• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.15 no.1
• /
• pp.79-83
• /
• 2019

Treacher Collins syndrome(TCS) is an autosomal craniofacial development disorder which results from mutations in the gene TCOF1. Major features include midface hypoplasia, micrognathia, microtia, conductive hearing loss. Oral manifestations are characterized by cleft palate, shortened soft palate, malocclusion, anterior open bite and enamel hypoplasia. The purpose of this presentation is to describe the interesting aspects of dental treatment of a patient with TCS. A 6-year-old boy with TCS visited Seoul National University Dental Hospital for dental caries. Multiple caries was observed from clinical and radiographic examination. Because of multiple caries and behavior management ploblem, dental treatment under general anesthesia was planned. Treatment of posterior teeth was performed and some primary teeth were extracted. General anesthesia was induced and maintained with sevoflurane, nitrous oxide and oxygen. Under general anesthesia, successful dental procedure was done. Considering behavior management problem and medical condition of patient with TCS, general anesthesia can be useful.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.1
• /
• pp.71-79
• /
• 2022

Excessive crown height space increases can cause crestal bone loss and screw loosening after prosthesis is placed. Milled bar and implant overdenture can be used as a treatment method for partially edentulous patients who have severe alveolar bone loss and excessive crown height space. Milled bar can provide primary splinting effect and stability between implants. Also, milled bar with additional retention device such as Advanced Dental Device-Treatment Of Choice (ADD-TOC) and magnet can provide additional retention force for implant overdenture. In this case, the patient has a partially edentulous mandible that has severe alveolar bone loss and multiple number of teeth loss after excision due to leiomyosarcoma. Because of the long-term loss of mandibular molars, the opposing teeth were extruded. Maxillary left molars were corrected to the occlusal plane through molar intrusion, and mandibular left molar region were treated with implant overdenture, using milled bar with ADD-TOC and magnet after implant placement. The clinical result was satisfactory on the aspect of esthetic and masticatory function.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.44 no.4
• /
• pp.446-454
• /
• 2017

Recently, there have been many studies on bulk-fill resin composites. However, studies on the proper materials for pediatric patients are rare. The aim of this study was to compare the cavity wall adaptation of bulk-fill resin composites with conventional resin composite in class II cavities of primary molars using microcomputed tomography (micro-CT). Standardized class II slot cavities were prepared in 80 exfoliated primary molars and randomly divided into 4 groups. The control group was restored with conventional resin composite, Filtek Z-350 XT (FZ), and the three groups were restored with bulk-fill resin composites, Filtek bulk-fill posterior (FB), Tetric N-Ceram Bulk Fill (TNC), Filtek bulk-fill flowable (FBF). All specimens were thermocycled and then immersed in 50% silver nitrate ($AgNO_3$) solution. Micro-CT was used to measure the penetration volume of the total silver nitrate and the degree of cervical marginal leakage and the number, size, and position of the voids were evaluated. The results revealed that the volume of silver nitrate were significantly different between FB and FZ (p < 0.05). The results also revealed that the penetration length of silver nitrate FBF showed statistically lower than the FZ and FB (p < 0.05). There was no significant difference between the groups in number and size of voids. In conventional resin composite, most of the voids were present inside the restoration (83.3%), but the voids in the bulk-fill resin composites incidence were higher in the gingivoaxial angle. The cavity wall adaptation demonstrated in class II restorations of primary molar by new bulk fill resin composites was similar to conventional incremental technique. Bulk-fill resin composites might be an clinical option for a faster restoration in deciduous teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.1
• /
• pp.55-63
• /
• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.4
• /
• pp.452-460
• /
• 2016

Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin's B-cell lymphoma found primarily in the pediatric population. In the oral cavity, this tumor can grow rapidly and often brings about facial swelling or development of an exophytic mass involving the jaws. A 5-year-old boy was referred for swelling and pain in the left mandibular area. The patient showed diffuse swelling on the left side of the mandible and firm-moderate tenderness upon palpation. An intraoral examination showed moderate mobility and sensitivity to percussion on the left primary first and second molars, without severe caries. A radiographic examination revealed complete loss of the lamina dura on the left primary second molar and permanent first molar. There was a radiolucent osteolytic lesion and destruction of the cortical bone of the left mandibular body. Based on the clinical, radiographic, and immunohistochemical findings, the patient was diagnosed with BL, and was referred to a pediatrician for systemic evaluation and intensive chemotherapy. Even before the completion of chemotherapy, the swelling resolved and the displaced teeth were relocated to a normal position. This patient showed a good prognosis due to prompt diagnosis and intensive chemotherapy. Early diagnosis and referral for treatment can prevent the development of BL.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.2
• /
• pp.146-154
• /
• 2011

An in vitro study on cariogenic potential of 8 over-the-counter syrups for children was performed. The experimental groups were 8 over-the-counter syrups. The positive control group was 10% sucrose solution, and the negative control group was artificial saliva. The pH of each group was determined. The buffering capacity was measured by the volume of 2 N NaOH adding to equalize the pH of 20 ml of experimental solution to pH 7. The consistency was measured by the time to pass Ostwald pipette for 2 ml of the experimental solution. The experimental solutions were inoculated with S. mutans and cultured in $37^{\circ}C$ anaerobic condition for 48 hours. To estimate acid production, pH of the experimental solutions were measured before and after the culture. The primary teeth specimens were soaked in the experimental solutions for 20 minutes three times a day. Except on those hours the specimens were stored in artificial saliva. After 5 days, the microhardness changes of the specimens were measured. These results show that most of syrup-form medicines for children tend to have cariogenic potential partially in endogenous pH, buffering capacity, consistency, acid production and erosive ability of enamel. For the oral health of children, the alternative sweeteners (ex. xylitol) may be substituted for the cariogenic sweeteners of syrups. Additionally, It may be helpful that the chewable tablet replace liquid or syrup in term of dose form.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.2
• /
• pp.275-280
• /
• 2009

Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.8 no.2
• /
• pp.113-117
• /
• 2012

Axenfeld-Rieger syndrome (ARS) is a rare disorder with variable morphology characterized by malformations of the anterior segment of the eye such as iris hypoplasia, iridocorneal adhesions, corectopia and polycoria. Craniofacial and dental anomalies are also regularly reported in connection with ARS. Dental features include hypodontia in primary and permanent dentition, microdontia, short roots and abnormally shaped teeth. The patient in this case is a 14-year-old girl who has visited Seoul National Dental Hospital in 2002 for the first time. A panorama was taken on the day of her first visit, and total absence of maxillary anterior dentition and mandibular premolars were observed. The patient was on a treatment schedule by the department of ophthalmology at Seoul National Hospital for a morphological dyplasia of the pupil and she was diagnosed with ARS. Periodic panoramic observations were performed followingly, and she was finally diagnosed of congenital missing of maxillary anteriors and mandibular second premolars. In 2009, composite resin build-ups of maxillary primary central incisors were performed, and she has been on her regular follow-ups until now.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.3
• /
• pp.401-410
• /
• 2006

Dental caries results from localized demineralization of tooth enamel by acids of bacterial origin produced from the fermentation of dietary sugars. A group of related oral bacteria, collectively known as mutans streptococci, are implicated as the primary etiological agents of human caries. Within this group, Streptococcus mutans has been known as a causative agent for dental caries. As well as acid production yielding the demineralization of tooth enamel, adherence and colonization of S. mutans to the teeth are also important for their virulence Cell-surface fibrillar proteins, which mediate adherence to the salivary pellicle are virulence components of mutans streptococci, and primary candidates for a human caries vaccine. Here we report that the AgI/II gene from S. mutans GS-5 were cloned by PCR amplification of the bacterial chromosomal DNA and the integrity of cloned genes were confirmed by nucleotide sequencing. Sequence analyses showed the sequence alignment of 280 nucleotides between the cloned AgI/II and the reported sequence of S. mutans GS-5 showed the perfect match The cloned genes which signal nucleotide was truncated, were transferred into bacterial expression vector and the recombinant proteins were purified as His-tag fusion proteins In order to generate polyclonal antibodies against the recombinant proteins, AgI/II mr, some $100{\mu}g$ of the proteins was injected into mice three times. It can be used for an effective vaccine production to prevent dental caries caused by pathogenic S. mutans.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.4
• /
• pp.649-656
• /
• 2005

The present study was designed to formulate cephalometric norms of normal occlusion for usage in orthodontic diagnosis of malocclusion in Korean children. Thirty two children, aged 4 to 6, with normal occlusion were chosen for this study, Sagittal and vertical relations were analyzed using lateral cephalogram and clinical photos and the measurements were compared with those of adults. On skeletal sagittal analysis, the mean values of the SNA and SNB angles were $83^{\circ}\;and\;78.72^{\circ}$. It showed that the mandible was retrognathic and retropositioned in comparison to those of adults. On skeletal vertical analysis, the mean values of the genial angle was $127^{\circ}$. This showed high angle pattern in children and reduction of genial angle due to counterclockwise rotation of the mandible is expected with growth. On soft tissue analysis, children showed convex pronto, obtuse nasolabial angle. On dental analysis, the mean values of the U1 to SN and IMPA were $91.04^{\circ}\;and\;86.57^{\circ}$. This showed retroclined upper and lower deciduous teeth in comparison to adults. For skeletal values, the liner values were generally greater in males than females.