• 대한소아치과학회지
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• 제36권3호
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• pp.337-347
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• 2009

영유아기 치아우식증은 복잡하고 다인자적 질환으로 숙주 및 미생물, 식이, 시간 등의 위험요소에 의해 질환이 진행된다. 이 중 미생물로 대변되는 Streptococcus mutans(S. mutans)는 우식 개시에 있어 중요한 역할을 하며, 어머니를 통한 수직 감염이 잘 알려져 있다. 영유아기의 어머니를 통한 조기 감염은 향후 유치열기 우식 발생과 높은 연관성을 나타내므로 우식위험요소에 대한 조기 파악은 미래의 치아우식증 예방에 있어 매우 중요하다. 최근 치아우식증의 원인 및 이에 미치는 요소들에 대한 연구가 활발하게 이루어지면서 우식 진행에 대한 정확한 예측을 위한 여러 가지 우식위험도평가(caries risk assessment) 도구가 개발되었는데, 이 중 대표적인 한 가지가 Cariogram이다. Cariogram은 개인의 우식활성도 및 우식위험요소(caries risk factor)의 상호작용을 그래프로 나타낸다. 이번 연구의 목적은 3${\sim}$5세의 중증 유아기우식증(Severe Early Childhood Caries; S-ECC)에 해당되는 어린이들과 그들의 어머니 사이에서 우식관련타액검사 및 최근 개발된 Cariogram을 이용하여 S. mutans의 수준 및 우식활성도에 대한 상관관계가 존재함과 우식위험요소 간의 연관성을 파악해 보았는데, 이를 통해 다음과 같은 결론을 얻을 수 있었다. 1. 중증 유아기우식증을 보이는 어린이에서 구강 내 존재하는 Streptococcus mutans의 수준은 비우식군보다 높았다(p<0.05). 2. 모자간 구강 내 존재하는 Streptococcus mutans 수준은 상관관계를 보였다(p<0.05). 3. 모자간 우식활성도를 Cariogram을 통해 측정해 본 결과 상관관계를 보였다(p<0.05). 4. 우식활성도에 미치는 우식위험요소는 어린이에서 숙주요소가 가장 큰 영향을 주는 것으로 나타났다. 이상의 결과로 S. mutans가 향후 치아우식증 발생 가능성을 예측하는데 있어 유용한 우식위험요소가 될 수 있으며, Cariogram을 통한 향후의 우식진행과 관련된 여러 가지 우식위험요소가 예측 가능하므로 이에 대한 조기 대처 및 예방적 처치가 가능하리라 사료된다.

• 대한통합의학회지
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• 제11권2호
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• pp.15-22
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• 2023

Purpose : This study aimed to analyze the level of understanding of Korean children and adolescents of caries risk assessment items in order to develop caries risk assessment tools. Methods : A total of 52 parents and 108 middle and high school students were analyzed for their understanding of nine items of the CAMBRA CRA for Korean children and adolescents. The nine questions were analyzed through a Likert five-point scale. Centralized distribution analysis was conducted to compare significant differences in the three groups' understanding of the questions. Results : The evaluation of the middle school and high school students' understanding showed that four items scored less than 3.0 points. The items were "Hyposalivatory medications (antihistamines, antipsychotics, asthma, etc.)," "Brushing below once a day," "F varnish last six months," and ".12 % chlorhexidine gluconate mouthrinse daily seven days monthly." The understanding of elementary school parents of ".12 % chlorhexidine gluconate mouthrinse daily seven days monthly" was less than 3.0 points. In addition, as a result of comparing the averages of the three groups, a statistically significant difference (p<.05) was found for a total of five items: "Hyposalivatory medications (antihistamines, antipsychotics, asthma, etc.)," 'Not used oral products such as floss and interdental toothbrushes," "F toothpaste 2× daily or more," "F varnish last six months," ".12 % chlorhexidine gluconate mouthrinse daily seven days monthly." Conclusion : This study was conducted to provide basic data for the development of a caries prevention program by identifying whether the caries risk assessment reconstituted in Korean style can be used for children and adolescents. More than half of the questions scored 3.0 points or higher and were generally completed. Nonetheless, a systematic program can only be completed if a plan is secured to improve repondents' understanding of the questions before a caries prevention program is developed.

• 치위생과학회지
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• 제13권2호
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• pp.115-124
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• 2013

Recently, there have been improvements in diagnostic methods for the assessment of early caries lesions. The reason is that dental professionals are seeking methods to reliably detect incipient dental caries and to remineralize them. This review examines the literature on principles, theoretical background, and history of the Quantitative Light-Induced Fluorescence (QLF) system (Inspektor Research Systems BV, The Netherlands). Furthermore, this paper discusses the potential application of QLF system to clinical practice for educational purpose, enabling dental hygiene students to perform oral health assessment using the QLF system. In addition, the clinical application of QLF system can motivate patients by providing additional visual information about caries and bacterial activity. The evidences on validity and reliability of the QLF system for detection of longitudinal changes in de/remineralization and caries were examined. The QLF system is capable of monitoring and quantifying mineral changes in early caries lesions. Therefore, it can be used to assess the impacts of caries preventive measures on the remineralization and reversal of the caries process. And the QLF system is a very promising equipment to assess educational effectiveness for dental hygiene students in their learning process. In conclusion, the QLF system is the most effective technology for more sensitive staging of caries and treatment without surgical intervention.

• Restorative Dentistry and Endodontics
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• 제49권1호
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• pp.4.1-4.9
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• 2024

Objectives: This study aims to correlate caries-causing microorganism load, lactic acid estimation, and blood groups to high caries risk in diabetic and non-diabetic individuals and low caries risk in healthy individuals. Materials and Methods: This study includes 30 participants divided into 3 groups: Group A, High-risk caries diabetic individuals; Group B, High-risk caries non-diabetic individuals; and Group C, Low-risk caries individuals. The medical condition, oral hygiene, and caries risk assessment (American Dental Association classification and International Caries Detection and Assessment System scoring) were documented. Each individual's 3 mL of saliva was analyzed for microbial load and lactic acid as follows: Part I: 2 mL for microbial quantity estimation using nutrient agar and blood agar medium, biochemical investigation, and carbohydrate fermentation tests; Part II: 0.5 mL for lactic acid estimation using spectrophotometric analysis. Among the selected individuals, blood group correlation was assessed. The χ² test, Kruskal-Wallis test, and post hoc analysis were done using Dunn's test (p < 0.05). Results: Group A had the highest microbial load and lactic acid concentration, followed by Groups B and C. The predominant bacteria were Lactobacilli (63.00 ± 15.49) and Streptococcus mutans (76.00 ± 13.90) in saliva. Blood Group B is prevalent in diabetic and non-diabetic high-risk caries patients but statistically insignificant. Conclusions: Diabetic individuals are more susceptible to dental caries due to high microbial loads and increased lactic acid production. These factors also lower the executing tendency of neutrophils, which accelerates microbial accumulation and increases the risk of caries in diabetic individuals.

• 대한치과의사협회지
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• 제49권1호
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• pp.16-21
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• 2011

Now it is time to move from the scientific basis of CAMBRA into practical methods for dentists to the incorporate concepts into practice. The aim of this article is to provide a clinical guideline for assessment of caries risk and for application for growing children.

• 대한소아치과학회지
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• 제33권3호
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• pp.548-557
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• 2006

• 대한소아치과학회지
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• 제43권4호
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• pp.382-390
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• 2016

청소년기에는 초기 우식 병소를 진단 기준에 포함시키는 것이 더 유리하기에 본 연구에서는 WHO basic methods 와 ICDAS-II 점수를 활용하여 13세와 16세 청소년의 우식 상태를 조사하였다. 전체 우식경험영구치지수는 3.71, 우식영구치지수는 1.94이었으며 16세에서 13세보다 높았다. 군별로는 대구치, 소구치, 전치의 순으로 우식경험영구치지수와 우식영구치 지수가 높았다. 전체 치아의 ICDAS-II code 0은 77.46%이었으며, 후방치열로 갈수록 우식치아의 수가 증가하였다. 전치와 소구치의 우식은 모두 법랑질에 국한되었다. ICDAS-II 점수는 초기우식병소 발견에 용이하여 우식관리의 예방적 접근이 가능한 방법이다.

• 한국치위생학회지
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• 제19권4호
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• pp.479-492
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• 2019

Objectives: This study aimed to develop the CAMBRA-kids application for the systematic management of dental caries among preschoolers, activate the dental caries management system, and contribute to the dental caries management of preschoolers. Methods: The collected data were analyzed using R studio 1.2.1335 for Windows (RStudio Inc., Boston, MA, USA, 2018). Algorithm evaluation, heuristic evaluation and usability evaluation were analyzed using descriptive statistics. Results: Both expert evaluations of the application's algorithms were calculated as 100%, for proficiency and efficiency. The application worked well with the designed algorithms, the risk group level of participants was categorized appropriately, and the risk management method was guided properly according to the risk group level. Of the five problems presented in the heuristic evaluation, 'the lack of security' and 'the lack of information on oral health care' received 'high severity' scores. The usability evaluation of the application produces an overall score of 3.27. In the subscales (participation, functionality, aesthetics, and information) of the Mobile App Rating Scale (MARS), the 'participation' domain received the lowest score of 2.56 and the 'functional' domain received the highest score of 3.70. Conclusions: The CAMBRA-kids application is expected to be applied and used in the field of preschoolers' oral health care management, and to contribute to the prevention of dental caries of preschoolers by activating the dental caries management system using the application.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.237-242
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• 2021

Purpose: The aim of this study was to analyse and review deep learning convolutional neural networks for detecting and diagnosing early-stage dental caries on periapical radiographs. Materials and Methods: In order to conduct this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines were followed. Studies published from 2015 to 2021 under the keywords(deep convolutional neural network) AND (caries), (deep learning caries) AND (convolutional neural network) AND (caries) were systematically reviewed. Results: When dental caries is improperly diagnosed, the lesion may eventually invade the enamel, dentin, and pulp tissue, leading to loss of tooth function. Rapid and precise detection and diagnosis are vital for implementing appropriate prevention and treatment of dental caries. Radiography and intraoral images are considered to play a vital role in detecting dental caries; nevertheless, studies have shown that 20% of suspicious areas are mistakenly diagnosed as dental caries using this technique; hence, diagnosis via radiography alone without an objective assessment is inaccurate. Identifying caries with a deep convolutional neural network-based detector enables the operator to distinguish changes in the location and morphological features of dental caries lesions. Deep learning algorithms have broader and more profound layers and are continually being developed, remarkably enhancing their precision in detecting and segmenting objects. Conclusion: Clinical applications of deep learning convolutional neural networks in the dental field have shown significant accuracy in detecting and diagnosing dental caries, and these models hold promise in supporting dental practitioners to improve patient outcomes.

• Restorative Dentistry and Endodontics
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• 제42권1호
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• pp.48-53
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• 2017

Objectives: The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo. Materials and Methods: A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fisher's Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05. Results: Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%). Conclusions: Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.