• The korean journal of orthodontics
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• v.52 no.4
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• pp.278-286
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• 2022

Objective: To evaluate differences in the adhesion levels of the most common oral pathogens, Streptococcus mutans and Porphyromonas gingivalis, in human saliva-derived microcosm biofilms with respect to time and raw materials of orthodontic brackets. Methods: The samples were classified into three groups of bracket materials: 1) monocrystalline alumina ceramic (CR), 2) stainless steel metal (SS), and 3) polycarbonate plastic (PL), and a hydroxyapatite (HA) group was used to mimic the enamel surface. Saliva was collected from a healthy donor, and saliva-derived biofilms were grown on each sample. A real-time polymerase chain reaction was performed to quantitatively evaluate differences in the attachment levels of total bacteria, S. mutans and P. gingivalis at days 1 and 4. Results: Adhesion of S. mutans and P. gingivalis to CR and HA was higher than the other bracket materials (SS = PL < CR = HA). Total bacteria demonstrated higher adhesion to HA than to bracket materials, but no significant differences in adhesion were observed among the bracket materials (CR = SS = PL < HA). From days 1 to 4, the adhesion of P. gingivalis decreased, while that of S. mutans and total bacteria increased, regardless of material type. Conclusions: The higher adhesion of oral pathogens, such as S. mutans and P. gingivalis to CR suggests that the use of CR brackets possibly facilitates gingival inflammation and enamel decalcification during orthodontic treatment.

• Restorative Dentistry and Endodontics
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• v.33 no.6
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• pp.507-517
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• 2008

There are considerable in vitro and in vivo evidences for remineralization and demineralization occurring simultaneously in incipient enamel caries. In order to "heal" the incipient dental caries, many experiments have been carried out to determine the optimal conditions for remineralization. It was shown that remineralization is affected by different pH, lactic acid concentrations, chemical composition of the enamel, fluoride concentrations, etc. Eighty specimens from sound permanent teeth without demineralization or cracks, 0.15 mm in thickness, were immersed in lactic acid buffered demineralization solutions for 3 days. Dental caries with a surface zone and subsurface lesion were artificially produced. Groups of 10 specimens were immersed for 10 or 12 days in lactic acid buffered remineralization solutions consisting of pH 4.3 or pH 6.0, and 100, 50, 25, or 10 mM lactic acid. After demineralization and remineralization, images were taken by polarizing microscopy (${\times}100$) and micro-computed tomography. The results were obtained by observing images of the specimens and the density of the caries lesions was determined. 1.As the lactic acid concentration of the remineralization solutions with pH 4.3 was higher, the surface zone of the carious enamel increased and an isotropic zone of the subsurface lesion was found. However, the total decalcification depth increased at the same time. 2.In the remineralization solutions with pH 6.0, only the surface zone increased slightly but there was no significant change in the total decalcification depth and subsurface zone. In the lactic acid buffer solutions with the lower pH and higher lactic acid concentration, there were dynamic changes at the deep area of the dental carious lesion.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.278-286
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• 2008

Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.2
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• pp.207-220
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• 2006

The newly developed equipments for the early detection of carious lesion are LFD (laser fluorescence device), Ultrasonic diagnostic system, CLSM(confocal laser scanning microscopy), QLF(quantitative light-induced fluorescence) and DIFOTI (digital imaging fiber-optic trans-illumination) system. In this study, DIFOTI system and LFD were used for the detection of early enamel caries. Twenty five primary teeth extracted from twenty one children at around the dentitional exchanging period were selected as samples. The results obtained from DIFOTI imaging and LFD measurement were compared with those of CLSM and comprehensive evaluations were made for the diagnostic capacity of each device. In vitro test, 40 sample teeth with their buccal & lingual surface formed by a window of $2{\times}3mm$ in diameter were immersed in artificial demineralizing solution for the period of 4, 8, 12 and 16 days. The results obtained from the experimental groups (DIFOTI, LFD) were compared to control group (CLSM) and we have reached to the following conclusions. 1. The sensitivity and specificity of DIFOTI system operated in oral environment was 88.2% and 76.9% respectively. 2. The sensitivity and specificity of LFD measured in oral environment was 76.5% and 69.2% respectively. 3, Regression analysis on the light transparent rate of DIFOTI showed its decrease according to the length of primary enamel decalcification performed in vitro(r=-0.96, p<0.05). 4. No statistically significant difference between LFT measurement and the length of in vitro decalcification was found in regression analysis (p>0.05). 5. The correlation coefficient of DIFOTI image transparent rate and the lesion depth of CLMS was -0.6988 (p<0.05), whereas no statistically significant difference was found for LFD measurement.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.151-161
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• 2007

Dental caries is the most common disease in the oral cavity However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss or inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM. The results were as follows, 1. In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p<0.05). 2. In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 3. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size. In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.51-59
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• 2005

The aim of this study was to compare the species and biotypes of mutans streptococci isolated from dental plaques sampled from the interfaces between the bracket aid tooth surface and smooth tooth surfaces In orthodontic patients. Dental plaque was collected from the interfaces between brackets aid teeth (test group), and from smooth tooth surfaces distant from brackets by more that 2mm (control group). The dental plaque collected by a sterilized curette was transferred into a vial of 1 X PBS. The sample in the vial was vigorously vortexed for 1 min and plated ou mitis-salivarius bacitracin (MSB) agar plate using cotton tips. The agar plates were incubated at $37^[\circ}C$ in a candle jar for 2 days, and again incubated for 1 more day at anambient temperature Individual colonies were cultured in TH broth at $37^[\circ}C\;CO_2$ incubator. The PCR-RFLP based on dextranase gene was performed for the identification of mutans streptococci at the species-level For biotyping of mutans streptococci, biochemical tests were performed There was no significant difference of the species of mutans streptococci isolated from both test and control groups However, the biotypes of the mutans streptococci isolated from test and control groups were different. These results may offer the basic data to verify the relationship between the mutans streptococci biotype and enamel decalcification or dental caries in orthodontic patients with fixed appliances.

• The korean journal of orthodontics
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• v.39 no.2
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• pp.105-111
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• 2009

Objective: To estimate the effects of bracket material type on enamel decalcification during orthodontic treatment, this study analyzed the adhesion level of mutans streptococci (MS) to orthodontic bracket materials in vivo. Methods: Three different types of orthodontic bracket materials were used: stainless steel, monocrystalline sapphire, and polycrystalline alumina. A balanced complete block design was used to exclude the effect of positional variation of bracket materials in the oral cavity. Three types of plastic individual trays were made and one subject placed the tray in the mouth for 12 hours. Then, the attached bacteria were isolated and incubated on a mitis salivarius media containing bacitracin for 48 hours. Finally, the number of colony forming units of MS was counted. The experiments were independently performed 5 times with each of the 3 trays, resulting in a total of 15 times. Mixed model ANOVA was used to compare the adhesion amount of MS. Results: There was no difference in colony forming units among the bracket materials irrespective of jaw and tooth position. Conclusions: This study suggested that the result of quantitative analysis of MS adhesion to various orthodontic bracket materials in vivo may differ from that of the condition in vitro.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.491-497
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• 2006

Orthodontic seamless bands are frequently used in pediatric dentistry. In the process of seating bands with luting cement coated inside, not uniformed coating might bring about various problems such as enamel decalcification and/or gingivitis, and this clinical trial was made to review several band-seating methods to exclude these risks. One kind of band luting cement and one size of seamless bands were used on the resin replicas of an extracted maxillary and mandibular 1st molar with three different seating methods 1. seating the band with the luting cement coated only inside the band, 2. seating the band with the luting cement coated inside the band and on axial surfaces of the teeth, 3. seating the band with the adhesive tape on the occlusal opening of the band and the luting cement coated only inside the band. After cement was completely set, bands were peeled off from the teeth and the status of cement coating was evaluated. With this experiment more uniformed coating of the luting cement was found in latter two groups. These methods are thought more appropriate to almost completely rule out the risk of unevenly coated cement beneath the bands by conventional method.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.1-12
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• 2006

The purpose of this study were to evaluate the efficacy of the newly developed Digital Imaging Fiber-Optic Trans-illumination (DIFOTI) system in detecting carious lesions in vivo as gold standard with confocal laser scanning microscopy and compared the efficacy of traditional radiography and DIFOTI system in vito as gold standard with confocal laser scanning microscopy, too. For the in vivo study, the subject pool consisted of 23 grammar school age patients just prior to entering the mixed dentition phase Each patient was given a DIFOTI examination of the anterior and posterior teeth. During $6{\sim}8$ months, the naturally expire primary teeth were collected and the efficacy of DIFOTI system was compared with confocal laser scanning microscopy. For in vitro study, 40 primary teeth were collected and decalcified by Carbopol decalcification solution for 1, 2, 4 and 8 days. Every experiment period, all teeth were DIFOTI examined and sectioned to take an image of confocal laser scanning microscopy Sensitivity and specificity were calculated from the result of DIFOTI examine and confocal laser scanning microscopy analysis. The results are as follows : 1. From the in vivo study, the sensitivity of DIFOTI examine was 0. 61 and specificity was 0.63. 2. From the in vivo study, the sensitivity of DIFOTI examine was 0.71 and specificity was 0.75.

• The korean journal of orthodontics
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• v.34 no.4 s.105
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• pp.363-370
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• 2004

Patients with fixed orthodontic appliances frequently have increased levels of plaque accumulation leading to the possibility of gingivitis or enamel decalcification. Although many methods may be helpful in reducing dental plaque formation, the optimal mechanical removal of plaque is the most important factor during orthodontic treatment. The purpose of this study was to evaluate the efficacy of an electric toothbrush (with a specially designed orthodontic brush head) compared to a manual toothbrush in controlling plaque and gingivitis for patients with fixed orthodontic appliances. Oral hygiene status was measured in thirty-four patients using a plaque index, a gingival index and a bleeding index, before and four weeks after the attachment of fixed orthodontic appliances. Patients were randomly divided into two groups: electric and manual toothbrush groups. Oral hygiene instruction was given according to the type of toothbrush used. The Braun Oral-B D9511 with Braun Oral-B Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M. 124 was given as the manual toothbrush. After four md eight weeks, oral hygiene status was measured again. Through a comparison between the electric and the manual toothbrush groups, the following results were obtained. 1. All oral hygiene indices showed an increasing tendency after four weeks of fixed orthodontic appliance. 2. All indices presented a decreasing tendency four and eight weeks after oral hygiene instruction. 3. In case of the gingival index and bleeding index, the decreasing tendency did not show a statistically significant difference between the electric and the manual toothbrush groups. 4. The decreasing tendency of plaque index presented a statistically significant difference between the two groups, showing that the electric toothbrush was more effective in terms of oral hygiene. These findings suggest that an electric toothbrush is useful to orthodontic patients with fixed appliances.