was calculated. Results: 100 shade ingot: when ceramic thickness was 1.0mm, $\Delta$E value for ceramic post larger than 1 but $\Delta$E value for metal and gold post was larger than 2. For ceramic thickness of 1.5mm, only $\Delta$E value for metal was larger than 2, and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 2. 200 shade ingot: when ceramic thickness was 1.0mm, $\Delta$E value for ceramic post was smaller than 1 but $\Delta$E value for metal and gold post was larger than 2. For ceramic thickness of 1.5 mm, only the $\Delta$E value for metal was larger than 2, and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 1. 300 shade ingot: when ceramic thickness was 1.0mm, only $\Delta$E value for metal was larger than 2 and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 1.5mm, $\Delta$E values for all specimens was smaller than 1. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 1. Conclusion: The final esthetic result of the IPS-Empress glass-ceramic restoration was not affected by the presence of different core materials when the thickness was more than 2.0 mm. When ceramic thickness decreases to 1.5mm, it is advised to take the substrate aspects into consideration. If the ceramic thickness is less than 1.0mm, using the tooth color matched substrate is strongly recommended.