• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.239-254
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• 2022

The high success rate of dental treatment is dependent on the cooperation of pediatric patients during procedures. Dental treatment often causes pain, particularly in children. The factors in providing treatment to pediatric patients include the characteristics and location of the tooth, profoundness of the anesthesia including the type of local anesthetic, and cooperation of the patient. Previous studies have examined several techniques to successfully achieve profound pulpal anesthesia in maxillary permanent teeth. The dentist should select the injection technique to be used based on patient needs. In children, either buccal with palatal injections or buccal with intra-septal injections may be used to anesthetize the permanent maxillary first molar. Buccal with palatal injections are commonly used prior to routine maxillary dental procedures. Currently, there are only a few studies on the employment of buccal with intra-septal injections to anesthetize permanent maxillary first molars in pediatric patients. This review will focus on efficacy of buccal with palatal versus buccal with intra-septal pulpal anesthesia of the permanent maxillary first molars in pediatric patients and aim to determine which technique should be used during routine dental procedures.

• 한국컴퓨터정보학회논문지
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• 제28권3호
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• pp.111-117
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• 2023

구강은 전신건강을 들여다 볼 수 있는 창문이자 많은 유해균이 들어오는 관문이기도 하다. 우리 몸에 있어서 아주 중요한 부분이다. 유전자 검사는 구강 내 세균을 검사하여 빅 데이터 AI 알고리즘 분석을 통해 우리 몸에 발생할 수 있는 전신질환까지 예측하여 예방 관리를 체계적으로 할 수 있다는 가장 큰 장점이 있다. 이에 본 논문은 연구자 가족이 직접 유전자 검사를 수행하여 결과를 도출해 보고자 한다. 본 연구는 2022년 11월 연구자 가족 4명이 서울시에 소재한 예방치과진료실 J치과의원에서 치과의사 1명, 치과위생사 1명에게 사전설명을 듣고 동의서 작성 후 구강검사와 유전자 검사를 수행하였다. 성인은 Dr.^***으로 중·초등학생은 He^***** 제품으로 유전자 검사를 하였다. 현재 우리나라에서 진행하고 있는 유전자 검사는 대상자가 피를 뽑지 않고 비교적 쉽게 접근할 수 있는 장점도 있지만, 시간, 비용 등 한계점도 있다. 그럼에도 불구하고 구강 내 미생물을 통해 전신질환을 예측할 수 있다는 점에서는 높이 평가할 부분이라고 생각한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.377-385
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• 2022

Background: Postoperative endodontic pain is an enigma for the dentist. This study aimed to evaluate the analgesic effect of 300 mg gabapentin or 75 mg pregabalin in reducing postoperative endodontic pain compared with a placebo. Methods: Ninety patients who needed root canal treatment with an initial numerical rating scale (NRS) pain score of > 4 (T0) were randomly divided into three groups (n=30). Patients were then administered either 300 mg gabapentin (group A), 75 mg pregabalin (group B), or a placebo (group C) 30 min prior to the start of endodontic treatment. A single operator performed single-visit endodontics, and pain was evaluated immediately after endodontic treatment (T1) and at 4 h (T2), 8 h (T3), 12 h (T4), 24 h (T5), 48 h (T6), and 72 h (T7) using the NRS. Ibuprofen/paracetamol (400 mg/325 mg) was administered as a rescue dose if needed. Results: Pregabalin performed significantly better when compared with gabapentin at all time points except at 72 h after treatment (P=0.170). The placebo group showed significantly higher pain scores than the other two groups. The percentage of pain relief was maximum for pregabalin (92.1%), followed by gabapentin (87.6%) and placebo (69.1%) at 72 h after treatment completion. Conclusion: This study showed that pretreatment with a single dose of pregabalin and gabapentin both had greater analgesic effects than a placebo. They can be effectively used to reduce postoperative endodontic pain.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권1호
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• pp.1-8
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• 2023

Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-in^TM) and the classic needle method during treatment-required infiltration anesthesia in children. Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05. Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750). Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-in^TM system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.383-391
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• 2022

Purpose: Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Materials and Methods: Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. Results: The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics(i.e., dice coefficient and intersection-over-union [IoU] score). MultiLabel U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Conclusion: Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.15-21
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• 2023

Purpose: Dental avulsion injuries have a poor prognosis that largely depends on the immediate steps taken to manage the avulsed tooth. A lack of knowledge about the initial management can lead to tooth loss, with further adverse implications for esthetics, phonetics, and overall growth and function. Hence, the present study aimed to assess parents' knowledge regarding dental avulsion and the variables associated with their knowledge of avulsion injuries. Methods: A series of closed-ended questions on parents' knowledge regarding avulsion, such as immediate management, storage media, handling, and urgency of visiting the dentist, was asked. Univariate associations between the outcomes were assessed using the Pearson chi-square test. The chisquare goodness-of-fit test was used to check whether the sample data were representative of the population. Results: In total, 211 mothers and 149 fathers were included, of whom 46.7% had experienced dental trauma during their own childhood. Sixty-one percent of mothers believed that they knew everything necessary about tooth avulsion and its management. A significant number of participants who thought that they had a good level of knowledge about avulsion chose water, tissue, or paper wrap to transport the tooth, and preferred tap water, alcohol, or antiseptic to clean the avulsed tooth. Conclusions: Both mothers and fathers had poor knowledge about tooth avulsion, indicating that there is an immediate need for educational programs focusing on this issue. Since a substantial proportion of participants believed incorrect information, it is vital to disseminate accurate information.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.143-151
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• 2023

Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion: Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

• Imaging Science in Dentistry
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• 제53권2호
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• pp.137-144
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• 2023

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

• The Journal of Advanced Prosthodontics
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• 제15권5호
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• pp.259-270
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• 2023

PURPOSE. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. MATERIALS AND METHODS. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). RESULTS. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists' groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). CONCLUSION. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권1호
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• pp.57-65
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• 2024

Background: The objective of behavioral guidance is to establish effective communication that aligns with a child's requirements to manage disruptive behavior. This study aimed to evaluate the effectiveness of the Tell-Show-Do and Ask-Tell-Ask techniques in managing dental anxiety in children during their initial appointment. Methods: The study included 50 children (28 boys and 22 girls) without any prior experience between the ages of 7 and 11 at their first dental visit. The children were randomly categorized into two groups: Group 1, Tell Shows Do, and Group 2, Ask-Tell-Ask. Subsequently, all children underwent noninvasive treatment procedures such as restorations, sealants, and oral prophylaxis. Furthermore, behavioral management techniques were employed based on the allocated group. Finally, anxiety levels for all children were assessed using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS) and heart rate at three different intervals (before, during, and after). The obtained data were entered into Microsoft Excel, and statistical analysis was performed using SPSS software. A paired t-test and Mann-Whitney U-test were used to compare the mean and median values of the two groups and determine their effectiveness. Results: Children in the TSD group exhibited statistically significant heart rates and RMS-PS scores in intra-group comparisons. However, children in the ask-tell-ask group showed a significant reduction only in the RMS-PS scores (P < 0.001) but not in the measures used to assess heart rate (P < 0.001). Conclusion: Tell-Show-Do was more effective than ask-tell-ask in alleviating dental anxiety in children. The simultaneous application of these two strategies can synergistically alleviate dental anxiety during a child's initial dentist appointment.