• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.68-74
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• 2023

Objectives: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and Methods: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV BPs and had at least one tooth extraction between 2012 and 2022. Patents' age, sex, systemic condition, the type of BP used, duration of BP used, number of tooth extraction, duration of drug holiday, localization of tooth extraction and incidence of MRONJ were recorded. Results: One hundred nine teeth were removed from 57 jaws in 51 patients. All tooth extractions were performed under perioperative antibiotic prophylaxis and with primary wound closure. The incidence of MRONJ was 5.3%. Stage 1 MRONJ developed in 3 patients (only one had a drug holiday). The median duration of drug holiday was 2 months. No significant difference between the patients with and without a drug holiday and MRONJ development was found (P=0.315). The mean age of patients developed MRONJ was 40.33±8.08 years. A statistically significant difference was found between age and MRONJ development (P=0.002). Conclusion: The effect of a short-term drug holiday on the development of MRONJ may be limited because BPs remain in bone tissue for a long time. Drug holidays should be applied with the approval of an oncologist with other preventive measurements.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.110-119
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• 2023

Purpose: This study aimed to investigate the proper wavelengths for safe levels of light-emitting diode (LED) irradiation with bactericidal and photobiomodulation effects in vitro. Methods: Cell viability tests of fibroblasts and osteoblasts after LED irradiation at 470, 525, 590, 630, and 850 nm were performed using the thiazolyl blue tetrazolium bromide assay. The bactericidal effect of 470-nm LED irradiation was analyzed with Streptococcus gordonii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, and Tannerella forsythia. Levels of nitric oxide, a proinflammatory mediator, were measured to identify the anti-inflammatory effect of LED irradiation on lipopolysaccharide-stimulated inflammation in RAW 264.7 macrophages. Results: LED irradiation at wavelengths of 470, 525, 590, 630, and 850 nm showed no cytotoxic effect on fibroblasts and osteoblasts. LED irradiation at 630 and 850 nm led to fibroblast proliferation compared to no LED irradiation. LED irradiation at 470 nm resulted in bactericidal effects on S. gordonii, A. actinomycetemcomitans, F. nucleatum, P. gingivalis, and T. forsythia. Lipopolysaccharide (LPS)-induced RAW 264.7 inflammation was reduced by irradiation with 525-nm LED before LPS treatment and irradiation with 630-nm LED after LPS treatment; however, the effects were limited. Conclusions: LED irradiation at 470 nm showed bactericidal effects, while LED irradiation at 525 and 630 nm showed preventive and treatment effects on LPS-induced RAW 264.7 inflammation. The application of LED irradiation has potential as an adjuvant in periodontal therapy, although further investigations should be performed in vivo.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.41.1-41.23
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• 2021

Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

• Journal of Technologic Dentistry
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• v.30 no.1
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• pp.109-119
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• 2008

The Status of oral health and dental prosthetic treatment in Daegu and Gyoung Buk area was examined. To investigate the correlation between factors such as demographic and socioeconomic characteristics and status of oral health and knowledge about oral preventive measures, a survey was performed. After analyzing the effects of knowledge levels about dental prosthetic treatment on the oral health status and preventive measures, following results were obtained. A Total of 625 people participated in the survey for three months from October 2007 to January 2008. The responses from the survey were then analyzed to assess whether those with less knowledge of preventive measures tended to have more dental prosthetic work. Of those that took part in the survey: ${\cdot}$ 30.2% were in their twenties ${\cdot}$ 56.2% were married ${\cdot}$ 51.4% of respondents had at least a college degree ${\cdot}$ 42.4% had monthly incomes below one million Won ${\cdot}$ 24.3% were students ${\cdot}$ 55.8% were from urban areas After studying the relationship between oral health and various demographics, researchers concluded that respondents' sex, income, job and place of residence had no effect on the overall status of their oral health. However, those that were divorcees or widows (1.95${_+}/{_-}$ 0.32), over the age of 70 (1.67${_+}/{_-}$0.31), or had little education (0.82${_+}/{_-}$0.28), all demonstrated a statistically significant effect on their oral health with a significance level of 0.05.Cross analysis revealed a p-value of 0.000. The correlation between knowledge of oral preventive measures and other factors was examined. No difference was found between men and women but people who were divorced or lost their spouse, people over the age of 60, and people with no education, the results of knowledge of oral preventive measure was poor as 1.74$\pm$0.44, 1.85$\pm$0.40, 1.85$\pm$0.44,and 1.60$\pm$0.47 separately. Cross analysis showed that p-value was 0.000 and correlation between knowledge of oral preventive measures and those factors were statistically significant at significance level of 0.05. The status of dental prosthetic treatment was investigated. Women, people with higher income, and married people had more dental prosthetic treatment and it was related to education, income, residential area, and the status of dental prosthetic treatment. The returns of those factors was 32.7%. Respondents$^{\circ}{\emptyset}$ oral hygiene status and knowledge of oral preventive measures was related to demographic or socioeconomic factors. Therefore, a preventive program for oral health care needs to be developed in advanced countries. Knowledge of oral health is below the international average and more research and effort needs to be put in to develop public knowledge of dental prosthetic treatment. Government intervention such as enacting an oral health initiative or dental insurance that covers prosthetic treatments is urgently needed.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.46-53
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• 2015

The purpose of this study is to identify the awareness of oral health workforce and the attitude concerning the health insurance benefit on topical fluoride application. The subjects are 173 dentists and 288 dental hygienists. The data were collected using a self-administered questionnaire and analyzed using SPSS 12.0 statistical program. The findings of the study were as follows: Agree's (including strongly agree) ratios regarding to the health insurance benefit of topical fluoride application was 92.5% for dentists and 90.8% for dental hygienists. Appropriate age of health insurance benefit about the topical fluoride application was elementary, middle and high school students (8~19 years). This response ratio was high 45.7% for dentists and 43.2% for dental hygienists. Appropriate copayment (mean value) of health insurance about topical fluoride application coverage showed that NaF, $SnF_2$ solution and acidulated phosphate fluoride gel were 25,782 Korean Won (KRW) for dentist and 14,282 KRW for dental hygienist. Fluoride varnish copayment was 31,705 KRW for dentist and 17,979 KRW for dental hygienist. Fluoride iontophoresis copayment was 40,156 KRW for dentist, and 21,210 KRW for dental hygienist. The frequency of health insurance benefits about topical fluoride application was high in 'unlimited (37.5%)' for the dentists and 'two times (31.3%)' for dental hygienists. In conclusion, topical fluoride application should be included as one of the health insurance benefit items for oral health.

• Journal of dental hygiene science
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• v.11 no.6
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• pp.521-526
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• 2011

The purpose of this study was to evaluate the long term effect of school-based oral health program on decrease of dental caries among elementary school children. The subjects of this study were total 727 students of one elementary school in Deagu, Korea. They had received school-based oral health programs for more than one year since 2004. This school-based oral health program included regular oral examination, fluoride mouth-rinsing, pit-and-fissure sealing, APF gel application, tooth brushing instruction and take the xylitol tablet after lunch during school days. The subjects' oral health status were examined by two calibrated dentists every year from 2004 to 2009. The DMFS index of $1^{st}$ grade to $6^{th}$ grade experimental and control group was 0.07, 0.39, 0.55, 0.67, 0.81, 1.79 and 0.31, 0.86, 1.07, 1.04, 2.71, 3.08 respectively. It's significantly different in $5^{th}$ grade(p<0.001) and $6^{th}$ grade(p=0.018) when it compare with control group. This study partially showed effect of school-based oral health programs on decrements of dental caries. This program should be expanded widely among elementary school in Korea. Xylitol tablet also recommended to included in school-based oral health programs.

• Journal of dental hygiene science
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• v.14 no.3
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• pp.319-324
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• 2014

The aim of this study was to evaluate influences of titanium dioxide ($TiO_2$) concentrations and irradiation times on growth of Streptococcus mutans when irradiated by visible light (405 nm wavelength) and by ultraviolet light (254 nm wavelength). To find the optimal antibacterial concentration of $TiO_2$, 0.01, 0.1, 1.0, and 10.0 mg/ml $TiO_2$ suspension was prepared with sterilized distilled water. S. mutans cultured media was added to $TiO_2$ solution to set the final cell count to $10^4CFU/ml$. The photocatalytic reaction was induced by irradiating 254 nm and 405 nm lights for 10 minutes. To compare the bactericidal activities according to irradiation times, all photocatalytic reaction was carried out with 0.1 mg/ml $TiO_2$ for 0, 10, 20, 30, and 40 minutes with both lights. After the photocatalytic reaction, $100{\mu}m$ of the reaction mixture was immediately plated on brain heart infusion agar. These plates were placed at 5% $CO_2$, $37^{\circ}C$, for 24 hours and the bacterial colonies were counted. All experiments were performed in quintuplicate. One-way ANOVA was used to determine whether there were any significant differences between the $TiO_2$ concentrations or the irradiation times. The most effective concentration of $TiO_2$ for its photocatalytic bactericidal effect on S. mutans was 0.1 mg/ml when irradiated with 254 nm and 405 nm lights. The longer the irradiation time, the bigger the bactericidal effect for both wavelengths. Over 99% of bacteria in the inoculum were killed after irradiation with 254 nm for 20 minutes and with 405 nm for 40 minutes. In conclusion, a photocatalytic reaction of $TiO_2$ induced by visible light of 405 nm constitutes the bactericidal effect on S. mutans.

• Journal of Korean Dental Hygiene Science
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• v.7 no.1
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• pp.17-28
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• 2024

Background: Oral health has a significant impact on systemic health, and the close association between oral and systemic diseases has been continuously reported. To prevent oral diseases, the role of oral hygiene products such as dental floss and interdental brushes, in addition to tooth brushing, is becoming increasingly important. This study aims to analyze the effect of using oral hygiene products on the lifetime prevalence of systemic diseases among Korean adults. Methods: This study utilized data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). The study population consisted of 13,199 adults aged 19 years and older. The independent variable was the use of oral hygiene products, and the dependent variable was the prevalence of systemic diseases diagnosed by a physician. Demographic variables, health status, and behavioral variables were included as covariates, and multivariable logistic regression analysis was performed. Results: The use of dental floss showed no significant association with the prevalence of systemic diseases. However, those who did not use interdental brushes had a 22% lower likelihood of dyslipidemia (OR 0.777, 95% CI 0.660-0.913). Among participants with periodontal disease, those who did not use dental floss had a significantly higher risk of myocardial infarction (OR 11.488, 95% CI 1.438-91.772). Conversely, those who did not use interdental brushes had lower risks of dyslipidemia, myocardial infarction, and angina, particularly among women and individuals under 65 years of age. Conclusion: This study found a low overall association between the use of oral hygiene products and the prevalence of systemic diseases, but there was a notable association with cardiovascular diseases. To reduce the risk of myocardial infarction, the prevention and treatment of periodontal disease, along with proper oral hygiene management, are crucial. Future prospective studies are needed to clearly establish the causal relationship between oral hygiene and systemic diseases.

• Imaging Science in Dentistry
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• v.43 no.2
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• pp.91-98
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• 2013

Purpose: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. Materials and Methods: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. Results: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. Conclusion: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.305-309
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• 2009

Dens evaginatus is a dental anomaly most commonly seen in premolar teeth in which a tubercle or protuberance projects from either the center of the occlusal surface or the buccal triangular ridge. These tubercles are easily fractured from mastication as the tooth erupts and frequently leads to pulp necrosis as a common complication. To prevent these sequelae, prophylactic treatment soon after the tooth starts erupting is essential. These preventive treatments include, selective grinding and protection of the tubercle by pit and fissure sealant. When the tooth does shows signs of pulp necrosis and apical periodontitis, endodontic procedures are needed. Apexification and apexogenesis are usually the treatment of choice for the affected teeth which have immature apices. Apexogenesis is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end. It involves removal of the inflamed pulp and the placement of calcium hydroxide on the remaining healthy pulp tissue. This case report describes an atypical apexogenesis of a mandibular premolar which showed to be a dens evaginatus. The tooth which was treated with calcium hydroxide shows good results and is planned for permanent root canal filling.