The Japanese Journal of Pediatric Dentistry
Online ISSN : 2186-5078
Print ISSN : 0583-1199
ISSN-L : 0583-1199
Volume 52, Issue 1
Displaying 1-14 of 14 articles from this issue
REVIEW
  • Ryota NOMURA
    2014Volume 52Issue 1 Pages 1-11
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Streptococcus mutans is a major pathogen of dental caries and also considered to be involved in infective endocarditis (IE). S. mutans strains are serologically classified into four serotypes, c, e, f, and k. Serotype c is the major type found in oral isolates from healthy subjects with a distribution frequency of approximately 70% to 80%, followed by serotype e (approximately 20%), while that for serotypes f and k is lower than 5%. On the other hand, serotype k strains have been identified with high frequency in S. mutans-positive extirpated heart valves specimens from IE patients.An approximately 120-kDa Cnm protein related to the collagen-binding activity of S. mutans was characterized in 2004. In our previous study, we identified several clinical strains of S. mutans, most which were serotype k, that did not possess the cnm gene but exhibited collagen-binding activity. Thus, we speculated that other unknown proteins with collagen-binding properties may exist in these serotype k strains, after which another collagen-binding protein of S. mutans was identified and named Cbm. In related experiments, the binding activity to type I collagen of strains positive for cbm encoding Cbm was significantly greater than that of cnm-positive strains. In addition, S. mutans strains possessing collagen-binding proteins and lacking expression of the cell surface 190-kDa protein antigen (PA) had high properties of adhesion to and invasion of human umbilical vein endothelial cells, which may be associated with virulence for IE.
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ORIGINAL ARTICLE
  • Design and Filling Method
    Michiyo IGARI, Hidetoshi OKADA, Kazuhiro SHIMAMURA
    2014Volume 52Issue 1 Pages 12-25
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    We examined the suitability of various cavity preparations for composite resin restoration of a complex cavity developed on the proximal surface of a deciduous molar. Factors contributing to the selection of composite resins and filling method were also examined Artificial deciduous mandibular second molars made of epoxy resin were prepared, then a cavity was made on the gingival wall with a width of 1 or 2 mm and one of three types of margins (straight, flare, reverse-curve). The resulting six types of dental cavities were filled with one of the following composite resins or a combination of two (combination filling) : SOLARE P (paste-type), UnifilLoFlo Plus (flowable-type), and MI Flow (flowable-type). In combination filling, a flowable resin and paste-type resin were filled into the lower and upper layer, respectively. Compression tests of the margin and junction areas of the cavity were performed using a device that applied a compressive load onto the cusp tip. Testing revealed the following.1.Compressive strength was lower in the margin than the junction area, regardless of cavity preparation design, type of composite resin used, and filling method, suggesting a higher risk of fracture in the margin.2.A reverse-curve margin design with the widest possible gingival wall and without causing pulp exposure is desirable for maintaining adequate thickness of the restoration and the dentin margin. This will consequently prevent fracture in the margin region.3.When the cavity margin opens outward, a thin gingival wall is likely to result with low compressive strength.4.When treating a cavity with an outward-opening margin that has developed over a wide area on the proximal surface, it is beneficial to prepare the cavity with sufficient gingival wall width and use composite resins with high compressive strength to prevent fracture in the margin area.5.Use of a flowable resin for the lower layer and conventional paste-type resin for the upper layer provides an effective filling method that improves clinical efficiency and compressive strength.Together, our results suggest that it is important to prepare an appropriate margin and cavity wall width when filling a complex cavity on the proximal surface of a deciduous molar. Furthermore, a selected combination of composite resins has an effect on the prognosis of a restored tooth.
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  • Haruko KASHIWAMURA
    2014Volume 52Issue 1 Pages 26-37
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    We manufactured a product termed Nano Seal, which consists of nano-sized particles of fluoroaluminosilicate glass dispersed in an aqueous solution as well as a phosphoric acid aqueous solution. The purpose of this study was to examine the acid protective effects of Nano Seal in comparison with APF using human teeth. Quantitative optical induction fluorescence (QLF) and field emission scanning electron microscopy (FE-SEM) were used to examine artificially decalcified and sound human enamel. The following results were obtained.1.FE-SEM observations of artificially decalcified enamel with incipient dental caries revealed decalcification in progress on the partial enamel surface as compared with immediately after application of the acid solution, as well as after 72 hours of decalcification in both the APF gel and APF liquid groups. On the other hand, the enamel surface was largely unchanged between before and after decalcification treatment when treated with Nano Seal.2.FE-SEM observation of decalcification showed that nano particles deposited on sound enamel surfaces by application of Nano Seal tightly covered the enamel within 72 hours.3.QLF evaluations of the acid protective effects of Nano Seal showed significantly greater acid resistance with both artificially decalcified enamel and sound enamel as compared to the control group.4.The acid protective effects of Nano Seal remained stable with repeated applications and decalcification procedures.Our results indicate that Nano Seal is a novel material for effective prevention of dental caries.
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  • Kaneji SHIBAZAKI, Noboru KUBOYAMA
    2014Volume 52Issue 1 Pages 38-46
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    We investigated the effects of antibacterial and nonsteroidal anti-inflammatory drugs [bacampicillin (BAPC), cefaclor (CCL), acetylsalicylic acid (ASA), indomethacin (IDM)] in different diets on pharmacokinetics in young rats with malocclusion. Five-week-old male Wistar rats were divided into groups of 8 and fed a solid (Solid-G) or mud (Mud-G) diet for 10 weeks. All molars in rats receiving Mud-G were extracted to induce malocclusion. BAPC and CCL concentrations in rat plasma after oral administrations of those (20 mg/kg) were measured using a paper disk method. The plasma concentration of the unchanged form was determined serially by HPLC for 12 hours after a single oral dose of ASA (20 mg/kg) and IDM (10 mg/kg). For pharmacokinetic analysis, BAPC, CCL, and ASA in a one-compartment model, and IDM in a two-compartment model were applied to the time course of plasma levels. Values for the following pharmacokinetic parameters were obtained. BAPC : Cmax (6.85 μg/ml) of Mud-G was significantly higher than that of Solid-G (5.34 μg/ml,p<0.01), Tmax of Solid-G and Mud-G was 23.3 and 37.5 minutes, respectively, and AUC of Solid-G and Mud-G was 10.4 and 14.5 μg・hour/ml, respectively. CCL : Cmax (7.17 μg/ml) of Mud-G was significantly higher than that of Solid-G (5.44 μg/ml,p<0.01), Tmax of Solid-G and Mud-G was 44.4 and 51.0 minutes, respectively, and ke of Solid-G and Mud-G was 1.14 and 0.69 hours-1, respectively. The levels of Cmax, Tmax, t1/2, and AUC in the pharmacokinetics of ASA and IDM in Mud-G were higher than that of Solid-G, while ASA and IDM in Mud-G were not significantly different than those of Solid-G. Furthermore, Cmax, Tmax, t1/2, and AUC levels in the pharmacokinetics of BAPC and CCL with Mud-G showed a remarkably significant increase in comparison with Solid-G, while there was no significant difference regarding ASA and IDM observed between Solid-G and Mud-G. These results suggest that a high drug concentration in plasma and slow disappearance resulted in a longer duration with the Mud-G diet.
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  • Minako IWATA, Yuko KOSHIKA, Ayako URANO, Ryo ARAI, Arisa YAMAGASHIRA, ...
    2014Volume 52Issue 1 Pages 47-53
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Japanese society has recently been facing problems associated with a declining birth rate. In that regard, the demands and needs of children and their parents at pediatric dental clinics of dental college hospitals might have changed. We surveyed patient age, chief complaints, district of residence,and presence/absence of referral letter among new patients. In addition, the results of this survey were compared with those of our previous survey carried out from 1996 to 1998. There were 1,816 children who visited the pediatric dental clinic of Tokyo Dental College of Suidobashi Hospital for the first time between January 2010 and December 2012. The following results were obtained ;1.The number of new patients under the age of 16 years in the present survey was significantly higher as compared with that in our previous survey. Children aged 4 and 7 years old accounted for the largest percentage of new patients (10.1% each).2.Consistent with the results of our previous survey, 72.1% of the new patients lived in the special wards of Tokyo.3.The most common chief complaint of the new patients was dental caries (35.8%), followed by an abnormal number of teeth including supernumerary and congenitally missing teeth (11.0%), malocclusion (10.9%), and dental trauma (10.9%). When new patients were classified according to age and chief complaint, those 3 to 4 years old accounted for the largest percentage treated for dental caries among all age groups. Children aged 1 and 2 years old accounted for a large percentage of the new patients with the complaint of dental trauma, while those aged 6 to 11 years old accounted for the largest percentage of patients who visited for malocclusion and abnormal tooth eruption. These results were consistent with those of our previous survey.4.The percentage of patients referred from other clinics was 52.6%, which was 25% higher as compared to that in our previous survey. The most common reason for referral was dental caries. Furthermore, 58.0% of new patients with dental caries had a referral letter, which was also higher as compared with our previous survey.As compared to the results of our previous survey, both the number of new patients and number of referred patients were significantly higher. These results show that pediatric dental clinics of college hospitals in metropolitan areas must deal with not only the various demands and needs of the guardians of children, but also cooperate in community dentistry.
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  • Yuko KOSHIKA, Minako IWATA, Ayako URANO, Ryo ARAI, Arisa YAMAGASHIRA, ...
    2014Volume 52Issue 1 Pages 54-61
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Although several studies have indicated that the prevalence of dental caries has decreased in Japanese children under the age of 3 years in recent years, many children still visit the pediatric dental clinics of college dental hospitals. We investigated the actual condition of dental caries in younger children in order to provide adequate medical information and healthcare to our patients and their parents, as well as local practitioners. We conducted this survey of 117 children aged under 3 years who visited the pediatric dental clinic of Suidobashi Hospital, Tokyo Dental College, for the first time between January 2010 and December 2012. We analyzed the prevalence and severity of dental caries,and obtained the following results.1.Of all surveyed patients, 76.9% lived in the special wards of Tokyo. Furthermore, 85% were aged from 18 months to 3 years of age.2.Of all children with dental caries, 80% had those reaching the dentine and 40% had exposed pulp. Dental caries with exposed pulp was observed in 11.8% of children under 18 months, in 39.4% of those from 18 to 23 months of age, and in 46.9% of those from 2 to 3 years of age.3.Of all children with dental caries, 26.5% had dental decay in more than half of the erupted primary teeth. Patients with a high dmf rate tended to show more severe dental decay.4.Among our patients, 59.0% had a referral letter from other clinics. Furthermore, 77.6% of patients with exposed pulp had a referral letter, whereas 54.4% of children without pulp exposure directly visited our clinic.5.Mother's milk and baby formula given in a feeding bottle were significant risk factors for both high dmf rate and severe dental caries in children who were 18 months of age and older.We found that a high percentage of first-time patients had severe dental caries, thus adequate diagnosis and appropriate treatment for dental caries in younger children remain important.
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  • Shuko MURATA, Hitoyata SHIMOKAWA, Kaori SHOI, Michiyo MIYASHIN
    2014Volume 52Issue 1 Pages 62-68
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    In cases of traumatic tooth avulsion, the existence and the integrity of periodontal ligament (PDL) cells play key roles in success of the replantation. We evaluated the effects of different types of commercially available tooth storage medium on human PDL cells in regard to cell viability, morphology and changes in pH of the medium.In this study, human PDL cells were placed in Teeth Keeper NEO (TN), DentSupply (DS), physiological saline, physiological saline added HEPES, cell culture medium, and cell culture medium added HEPES for 30 minutes and 3, 6, 12, and 24 hours at room temperature. The number of viable cells at those time points was determined using a colorimetric assay of dehydrogenases in the storage medium. The highest level of cell viability was observed in cell culture medium with HEPES, which was used as a positive control. The rapid reduction of cell viability in cell culture medium was rescued by adding HEPES, indicating that the reduction was caused by pH changes during the experiment. Cell morphology findings also showed the least degeneration in the medium. The cell viability and integrity in TN and DS were maintained for up to 6 hours, and then gradually decreased with time. There were no significant differences between TN and DS in regrard to cell viability throughout experimental period, though PDL cells in TN showed less degeneration at 12 and 24 hours in terms of cell morphology.
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CASE REPORT
  • Haruka FUSE, Yukie SHIMADA, Takahiro FUNATSU, Yukiko MUNETA, Taro IRIE ...
    2014Volume 52Issue 1 Pages 69-76
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Among jaw cysts seen in children, the ratio of dentigerous cysts is high and they most commonly occur in the mandibular premolar area. We treated an 11-year-old boy with connected odontogenic cysts located in the left side mandibular premolar area, which caused abnormal localization of the tooth germs of the succedaneous teeth. Panorama X-rays findings showed that the mandibular left side canine and second premolar were impacted, and transmitted images around the tooth crowns. These transmitted images were connected around the root apex of the left side mandibular first deciduous molar, which had undergone root canal treatment. In addition, CT findings showed some non-transmitted images in the area of the cysts. We extirpated the cysts along with extraction of the first premolar under general anesthesia. During surgery we noted that the cysts ranged from the impacted mandibular canine on the left to the mesial root of the first molar and included the root apex of the half erupting first premolar. The first premolar was extracted in an attempt to save its successor. Following that treatment, the canine and second premolar erupted. Treatment of a cyst should be decided after considering various factors such as its shape and position in the jaw bone, and state of impacted teeth.
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  • Shin TAKAGI, Hironobu TAMURA, Takashi YABE
    2014Volume 52Issue 1 Pages 77-82
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    We report a rare case of ameloblastic fibro-odontoma in the right maxilla molar area of a 9-yearold boy. The patient visited a dental clinic for caries treatment. A panoramic X-ray examination revealed a cyst-like image, which had a sharp margin and uneven radio-opacity in the inner part of the right maxilla molar area. In addition, the maxillary second molar was recognized to be impacted. The facial appearance of the patient was symmetrical, while a slightly elevated bone-like hard portion was observed in the area of the right maxilla molar. Surgical removal of the mass and fenestration were performed under general anesthesia on the basis of a clinical diagnosis of an odontoma in the right maxillary molar in August 2011. Histopathological findings of the specimen led to a definitive diagnosis of ameloblastic fibro-odontoma. The impacted tooth was expected to erupt approximately 10 months later and follow-up examinations were continued.
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  • Kazunori KOMINE, Wakiko TERAUCHI, Kazunori TAKAMORI, Shunichi OKA, Tet ...
    2014Volume 52Issue 1 Pages 83-89
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Latex allergy is an immediate-type allergy caused by allergen and Ig-E antibody reactions, and several studies have demonstrated that from 20% to 50% of affected patients show allergic reactions to fruit such as bananas, chestnuts, and avocados. This cross-reaction is known as “latex-fruit syndrome.” We treated a 3-year-old girl with latex-fruit syndrome, who was referred to our department for treatment of dental caries by a general dentist. In addition to asthma and atopic dermatitis, she had allergic reactions to many food items and was diagnosed with latex-fruit syndrome at the age of 2 years 3 months. We were concerned about potential allergic reactions to dental materials and drugs during treatment, and confirmed negative results to several dental materials and drugs by patch skin testing. The patient underwent composite resin restoration under local anesthesia with vital signs monitored by a dental anesthesiologist. No allergic reactions were observed during or after treatment. Medical practitioners will occasionally encounter patients with allergies in daily clinical practice and anaphylactic shock has a risk of death if emergency treatment is inadequate. The present patient was at high risk for anaphylactic shock. Therefore, a patch test for dental materials and dugs was performed before beginning therapy, and vital signs were monitored by a dental anesthesiologist during treatment. It is important for clinicians to diagnose allergies and take precautionary measures against anaphylactic reactions prior to treatment, for both patient safety and to alleviate anxiety in their guardians.
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  • Ryoko HIRATA, Yasutaka KAIHARA, Nami MIYAKE, Kaoru SAKURAI, Chieko MIT ...
    2014Volume 52Issue 1 Pages 90-96
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    Many children with autistic spectrum disorder (ASD) and with or without intellectual disability have weak central coherence and a tendency to learn in a visual manner. Because of individual differences in the developmental status of ASD children, personalized support is optimal. However, there is scant published information about methods for providing individualized support in dental practice for children with ASD. Here, we describe effective strategies for providing individualized support in dental practice for children with ASD treated at our clinic.Case 1 : Boy, aged 2 years 11 months, with high-functioning autism and AD/HD This child was able to read hiragana letters and numerals at the age of 3. Therefore, we showed him information about the clinical procedures (Word schedule) to remove emotional confusion about dental practice. We noted ”reward” in red to give him a clear concept of the finish. The reward was included as a “reinforcer” and we used a drawing of his favorite cartoon character.Case 2 : Boy, aged 6 years 11 months, with autism and intellectual disability Picture cards portraying the events of the dental procedures in sequential order were shown to the child prior to and during therapy, with the picture card for each event removed when that step had been completed and a signboard with a red circle containing words of praise shown to the child. Thus, he received praise visually as well as through verbal encouragement. We also showed the child a timer that counted down the seconds until the procedure would be completed.Using these approaches, we were able to successfully facilitate dental treatments for children with ASD. It is clear that an individualized method, generated by assessing the development and behavior of each child, is advantageous for providing support of children with ASD.
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  • Survey of clinical records for 10 years
    Ryohei KAMOSHITA, Yoshiko YOSHIDA, Masami TAKEMURA, Chiaki ISHIDA, Azu ...
    2014Volume 52Issue 1 Pages 97-102
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    A clinical survey was conducted of patients who visited the clinic of the Department of Pediatric Dentistry at the Dental Hospital of Nihon University School of Dentistry and underwent dental treatment under general anesthesia from January 2003 to December 2012. The results are as follows.1.Survey results were obtained for 199 boys and 103 girls, with an average age of 5 years 4 months.2.Of the 311 cases, 246 were children with systemic diseases or normal children who were noncooperative with dental treatment. Thirty-seven were disabled and 28 were children who had difficulties with repeated visits to the dental hospital.3.The 37 cases were comprised of children with autism (n=20), uncomplicated mental retardation (n =12), Down syndrome (n=1), mental retardation with epilepsy (n=1), mental retardation with cerebral palsy (n=1), 18 p syndrome (n=1), and Williams syndrome (n=1).4.Of all 311 patients, 222 underwent dental treatment on an outpatient basis. The average anesthesia administration time was 2 hours 21 minutes.The average number of restored teeth per case was 10.7. Furthermore, the average number of teeth per patient restored with composite resin was 5.4, while that of teeth that underwent endodontic therapy and extraction were 1.6 and 1.4, respectively.
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  • Namiko KOBAYASHI, Haruko FUJITA, Kyoko KIKUCHI, Masaaki ISHIKAWA
    2014Volume 52Issue 1 Pages 103-109
    Published: February 25, 2014
    Released on J-STAGE: May 30, 2015
    JOURNAL FREE ACCESS
    We presented two cases of gingival fibromatosis, one with hereditary gingival fibromatosis (HGF) and another with idiopathic gingival fibromatosis (IGF). The Case 1 patient was a boy (2 years 10 months old) with gingival hypertrophy. His father and grandmother also had similar conditions in their childhood. An intraoral examination showed that nearly all teeth were covered with enlarged gingiva, while histopathological findings demonstrated thickening of the epithelium. Under the epithelium, cell components were sparse and collagen fibrils were dense, with slight cellular infiltration. Our diagnosis was hereditary gingival fibromatosis. The Case 2 patient was a girl (10 years 0 months old) with gingival enlargement. Her medical history was irrelevant and family history was negative. Gingival hyperplasia was observed over the maxilla and mandible, which covered half to two-thirds of the crown of each tooth. The histological characteristics were nearly the same as in Case 1. Our diagnosis was idiopathic gingival fibromatosis. We performed a gingivectomy several times in both cases as well as periodic oral hygiene consultations because of the recurrence of gingival hyperplasia. With improvement of oral hygiene technique, good results were seen in both cases. Our experience reconfirmed the importance of plaque control for treating gingival fibromatosis.
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