Factors Influencing Prognosis of Traumatized Tooth in Primary Tooth Intrusion

채용권,한윤경,남옥형,김미선,이효설,김광철,최성철 대한소아치과학회 2019 大韓小兒齒科學會誌 Vol.46 No.1

The purpose of this study was to investigate the characteristics of intrusion in primary dentition and to evaluate factors influencing complications of primary and permanent dentition during long-term follow-up period. 61 patients (84 teeth) were selected in this study. Medical records of 61 patients were reviewed and age, gender, cause of injury, site of injury, severity of traumatic injury, other injuries associated with trauma, treatment method, and complications of primary and permanent dentition were examined. Collected data were statistically evaluated using Chisquare test and Fisher’s exact test. Intrusion in primary anterior teeth was predominant in boys over girls and fall was the most common cause of trauma. It was most common at home and occurred most in the primary maxillary central incisors. Severity had an effect on the incidence of sequelae in permanent successors (p = 0.014). The incidence of complications was significantly lower in patients with soft tissue injuries than in patients with other periodontal injuries (p = 0.000).

Differential gene expression profiles of periodontal soft tissue from rat teeth after immediate and delayed replantation: a pilot study

채용권,신서영,강상욱,최성철,남옥형 대한치주과학회 2022 Journal of Periodontal & Implant Science Vol.52 No.2

Purpose: In dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation. Methods: Maxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences. Results: The hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=–1.82, Q=0.002), angiogenesis (NES=–1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=–1.46, Q=0.051) were negatively highlighted. Conclusions: Differentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.

소아치과 전문의 인력 현황 및 공급 적정성에 관한 연구 – 급여 진료 항목을 기준으로

임여원,채용권,이고은,남옥형,이효설,최성철,김미선 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.3

The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into ‘general characteristics’, ‘number of dental treatments and working days per year’, ‘proportion of covered services’, ‘perceptions of supply and demand of pediatric dentists’. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future. 본 연구의 목적은 소아치과 전문의 인력 현황을 파악하고 만 19세 미만 환자의 연간 치과 이용량과 소아치과의사의 진료 생산성을 바탕으로 소아치과 전문의 인력 공급의 적정성을 평가하는 것이며 향후 정책 수립을 위한 의견을 알아보고자 하였다. 소아치과의사들을 대상으로 온라인 설문조사를 통해 ‘일반적인 특성’, ‘연간 진료 횟수 및 근무 일수’, ‘급여진료 비율’, ‘전문의 수급 인식’에 대한 응답을 수집하였다. 대한소아치과학회, 건강보험심사평가원, 국민건강보험공단, 국가통계포털을 통해 소아치과의사 현황 및 진료 청구 횟수, 연간 출생아 수 감소 등을 조사하였다. 진료과목을 소아치과로 표방하는 치과는 전체 의료기관의 절반에 달했지만 실제 소아치과 의사가 근무하는 곳은 3.78%에 불과했다. 전체 소아치과의사의 61.36%가 수도권에 집중된 지역적 불균형을 보였다. 지난 20년 동안 소아청소년 인구는 지속적으로 감소했지만, 급여 진료 청구 횟수는 지속적으로 증가하고 있다. 지난 10년간 소아치과 전문의 적정 공급량은 4,000명 내외로 유지되었다. 소아치과 의사의 92.15%가 정부 차원의 정책 마련과 지원 방안이 필요하다고 생각하였다. 본 연구가 향후 소아치과 전문의 수요예측 방법 확립을 위한 기초자료로 활용될 수 있기를 기대한다.

치과의사의 아동 학대 및 방임에 대한 인식과 신고 의무 태도

장다혜,채용권,이고은,남옥형,이효설,최성철,김미선,Da Hyeo Jang,Yong Kwon Chae,Ko Eun Lee,Ok Hyung Nam,Hyoseol Lee,Sung Chul Choi,Mi Sun Kim 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.1

In this study, the recognition of child abuse and neglect (CAN) and reporting attitudes of general dentists and pediatric dentists in Korea were estimated. A survey was conducted among dentists working at clinics or university hospitals, including interns and residents at dental hospital training institutions. The questionnaire, consisting of 32 questions and detailed questions, subdivided into 'general characteristics of respondents', 'CAN', 'CAN report', 'laws to CAN', 'countermeasures against CAN'. The survey was conducted using a messenger, and 176 respondents' answers were analyzed. The recognition of CAN showed high scores in the order of physical abuse, neglect, and emotional abuse. The positive attitude toward reporting CAN had a higher score than the negative attitude. Of the total respondents, 19 said they reported child abuse, and 18 said they were suspected of child abuse but hesitated to report it. Among the laws related to CAN, the protection measures for CAN reporters and the protocol for CAN showed low awareness. Since then, they have wanted to know how to find abused children and how to deal with them in education. This study is expected to be used as data to improve dentists' awareness and consciousness of CAN in the future.

국민건강보험에 대한 소아치과 의사들의 요구와 인식 조사

김윤형,채용권,이고은,김미선,남옥형,최성철,이효설 대한소아치과학회 2022 大韓小兒齒科學會誌 Vol.49 No.3

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into ‘general background of the respondents’, ‘the awareness on national health insurance (NHI) and DHI’, ‘the awareness on DHI pertaining to pediatric dentistry’, ‘issues that need improvement on DHI pertaining to pediatric dentistry’, ‘DHI claims’, and ‘the roles of KAPD in DHI’. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry. 이 연구의 목적은 치과건강보험에 대한 소아치과 의사의 인식과 견해를 조사하는 것이다. 대한소아치과학회 회원들을 대상으로 온라인 설문조사를 실시하였다. 총 문항 수는 41문항이며, 문항은 6개의 항목 ‘설문 응답자의 일반적인 특성’, ‘국민건강 보험과 치과건강보험’, ‘소아치과 영역의 치과건강보험’, ‘소아치과와 관련된 치과건강보험 제도 개선점’, ‘치과건강보험청구’, ‘치과건강보험과 관련한 대한소아치과학회 역할’으로 이루어졌다. 총 302명이 응답하였고, 응답률은 28.9%였다. 기록이 미비한 2명을 제외하고, 총 300명을 분석대상으로 하였다. 소아치과 의사들은 치면열구전색술, 광중합형 복합레진 충전에 정량광형광기 치아우식검사에 비해 높은 만족도를 보였다(p < 0.017). 소아치과 의사들은 보험수가 인상이 가장 필요한 항목은 영구치 복합레진 충전(65.7%), 보험급여가 가장 필요한 항목은 불소도포(74.7%)라 생각하였다. 치과건강보험 청구는 대체로 치과위생사 또는 간호조무사가 담당하였다. 소아치과 의사들은 학회에서 치과건강보험에 대한 정보를 제공하는 것에 대해 긍정적으로 생각하였다. 이 연구는 향후, 소아치과 영역 치과건강보험제도의 정책적 발전을 위한 기초자료로 활용될 수 있을 것이라 사료된다.

Long-Term Outcome of Reattached Tooth Fragment in Permanent Anterior Teeth of Children and Adolescents

강호연,채용권,이고은,이효설,최성철,남옥형,Kang, Hoyeon,Chae, Yongkwon,Lee, Koeun,Lee, Hyo-seol,Choi, Sungchul,Nam, Okhyung Korean Academy of Pediatric Dentistry 2021 大韓小兒齒科學會誌 Vol.48 No.1

This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (p > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (p = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (p = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown. 이 연구의 목적은 소아 및 청소년의 영구치 치관 파절시 파절편 재부착술의 추적 관찰 결과를 평가하고자 함에 있다. 21명의 27개의 영구치 파절편 재부착술을 시행한 환자를 대상으로 임상 사진, 방사선 사진 및 의무기록을 활용하여 평가하였다. 파절편 탈락은 총 17개 치아에서 관찰되었으며 반복적인 외상이 가장 빈번한 실패 원인이었다. 파절편 재부착술과 치수치료 시행 유무는 통계적으로 유의미하지 않았다(p > 0.05). 평균 파절편 비율은 0.482 ± 0.147이며 성공률은 파절편 비율과 유의미한 상관관계를 나타냈다(p = 0.018). 평균 파절편 유지 기간은 72개월이며 파절편 유지 기간과 파절편의 비율은 통계적으로 유의미한 상관관계를 나타냈다(p = 0.003). 소아 및 청소년의 영구치 치관 파절시 파절편 비율이 50% 미만인 환자에서 파절편 재부착술은 예측 가능한 치료 방법이 될 수 있다고 판단된다.

Effect of Polydeoxyribonucleotide on Human Periodontal Ligament Cells as a Storage Medium for Avulsed Tooth

노상태,채용권,이고은,김미선,남옥형,이효설,최성철 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.3

Objective: This study aimed to evaluate the suitability of polydeoxyribonucleotides (PDRN) as a storage medium for avulsed teeth. Materials and Methods: The viability of human periodontal ligament (PDL) cells stored in Hank’s balanced salt solution and PDRN solutions (concentrations, 10, 25, 50, and 100 μg/mL) and tap water was measured using the Cell Counting Kit-8 and Live/Dead assays. In addition, Nitric oxide detection and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to evaluate the anti-inflammatory effect of PDRN. Results: The viability of PDL cells stored in a 100 μg/mL PDRN solution was significantly higher than that of cells stored in the other solutions (p < 0.01). Furthermore, cells stored in 100 μg/mL PDRN solution demonstrated a significantly reduced NO production (p < 0.0001), and cells stored in 50 and 100 μg/mL PDRN solutions expressed significantly lower levels of tumor necrosis factor α, interleukin (IL) -4, IL-6, and IL-10 (p < 0.01) compared to cells stored in HBSS. Conclusion: The PDRN solution exhibited cell-preserving and anti-inflammatory effects on the PDL cells. The findings of this study can serve as a basis for further experiments directed at the development of an effective storage medium for avulsed teeth.

Evaluating Measurements: A Comparative Study of Digital and Plaster Models for Orthodontic Applications in Mixed Dentition

신서영,채용권,이고은,김미선,남옥형,이효설,최성철 대한소아치과학회 2024 大韓小兒齒科學會誌 Vol.51 No.1

This study aimed to assess the accuracy of tooth widths, intermolar widths, and arch lengths acquired through two intraoral scanners, including iTero Element Plus Series (Align Technology, Santa Clara, CA, USA) and Trios 4 (3Shape, Copenhagen, Denmark), specifically on mixed dentition. A total of 30 subjects were divided into 2 groups, each undergoing both alginate impressions and intraoral scanning using either the iTero or Trios scanner. The plaster models were measured with a caliper, while the digital models were measured virtually. In the iTero group, all tooth width measurements exhibited differences compared to the plaster values, except for maxillary left lateral incisors (p = 0.179), mandibular right (p = 0.285), and left (p = 0.073) central incisors. The Trios group did not display significant differences in any of the tooth width measurements. Intermolar width comparisons for both groups indicated differences, except for mandibular primary canine to primary canine values (p = 0.426) in the iTero group. Regarding arch length, the mandibular anterior, maxillary right, and left arch lengths in the iTero group demonstrated larger caliper values than those of iTero. Conversely, in the Trios group, all parameters showed smaller caliper values, especially in upper anterior, maxillary right, mandibular right, and mandibular left arch lengths with significance (p = 0.027, 0.007, 0.003, and 0.047, respectively). Despite the differences between the two groups, digital models might be clinically suitable alternatives for plaster models. Pediatric dentists should carefully assess these differences, as a comprehensive evaluation would result in precise orthodontic treatment planning and favorable outcomes for young patients with mixed dentition.

Ginsenoside Rb1함유 필름의 구강 내 창상 회복 촉진 효과

이정현,박승환,Asiri Naif Mohammed,이명한,권동건,채용권,이고은,김미선,이효설,최성철,남옥형 대한소아치과학회 2022 大韓小兒齒科學會誌 Vol.49 No.3

This study aimed to evaluate the effects of two ginsenoside Rb1 (G-Rb1) loaded films on oral wound healing. Two types of G-Rb1 films, G-Rb1 loaded carboxymethyl cellulose (GCMC) film and G-Rb1 loaded hyaluronic acid (GHA) film, were developed. A total of 36 Sprague-Dawley rats were divided into 3 groups: control, GCMC, and GHA. After wound formation on midpalate, the control group was left without treatment, whereas the experimental groups had films attached. The specimen was analyzed clinically and histologically after 7 and 21 days. For clinical analysis, the area of incompletely re-epithelialized wound was measured. For histological analysis, the distance between the margins of the wound (soft tissue gap) was measured and the percentage of the collagen-stained area on the specimen was calculated. In clinical and soft tissue gap analysis, the GCMC group presented improved healing compared to the GHA group and the control at day 7 (p < 0.05). And, both GCMC (9.74 ± 10.12%) and GHA groups (19.50 ± 14.47%) presented greater collagen-positive pixels compared to control (0.89 ± 1.60%) at day 7 (p < 0.05). However, there were no differences in these parameters among the groups on day 21. Therefore, G-Rb1 loaded films improved oral wound healing. 이 연구의 목적은 Ginsenoside Rb1이 함유된 2가지 원형 필름의 구강 내 창상 치유에 대한 효과를 평가하는 것이다. 총 36마리의 백서를 각각 대조군, GCMC군, GHA군의 세 가지 군으로 나누어 연구를 진행하였다. 실험 동물의 정중구개부에 창상을 형성한 후, 대조군은 개방 창상으로 남겨두고, 실험군에는 각각의 필름을 적용하였다. 시편은 7일차와 21일차에 임상적, 조직학적 분석을 시행하였다. 임상적 분석을 위하여 재상피화가 일어나지 않은 창상의 면적을 계산하였고, 조직학적 분석을 위하여 스캔된 조직 표본 상에서 창상의 변연 사이 거리(Soft tissue gap)와 Collagen이 염색된 면적의 백분율을 측정하였다. 7일 희생군의 임상적 분석과 조직학적 분석 중 창상의 변연 사이 거리 모두에서 GCMC 군이 대조군과 GHA 군에 비해 높은 치유율을 보였다(p < 0.05). 7일 희생군의 GCMC 군과 GHA 군 모두에서 대조군에 비해 콜라겐 합성이 많이 발생하였다(p < 0.05). 하지만, 21일 희생군에서는 각 군간에 임상적 및 조직학적 분석 모두에서 유의미한 차이가 나타나지 않았다. 이 연구를 통해 Ginsenoside Rb1 함유 필름이 구강 내 창상 치유를 향상시킴을 확인하였다.