• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.31-41
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• 2021

The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman's correlation coefficient, ϒ_S = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒ_S = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒ_S = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.528-533
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• 2012

Objective : In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. Methods : One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. Results : Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was $50{\pm}45$ months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. Conclusion : In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.131-139
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• 2022

This study aimed to evaluate the effectiveness of deep convolutional neural networks (CNNs) for diagnosis of interproximal caries in pediatric intraoral radiographs. A total of 500 intraoral radiographic images of first and second primary molars were used for the study. A CNN model (Resnet 50) was applied for the detection of proximal caries. The diagnostic accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under ROC curve (AUC) were calculated on the test dataset. The diagnostic accuracy was 0.84, sensitivity was 0.74, and specificity was 0.94. The trained CNN algorithm achieved AUC of 0.86. The diagnostic CNN model for pediatric intraoral radiographs showed good performance with high accuracy. Deep learning can assist dentists in diagnosis of proximal caries lesions in pediatric intraoral radiographs.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.437-445
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• 1995

The purpose of this study was to evaluate the equivalent and effective dose, and estimate radiation risk to the critical organs of head and neck region from the use of adult and child mode in panoramic radiography. The results were as follows. 1. The salivary glands showed the highest equivalent and effective dose in adult and child mode. the equivalent and effective dose in adult mode were 837μSv and 20.93μSv, those in child mode were 462μSv and 11.54μSv, respectively. 2. Total effective doses to the critical head and neck organs were estimated 34.21μSv in adult mode, 20.14μSv in child mode. From these datas, the probabilities of stochastic effect from adult and child mode were 2.50x10/sup -6/ and 1.47x10/sup -6/. 3. The other remainder showed the greatest risk of fatal cancer. The risk estimate were 4.5 and 2.7 fatal malignancies in adult and child mode from million panoramic examinations. The bone marrow and thyroid gland showed about 0.1 fatal cancer in adult and child mode from these examinations.

• Clinical and Experimental Pediatrics
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• v.54 no.3
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• pp.123-127
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• 2011

Purpose: Kawasaki disease (KD) is the main cause of acquired heart disease in children. In addition to cardiovascular involvement, many complications have been recognized in KD. However, respiratory complications have been rarely reported. We investigated the differences in clinical characteristics, laboratory findings, radiography findings, and echocardiography findings of Mycoplasma pneumoniae infection and other types of pneumonia in KD patients. Methods: Among 358 patients with KD, 54 developed concurrent pneumonia. Among the 54 patients, 12 (22.2%) with high titers of anti-M. pneumoniae antibody (AMA) (>1:640) were grouped in the M. pneumoniae group and 42 were included in the control group. Serum AMA was measured in each patient. Clinical laboratory findings and total duration of fever were analyzed. Results: The duration of fever, serum hemoglobin, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, albumin level, and the incidence of coronary arterial lesions showed no statistical difference in the 2 groups. Neutrophil count was significantly higher in the M. pneumoniae group than in the control group. Among various radiography findings observed in pneumonia, consolidation and pleural effusion were more frequent in the M. pneumoniae group than in the control group. On the other hand, parahilar peribronchial opacification, diffuse interstitial lesion, and normal findings prevailed in the control group. Conclusion: KD patients can have concurrent infections, especially pulmonary symptoms. The cause of KD is likely to be associated with M. pneumoniae infection. Thus, immediate treatment of M. pneumoniae infection in KD patients is very important.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.167-174
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• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.57-64
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• 2018

Pre-eruptive intracoronal resorption (PEIR) is a developmental defect in the crown of a pre-eruptive tooth. The purpose of this study was to investigate the relationship between the size of the pre-eruptive buccal pit radiolucency, which is suspected as PEIR on a panoramic radiography, and the need for restoration after the eruption of a mandibular first molar. The experimental group included 35 mandibular first molars, in which lesions requiring definite restoration were observed during eruption. The control group consisted of 64 sound mandibular first molars after eruption. The sex, age, tooth position, tooth formation stage, size of the pre-eruptive buccal pit radiolucency, and restoration methods in the experimental group and control group were examined. Compared with the control group, the experimental group showed a statistically significant difference in the size of the buccal pit before eruption. The buccal pit size for predicting the need for restoration was further examined by receiver operating characteristic curve analyses, and the area under the curve was $0.813{\pm}0.047$. If radiolucency is observed at the buccal pit of the mandibular first molar before eruption, periodic observations and post-eruption examinations are required.

• The Journal of the Korean dental association
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• v.55 no.8
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• pp.516-526
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• 2017

Objective: To suggest diagnostic reference levels (DRLs) for dental panoramic radiography in adults and children through the nationwide survey in Korea. Materials and Methods: Two hundred twelve dental institutions on a national basis were visited. The radiographic examination protocols were surveyed and their patient doses at the clinical exposure setting for adult and children (5- and 10-year old) were measured at 244 panoramic radiographic equipment. The measured DAP were analyzed and compared according to age group, the size of hospital, the type of radiographic system, the installation duration of equipment. Results: The mean exposure parameters were 70.1 kV, 9.2 mA, 14.4 second for adult and 66.6 kV, 7.9 mA, 13.8 second for 10-year old child and 65.5 kV, 7.3 mA, 13.7 second for 5-year old child. The mean and third quartile patient DAPs were $138.3mGy\;cm^2$ and $151.0mGy\;cm^2$ for adult, $99.5mGy\;cm^2$ and $104.8mGy\;cm^2$ for 10-year old child and $89.5mGy\;cm^2$ and $95.5mGy\;cm^2$ for 5-year old child. The mean patient dose at the university dental hospital was lower than that at the dental clinic (p<0.05). The mean patient dose of direct digital radiography type was higher than that of film-based type. However, the difference did not show statistically significance. Conclusion: DRLs for dental panoramic radiography in adult, 10- and 5-year old child were suggested to be $151mGy\;cm^2$, $105mGy\;cm^2$, and $96mGy\;cm^2$ in Korea based on this nationwide survey.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.448-452
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• 2003

Ameloblastic fibro-odontoma is a rare benign odontogenic tumor that mainly occurs at mandibular molar area. Radiography usually shows a well-defined radiolucent area containing various amounts of radiopaque material of irregular size and form. In histiologic aspect, Ameloblastic fibro-odontoma composed of connective tissue characteristic of an ameloblastic fibroma and calcined tissue identifying the tumor as a complex odontoma. Thirteen years two months aged boy of this case visited with chief complaint of delayed eruption of mandibular left canine. After enucleation of lesion, biopsy was done and diagnosed by ameloblastic fibro-odontoma. In continous follow-up check, canine erupted normally after operation.

• Imaging Science in Dentistry
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• v.41 no.2
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• pp.63-69
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• 2011

Purpose : The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. Materials and Methods : Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. Results : The smallest difference between the calculated and the actual distance was $0.1{\pm}0.7 \;mm$ in Group 1/ Method 3. The largest difference was $-4.2{\pm}1.6 \;mm$ in Group 3/Method 2. In all groups, method 3 was the most accurate. Conclusion : Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.