Association of maxillary dental developmental abnormality with precocious puberty: a case-control study

Background: Dental studies of precocious puberty have focused on examination of jaw and dentition growth. The aim of the study was to analyze the relationship between precocious puberty and maxillary dental developmental abnormalities (DDAs). Methods: This retrospective study was conducted on the Korean patients in whom dental panoramic and hand-wrist radiographs had been taken before they were 15 years of age. The maxillary DDAs were assessed as mesiodens, congenital missing teeth, peg-shape lateral incisors, or impacted teeth. The chronological ages of the control group members were within the normal range of the hand-wrist bone age. Others with a peak luteinizing hormone of ≥ 5 and < 5 IU/L were allocated to central precocious puberty (CPP) and peripheral precocious puberty (PPP), respectively. Results: Of the enrolled 270 patients, 195, 52, and 23 were allocated to the control, CPP, and PPP groups, respectively. The maxillary DDAs were significantly more prevalent in the CPP group than in the other groups. Among those with maxillary DDA, the mesiodens predominated. Age- and sex-adjusted multivariate analysis revealed maxillary DDA (odds ratio, 3.36; 95% CI, 1.60-7.05) and especially mesiodens (odds ratio, 5.52; CI, 2.29-13.28) to be significantly associated with CPP. Conclusions: Maxillary DDAs were significantly more prevalent in the CPP group than in the PPP or control groups. Among the many types of maxillary DDAs, mesiodens was significantly associated with CPP and may be considered a predictor of the development of CPP.ope

Comparison of Obturation Quality after MTA Orthograde Filling with Various Obturation Techniques

This study aimed to quantify and compare the obturation quality after mineral trioxide aggregate (MTA) orthograde fillings with three different obturation techniques. Thirty-three extracted human maxillary molars were collected. Distobuccal and palatal canals were prepared to an apical size of #40/06 with a Profile Ni-Ti system. All 66 canals were divided into two groups according to the material (EZ-seal or OrthoMTA) and then obturated using three different techniques: manual compaction using S-kondenser (group H), compactor activation (group C), or reverse rotary motion of Ni-Ti file (group R). The obturated roots were scanned using micro-computed tomography (micro-CT). The percentage of voids located in the apical 5 mm was measured separately, that is, closed, open, and total porosity. There was no relation between the filling material and obturation technique (p > 0.05). The percentage volume of open and total porosity was higher in EZ-seal than in OrthoMTA (open: p = 0.002, total: p = 0.001). Group H showed higher open and total porosity than groups C and R. Micro-CT analysis showed that the void volume after orthograde MTA fillings significantly decreased when the additional activation was accompanied by hand condensation. Obturation with a Ni-Ti file using reverse motion could be recommended as an MTA orthograde filling technique.ope

Dentists' clinical decision-making about teeth with apical periodontitis using a variable-controlled survey model in South Korea

BACKGROUND: This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making. METHODS: A questionnaire with 36 questions about identical patient information, clinical signs, and symptoms was filled out by participants. Each question referred to a radiograph that had been manipulated using computer software in order to control tooth-related factors. Participants were instructed to record their demographic information and choose the ideal treatment option related to each radiograph. Simple and multivariable logistic regression analyses (p < .05) were used to investigate factors related to the decision to extract the tooth. We divided factors into dentist-related factors (gender, years of experience, and professional registration) and tooth-related factors (tooth position, coronal status, root canal filling status, and size of the periapical radiolucency). Dentists were categorized into three groups, based on professional registration: general dental practitioners (GDPs), endodontists, and other specialists. Simple logistic regression analysis (p < .05) was used to evaluate the tooth-related factors influencing extraction, depending on the dentists' specialty. RESULTS: Participants mostly preferred saving the teeth over extraction. This preference was highest among the endodontists, followed by other specialists and GDPs. Extractions were significantly preferred for molars, teeth with previous root canal fillings, and those with apical lesions greater than 5 mm. CONCLUSIONS: This study suggests that dentists' decision-making regarding teeth with apical periodontitis was associated with their work experience and specialty and influenced by tooth position, root canal filling status, and size of the apical lesion. CLINICAL RELEVANCE: This survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists' specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion.ope

A rare case of chronic nonbacterial osteomyelitis of the mandible in a young adult male

Chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis, is a rare disease of unknown etiology mainly affecting girls with a mean age of 10 years. The disease is characterized by nonbacterial osteolytic lesions and swelling of the adjacent soft tissues and has nonstandard treatment protocols. Unifocal CNO typically involves the mandible. Mandibular CNO is difficult to differentiate from bacterial osteomyelitis because of its similar radiographic profile and clinical symptoms. Therefore, magnetic resonance imaging (MRI) should be considered if infectious osteomyelitis has not been diagnosed by laboratory examination. Our patient was a young adult man with mandibular CNO presented with atypical bone fragments on MRI. Clinical symptoms improved within 3 days after surgical intervention to remove the fragments and treatment with a nonsteroidal anti-inflammatory drug (NSAID). NSAID therapy was discontinued at postoperative day 20, and the patient has experienced no recurrences at 5 months after surgery.ope

Incidence of edentulism among older adults using the Korean National Health Insurance Service database, 2013-2018

Objectives: Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS). Methods: Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models. Results: Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population registered in the KNHIS (CIRs, 707.92 to 895.92; AIRs, 705.11 to 889.68; p<0.01). The incidence tended to increase in both genders (p<0.01). Both CIRs and AIRs in specific regions also showed slight but significant annual increases except for Jeju Island (p<0.01 or <0.05). The incidence showed increasing trends (p<0.01) in all income quintiles apart from the highest quintile. The edentulism incidence was highest in the lowest income group (the first quintile). Conclusions: Our data showed that the incidence of edentulism among the elderly showed an increasing trend from 2013 to 2018. This result provides a basis for future epidemiological studies on the incidence of edentulism in the older Korean population.ope

A Study on the Socio-cultural Function of Network Dental System

The purpose of this study was to explore the socio-cultural function of network dental system and suggest the improvement of limitations of the current network dental system format. The Parker E-system, which appeared in the early 20th century in the United States, was examined to identify the early stage of the network dental system. Next, large network systems in other areas were compared as examples to consider the current operational form of network hospitals and clinics. The network dental system shows its strength in securing profits for healthcare systems, but it has ethical issues in terms of publicness of medical establishments. When comparing network dental systems to medical, Korean medical, and pharmacy networks, the dental network was identified as being in the middle of networks of other domains in terms of expertise, universality, and vertical relationships. Brand value is lower than other domains. This study suggests that the network dental system needs to specialize in the role of the Management Service Organization to strengthen their values. Institutional supports should be provided to perform public functions in the community.ope

Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study

BACKGROUND: In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. METHODS: Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010-2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010-2012) and post-policy periods (2014-2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. RESULTS: The prevalence of dental scaling non-users declined from 58.0 to 48.7% in the highest income group and from 86.3 to 78.8% in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95% CI: 11.9-11.9) to 15.5 (95% CI: 15.5-15.5)%, and the adjusted prevalence ratio increased from 1.19 (95% CI: 1.19-1.20) to 1.29 (95% CI: 1.29-1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. CONCLUSIONS: The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered.ope

Topical ferumoxytol nanoparticles disrupt biofilms and prevent tooth decay in vivo via intrinsic catalytic activity.

Ferumoxytol is a nanoparticle formulation approved by the U.S. Food and Drug Administration for systemic use to treat iron deficiency. Here, we show that, in addition, ferumoxytol disrupts intractable oral biofilms and prevents tooth decay (dental caries) via intrinsic peroxidase-like activity. Ferumoxytol binds within the biofilm ultrastructure and generates free radicals from hydrogen peroxide (H2O2), causing in situ bacterial death via cell membrane disruption and extracellular polymeric substances matrix degradation. In combination with low concentrations of H2O2, ferumoxytol inhibits biofilm accumulation on natural teeth in a human-derived ex vivo biofilm model, and prevents acid damage of the mineralized tissue. Topical oral treatment with ferumoxytol and H2O2 suppresses the development of dental caries in vivo, preventing the onset of severe tooth decay (cavities) in a rodent model of the disease. Microbiome and histological analyses show no adverse effects on oral microbiota diversity, and gingival and mucosal tissues. Our results reveal a new biomedical application for ferumoxytol as topical treatment of a prevalent and costly biofilm-induced oral disease.ope

한국 노인의 주관적 구강건강상태: 2016-2018

The factors affecting the subjective oral health status of the elderly were investigated using a single-item scale, Self-Reported Oral Health (SROH), which is recognized for its reliability. Among the data of the 7th period (2016-2018) of the Korea National Health and Nutrition Examination Survey (KNHANES), the elderly 65 years or older were targeted, and negative responses to subjective oral health status were used as the dependent variable. Multivariable logistic regression was performed by select ing demographic variables, health status and behavioral variables, oral health status and management behavioral variables. Statistical analysis was performed using SPSS Statistics version 25.0. Subjective general health status, maxillary and mandibular prosthesis status, number of decayed teeth, and CPI (Community periodontal index) were statistically significant (p<0.05). On the other hand, the patients who had full dentures and 13-28 missing teeth responded that their subjective oral health was better than those without prostheses and missing teeth. This means that it is important not only to have a large number of teeth left, but to keep them in good health. Therefore, more ef forts should be made to keep the teeth of the elderly more healthy.ope

Clinical Practice Guidelines for Oral Frailty

The associations between lowered oral health status and frailty in elderly have been previously reported in many studies. Despite the increasing number of elderly populations in Korean society, there have been no at tempt to develop clinical practice guideline and diagnostic criteria for oral frailty. Hence, this study reviewed the previous cohort studies and systematic reviews about oral frailty and proposed 15 recommendations as an oral frailty guideline for Korean elderly on the basis of the evidence-based methodology. This clinical practice guideline will provide overall guidance on the identification, diagnosis, and management of oral frailty in pri mary dental care setting and finally help to achieve healthy aging in elderlyope