Usefulness of Mouth Guard when the Endotracheal Intubation Is Indicated for Treacher Collins Syndrome Patient

Treacher Collins syndrome (TCS) is autosomal dominant disorder that occurs approximately 1 in 25,000 to 50,000 live births. The main signs of syndrome are hypoplasia of facial bone and microtia. One in third of them is associated with cleft palate and often shows dental hypoplasia. TCS patients need several number of surgery with general anesthesia throughout their life time for recovery of function and esthetic. Endotracheal intubation of TCS patient is very difficult due to microstomia, retrognathia, choanal stenosis, and decreased oropharyngeal airway. Therefore, general anesthesia of adolescent TCS patient with immature incisor roots has high risk of causing dental trauma. This case is regarding TCS patient who was referred to the Department of Pediatric Dentistry, Yonsei University for avulsed upper left central incisor during endotracheal intubation. The purpose of this report is to emphasize the usefulness of mouth guard to prevent dental trauma when endotracheal intubation is needed for TCS patient.ope

Dentin dysplasia type I: A case report

A case of dentinal dysplasia type I is presented. Dentin dysplasia type I is a rare dental anomaly that is characterized by disturbance in dentin formation. It appears to be normal clinically, but, radiographically, it is characterized by obliteration of all pulp chambers and short, blunted, and malformed roots. Histological analysis shows whorls of tubular dentin and atypical osteodentin. In this case, features of dentin dysplasia type I in mixed dentition is presented. The clinical, radiographic, and histopathological findings of this condition are described along with its management.ope

The effect of EGF, T3 and HB-EGF on human periodontal fibroblasts

Viable cells of periodontal ligament would be an important factor for the successful replantation of an avulsed tooth. Therefore, it is critical to choose the storage medium for the preservation of traumatically avulsed teeth. Growth factors and hormones could be considered for the therapeutic application of the maintenance of viable periodontal ligament fibroblasts (PDLFs). Epidermal growth factor (EGF) has been suggested as an important player for the regeneration and wound healing process on other tissues. Therefore, EGF was evaluated for the therapeutic application on avulsed teeth. In addition, the synergic effect of EGF with tri-iodothyronine (T3) and heparin-binding epidermal growth factor-like growth factor (HB-EGF). The cell proliferation of PDLFs was determined by MTT assay and increased dose-dependently up to 10 ng/ml in the presence of EGF. Maximum cellular growth was shown at the concentration of 10 ng/ml EGF. Also, EGF promoted the wound healing of PDLFs examined by in vitro wound healing assay. Combined effects of EGF with T3 or HB-EGF on the proliferation of PDLFs were also studied. Interestingly, EGF showed the synergic effect on the proliferation of PDLFs with T3 and HB-EGF. To find out the mechanism of the synergic effect of EGF and T3, the effect of T3 on the expression of endogenous EGF receptor was determined by RT-PCR. The result was that T3 enhanced the expression of EGF receptor in PDLFs. It suggested that EGF might be a good choice for a therapeutic application, which can be used as combination with T3 and HB-EGF.ope

VALPROATE-INDUCED GINGIVAL OVERGROWTH : A CASE REPORT

Drug-induced gingival overgrowth is an abnormal increase of gingival tissues caused as a side effect of systemic medication. This report presents a severe case of valproate-induced gingival overgrowth combined with ulcerative and hemorrhagic lesions in a patient with Lennox-Gastaut syndrome. Considering the patient’s limited cooperative ability, gingivectomy and excisional biopsy under general anesthesia were performed. The lesions were successfully treated without recurrence. When gingival enlargement does not subside with nonsurgical treatments, surgical procedure and excisional biopsy are to be performed. Postoperative management of oral hygiene is critical to prevent recurrence.restrictio

Activation of G Proteins by Aluminum Fluoride Enhances RANKLMediated Osteoclastogenesis

Receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis is accompanied by intracellular Ca2+ mobilization in a form of oscillations, which plays essential roles by activating sequentially Ca2+/calmodulin-dependent protein kinase, calcineurin and NFATc1, necessary in the osteoclast differentiation. However, it is not known whether Ca2+ mobilization which is evoked in RANKL-independent way induces to differentiate into osteoclasts. In present study, we investigated Ca2+ mobilization induced by aluminum fluoride (AlF4-), a G-protein activator, with or without RANKL and the effects of AlF4- on the osteoclastogenesis in primary cultured mouse bone marrow-derived macrophages (BMMs). We show here that AlF4- induces intracellular Ca2+ concentration ([Ca2+]i) oscillations, which is dependent on extracellular Ca2+ influx. Notably, co-stimulation of AlF4- with RANKL resulted in enhanced NFATc1 expression and formation of tartrate-resistant acid phosphatase (TRAP) positive multinucleated cells. Additionally, we confirmed that mitogen-activated protein kinase (MAPK) is also activated by AlF4-. Taken together, these results demonstrate that G-protein would be a novel modulator responsible for [Ca2+]i oscillations and MAPK activation which lead to enhancement of RANKL-mediated osteoclastogenesis.ope

Detection of Hidden Proximal Caries using Q-ray view in Primary Molars

The purpose of this study was to evaluate the ability of Q-ray view (All-in-one Bio, Seoul, Korea) in detection of proximal caries in primary molars with sound marginal ridges. Thirty two children aged 3-9 years (average 5.6 ± 1.3 years old) were chosen, and two examiners evaluated 100 proximal surfaces of primary molars with sound marginal ridges. The teeth were examined with; (a) visual examination, (b) Q-ray view, (c) DIAGNOdent (KaVo, Biberach, Germany) and (d) digital periapical radiography. Kappa statistic was used to assess the agreement between each examination method and the degree of caries progression. The kappa values for enamel caries were 0.15 (visual examination), 0.10 (Q-ray view), 0.25 (DIAGNOdent) and 0.68 (digital periapical radiography). The kappa values for dentinal caries were 0.34 (visual examination), 0.56 (Q-ray view), 0.44 (DIAGNOdent) and 0.70 (digital periapical radiography). Although Q-ray view showed low diagnostic ability in detection of enamel caries, it was effective in detection of hidden proximal caries extended into dentin. Q-ray view would be a useful and simple device which could aid pediatric dentists in detection of hidden proximal caries in primary molars especially when examining uncooperative children or disabled persons.ope

매복 상악 중절치의 강제 견인 후 치아길이에 영향을 미치는 요소

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth. The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.ope

FIBROUS DYSPLASIA CAUSING FACIAL ASYMMETRY : A CASE REPORT

Fibrous dysplasia(FD) is a benign fibro-ossifying disease in which fibrous tissue replaces normal bone and marrow. Craniofacial bones, including the maxilla and mandible, are commonly involved. A 7 year-old girl visited the clinic with a chief complaint of gingival swelling around the lower left primary molar. Mild bulging of the lower left periodontal tissue was observed. Not only the mandible, but also the maxilla, zygoma, sphenoid, and temporal bones were affected by FD. Permanent tooth germs were involved in the lesions and facial asymmetry was caused by lower left bone expansion. She was scheduled for a follow-up visit at the department of pediatric dentistry and oromaxillofacial surgery.ope

EXTRACTION OF MULTIPLE SUPERNUMERARY PREMOLARS IN MENTAL RETARDATION PATIENT : CASE REPORT

The supernumerary premolars account for 4%-9% of all supernumeraries and reported prevalence is 0.01%-1.00%. Multiple supernumerary teeth can be seen in syndromic phenotypes. But, only 2% of supernumerary premolars exhibited any pathological changes. Most of them cause interference with normal occlusal development that makes maintaining the disabled patients's oral hygiene difficult. It is recommended to delay the timing of extraction until the full permanent dentition is mature. If there is no complication, leaving the supernumerary premolars impacted is recommended. This case is about mental retardation patients with multiple supernumerary premolars.ope

Evaluation of the Developmental Age of Permanent Teeth by the Nolla Method

The developmental age of permanent teeth was evaluated in children and adolescents according to age and gender using the Nolla Method. A retrospective study was performed on panoramic radiographs of 1,200 subjects aged 4-15 years, including 50 children for each age/gender group. Three well-trained examiners estimated the developmental stage of upper and lower permanent teeth using the Nolla Method. The inter-examiner reliability was excellent (intra-class correlation coefficient value = 0.973). The mean developmental age was calculated. In boys, Nolla stage 6, indicated by crown completion, was seen in the central incisor, lateral incisor, canine, first premolar, second premolar, first molar, and second molar at 5.4, 6.4, 6.7, 7.5, 7.8, 4.6, and 8.1 years, respectively, in the maxilla and at 4.8, 5.1, 6.0, 6.5, 7.2, 4.5, and 8.0 years, respectively, in the mandible. In girls, Nolla stage 6 was seen at 5.3, 6.0, 6.3, 7.3, 7.7, 4.8, and 8.1 years, respectively, in the maxilla and at 4.8, 5.1, 5.9, 6.5, 7.2, 5.0, and 7.9 years, respectively, in the mandible. In this study, the developmental age of permanent teeth was evaluated in Korean children and adolescents who visited Yonsei University Dental Hospital. This study may be helpful in diagnosis and treatment planning in the clinic.ope