• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.38-44
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• 2015

Children commonly experience orofacial injuries and often need emergency treatment. Due to fear and anxiety, children tend to be uncooperative in emergency rooms. Ketamine hydrochloride is a well-known sedative agent at medical-based emergency rooms which has been used for procedural sedation. In this paper, we will discuss the sedation of uncooperative young patients, who needed dental treatments in the emergency room at Wonju Severance Christian Hospital, using ketamine. We collected the records of patients under 18-years-old who visited the emergency room for dental treatment from January 2010 to May 2014. The data was categorized by age, sex, required dental treatments and application of ketamine sedation. Among 659 pediatric patients who visited for emergency dental treatments, 118 patients were treated under sedation using ketamine. Majority of patients were under the age of 6 (110 patients), and the most frequent cause of sedation was suture of oral laceration (105 patients). Though ketamine should not be used by dentists alone, dentists in emergency rooms can easily meet the patients under deep sedation using ketamine. Hence, dentists in emergency rooms need to be aware of the clinical effects, considerations, and potential adverse effects of ketamine.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.260-266
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• 2010

Trauma to the primary teeth may have an effect on the successive permanent teeth. Thus, the treatment plans should be focused on safety of their permanent teeth. The degree of developmental disturbances in those permanent teeth depends upon many factors including the age of the children, developmental conditions of the affected teeth, types and severities of trauma and time interval from the moment of trauma to the initial treatment the patients received. The complications of the effected permanent teeth vary from the mild enamel hypoplasia to the premature finishing of teeth development. In this study, children whose ages were 33 months, 5 years, and 26 months presented the developmental disturbances to their permanent teeth, which resulted from the trauma to the primary teeth: the intrusion, the avulsion, and the subluxation. There showed a mild complication in the case of subluxation resulting in enamel hypoplasia, but, the more severe complication of the root dilacerations occurred in the case of intrusion. Furthermore, the 5-year-old patient whose primary dentition was near in transition period to the permanent one, the more complicated problem such as stop of root development of the permanent teeth was resulted from the avulsion. Thus, one should assume that the types of trauma and the age of the children at the moment of trauma have different effects on those successive permanent teeth. In conclusion, when the trauma that causes changes in the position of primary teeth happened, it is important to arrange an appropriate treatment procedure considering the types of trauma and the developmental conditions of the permanent teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.296-302
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• 2011

Idiopathic gingival fibromatosisrarely occurs, but frequently recurred after surgical removal. It usually occurs in generalized symmetrical pattern but sometimes in localized unilateral pattern. The localized pattern usually affects the maxillary molar and tuberosity area. This disease usually causes tooth migration, malocclusion, and problems in eating, speech, and esthetics. A boy showed dense gingival fibromatosis localized at primary maxillary right lateral incisor area at the age of 5 years, and his maxillary right lateral incisor become severely displaced at the age of 9 years. He had no medical and hereditary factors relevant to the gingival fibromatosis. However, the dense fibrous tissue was dominant in his labial gingiva of maxillary right incisors. In order to realign the displaced incisors by orthodontic treatment, the dense fibrous tissue covered the defect space between the central incisor and the displaced lateral incisor was surgically removed. The removed specimen was examined by simple immunohistochemical(IHC) array method. IHC array showed increased expression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$ in keratinocytes, fibroblasts, endothelial cells, and macrophages of gingival fibromatosis tissue. Therefore, it was suggested that the gingival fibromatosis be caused by the concomitant overexpression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$, and resulted in the fibroepithelial proliferation and the inflammatory reaction of gingival tissue.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.344-351
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• 2020

Amelogenesis imperfecta (AI) occurs either in isolation or in association with other dental abnormalities and systemic disorder. A rare syndrome associating AI with nephrocalcinosis was named as Enamel Renal Syndrome (ERS; OMIM #204690). This syndrome is characterized by severe enamel hypoplasia, failed tooth eruption, intra pulpal calcifications, enlarged gingiva, and nephrocalcinosis. Nephrocalcinosis is a condition where calcium salts are deposited in renal tissue, and this may lead to critical kidney complications. This rare syndrome shows pathognomonic oral characteristics that are easily detectable at an early age, which proceeds the onset of renal involvement. Pediatric dentists are the first oral health practitioners whom ERS patients will meet at early age. The role of pediatric dentists is critically important for early diagnosis and referral of patients to both nephrologists for renal assessment and geneticists for identification of causative mutation and diagnosis. Early detection of renal involvement may provide chances to prevent further undesired renal complications.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.146-151
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• 2008

Purpose : Multidrug-resistant Acinetobacter baumannii (A. baumannii) is recognized to be the most difficult pathogen to control and treat in pediatric burn centers. We analyzed the antibiotic susceptibility pattern of A. baumannii in our pediatric burn intensive care unit during the past 7 years. Methods : We retrospectively evaluated 56 patients (105 samples) under the age 15 years and who were infected with A. baumannii between January 1999 and December 2005. Results : Fot the 56 patients, the ratio of males to females was 1.15:1 and the median age was 48.3 months. The sites of 105 isolates were wounds (65%), sputum (20%), blood (6 %), cutdown tips (5%), endo-tip tubes (2%) and urine (2%). A. baumannii presented yearround. The annual antimicrobial resistance rate increased and the multidrug resistant rate for two or more antibiotics was 93.33%. For 3 patients in whom resistance emerged, the interval period between the susceptible and resistant strains after antibiotic use was a mean of 10 days. The A. baumannii isolated from blood were all multi-drug resistant pathogens. Conclusion : Multidrug resistance of A. baumannii is increasing. Strict infection control guidelines and active surveillance are needed for the prevention and treatment of A. baumannii in hospitals.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.1
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• pp.13-18
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• 2013

CATCH 22 syndrome is a one of the most common chromosome microdeletion syndrome with multiple organ anomalies in humans, with an incidence of approximately 1:4,000 to 1:5,000 live births. It is caused by a microdeletion of 1.5 to 3.0 megabases on the long arm of chromosome 22. The phenotypic spectrum of this disorder is wide and various. A 19-year-old patient who showed delayed growth and development (Height; 110 cm, Weight; 18 kg) was referred to our department for the treatment of dental cavities. She was diagnosed as CATCH 22 syndrome in 2004. Physical examination revealed hypertelorism, a short philtrum, thick reflected lips and a small mouth. She underwent cleft palate surgery at 1 year of age and heart valve surgery due to the cardiovascular abnormality at 13 years of age. Convulsive seizures had persisted until 5 years ago but are well controlled at present. Oral examination showed poor oral hygiene, crowding, prolonged retention on #65, 75 and dental cavities on #16, 21, 65, 26, 36, and 46. Cavity treatment and prophylaxis were performed under general anesthesia. Also continuous follow-up checks have been carrying out with the periodic prophylaxis and dental home education. Problems with numerous cavities and gingivitis which can lead to specific risks are common for CATCH 22 syndrome patients. It is therefore of great importance that these patients are referred to foremost physician and dental specialist for the oral care. In addition, preventive treatment targeting the risk of dental cavities and gingivitis is especially important and, as the syndrome involves many different medical problems, the dental treatment should be carried out in collaboration with the patient's physician.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.44-53
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• 2017

Purpose: The aim of this study was to investigate the risk factors for posttransplant lymphoproliferative disorder (PTLD) and to evaluate the association between Epstein-Barr viral load and the development of PTLD in pediatric heart transplant recipients. Methods: We reviewed children aged <18 years who underwent heart transplantation and quantitative analysis of blood Epstein-Barr virus (EBV) viremia at our institute from January 2006 to March 2015. Clinical characteristics and EBV viral loads were compared according to the presence of PTLD. Results: Over 9 consecutive years, a total of 40 heart transplant recipients, were included. Among 28 children with available EBV viral load measurements, seven patients (25%) had EBV viremia only defined as at least one time of ${\geq}457copies/mL$. PTLD occurred in three recipients (7.5%) 4.3, 6.3, and 17.0 months after transplant and all PTLD cases had preceding EBV viremia. The median age at transplant was 5.3 years (range, 0.5 to 6.0 years) in the PTLD group, compared with 11.9 years (range, 0.3 to 17.8 years) in the non-PTLD group (P=0.021). The median values of the peak EBV levels in the PTLD group were 3,452,170 copies/mL (range, 46,750 to 7,622,910 copies/mL); the peak EBV levels in the non-PTLD group were 3,112 copies/mL (range, 2,250 to 103,000 copies/mL). Conclusions: Younger age at transplant and presence of EBV viremia were associated with the development of PTLD in pediatric heart transplant recipients. A prospective study will be required to determine the blood EBV load for predicting the development of PTLD in these patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.669-676
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• 1999

The dentigerous cysts originate through alteration of the reduced enamel epithelium after amelogenesis is completed, with accumulation of fluid between the layers of the enamel epithelium, or between this epithelium and the tooth crown. Next to the radicular cyst, they are the second most common type of odontogenic cyst. They occur over a wide age range with a peak frequency in the 2nd to 3rd decade. A substantial majority involve the mandibular third molars, followed in order of frequency by the maxillary permanent canines, mandibular second premolars, and maxillary third molars. With regard to the treatment of these cysts, the marsupialization procedure with obturator is recommended during the age when the eruptive force of the teeth is still strong. It can be effective when preservation of the displaced teeth is desirable. We treated the dentigerous cyst by marsupialization with obturator and guided the eruption of involved teeth to normal position. And we got the results as follows : 1. Severely dislocated teeth associated with dentigerous cyst erupted into proper position. 2. The enamel hypoplasia and the root deformity were observed some cases. 3. The bone expansion and defect were healed without infection and recurrence.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.352-358
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• 2010

Chemotherapy or radiotherapy used for the treatment of pediatric cancer may have many adverse effects on the oral cavity. Oral mucositis, reduced salivary flow, oral infection, hypodontia, microdontia, arrested root development, and enamel hypoplasia are common oral complications. The aim of this study is to evaluate the effects of cancer therapy on dental caries activities. The children who had been treated for neuroblastoma in the department of pediatrics, Samsung Medical Center, were included and healthy children served as controls. The salivary flow rate, salivary buffering capacity, and Streptococcus mutans counts of both groups were evaluated using Dentocult$^{(R)}$ SM and Dentobuff$^{(R)}$ Strip. The dental caries activity related to the age at the start of treatment and the time elapsed since treatment completion were also evaluated. As a result, neuroblastoma patients had significantly lower salivary flow rate than the controls, while there were no significant differences between two groups as for salivary buffering capacity and Streptococcus mutans counts. The dental caries activities related to the age at the start of treatment and the time elapsed since treatment completion were not significantly different.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.397-406
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• 2002

The purpose of this study was to clarify the palatal arch length, width and volume in the primary and permanent dentition. Samples were consisted of normal occlusion in the primary dentition(50 males and 50 females) and permanent dentition(43 males and 43 females). Their upper plaster casts were used and through 3-dimensional laser scanning(3D Scanner, DS4060, LDI, U.S.A.), cloud data, polygonization, section curve, loft surface and fit and horizontal plane were made for measuring the palatal arch length, width and volume(Surfacer 10.0, Imageware, U.S.A.). Correlation coefficients were calculated separately for males and females in each group(SPSS 10.0). The results were as follows : 1. Average distance from the fit plane to the points(tooth-tooth-palate) was greater in the permanent dentition than those of primary dentition. 2. Palatal volume was greater more than 3 times in the permanent dentition, especially it was greater in male compared to female with significance(p<0.05). 3. Palatal width of male was greater in the primary and permanent dentition but palatal length, only in the permanent dentition than that of female(P<0.05). 4. Correlation coefficients were statistically most significant between the palatal volume and size of posterior palatal width and total palatal length(r=0.401, r=0.450, r=0.678, r=0.654).