• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.341-347
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• 2003

Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.492-498
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• 1999

Oculodentodigital syndrome(ODD) was first reported by Lohmann in 1920 and termed by Meyer Schwicketath, which they called "dysplasia oculo-dento-digitalis" in 1957. It is somewhat rare heritable disease. ODD is generally inherited in an autosomal dominant pattern with a complex phenotype. The characteristic features are : (1) unique facial features, (2) microphthalmos, (3) syndactyly and camptodactyly of 4th and 5th fingers, (4) osseous anomalies of the middle phalanges of 5th fingers and toes, (5) enamel hypoplasia, (6) dry lusterless hair. We found several occlusal wearing and yellow discoloration of succedaneous teeth, multiple caries lesions, premature loss and pulpal involvement of primary teeth with associated enamel abnormalities caused by generalized enamel hypoplasia in a fairly constant oral finding. Occasionally partial anodontia, microdontia and cleft lip and palate can be manifested. This case, a 9-year-old female with repaired bilateral syndactyly was referred to pediatric dental clinic, Pusan National University Hospital for evaluation of severe attrition of teeth and caries lesions. She had most of the above mentioned typical manifestations of the syndrome. Dental treatment including caries control, stainless steel crown were performed.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.545-550
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• 2010

Freeman-Sheldon Syndrome (FSS, also known as "Whistling Face Syndrome") is a rare genetic condition which characteristically includes a small "whistling" mouth, a flat mask-like face, club feet, joint contractures usually involving the fingers and hands, and under-development of the cartilage of the nose. Intelligence is usually normal. Most of the features of this syndrome are due to muscle weakness. The patient, 11 years old boy was consulted from pediatrics to pediatric dentistry due to dental management. After clinical & radiographic examinations, severe multiple problems were found. Dental problems were microsomia(whistling mouth) & micrognathia, perioral muscle contracture, restricted mouth opening, poor oral hygiene & care, generalized dental caries, high palatal vault, severe malocclusion & crowding. And Orthopedic problems, ophthalmic & respiratory, anesthetic problems were found. Then He also had psychiatric problem, hospital(dental) phobia due to previous medical history(frequent hospitalization). And he had genital problem, cryptochidism, too. Due to these intricate problems, he suffered with feeding, swallowing difficulties and showed growth retardation. For enhancing patient's oral health, pediatric dentist, orthodontist, oral surgeon, pediatrician, psychiatrist, orthopedist, they all agree with early, cautious intervention and treatment. So, he has been treated by multidisciplinary care, now he is recovering general health maintenance.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.710-716
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• 1998

It is one of difficulties to control children who show definitely negative behavior in dental clinic. In such a case, the pharmacologic management has been used to provide quality care, minimize the extremes of disruptive behavior, promote a positive psychologic response to treatment and patient welfare and safety. Deep sedation can be defined as a controlled, pharmacologically-induced state of depressed consciousness from which the patient is not easily aroused which may be accompanied by a partial loss of protective reflexes. In this retrospective report, the sedation records of 200 pediatric dental patients of ASA Class I & II who were not successfully treated under conscious sedation were used for analysis. Most frequently used regimen of deep sedation was the co-medication of midazolam(0.3mg/kg), enflurane(1.0-2.0 vol%) and 50-70% $N_2O_2$. The average age and weight of the patients was 4.6 yr (S.D: 2.72) and 18.7kg(S.D: 6.35) respectively. The average operative time was 52 minutes and midazolam (0.1-0.2cc) was additionally administered intranasally to prolong the operative time as needed. The episodes of untoward side effects were reported during and/or after the procedure in 58 patients. Serious adverse reactions such as cyanosis or laryngospasm were even reported in 7 patients but without mortality. Deep sedation is a very effective way of completing the dental treatments for those who failed to respond well to the conscious sedation. This technique has many practical advantages over general anesthesia case but the demands for the rigid monitoring criteria limit its use in general practice setting. The continuous efforts to improve the safety of the medication and the technique are required for the benefits of the patients and parent.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.126-131
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• 2005

The purpose of this study was to observe the potentiality of a mixture of antibiotics to relieve the endodontic and periapical infections in primary teeth. A mixture of metronidazole, ciprofloxacin, and minocyclin in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. For application of this mixture, medication cavities were prepared at orifices of root canals by using the $Fissurotomy^{(R)}$ burs(S S White, USA). The cavities and bottom of pulp chamber were filled with antibiotics mixture. In this cases, clinical symptoms were improved following a single application of that mixture. Gingival swelling, pain, and fistulae were disappeared within a week. More long term evaluation will be needed. Although there were no reports of side effects, care should be taken if children are sensitive to antibiotics. Within the limitations of this case, the mixture of 3 antibiotics provided an excellent improvement in treatment of infected primary teeth under the physiologic root resorption.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.38-46
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• 1998

Management of children who show negative response to treatment was difficult. Usually the dentist used the restraintor sedatives for these children. Especially it is very difficult to management of definitely negative behavior patients who resist to ordinary sedative technics including psychosedation and various sedatives. These patients were managed with general anesthesia. Midazolam was used for sedation of non-cooperative pediatric patients and halothane for induce initial sleepness, If the patient shows negative response to management after 15 minutes of midazolam administration, used the halothane in 30 to 120 seconds for calm down the patient. After induce sleepness, cut off the halothane administration and maintain the sedation with $N_2O$ in 50-70 vol.% concentration. This technic reduce the toxity and untoward effects of major anesthetics. To compare the difference of sedation effect by dosage, dose of 0.2mg/kg and 0.3mg/kg were injected respectively. Though there's no statistical difference in duration and results between two dosage but show the increment of score with age, If the patients show positive response to management after midazolam administered. try to conscious sedation with nitrous oxide in 30 to 70 vo.% concentration. Nitrous oxide concentration was administered slowly according to their consciousness and response to treatment by increment or decrement. The success rate of conscious sedation were 21.2% in 0.2mg/kg and 30.3% in 0.3mg/kg. There's many factors in proceed of conscious sedation. The most important factors are age of patient and experience of children for dental care.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.133-138
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• 1997

Prader Willi Syndrome(PWS) was first recognized and reported by Prader-Willi. The etiology of the syndrome is not fully understood, but 50-70% of the patients show small deletion in chromosome 15. Manifested symtoms vary according to developmental age. In early life, hypotonia, areflexia, feeding difficulties, hypothermia, microgenitalia, hypoplastic scrotum, cryptochordism were observed. But in several years, hypotonia disappears, and polyphagia, decreased satiety, psychomotor retardation, obesity, hypogonadism and short stature become main problems. Behavioural problems including temper and aggressive outbursts, stealing food, hoarding food, and self excoriating skin picking, trichotillomania are more prominent during adolescence and young adulthood. Also, irritable, depressed mood are described. Lots of psychological and behavioural problems explain the reason why psychiatrists have managed and reported this syndrome. However, there has been no official report of PWS in our country. So authors report the clinical characteristics and issues in management of a patient with PWS.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.168-179
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• 2002

The purpose of this study was to find a method for improving the children's behavior during dental treatment in relation with dentist's attire. For this study 150 children, visiting a dental clinic, were asked to participate in a survey on the attire of the dentist. The results of the survey were as follows: 1. In the survey for the preference between gown and ordinary clothes according to sex(P<0.05), age(P<0.05), residence (P<0.05) and number of visits(P<0.05), there was more preference for gown(65.3%). 2. The preference for the type of gown and attire under the gown was a long gown and white shirt (30.7%), followed by a suit-like gown (18.7%) and white shirt, and long gown and polo shirt(17.3%). 3. The preference for the color of gown was white(34.7%), followed by pink (18.7%), green(18.0%), blue(15.3%) and yellow(13.3%). 4. The preference for the pattern on the gown was cartoon characters(49.3%), followed by hospital logo(28.7%) and no pattern(14.7%). 5. The preference for ordinary clothes of female dentists was polo shirt(37.3%), followed by striped shirt(28.7%), round T-shirt(18.7%), and everyday Korean traditional dress(15.3%). 6. The preference for ordinary clothes of male dentists was pattern necktie and no pattern Y-shirt(28.0%), followed by no pattern necktie and Y-shirt(21.3%) or pattern shirt with no necktie, and no pattern Y-shirt with no necktie(14.7%). 7. The preference on the protective equipment worn was mask and glove(28.7%), followed by no protective equipment(26.7%), mask, glove and protective glasses(22.7%) at)d only mask(22.0%). Based on the above results, it seems that parting with the traditional white gown and wearing multi-color and pattern attire will provide psychological stability and help improve children's behavior during treatment.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.50-54
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• 2004

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.270-277
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• 2002

Since founded in 1959, it's well known that the KAPD has pioneered in the researches and clinical aspects of pediatric dentistry in Korea. It's official journal, the Journal of the KAPD, was first published in 1974 and has pressed total 956 articles up to now(March, 2001). In this study, all the articles pressed in this journal have been surveyed, focussing in their main theme, their chronological and thematic distribution. The thematic classification was made with the reference of the previous studies and renowned textbooks in pediatric dentistry. And we obtained the results as follows: 1. The researches on dental materials and dental equipments have shown continuous increase throughout the period. 2. The researches on dental caries, caries prevention and systemic disorders have occupied relatively high proportion consistently. 3. The researches on malocclusions and cysts/minor surgery have shown increasing tendency in the second period, but are decreasing in the third period. 4. The researches on craniofacial growth/development, tooth development/eruption, developmental disorders of teeth, management of eruption space have shown decreasing tendency. 5. The researches on behavioral research, oral habits, occlusion of primary-mixed dentition have shown very low proportion, reaching no more than 1% throughout the period.