Chloral hydrate is the oldest and most common sedative drug used in moderate sedation for pediatric dental patients. Hence, the purpose of this article is to review the safety and possible adverse events of this drug when used for pediatric dental treatment. A bibliographic search in PubMed, MEDLINE, Cochrane Library and KMbase, KISS, DBpia, KoreaMed, and RISS databases was performed. Using the keywords "dental sedation," "chloral hydrate," and "children or adolescent," 512 scientific articles were found. Subsequently, 183 studies were individually assessed for their suitability for inclusion in this literature review. Altogether, 24 studies were selected. They included 12 cases of death before, during, or after chloral hydrate sedation for dental treatment, majorly due to dosing error and use of multiple sedatives. Additionally, intraoperative adverse events were mostly respiratory problems such as hypoxia and apnea, but most events were temporary. After treatment, prolonged sedation, including excessive sleep and less activity were the most common postoperative adverse events, and even death cases were reported. Despite the wide acceptance of chloral hydrate as a sedative-hypnotic agent, the risk of adverse events and adequate dose should be of great concern when using it for pediatric dental sedation.

The aim of this study was to evaluate the antibacterial effect on Enterococcus Faecalis and physical properties of chitosan added calcium hydroxide canal filling material.<br/>Low, medium, high molecular weights of chitosan powder were mixed with calcium hydroxide canal filling material. Also, for each molecular weight group, 1.0, 2.0, 5.0 wt% of chitosan powder were added. An overnight culture of <i>E. faecalis</i> was adjusted to 1 × 10⁶ CFU/ml. For test of antibacterial effect, three different molecular weights of 2.0 wt% chitosan and three different concentrations of high molecular weight chitosan were mixed with calcium hydroxide canal filling material. The absorbance of plates was analyzed using spectrophotometer at 570 nm with a reference wavelength of 600 nm. Physical properties such as flow, film thickness and radiopacity were examined according to ISO 6876 : 2012.<br/>All molecular weight type of chitosan containing material showed inhibitory effect against E. faecalis growth compared to non-chitosan added calcium hydroxide canal filling material group (<i>p</i> < 0.05). High molecular weight chitosan containing material showed the most antibacterial effect. Also, the antibacterial effect decreased as the incorporated amount of chitosan decreased (<i>p</i> < 0.05). Every molecular weight group of material containing chitosan had a tendency for reduced flow and radiopacity, increased film thickness according to amount of chitosan. Low molecular weight of 1.0 wt% chitosan addition did not show any significant difference of physical properties compared to conventional calcium hydroxide canal filling material.<br/>In conclusion, for reinforcement of antibacterial effect against <i>E. faecalis</i> and for favorable physical properties, 2.0 wt% of chitosan adding is recommended. Considering its antibacterial effect of chitosan, further studies are required for clinical application of chitosan in endodontics and pediatric dentistry.

Therapeutic iodoform (CHI3) is commonly used as a root-filling material for primary teeth; however, the side effects of iodoform-containing materials, including early root resorption, have been reported. To overcome this problem, a water-soluble iodide (NaI)-incorporated root-filling material was developed. Calcium hydroxide, silicone oil, and NaI were incorporated in different weight proportions (30:30:X), and the resulting material was denoted DX (D5~D30), indicating the NaI content. As a control, iodoform instead of NaI was incorporated at a ratio of 30:30:30, and the material was denoted I30. The physicochemical (flow, film thickness, radiopacity, viscosity, water absorption, solubility, and ion releases) and biological (cytotoxicity, TRAP, ARS, and analysis of osteoclastic markers) properties were determined. The amount of iodine, sodium, and calcium ion releases and the pH were higher in D30 than I30, and the highest level of unknown extracted molecules was detected in I30. In the cell viability test, all groups except 100% D30 showed no cytotoxicity. In the 50% nontoxic extract, D30 showed decreased osteoclast formation compared with I30. In summary, NaI-incorporated materials showed adequate physicochemical properties and low osteoclast formation compared to their iodoform-counterpart. Thus, NaI-incorporated materials may be used as a substitute for iodoform-counterparts in root-filling materials after further (pre)clinical investigation.

The aim of this study is to compare the properties of odontoblast gene of early passage cells and late passage cells derived from impacted maxillary supernumerary teeth.Impacted supernumerary teeth with maxilla were extracted from 12 patients (8 males, 4 females) between 6 - 9 years old without medical history. Real-time polymerase chain reaction (PCR) was conducted to compare characterization of odontoblast cell in the 3rd and 10th passage, and between with bone inducing additive group and without additive group. Genes for odontoblasts characteristics are osteonectin (ONT), alkaline phosphatase (ALP), osteocalcin (OCN), dentin matrix protein 1 (DMP-1) and dentin sialophosphoprotein (DSPP). The level of gene expression was in a decreasing order of ONT, ALP, OCN, DMP-1 and DSPP in the 3rd passage, and in decreasing order of ONT, DMP-1, OCN, ALP, and DSPP in the 10th passage in the undifferentiation and differentiation group. The order of ONT, DMP-1, and OCN did not changed. ALP and DMP-1 were switched in order. ALP and DMP-1 may be used as important markers for differentiating between the 3rd passage and 10th passage cells. Considering that supernumerary tooth was extracted young age and the time required to cultured 10th passage was short, supernumerary tooth can be considered a useful donor site of dental pulp stem cells.