• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.317-325
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• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

• Imaging Science in Dentistry
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• v.48 no.4
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• pp.245-254
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• 2018

Purpose: To assess the effects of object position in the field of view (FOV) and application of a metal artifact reduction (MAR) algorithm on the diagnostic accuracy of cone-beam computed tomography (CBCT) for the detection of vertical root fractures(VRFs). Materials and Methods: Sixty human single-canal premolars received root canal treatment. VRFs were induced in 30 endodontically treated teeth. The teeth were then divided into 4 groups, with 2 groups receiving metal posts and the remaining 2 only having an empty post space. The roots from different groups were mounted in a phantom made of cow rib bone, and CBCT scans were obtained for the 4 different groups. Three observers evaluated the images independently. Results: The highest frequency of correct diagnoses of VRFs was obtained with the object positioned centrally in the FOV, using the MAR algorithm. Peripheral positioning of the object without the MAR algorithm yielded the highest sensitivity for the first observer (66.7%). For the second and third observers, a central position improved sensitivity, with or without the MAR algorithm. In the presence of metal posts, central positioning of the object in the FOV significantly increased the diagnostic sensitivity and accuracy compared to peripheral positioning. Conclusion: Diagnostic accuracy was higher with central positioning than with peripheral positioning, irrespective of whether the MAR algorithm was applied. However, the effect of the MAR algorithm was more significant with central positioning than with peripheral positioning of the object in the FOV. The clinical experience and expertise of the observers may serve as a confounder in this respect.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.87-94
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• 2009

Purpose: The aim of this study was to compare the effectiveness of hydroxyapatite containing toothpaste with positive control toothpastes in reducing dentine hypersensitivity. Materials and methods: This clinical trial was a double-blind, randomized, parallel group comparison of two, namely hydroxyapatite containing toothpaste and strontium chloride containing toothpaste. A total of 55 subjects were included in this study. The subjects were given randomly assigned one of the two toothpastes after received tooth brushing instruction at baseline. Some clinical indices(PI, GI, PD), verbal rating score(VRS) for sensitivity to stimulus, the effect in relieving sensitivity and visual analogue scale(VAS) for sensitivity at baseline, week 2, week 4 and week 8 were assessed. All data were evaluated by intention-to-treat analysis. Results: Overall, PI and GI scores were significantly reduced compare baseline in all groups(p<0.05). In addition, there was significant difference in PI at 4 weeks and in GI at 4, 8 weeks between groups. The proportions of subjects relieved sensitivity were 70.4% in experimental group and 57.1% in control group at 8 weeks respectively. The VRS for sensitivity to three kinds of stimuli and VAS for sensitivity decreased according to time, there was no overall difference between two groups(p>0.05). Conclusion: This study demonstrated that the new hydroxyapatite containing toothpaste was similarly effective in reducing dentine hypersensitivity with pre-existing benchmark toothpaste.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.390-396
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• 2012

Infraocclusion is defined as tooth whose relative occlusal movement was blocked during the period of active eruption due to ankylosis and so on. Then infraoccluded tooth remains under the occlusal plane composed by adjacent structures showing normal eruption patterns. Untreated infraocclusion may cause: prolonged retention of infraoccluded teeth; extrusion of apposed teeth; destruction of periodontal tissues by occlusal force and food packing; increased sensitivity for dental caries; and disturbances on eruption pathway of succedaneous teeth. Therefore, periodic check-ups and proper treatments are required. There are many treatment options on infraoccluded deciduous molars such as periodic observation, conservative method, restoration and space regaining with extraction of the teeth. The choice of treatment may depend on the presence of succedaneous teeth, time of diagnosis and degree of infraocclusion. In this case report, three patients showing displacement of the second premolars due to infraocclusion of upper second primary molars, were treated by means of space regaining with removable orthodontic appliances and extraction of ankylosed primary molars. All malpositioned permanent premolars in the 3 cases showed ordinary eruption pathways after treatment.

• The korean journal of orthodontics
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• v.38 no.4
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• pp.265-274
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• 2008

Objective: The aim of this study was to evaluate the potency of panoramic radiography for the detection of maxillary impacted canines. Methods: Twenty-five patients were selected, comprised of 7 males (mean age: 10.9 years, range: 8.5 - 14.5 years) and 18 females (mean age: 10.9 years, range: 8.2 - 15.7 years). In total, thirty-five maxillary impacted canines were estimated. The position of the canine and root resorption of adjacent teeth were evaluated on panoramic radiography and 3D CT. Results: Except for angulation to the occlusal plane, the other parameters, such as tooth length, crown width, vertical distance and lateral shift showed larger values on panoramic radiography compared to 3D CT. In palatally impacted cases, the angulation of canine was smaller, and the vertical distance to the occlusal place was larger on panoramic radiography than 3D CT. For labially impacted canines, tooth length, crown width, and angulation to the occlusal plane were similar for the two methods. The sensitivity for detecting root resorption on panoramic radiography was calculated as being 33.3% of 3D CT. Conclusions: The position of labially impacted canines can be effectively estimated using panoramic radiography, but palatally impacted canines need further investigation such as 3D CT for proper diagnosis.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.436-444
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• 2010

Objectives: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. Materials and Methods: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. Results: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and $\leq$ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. Conclusions: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.3
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• pp.231-242
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• 2006

Statement of problem: The sealing of the opened dentinal tubules that follows the tooth preparation for the prosthodontic restoration is considered as clinical process to reduce postoperative sensitivity. Purpose: This study investigated the effect of desensitization treatment on shear bond strength of luting cements. Materials and Method: Total 80 dentin specimens were divided into two groups according to the kinds of luting cements. Each groups was further divided into 4 subgroups with AQ $bond^{(R)}$, $Saforide^{(R)}$, Diode laser $MDL-10^{(R)}$ application and without desensitization treatment. After desensitization treatment application, Ni-Cr specimens were luted to dentin surface with Fuji $CEM^{(R)}$ and $Panavia-F^{(R)}$. Specimens were placed in distilled water at $37^{\circ}C$ for 24 hours and shear bond strength between metal and dentin was measured by a universal testing machine. Results: 1. In Fuji $CEM^{(R)}$ cemented groups, the combination of AQ $bond^{(R)}$ showed the greatest strength, followed by diode laser, no desensitizer treatment, and $Saforide^{(R)}$. Both AQ $bond^{(R)}$ and Diode laser groups had a significant difference than no desensitization treatment group and $Saforide^{(R)}$ group(p<0.05). 2. In $Panavia-F^{(R)}$ cemented groups, the combination of Diode laser showed the greatest strength, followed by AQ $bond^{(R)}$, $Saforide^{(R)}$, and No desensitization treatment. All desensitization treatment groups had a significant difference than no desensitization treatment group(p<0.05). 3. All $Panavia-F^{(R)}$ groups showed a significant higher shear bond strength than all Fuji $CEM^{(R)}$ groups(p<0.05). Conclusion: The results of this study showed possibility of bond strength increase after desensitization treatment. The application of desensitization treatments like AQ $bond^{(R)}$, $Saforide^{(R)}$, and Diode laser $MDL-10^{(R)}$ have advantages in exposed dentin surface after tooth prep.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.20.1-20.14
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• 2020

Objectives: To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers. Materials and Methods: Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (n = 8). The rats were euthanized and the maxillae were processed and evaluated by histopathological and immunohistochemical analyses. The data were analyzed using the Kruskal-Wallis test, followed by the Dunn test (p < 0.05). Results: In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours. Conclusions: The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.275-283
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• 2023

The progressive wear of teeth is a physiologic process of aging, but excessive wear can lead to occlusal disharmony, tooth sensitivity and pulp exposure, decreased masticatory efficiency, and aesthetic problems. It should be treated by evaluating the cause of tooth wear and establishing a stable centric relation with appropriate vertical dimension of occlusion and occlusal plane. The present case report successfully rehabilitated a full-mouth case of a severely worn dentition with the use of digital facebow transfer and virtual articulator.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.177-184
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• 2018

Purpose: This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods: Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups(VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results: The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion: Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.