• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.65-72
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• 2008

Pulse oximeter to monitor oxygen saturation during pediatric dental sedations enables early detection of hypoxemia. The purpose of this study was to monitor the hemoglobin oxygen saturation level and pulse rate of nonmedicated pediatric patients during routine restorative procedures to study the effect of procedure and treated jaw. We obtained data from 53 children treated at the Department of Pediatric Dentistry, Chonbuk national university hospital. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry at each step of treatment. The results are as follows: 1. In non-anesthesia group, steep increase of pulse rate was observed during rubber dam application in the maxilla and during cavity preparation in the mandible. 2. In anesthesia group, pulse rate started to decrease after the rubber dam application in the maxilla, while its decrease observed since cavity preparation step in the mandible. 3. In non-anesthesia group, oxygen saturation level was relatively constant during all steps in the maxilla, but in mandible, it was higher during operation compared to its pre and post operation baseline. 4. In anesthesia group, oxygen saturation level was observed at 99% level through all steps in both jaw groups, and there was no statistical significance between the maxilla and the mandible groups(p>0.05). The purpose of this study was to evaluate the effect of routine dental treatment on the pulse rate and oxygen saturation level in nonmedicated pediatric patients during routine restorative procedures in the maxilla and mandible.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.153-159
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• 2012

The objective of this study was to assess the effect of salivary contamination on shear bond strength of pit and fissure sealant using several bonding agents by means of applying saliva at different stages of treatment. 56 teeth were randomly divided into one of seven groups (8 per group): (Group A, B) acid etching; (Group C, D, E) Adper$^{TM}$ Single Bond after acid-etching; (Group F, G) Adper$^{TM}$ Prompt L-pop. Saliva was applied to teeth surface of B, D, E, and G groups for 10 seconds. Especially, group D was contaminated after acid-etching and group E was contaminated with saliva after adhesive application. After light curing, all of the specimens were thermocycled and the shear bond strength tests were performed. The results were as follows. 1. In generally performed pit and fissure sealant group, shear bonding strength significantly differently reduced when was contaminated by saliva (p<0.05). However the group that was applied with bonding agent during pit and fissure sealant procedure, there were no significant differences in the kind of bonding agents nor the stage of contamination. 2. In group that was not contaminated by saliva during pit and fissure sealant treatment, Adper$^{TM}$ Single Bond yielded the highest bonding strength but there were no significant differences. 3. The failure pattern on the debonded surfaces shows that most specimens from groups using bonding agents showed cohesive failures while most specimens from groups that didn't use bonding agents showed adhesive failures.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.65-72
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• 2010

General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.173-189
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• 2000

The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.1-16
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• 2006

The most important progress in diagnostic sciences is the increased sensitivity and specificity in diagnostic procedures due to the development of micromethodologies and increasing availability of immunological and molecular biological reagents. The technological advances led to consider the diagnostic use of saliva for an array of analytes and DNA source. The purpose of the present study was to compare DNA from saliva with those from blood and buccal swab, to evaluate diagnostic and forensic application of saliva, to investigate the changes of genomic DNA in saliva according to the storage temperature and period of saliva samples, and to evaluate the integrity of the DNA from saliva stored under various storage conditions by PCR analysis. Peripheral venous blood, unstimulated whole saliva, stimulated whole saliva, and buccal swab were obtained from healthy 10 subjects (mean age: $29.9{\pm}9.8$ years) and genomic DNA was extracted using commercial kit. For the study of effects of various storage conditions on genomic DNA from saliva, stimulated whole saliva were obtained from healthy 20 subjects (mean age: $32.3{\pm}6.6$ years). After making aliquots from fresh saliva, they were stored at room temperature, $4^{\circ}C$, $-20^{\circ}C$, and $-70^{\circ}C$. Saliva samples after lyophilization and dry-out procedure were stored at room temperature. After 1, 3, and 5 months, the same experiment was performed to investigate the changes in genomic DNA in saliva samples. In case of saliva aliquots stored at room temperature and dry-out samples, the results in 2 weeks were also included. Integrity of DNA from saliva stored under various storage conditions was also evaluated by PCR amplification analysis of $\beta$-globin gene fragments (989-bp). The results were as follows: 1. Concentration of genomic DNA extracted from saliva was lower than that from blood (p<0.05), but there were no significant differences among various types of saliva samples. Purities of genomic DNA extracted from stimulated whole saliva and lyophilized one were significantly higher than that from blood (p<0.05). Purity of genomic DNA extracted from buccal swab was lower than those from various types of saliva samples (p<0.05). 2. Concentration of genomic DNA from saliva stored at room temperature showed gradual reduction after 1 month, and decreased significantly in 3 and 5 months (p<0.05, p<0.01, respectively). Purities of DNA from saliva stored for 3 and 5 months showed significant differences with those of fresh saliva and stored saliva for 1 month (p<0.05). 3. In the case of saliva stored at $4^{\circ}C$ and $-20^{\circ}C$, there were no significant changes of concentration of genomic DNA in 3 months. Concentration of DNA decreased significantly in 5 months (p<0.05). 4. There were no significant differences of concentration of genomic DNA from saliva stored at $-70^{\circ}C$ and from lyophilized one according to storage period. Concentration of DNA showed decreasing tendency in 5 months. 5. Concentration of genomic DNA immediately extracted from saliva dried on Petri dish were 60% compared with that of fresh saliva. Concentration of DNA from saliva stored at room temperature after dry-out showed rapid reduction within 2 weeks (p<0.05). 6. Amplification of $\beta$-globin gene using PCR was successful in all lyophilized saliva stored for 5 months. At the time of 1 month, $\beta$-globin gene was successfully amplified in all saliva samples stored at $-20^{\circ}C$ and $-70^{\circ}C$, and in some saliva samples stored at $4^{\circ}C$. $\beta$-globin gene was failed to amplify in saliva stored at room temperature and dry-out saliva.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.257-265
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• 1999

To investigate the sequential changes in microvascular architecture and osseous regeneration during the bony healing after an application of the guided tissue regeneration method, we made artificial defects measuring $0.7cm{\times}0.3cm$ in size on femoral bones of rats measuring about 200gm and applied non-absorbable TEFE membrane at experimental sites but not at control sites. Then we observed the sequential changes and correlations between new vacuolation and bony regeneration using microvascular corrosion cast method and routine light microscopic observation at 1, 2 and 3 weeks after operation, respectively. The results showed that there were close relationships between regeneration of microvasculature and bone. In early phase, the invasion of granulation tissue at control sites delayed bony regeneration, however, in later phase, there was no remarkable differences in bony regeneration between control and experimental sites. The placement of barrier also affected in revascularization of regenerating bony defects. This is, the experimental sites showed parallel arranged nutritional vessels along long axis with well developed retiform plexus whereas the control revealed vertical invasion of microvasculature from outside of marrow space through bony defects which was also rearrange with time into parallel pattern with a vertical plexus but lesser organized than that of experimental sites. These findings suggest that the reconstruction of regenerating vasculature within the marrow cavity only may be sufficient and/or more be efficient in regeneration of bony defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.240-248
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• 1999

To investigate the expression pattern of noncollagenous bone matrix proteins such as osteonectin(OSN), osteopontin(OPN) and osteocalcin(OSC) mRNA during bony healing procedure induced by guided bone regeneration method, we made artificial defects on bilateral femur of rats. Then induced bony healing by application of a nonabsorbable PTFE membrane in experimental sites and without its application in control sites for 3 weeks. The mRNA expression pattern at specimens obtained at 1, 2 and 3 weeks after operation was detected by in situ hybridization method using its antisense mRNA probes. The experimental sites revealed more rapid and favorable bony healing than control sites and new bone formation was limited within defected area by inhibitory activity of bone marrow cells. In experimental sites, the OSN and OSC mRNA were expressed strongly on osteoblasts of regenerating cortical bone at 1st week and on osteoblasts lining the trabecular bone in marrow space at 3rd week, whereas, in control sites, their expression were noted on osteoblasts lining the reactively formed sponge bones at 2nd and 3rd week. In addition, the OPN mRNA was expressed on osteoblasts and osteoclasts at sites of remodeling and osteocytes of remained trabecular bone of defected area in experimental sites and on macrophages at 1st week and osteoclasts at sites of remolding at 2nd and 3rd week in control sites. The above findings suggest that the more rapid and favorable bony healing might be induced by blocking of invading fibrous connective tissue into bony defects. And the earlier expression of OSN and OSC mRNA on osteoblasts of experimental sites suggest that the formation and resorption of regenerating bone was more rapidly progressed in confined spaces made by applicate membranes.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.80-85
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• 2017

Angelman syndrome is a rare disorder caused by deletion or inactivation of genes on the maternally inherited chromosome 15. This neurodevelopmental disorder is characterized by developmental and intellectual delay, speech impairment, sleep disturbance, seizures, motor dysfunction, and frequent laughing or smiling. Orofacial characteristics include a prominent mandible, large mouth, prominent cheeks, a tendency to rest the tongue between the dental arches, excessive drooling, and excessive chewing behavior. Patients with this syndrome usually require general anesthesia even in a simple operation, because of risk of perioperative seizure during dental procedure. This is a case report about dental treatment of a 3-year-old female patient with Angelman syndrome under general anesthesia. This case suggests that the dental treatment under general anesthesia can be considered a safe component for the uncooperative, delayed developmental patients with underlying disease. Also, periodic dental exam appointment should be made to provide the patients with preventive treatments and to make them remain familiar with the dental environment.