ISSN : 0376-4672
The purpose of this study was to examine dental care utilization and expenditures among children aged 0 to 19 years using Korea Health Panel Survey (KHPS) data in 2008 - 2013. Weighted estimates were nationally representative and statistical significances were analysed by 2 test or adjusted Wald test using STATA 13 software. While dental care utilization increased steadily among children from 2008 through 2013, less than one-third the children received dental care in 2013. Compared with 2008, the proportion of restorative care, oral surgery, preventive care decreased and the proportion of orthodontic care, prosthetic care increased. While the proportion of amalgam markedly decreased, the proportion of resin increased. This study highlight socioeconomic disparities in dental utilization and expenditures among children. Especially the findings provide a baseline assessment for examining trends on dental care for children in the future.
The Generalized Estimating Equations (GEE) approach is a widely used statistical method for analyzing longitudinal data and clustered data in clinical studies. In dentistry, due to multiple outcomes obtained from one patient, the outcomes produced from an individual patient are correlated with one another. This study focused on the basic ideas of GEE and introduced the types of covariance matrix and working correlation matrix. The quasi-likelihood information criterion (QIC) and quasi-likelihood information criterion approximation (QICu) were used to select the best working correlation matrix and the best fitting model for the correlated outcomes. The purpose of this study is to show a detailed process for the GEE analysis using SPSS software along with an orthodontic miniscrew example, and to help understand how to use GEE analysis in dental research.
Background/Purpose: The purpose of this study was to evaluate the effect of Nd:YAG irradiation on adherence of retrograde filling materials (mineral trioxide aggregate [MTA] and Super-EBA) by micro-computed tomography (CT) measurement and to observe the dentinal surface after irradiation by scanning electron microscopy (SEM). Materials and methods: Forty retrofilling models using extracted human teeth were divided into four groups according to the material and method used: ProRoot MTA (MTA group), Super-EBA (EBA group), MTA with Nd:YAG laser irradiation (LMTA group), and Super-EBA with Nd:YAG laser irradiation (LEBA group). All specimens were stored in 100% humidity for 24 hours until micro-CT was performed. The gap volume of the tooth/material interface was measured using the CTAn program. In six samples, the laser-irradiated dentin surface was observed using SEM. Results: The mean percent difference in gap volume was not statistically significant between the Nd:YAG laser-irradiated groups and non-irradiated in both materials(P > 0.05). The gap volume in the MTA group was significantly lower than that in the EBA group (P < 0.05). Examination of the non-irradiated specimens by SEM showed patent dentinal tubules. In contrast, alterations in the texture of the dentin surface and obliteration of the dentinal tubules were evident in the Nd:YAG laser-irradiated specimens. Conclusion: In this study, changes in the dentinal surface after Nd:YAG irradiation did not affect adherence between the apical filling material and the dentin wall.
Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.
The comparison of the repeated measurements is often needed to see whether they agree sufficiently, when a measurement is repeated under identical conditions by different raters. Such investigations are often analyzed inappropriately, by using correlation coefficient. The purpose of this study is to introduce statistical methods for accessing the agreement of the repeated measurements, which include Bland-Altman plot, intra class correlation, Passing-Bablok regression and Cohen’s kappa coefficient, and to show how to execute them using examples.
Objectives: Periodontitis is multifactorial disease mainly caused by microbial community. Recently, some research has been conducted to find other possible risk factors including stress hormones related to periodontitis. Psychological stress can affect the periodontal health by a variety of biological mechanisms. This study compared the stress hormone levels in healthy subjects and patients with periodontal disease using saliva in order to investigate the association between periodontitis and stress. Methods: The human saliva was collected from 38 periodontally healthy individuals and 34 patients with chronic periodontitis under Institutional Review Board. Their age was 20-60 years (40.3 10.45). From these samples, determination of salivary levels of cortisol and Dehydroepiandrosterone (DHEA) performed by enzyme immunoassay kit (Salimetrics Europe, Suffolk, UK). The independent t-test and Mann-Whitney test for trend was applied using IBM SPSS statistics version 12.0 Program to analyze statistically significant differences. Results: Salivary cortisol levels of periodontitis patients were higher than those levels of healthy subjects (P < 0.001), while salivary DHEA levels of periodontitis patients were not significantly different (P = 0.431). Salivary cortisol/DHEA ratio of periodontitis patients was higher than those levels of healthy subjects (P < 0.001). Conclusions: Our study demonstrates the high levels of cortisol concentrations and cortisol/DHEA ratio in saliva of periodontitis patients than those of healthy subjects. Since cortisol levels and cortisol/DHEA ratio can be significant factors related to the severity of periodontal disease, our study would be helpful for early diagnosis and treatment of periodontal disease.
Psychological and cognitive development in child and adolescent periods is key knowledge for understanding children and adolescents’ behavior and inducing their actions. So far, psychoanalytic approaches have been primarily researched by Freud’s analytical tools and Piaget’s analysis on cognitive developments have been mainly employed to explore children and adolescents’ psychological developments. In addition, other various theories have been suggested in order to explain children and adolescents’ psychological developments. However, in reality, it is difficult to integrate diverse theoretical lens to investigate children and adolescents’ psychological developments. Considering this constraint, in clinical dentistry, the conventional theoretical instruments have been still widely employed to guide children and adolescents’ behavior.
Attitudes of parents toward behavior guidance techniques used in pediatric dentistry have changed for decades. Some techniques were regarded acceptable with authority of dentists’ assistance, but now face the objection of caregivers. For the way of breeding is changing, dentist should understand the situation and try to communicate with caregiver for eliminating misunderstanding of the procedures that could induce lawsuit for abusive techniques. Most of all, dentist should try to find the best method for the patient and help to overcome the fear and anxiety. The meaningful knowledge driven from clinical experience should be shared with other dentists to build up sound theoretical foundation.
Managing uncooperative behaviors related to dental treatment is necessary for guiding children and adolescence to more favorable behaviors. The first approach should be controlling their behaviors using non-phamarcologic behavior management techniques. However, if this approach fails, it is helpful to control negative behaviors pharmacologically. Accordingly, sedation is frequently used to relieve anxiety related to dental treatment. Also, general anesthesia has been applied to the situations in which sedation is either ineffective or impossible to gain cooperation during treatment. This article discusses the pharmacology of widely used sedatives for children and adolescence and clinical considerations of managing uncooperative children and adolescence with the use of sedation. Furthermore, we recommend clinical indication of selecting general anesthesia rather sedation for the purpose of behavior management.
