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There are many studies and reviews of the relationship between the asthma disease in young individuals on the one hand and caries and dental erosion on the other. The causes of caries and dental erosion might be related to the asthmatic drugs, low pH and the sweeteners that the inhaled drug contains and perhaps even the lifestyle of children and adolescents with asthma. The main focus of this review is therefore to describe various preventive strategies, based on long experience of preventive dental care in Sweden. Two fact boxes are presented, one on fluoride toothpaste as a population-based intervention for different ages and one on diet counselling in children and adolescents with asthma. The most important thing is to introduce fluoride toothpaste early in the child's life and that the parents brush the child's teeth twice a day, in the morning after breakfast and at night before bedtime, up to the age of 10. Moreover, a high-risk approach with an additional fluoride supply at home is presented, together with the application of fluoride varnish at the clinic. Regarding diet counselling, it is important to make sure that the child has regular meals during the day, maximum five to six times a day, to allow the teeth to rest between meals and restrict sweets and soft drinks to once a week. It is important to identify children and adolescents with asthma as early as possible and to refer them to a dental team for preventive treatment.

Background/purpose: The efficient rapid sintering technique has employed to dental zirconia ceramics for shortening the fabrication time of zirconia restorations. The purpose was to compare the optical properties of two generations of rapid sintered translucent zirconia using two dental colorimeters. Materials and methods: Two generations of translucent zirconia ceramics, 3 mol% yttria-tetragonal zirconia polycrystal (3Y-TZP): Copran Zr-i Ultra-T (UT) and Cercon HT (HT), and 5 mol% yttria-tetragonal zirconia polycrystal (5Y-TZP): Cercon xt (XT), of different thicknesses (0.5, 0.8, and 1.2 mm; n = 5) underwent rapid sintering (RS) or conventional sintering (CS). The CIELAB values were measured on the white and black backgrounds, respectively, by digital colorimeters, shadepilot, DeguDent (DD) and Easyshade V, Vita (Vita). Translucency parameter (TP), color difference (ΔE), surface morphology, and surface roughness were evaluated. Results: RS resulted in reduced lightness, except in the XT group. The chromaticity increased slightly after RS. Translucency decreased with increasing material thickness. ΔE values differed between both sintering processes but were clinically acceptable (ΔE

Background/purpose Ceramic restorations have been increasingly applied over recent years. But the performance of cement is still unknown after cementation. This study was aimed to compare the compressive strength and the performances of three different types of composite resin after lithium disilicate inlay cementation. Materials and methods Twenty-four human maxillary premolars were embedded in resin blocks, finished a MOD inlay preparation and scanned with an extraoral scanner. Lithium disilicate ceramic inlays (IPS e.max, Ivoclar Vivadent, Liechtenstein) were fabricated according to the scanner's model. All the specimens were then etched, bonded, and cemented with three different composite resins. Right after 5000 thermal cyclings, the specimens were accepted compressive tests to evaluate the compressive strength and failure types. Moreover, the fracture fragments of the specimens were examined using scanning electron microscopy (SEM) to verify the fracture type. Results Dual-cured resin cement (Rely X Ultimate) showed the highest compressive strength (1002 ± 508 N), followed by the light-cured flowable resin (Z350 XT) (971 ± 209 N) and light-cured bulkfill (Filtek Bulkfill) resin (581 ± 191 N). Type IV (root fracture) failures in the dual-cured resin cement group was 25%, and light-cured flowable resin was 37.5%. But none of type IV fracture was found in the light-cured bulkfill flowable group. Conclusion Dual-cured resin cement demonstrates the highest compressive strength after ceramic inlay cementation. Light-cured bulkfill resin shows the lowest compressive strength, but catastrophic failure is absent in this group.

Background/purpose This study aimed to determine the correlation between the occurrence of three-rooted deciduous mandibular second molars and three-rooted permanent mandibular first molars in children. Materials and methods Orthopantograms (n = 977) obtained from August 2008 to December 2010 were retrospectively screened and examined. Among the 977 orthopantograms, those of 591 participants (314 boys and 277 girls; mean age, 8.7 years) with bilateral deciduous mandibular second molars and permanent mandibular first molars were studied. The gender predilection and prevalence of three-rooted mandibular molars were assessed, and the pattern of concurrence was investigated. Results The prevalence of three roots were 28.4% and 27.6% in the deciduous mandibular second molars and permanent mandibular first molars, respectively. Bilateral occurrence of three-rooted mandibular molars was almost 60% for both deciduous and permanent molars. There was a significantly greater prevalence of three-rooted mandibular molars on the right side of the mandible than that on the left side. Conclusion Deciduous and permanent molars show a similar prevalence of three roots. The presence of three-rooted deciduous mandibular second molar can strongly predict the possibility of three roots in permanent mandibular first molar.

Background/purpose: Asthma is a common, chronic disease that causes respiratory symptoms in children. Dental caries is also a common chronic disease in the pediatric population. Therefore, the aim of the present study was to investigate the correlation between asthma medications and dental caries among children in Taiwan. Materials and methods: The Taiwan National Health Insurance Research Database was used in this retrospective cohort study to analyze the correlation between asthma and dental caries in children. The prevalence and severity of caries were compared between children with and without asthma. The effects of different asthma medications on dental caries were also compared. Results: A total of 4601 children with asthma and 4589 children without asthma were included in this study. The caries prevalence of children without asthma was 85.2%, and that of children with asthma was 90.0%. The prevalence of caries in children with asthma was significantly higher than that in children without asthma (P

Background/Purpose: Mutans streptococci (MS) and lactobacilli (LB) are associated with dental caries, but the acquisition of these organisms in young children with early childhood caries (ECC) and severe early childhood caries (S-ECC) has only been partly described. The purpose of this study was to evaluate the salivary MS and LB levels of preschool children with ECC and S-ECC, and the correlation of MS, LB levels with caries severity. Materials and methods: The study population was comprised of children from 3 to 6 years of age who visited the Pediatric Dental clinic of TCVGH. Oral examinations were performed, and whole unstimulated salivary samples were collected for buffer capacity, MS and LB counts by using commercially available diagnostic kits (CRT bacteria kit). The participants were divided into mild (dmft 9) groups; the salivary microbiological tests and buffer capacity were compared. Results: A total of 72 children with a mean age of 4.5 years participated in this study. The salivary test showed that the higher the salivary MS level the more severe the caries status in children (P = 0.001). There was also a tendency toward a higher salivary LB level in children with more severe caries, but the difference was not significant (P = 0.088). There was no significant correlation between buffer capacity and caries status. Conclusion: The salivary MS level in preschool children was significantly correlated with the severity of early childhood caries. Keywords: Early childhood caries, Severe-early childhood caries, Mutans streptococci, Lactobacilli, Preschool children

The bond strength and durability of highly translucent zirconia ceramics to dentin is still unclear. The purpose of this study was to investigate the effect of various surface treatments on the bond strength of self-adhesive resin cements to high-translucent zirconia crowns and dentin.A high-transparent zirconia and three self-adhesive resin cements (G-CEM LinkAce (GCL), RelyX U200 (RXU) and TotalCem (TTC)) were used. The zirconia surface was sandblasted with 50 μm alumina particles or coated with an SR Link primer, while a dentin primer (Tetric N-Bond Universal, TBU) was applied to the surface of the dentin. By using three self-adhesive resin cements, zirconia samples were bonded to the dentin surfaces of human teeth. The shear strength of the specimens was measured before and after 10,000-cycle thermocycling or 90-day aging.When using GCL to bond with the untreated dentin and various zirconia surfaces, the shear bond strength of the sandblasted (ZThe zirconia surface pretreated by sandblasting and bonding agent, which was sequentially bonded with a primer-treated dentin by using resin cements, can provide excellent shear bond strength and anti-aging performance.

Background: Adverse pregnancy outcomes (APOs) are associated with periodontal disease owing to the induction of a chronic systemic inflammatory response. Hence, knowledge of periodontal status during pregnancy is important in order to reduce the risk of APOs. The aim of this study was to compare the risk of APOs in women with and without periodontal disease to ascertain whether regular scaling performed prior to pregnancy improves the risk of APOs. Method: This case-control study enrolled1,386,887 pregnant women from the National Health Insurance Research Database who gave birth to their first child between 1 January 2004 and 31 December 2014. The study population included mothers who gave birth to low birth weight (LBW) and non-LBW newborns, totaling 86,958 and 1,299,929, respectively. Scaling and periodontal emergency treatment during and before pregnancy were assessed. Univariable and multivariable logistic regression analyses were performed to identify the associations between periodontal treatment and LBW risk. Results: Compared with the comparison cohort, the pregnant women who didnot have periodontal emergency treatment or scaling treatment during pregnancy exhibited a significantly increased risk of LBW than those who had treatment. Women who underwent scaling within the2 years before pregnancy or during pregnancy had a lower risk of delivering a LBW baby (odds ratio (OR), 0.93; 95% confidence interval (CI), 0.91–0.94). In the normal group, the mothers who had periodontal emergency treatment within the2 years before pregnancy or during pregnancy had a higher risk of delivering a LBW baby (OR, 1.05; 95% CI, 1.02–1.08). In those who had scaling treatment, a lower risk of delivering a LBW baby was noted (OR, 0.95; 95% CI, 0.93–0.97). Conclusion: The risk of LBW was significantly increased in women who underwent periodontal treatment, and our findings suggested that periodontal disease is an important risk factor for preterm LBW babies in an East Asian population.

Background/Purpose: Dental caries in primary dentition is a major public health problem in many countries, as well as Taiwan. The service of professional topical fluoride application for children under 5 years of age, performed twice a year by the BNHI in Taiwan through the “Preventive Dental Health Service for Children” plan, began in July 2004. The purpose of this study was to examine the effect and trend of professional topical fluoride application on dental utilization. Materials and methods: The sample subjects were taken from the Normalized Million People File of 2010 in the National Health Insurance Research Database from 2000 to 2012, for the purpose of analyzing the status of the professional topical fluoride program. The main analysis included utilization of professional topical fluoride application, utilization of restorative treatment and utilization of endodontic therapy in children 1-to-5-years of age. The Cochran–Armitage trend test was used for statistical analysis. Results: Professional topical fluoride utilization increased year upon year, particularly after 2012 (P

Ti-24Nb-4Zr-8Sn (Ti2448), a new β-type Ti alloy, consists of nontoxic elements and exhibits a low uniaxial tensile elastic modulus of approximately 45 GPa for biomedical implant applications. Nevertheless, the bio-corrosion resistance and biocompatibility of Ti2448 alloys must be improved for long-term clinical use. In this study, a rapid electrochemical anodization treatment was used on Ti2448 alloys to enhance the bio-corrosion resistance and bone cell responses by altering the surface characteristics. The proposed anodization process produces a unique hybrid oxide layer (thickness 50–120 nm) comprising a mesoporous outer section and a dense inner section. Experiment results show that the dense inner section enhances the bio-corrosion resistance. Moreover, the mesoporous surface topography, which is on a similar scale as various biological species, improves the wettability, protein adsorption, focal adhesion complex formation and bone cell differentiation. Outside-in signals can be triggered through the interaction of integrins with the mesoporous topography to form the focal adhesion complex and to further induce osteogenic differentiation pathway. These results demonstrate that the proposed electrochemical anodization process for Ti2448 alloys with a low uniaxial tensile elastic modulus has the potential for biomedical implant applications.

V-free Ti alloys are viewed as a promising alternative to biomedical Ti–Al–V alloys in bone implant applications. However, the biological response to these alloys depends heavily on the surface characteristics of the implant as well as on the choice of material. This study treated Ti–6Al–7Nb alloys with electrochemical anodization in an alkaline solution for the creation of a thin nanoporous layer (

This is a case report of multiple supernumerary teeth of identical twins with 5 years of follow-up. The occurrence of supernumerary teeth in twins is an unusual event. This case report describes 7-year-old Taiwanese twin brothers who both presented with multiple supernumerary teeth in the premaxillary and mandibular premolar regions. The supernumerary premolars developed much later than the premaxillary supernumerary teeth in these twins. The supernumerary premolars caused impaction of the mandibular first premolars. Cases with multiple supernumerary teeth in twins are unusual, especially of supernumerary teeth affecting both the premaxilla and mandible. Such cases imply that heredity plays a role in the occurrence of supernumerary teeth.

This study investigated the effect of nitriding surface treatment on the corrosion resistance of commercial dental alloy, in the form of helical nickel–titanium (Ni–Ti) files, when treated with 5.25% sodium hypochlorite (NaOCl) solution. The surface of dental helical Ni–Ti files was modified using nitriding treatment at 200 °C, 250 °C and 300 °C in an NH 3 -containing environment. The surface morphology and chemical composition of the Ni–Ti files were analyzed using scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS), respectively. The corrosion resistance of the Ni–Ti files when treated with a clinical solution of 5.25% NaOCl was evaluated using the linear polarization method and by potentiodynamic polarization curve measurement. The nitriding treatments at different temperatures created titanium nitride (TiN) on the surface of the helical Ni–Ti files. The Ni–Ti files nitrided at 200 °C and 250 °C showed higher polarization resistance and higher passive film breakdown potential together with a lower passive current than untreated files. The presence of TiN on dental Ni–Ti files significantly increased the corrosion resistance of the files in the presence of 5.25% NaOCl solution.

To evaluate the clinical efficiency and patient acceptance during cavity preparation in children, a direct comparison was made between Er:YAG laser preparation and conventional mechanical preparation of caries using a split-mouth design.The Er:YAG laser system was developed for cutting dental hard tissue and has been approved as a useful alternative method for cavity preparation.Children with previously unrestored and matched carious cavities in non-pulpally involved anterior teeth were selected, and the sequential order of treatment was randomized. In total, 40 children from 4 to 12 years old took part in the study. Two teeth each in the 40 patients were prepared without anesthesia and restored with a light-cured compomer following application of a bonding agent. The time spent on cavity preparation and the behavior of the patients during cavity preparation were recorded; finally, a modified face scale was used for pain assessment. In addition, the children were asked to indicate whether they found the laser or the mechanical approach more uncomfortable, and their preferred treatment when undergoing future caries therapy.The analysis of pain indicated that 82.5% of children felt no pain at all with the laser preparation, and they also showed much more body and head movement with the conventional mechanical preparation. Although the Er:YAG laser took about 2.35 times longer to prepare the same type of cavity, 92% of the children said that they would prefer laser preparation for further caries therapy.Cavity preparation with the Er:YAG laser would seem to be an option for fearful children, since it produces less pain and has acceptable efficiency compared to the conventional mechanical preparation.

The purpose of this study was to compare the effects of Nd:YAG laser pulpotomy to formocresol pulpotomy on human primary teeth. Patients with a primary tooth that required pulpotomy because of pulpal exposure to caries, were selected for this study. After removal of coronal pulpal tissue, Nd:YAG laser at 2 W, 20 Hz, 100 mJ or a 1:5 dilution of formocresol was introduced into the canal orifice for complete hemostasis. IRM paste was then placed over the pulp stump, and the tooth was restored either with composite resin or stainless steel crown. Sixty-eight teeth were treated with Nd:YAG laser and followed up for 6 to 64 months. Clinical success was achieved in 66 out of the 68 teeth (97 %), and 94.1 % were radiographically successful. In the control group, 69 primary molars were treated with formocresol and followed up for 9 to 66 months; 85.5 and 78.3% achieved clinical and radiographic success, respectively. The success rate of Nd:YAG laser pulpotomy was significantly higher than that of formocresol pulpotomy. The permanent successors of the laser-treated teeth erupted without any complications.

The purpose of this study was to determine the prevalence of 3-rooted primary mandibular second molar teeth in Chinese patients via vertical bitewing radiography.Vertical bitewing radiographs of 227 patients previously obtained from the Department of Pediatric Dentistry, Taichung Veterans General Hospital, Taichung City, Taiwan, from June 2004 to July 2007 were retrospectively screened and examined. Images of 185 patients (92 boys and 93 girls; mean age=5.6 [range=2.5-11.9] years old) with bilateral primary mandibular second molars were studied. The gender, symmetry, and frequencies of occurrence of 3-rooted primary mandibular second molars were compared.Eighteen (9%) 3-rooted primary mandibular second molars were found in the 185 patients, with a bilateral incidence of a symmetrical distribution of 28% (5/18). The prevalence of 3-rooted primary second molars did not differ significantly between the mandible's right and left sides (P.41), or with gender (P.31).The data presented here indicate that approximately one tenth of Chinese individuals have a 3-rooted primary mandibular second molar and that this condition is bilaterally symmetric in approximately one third of such individuals in a Taiwan hospital.

Summary Objectives : The purpose of this study was to identify the optimal laser energy range of Er:YAG laser irradiation for laser-induced caries prevention (LICP). Methods : Twenty-one human non-carious molars were selected. The teeth were covered with nail varnish, except two 4 mm×1 mm windows on both the buccal and lingual surfaces. The windows were randomly assigned to groups A, B, C and D, receiving no irradiation, 100, 200 and 300 mJ irradiation, respectively. The pulse width 10 pps (pulse per second) with a 1.0 mm spot size was used. After the laser treatment, each tooth was cut into two halves longitudinally. Then a two-day pH-cycling was performed, with an 18-hour demineralization followed by a 6-hour remineralization. Sections of 120±20 μm in thickness were obtained from each window. Lesion depth was measured using polarized light microscope coupled with an image analysis software. One-way ANOVA and post-hoc Tukey tests were used for evaluation of treatment effects. Results : The laser treatments of 100 and 200 mJ have demonstrated significant protection of enamel demineralization ( p =0.01 and 0.001, respectively), but not the treatment with 300 mJ ( p =0.106). A smaller lesion depth was observed for the 200 mJ group (97.1 μm) than that of the 100 mJ group (105.6 μm). Compared with the control, a lesion reduction of 32.78 and 26.93% for the 200 mJ group and the 100 mJ group were obtained, respectively. Conclusion : Caries prevention may be achieved by using Er:YAG laser treatment if the optimal range of laser parameters for LICP can be employed.

Background/purpose Midline diastema in mixed dentition is a concern for both parents and children; therefore, determining the timing of closure of developmental diastema is essential for clinical practice. Data on midline diastema in Taiwanese children are scant. The purpose of this study was to investigate the prevalence of maxillary midline diastema in different age groups of children in Taiwan and to determine the time of closure of the developmental diastema. Materials and methods The sample population comprised elementary school children in Taichung City, Taiwan, whose ages were between 6 and 12 years. We screened a total of 1136 children and selected 917 for this study. Inclusion criteria were the presence of both permanent maxillary central incisors and absence of obvious dental or dentofacial abnormalities. Children who had a history of orthodontic treatment or crown restoration of anterior teeth were excluded. Diastema widths were measured clinically with a Boley gauge. Results The prevalence of diastema was 64.6% among 6-year-old children but only 14.3% among the 12-year-olds. The prevalence of diastema was higher in boys than girls after the age of 9. There were statistically significant differences between boys and girls in the prevalence of diastema at ages 9 and 12. The mean size of diastema was 1.9 mm for 6-year-olds and 1.21 mm for 12-year-old children, indicating a significant reduction of diastema size with age. Before the eruption of lateral incisors, the prevalence of midline diastema was 60.4% among all children, and it declined to 14.5% after the eruption of canines. Conclusion The prevalence of midline diastema decreased with age. It also declined with lateral incisor and canine eruption; it was 14.5 % after canine eruption. Therefore the orthodontic intervention of diastema should be delayed until canine eruption.