This study was performed to examine the susceptibility to dental diseases among persons with severe motor and intellectual disabilities under tube-fed. The subjects included 17 patients being tubefed (tube group, the mean period of the tube-fed: 4.3±4.3 years, the mean age: 13.2±6.4 years)and 24 patients receiving normal diet (non-tube group, the mean age: 18.6±4.8 years). A survey of the incidence of dental diseases was conducted, and oral hygiene, the number of caries teeth and severity of gingivitis were compared between the two groups.
1. The mean caries incidence in the tube group was 0.1±0.1 teeth/year, which was significantly smaller than that in the non-tube group, which was 0.6±0.7 teeth/year.
2. When plaque deposition was estimated using PII, the tube group showed significantly lower PIT.
3. When calculus deposition was examined, about 60% of the subjects exhibited calculus deposition on the buccal and lingual surfaces in both groups, but more than half of the subjects in the tube group exhibited calculus deposition on the occlusal surfaces.
4. When the severity of gingivitis was compared using GI, many of the subjects showed mild gingivitis in both groups.
5. This survey indicated that patients being tube-fed many run small risk of incurring dental caries, but are highly susceptible to periodontal diseases.

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The purpose of this study was to observe the clinical efficacy of the chemo-mechanical caries removal gel Carisolv^TM (MEDI-TEAM) on primary teeth and to investigate the influence of Carisolv^TM on the hardness of the dentin after caries removal.
Clinical observation was carried out on 11 primary teeth of 6 children aged from 6 years 2 months to 9 years 10 months (average: 7 years 8 months) using Carisolv^TM to remove caries.
The Knoop hardness of the dentin after caries removal was also measured on 5 extracted primary canines which had decay in dentin. The teeth were longitudinally sectioned at the center portion of the cavity. For one side of the sectioned specimens, caries was removed using CarisolvTM and originaly developed hand instruments (Carisolv Group) and for the other side of the sectioned specimens, caries was removed using a round bur fixed with a high speed handpiece (Bur Group). The Knoop indentor using a load of 10 g for 15 seconds was used to measure the indentations. The hardness was determined every 50μm from the caries removed surface to 300 μm depth toward pulp chamber wall at the center of the cavity,200μm incisalward and 200μm cervicalward from the center of the cavity. All of the data were statistically analyzed using a one way ANOVA with subsequent Tukey-Kramer multiple comparison tests at p<0.05. The results obtained were as follows. (Clinical observation):
1) None of the patients complained to pain during caries removal byCarisolvTM.
2) For 9 teeth out of 11, a bur fixed with a handpiece or an air turbine was required for cavity preparation or caries removal.
3) For 5 teeth out of 11, local anesthesia was required for use of an air turbine (4 teeth) or rubber dam (3 teeth).
4) For 7 teeth out of 11, slight redness and swelling of the gingiva was observed after treatment by CarisolvTM.
5) For 7 teeth out of 11, the caries was not sufficiently removed by CarisolvrTM. (Microhardness test):
1) In the comparison of the Knoop hardness between the Carisolv Group and Bur Group, there was no significant difference at the all measuring depths.
Carisolv^TM might be effective for the child patients who are adverse to the sound and the vibration of an air turbine and a handpiece.

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A 5 year,5 month old girl who complained of gingival enlargement was referred to the Department of Pediatric Dentistry, Nihon Univ. Sch. of Dent. at Mastudo. The father of the patient had been treated for a similar condition in his youth, and had been observed in the family of the father the same disease.
A diagnosis was made of Hereditary gingival fibromatosis (HGF) which was based on family, medical history and histopathological evaluation.
This article is a dental and immunohistochemical study of the HGF patient. Dental studies investigated dental and panoramic X-rays, cepharometric analysis and the size of the primary dental arch, while histopathological studies were performed on the immunolocalization of the cell proliferate maker (PCNA) and the protease makers of the extracellular matrix (MMP-1) in HGF and normal gingiva using monoclonal antibodies. As for the dental studies, she was obtained about the same normal children.
The HGF patient was observed that PCNA positive cells increased rather more than the normal gingival epithermal and connective tissue (p<0.01 ANOVA).
However, MMP-1 positive cells were low immunoreactivities compared with normal connective tissue (p<0.01 ANOVA).
These results suggested that HGF revealed imbalance in the high epidermal cell proliferation and low pretense activity for ECM occurrence with respect to gingival tissue overgrowth.

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The purpuse of the present study was to analyze the maxillo-facial complex of the children in the prone sleeping position in infancy (PP).
The materials consisted of cephalograms of the decidous dentition obtained from 14 Japanese children (7 boys and 7 girls).
Dimensional and angular analysis were performed.
The results were also compared with the latest cephalometric standards of Japanese children.
The findings were summarized as follows:
1. S-N and N-Me in PP were larger than those in the latest standard cephalometric standards of Japanese children.
2. Y-axis in PP tended to be larger than those in the latest standard cephalometric standards of Japanese children.
3. Facial angle in PP was smaller than those in the latest standard cephalometric standards of Japanese children.
In conclusion, the maxillo-facial complex of PP tend to show a long anterior cranial base, a long facial height, and backward shifting of the mandible.

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In the present study, sexual differences in deciduous tooth crown diameters were investigated in Japanese children. Plaster casts of the deciduous dentitions obtained from 50 boys and 50 girls were examined. Mesiodistal and buccolingual crown diameters were measured using a digital caliper (0.01mm) according to the method of Sugiyama & Kurosu (1964). These measurements were performed three times by one of the present authors, and intra-observer measurement errors were calculated by the single determination method. The crown index [(buccolingual crown diameter/mesiodistal crown diameter)×100] was calculated in order to provide a comparison of crown proportions. Percentage sexual differences were calculated for each measurement and index.
Intra-observer measurement errors were very small (<0.1 mm) and are unlikely to have influenced the statistical analysis. The mean values for all of the crown diameters examined were larger in boys than in girls, and percentage sexual differences ranged from approximately 1 to 3%. In the maxillary deciduous teeth, the buccolingual crown diameters had larger percentage sexual differences than did the mesiodistal crown diameters. In contrast, in the mandibular deciduous teeth, the mesiodistal crown diameters had larger percentage sexual differences than the buccolingual crown diameters. Buccolingual crown diameters varied more than the mesiodistal crown diameters. Crown indices showed less sexual differences, with the exception of the mandibular deciduous canine.

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The purpose of this study was to investigate the concentration of fluoride in various kinds of tea and the conditions of infusing. The samples of tea-leaves used were each of the regular and highgrade green teas made in Uji and Shizuoka prefecture, regular and high-grade roasted tea made in Shizuoka prefecture, oolong tea made in China and black tea made in Sri Lanka. We used green tea produced in 1996 as an old tea and that produced in 1997 as a new one. The temperature of the tea infusion was at 50°C,60°C,70°C,80°C and 90°C, and tea was infused for 30 sec,1 min,2 min,5min and 10 min. The highest concentration of fluoride was found in black tea, followed by roasted tea, green tea and oolong tea at any temperature for any length of time infused. Whereas, roasted tea had the highest concentration of fluoride, followed by oolong tea, green tea and black tea when teas were exuded overnight with water at room temperature. The fluoride concentration of the low-grade green tea was higher than that of high-grade green tea. We suggest that low-grade green tea-leaves contain a high concentration of fluoride. In conclusion, we suggest that the fluoride concentration of tea infusion depends on the fluoride concentration of the local soil and on the production method. We confirmed that the fluoride concentration of the regular green tea is higher than that of the high-grade one.

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The three-dimensional changes of the dental arch form and occlusion were investigated during the treatment of children with the anterior crossbite in the primary dentition period. Four kinds of the appliances, the chin cup, the activator, the lingual arch and the maxillary protracting bow appliance, were used for the occlusal guidance at the Pediatric Dental Clinic of Kyusyu University Dental Hospital. To compare the treatmemt effects of these four appliances, the arch forms of the mandibular dentition, the horizontally projected areas surrounded by the maxillary and the mandibular dental arches, as well as the horizontal relationship of occlusion, were three-dimensionally analyzed using the plaster models before and after the occlusal guidance.
The results were as follows:
1) The treatment of the anterior crossbite during the primary dentition period caused obvious changes in the forms of the mandibular dental arches in all groups.
2) The horizontally projected areas of the maxillary dental arches increased after treatment in the chin cup, the activator and the lingual arch groups, and decreased in the maxillary protracting bow appliance group. In cotrast, those of the mandibular dental arches decreased in all groups.
3) The lingual arch group showed the largest positional change of the anterior part of the maxillary and the mandibular dental arches. The maxillary protracting bow appliance group also showed the largest positional change of the posterior part of both dental arches.

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Study models of 20 cases of crowding of the upper incisors in the mixed dentition period before treatment were used as materials. Space analyses were conducted to predict the possibility of proper alignment of the upper arch of the early permanent dentition quantitatively, and the relationship between the space analysis and the result of the upper arch alignment after treatment was considered. Ono's simple regression analysis was used to calculate the required arch length, and two methods were adopted to measure the available arch length after assuming the easement of the crowding of the upper incisors. One was the conventional segment method in which both the linear incisor and buccal arch lengths were added up, while the other was the preformed wire method that is proposed in this paper.
The results were as follows;
1. Differences between the estimated values of the required arch lengths and their measured values in the permanent dentition were so small that they were sufficient to be within the clinical tolerance level.
2. Even in the cases in which proper alignment of the upper arch in the early permanent dentition was acquired, there were many cases in which the segment method had shown the negative results of 2,3 mm at one side.
3. It seemed that the analyses of the preformed wire method reflected roughly the results of the upper arch alignment in the early permanent dentition.
4. In cases in which morphological distortions of the upper arch were relatively slight, the differences between the two methods of calculating the available space were small. On the other hand, in cases in which the morphologies of the upper arch were V-shaped, the differences between the two methods tended to become larger.
5. It seems that applying the results of the segment method into practice directly should be restricted and the preformed wire method, leaving a little room for improvement, was applicable to the space analysis of upper incisor crowding cases.

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The purpose of this study was to find the shortest application period of Ca(OH)₂ for dentin bridge formation after vital pulpotomy. It also aimed at evaluating the pulpal changes and dentin bridge formation after removal of Ca(OH)₂ and necrotic tissue following vital pulpotomy. Rat molars were used and the period of application of Ca(OH)₂ was for a one, seven, fourteen, or forty two days. The experiment lasted 42 days. Histopathological changes of the pulp and dentin bridge formation were observed. Statistical analysis was done using Fisher's exact probability method.
The results were as follows after the 42 day period of the experiment.
1) A dentin bridge was formed in teeth for which the duration of application period of Ca(OH)₂ was one or seven days. The probability of dentin bridge formation was lower however, in teeth for which the duration of the application period was fourteen days. The dentin bridge formation was evident in teeth with fourteen days of application of Ca(OH)₂.
2) Necrotic tissue was observed again at forty two days, even if the Ca(OH)₂ and necrotic tissue were removed at one, seven or fourteen days during which the dentin bridge formation was not yet observable.
These findings suggest that the dentin bridge formation is best shown with a 14-day application period of Ca(OH)₂, but removal of Ca(OH)₂ and necrotic tissues at this time shows reformation of necrotic tissue. It is therefore suggested that clinical removal of Ca(OH)₂ and necrotic tissues be done later when the dentin bridge formation is completed.

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It has been reported that a patient's uncasiness and apprchension increase during dental treatment from a recollection of pain and disconfort when the senses of seeing and hearing are stimulated. The present study was therefore undertaken to determine the effect of blocking of stimulation on emotional changes. The subjects were 7 students from the dental department of our university who understood the project and showed a willingness to participate. Their internal behavier fluctuations (PL; plethy-smograme of the car lobe) at the time of infiltration anesthesia and sham cutting were analyzed. They were also given a questionnaire.
The following four techniques were employed. To block the visual and auditory sensations, some were given music to listen to over earphones (hearing only), others watched enjoyable videos employing virtual vision (seeing only), others watched enjoyable videos with sound, chosen by us or by themselves, employing virtual vision (hearing and seeing). There was also a control which employed none of these techniques.
A summary of the results follows.
1) Obsevation of internal behavior revealed that the PL change rate at the time of infiltration anesthesia and sham cutting was highest in the control. There was a tendency for the PL rate to be lower in the groups which used their senses of hearing and seeing together than those who used one or the other sense separately.
2) Observation on the scores of the questionaires indicating the degree of pain and discomfort at the time of infiltration anesthesia and sham cutting revealed a tendency towards lower scores for those who used their senses of hearing and seeing together than for those who used one or the other separately.
The conclusion from the above findings is that recollection of pain and discomfort through the senses of hearing and seeing can effect the degree of the actual pain pain and discomfort during dental treatment, but that these adverse emotional feelings can be decreased by blocking the stimulation of the visual and auditory sensations.

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Temporomandibular disorders (TMD) have been increasing year by year. In pediatric dentistry, examination of TMD is becoming common. In this study, the maximum amount of mouth opening was examined for 2,852 children (male: 1,300, female: 1,552), from 2 to 18 years of age.
We compared the relationship between the maximum mouth opening with age, height and weight.
The results were as follows;
1. The maximum amount of mouth opening increased with age, and the values were greater in males than in females. It did not increase after 15 years of age in females.
2. The maximum amount of mouth opening increased with height and weight, and except for certain heights and weights, the values were greater in males than in females.
3. Based on age, height and weight, the difference according to sex was more outstanding at the start of puberty in the male.
4. Height showed the highest correlation among age, height and weight.

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To clarify the characteristic of the sideshift of the child at the lateral gliding movement 20 child groups (10 males and 10 females) and 20 adult groups (10 males and 10 females)were used as testees.
Their sideshifts were measured with a measuring assembly for lower jaw movement with six degrees of freedom. The element was obtained and the following conclusions were obtained since the comparison was made separately for the element which moved to purely lateral and the element which moved while rotating with the examinations were performed.
As for the amount of the total sideshift of the significant difference was not found between males and females. The value was 1.82±0.88 mm in the child group and 1.29±0.90 mm in the adult group. The child group clearly indicated a larger value compared with the adult growp.
The rotational transfer element was 0.32±0.07 mm in the child group and 53±0.15 mm in the adult group. The adult group clearly indicated a larger value compared with the child group.
The purely lateral movement element was 150±0.90 mm in the child group and 0.76±0.85 mm in the adult group. The child group clearly indicated a larger value compared with the adult group.
The ratio of the rotational component was 17.8% in the child group and 42.3% in an adult group. In the child groups there were ferer tendencies compared with the adult group.

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Nitric oxide (NO) has been implicated as a biological mediator in a number of organs. We found that cultured human periodontal ligament (hPDL) cells spontaneously produce NO in a serum-free condition. This NO production was not affected by culturing the cells with interleukin-1β(IL-1β). The amount of NO production in the hPDL cells (1.0×10⁶ cells/well) was 0.28±0.23 nmol/12 h when the cells were cultured with a serum-free medium and was 0.41±0.22 nmol/12 h with a medium containing 20 ng/ml IL-1β. In contrast, NO production in the mechanically stimulated hPDL cells(4.0×10⁵ cells/well)was 9.22±1.37nmol/12h in αMEM containing 10% fetal calf serum. The value was significantly higher (p<0.001) than the control value (1.04±0.22nmol/12h) obtained from unstimulated cells. The NO production was dependent on both magnitude of the tension force and frequency of the stretching cycle.
These results indicate that hPDL cells produce NO independently of IL-1β and that the NO production was enhanced by mechanical stimuli.

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To investigate the effectiveness and safety of clinical application of the Er: YAG laser used for cavity preparation in pediatric dentistry, the effects of heat on the dental hard tissue and pulp were examined. Human immature permanent premolars with incomplete apices that had been extracted for orthodontic treatment were chosen for the experiment. After the occlusal surface of the specimen was reduced to expose the dentin so that the thickness of the dentin was either 1.0 or 1.5 mm, the specimens were irradiated at 50,100 or 150 mJ/pulse, and 10 pps while spraying with water. For laser irradiation, the contact tip of 0.6 mm in diameter was held in contact with the specimen. The irradiation time was either 2,5, or 10 s, and 5 specimens were irradiated for each irradiation condition and each dentin thickness (total 90 specimens). Changes in the temperature were measured using an alumelchromel thermocouple, and the mean value and standard deviation were determined for each of the 5specimens. The influences of the irradiation time and the dentin thickness were examined by comparing changes in the temperature for each irradiation condition.
1. The rise in temperature rise resulting from irradiation increased in accordance with the energy of the radiation, the period of irradiation, and the thickness of the dentin.
2. The temperature of the pulpal dentin rose due to laser irradiation, but with sufficient water spray, the average rise in temperature was maintained under 5 degrees under all irradiation conditions, indicating the absence of adverse effects on the pulp.
3. When irradiation was performed at 150 mJ/pulse with an exposure time of 5 s or 10 s, some individuals showed more than 5 degrees of maximal increases in temperature, suggesting possible adverse effects on the pulp in some individuals.

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The purpose of this series of studies was to examine the effectiveness and safety of application of the Er: YAG laser to cavity preparation in pediatric dentistry. Following the first report, we examined the effects of laser irradiation on the dental hard tissue and pulp by performing two experiments using young rats. In Experiment 1, the irradiated surface was observed using scanning electron microscopy to evaluate different irradiation conditions. The upper incisors in the developmental stage with incomplete apices of male wistar rats weighing 30-50 g of 3 weeks of age were used for the experiment. Laser irradiation was performed at 50,100 or 150 mJ/pulse, and 5 rats were used for each irradiation condition (total 15 rats). In Experiment 2, the pulp tissues of rats were observed histopathologically to examine the effects of laser irradiation on the rat pulp. Using 24 rats for each irradiation condition (total 72 rats), the occlusal surface of the right lower molars was irradiated. These rats were then divided into 3 groups according to the postoperative period (immediately,7 days and 30days after irradiation), and postoperative changes in the pulp were observed.
1. Using scanning electron microscopy of the irradiation surfaces, no smear layer was not observed under any condition, which can be observed after using high speed rotary cutting instruments, and the dentinal tubules were found to be cut open.
2. Based on histopathological study, circulatory disorders such as hyperemia, hemorrhage and exudative changes, disarray in the arrangement of the odontoblasts, and absence of the pulpo-dentinal membrane were observed immediately after irradiation. At 7 days after irradiation, these changes were reduced with formation of osteodentin and proliferation of the pulp cells under all irradiation conditions. At 30 days after irradiation, there were no marked changes in the pulp tissue.

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Effects of rearing senescence accelerated mice (SAM P-1) with solid and fine-grained diets on general growth, progression of aging, and longevity were studied.
1) No differences were noted in body weight and diet consumption in the two groups.
2) The score was always higher in the fine-grain-diet group than in the solid-diet group, and the difference increased with advancing age.
3) Spontaneous locomotor activity attained its peak level in the 15 th week in the solid-diet group, and in the 12th week in the fine-grain-diet group, and decreased gradually thereafter. Activity was always lower in the fine-grain-diet group than that in the solid-diet group.
4) No amiloid deposition in the tongue was noted in the 4th week. In the 24th and 52nd weeks, it was higher in the fine-grain-diet group than in the solid-diet group.
5) Mice in the fine-grain-diet group tended to die earlier.
The present results suggest that the aging process progresses more quickly, and longevity is shortened by rearing the SAM P 1 mice with the fine-grained diet, as compared with the solid diet.

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The purpose of this study was to examine the developmental morphology of the mandible in fetal mice using pregnant females with retinoic acid (RA) excess. RA solutions with various concentrations and administration times injected into the abdominal cavity of mice between 7 and 14 days of pregnancy. Fetuses were removed on day 18 of the pregnancy from the mother animals under anesthesia.
The mandibles were then extirpated, stained with a mixture of alizarin red and alcianblue solution, and mounted as transparent preparations by clearing to study the bone and cartilage architecture.
In addition, some of the mandibles were cut into serial sections and processed for examination by the light microscopy. The following results were obtained.
1) The fetuses from the maternal group that received RA before day 10 of the pregnancy showed maxillo-facial abnormality at a higher frequency than those from mothers given RA later in the pregnancy.
2) The fetuses in the group administrated RA at 5-50μg/g weight on day 7 of the pregnancy exhibited malformation in the maxillo-facial region, the frequency being particularly high in the mandibles.
3) Almost all of the mandubular abnormalities involved hypoplasia, in which the mandibular ramus was extremly thin or the coronoid process was lacking, accompanied by exencephaly.
4) The mandibular ramus with hypoplasia showed underdevelopment of bone and cartilage tissue. The articular disc and fibrous covering were also underdeveloped.
5) Compared with severe abnormality of the mandibular ramus shape and tissue formation, that of the mandibular body was slight.

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The experimental fiber-reinforced resin splint materials were prepared, and their mechanical properties (transverse strength and elastic modulus) were investigated. These resin splints were based on urethane dimethacrylate-based monomer, silica filler, and polymethylmethacryalte polymer beads. To improve the mechanical properties of the resin splints, glass cloth and glass fiber were incorporated into the splints. The results of this study revealed that the incorporation of glass fiber was effective in improving the mechanical properties. The mechanical properties of glass fiber-filled splints were significantly improved by increasing the ratio of glass fiber. The glass cloth-filled splints showed lower mechanical properties than the glass fiber-filled splints. The mechanical properties of the glass fiberfilled splints were not affected by immersion in water. These results suggested that glass fiber reinforcement would be an effective method for improvement of the mechanical properties of the experimental resin splint materials.

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A new caries activity test (Cariostat-LB) was developed. This study was conducted to investigate the influences of incubation time for S. mutans and Lactobacillus of this Cariostat-LB test. The relationship between Cariostat-LB and the caries indexes was also investigated among 362 children 4-5years of age.
The following results were obtained;
1. A color change after incubation at 37°C for 72 hours was found in the Lactobacillus material, but not in S. mutans.
2. The caries prevalence, mean dt, mean dft and caries severity index (CSI) of the subjects were 63.9%,2.4,4.1,7.9, respectively.
3. A rapid color change was found from 48 to 72 hours after starting incubation of the subjects.
4. The Cariostat-LB showed significant correlation with dt, dft and CSI (p<.001).
5. The high risk group designated according to Cariostat-LB had a more severe oral status than the low risk group (p<.001)
From these results, it was suggested that the Cariostat-LB could be useful for clinical application.

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This study was conducted to examine the validity of the Cariostat test among kindergarden children. Two cotton swabs were used to take plaque samples and to put them separately into Cariostat amples. One ample was made to incubate immediately after that (control group), while the other ample was made to incubate after keeping it at 18°C for 24 hours (study group). The Cariostat scores of each group were compared and the following results were obtained;
1. There was no significant difference in the distribution of Cariostat scores between the control and study groups.
2. The passing time period from sampling to estimation did not influence the results of Cariostat scores in this study.
3. The Cariostat scores showed a highly significant correlation in two groups (p<0.01). Forty two percent of the cariostat scores in both groups showed same scores at 24 hours. Similarly,46% of the cariostat scores showed the same results at 48 hours and 52% indicated the same results at 72 hours. From these results, it was suggested that the Cariostat had a validity even when starting the incubation after keeping the amples at 18°C for 24 hours.

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We occasionally encounter patients with submerged deciduous teeth in the clinical practice of pediatric dentistry. The incidence of this disorder ranges from 1% to 10%. Here we report a case of patient with 6 submerged teeth involving both the upper and lower dentition. The patient was Japanese boy 14 years,2 months of age.
1. The mother of the patient reported no history of abnormalities including diseases and trauma during the gestational period.
2. The patient showed Angle's class II division 2 in the posterior region, marked deep overbite in the anterior region, and open bite in the premolar region.
3. Dental radiography revealed that among the submerged deciduous teeth, the major portion of the crown of the lower first and second deciduous molars on the right side and the lower second deciduous molar on the left side and the upper second deciduous molars on the right side had erupted from the alveolar bone, but the bilateral upper first deciduous molars were situated even lower. Root resorption was confirmed in all of the submerged deciduous teeth. Displacement of the lower premolars was also noted.
4. With lateral roentgenographic cephalometry, ANB showed a skeletal class 1 jaw relationship, and the mandible demonstrated a low angle, indicating counter clockwise rotation of the mandible.
5. On histopathological examination, bone formation was noted in contact with the resorption cavity of the residual crowns, indicating bony ankylosis.

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Dental care for a Japanese girl who had protrusion of the upper anterior teeth caused by swallowing habits with lip biting and scissors bite which developed during occlusal treatment, was rendered with the removable appliances from 8 years-8 months of age to the permanent dentition period. At 9years of age, a removable biteplate was used for breaking the oral habit and improving the upper anterior protrusion. At 10 years-6 months of age, the protrusion was improved, but the scissors bite of the right premolars developed due to the excessive dimension of the maxillary dental and basal arch width. A removable appliance for reducing the maxillary dental arch width was designed by utilizing an expansion screw reversely and she started to use it at 10 years-11 months of age. She used this appliance for 5 months, and the sicssors bite was corrected. After using a retainer for 10 months, the treatment ended. Since these removable appliances functioned suitably and the compliance of the patient to the treatment was satisfactory, an esthetically as well as sufficiently functional permanent occlusion was established.

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Nifedipine, a calcium antagonist, is commonly prescribed medication for hypertension and angina pectoris. Many clinical cases of gingival hyperplasia associated with nifedipine therapy have been reported since 1984, when Ramon et al reported the first case. Child cases have however been rarely documented. We report a case of gingival hyperplasia induced by nifedipine administration in a 13year-old girl. Oral examination showed marked gingival hyperplasia around the interdental papillae of the upper and lower incisors. The affected gingiva were nodular and elastically hard. Since the patient had received nifedipine for 9 months for treatment of renal hypertension, we suspected side-effects caused by the nifedipine and consulted her pediatrician about a change in the patient's medication. Since the hyperplastic gingiva did not improve in spite of a gradual reduction of the dose of nifedipine, plaque control and scaling, we performed gingivectomy under local anesthesia. There have not been any signs of recurrence during the following 11 months of observation. Histopathologically, drug-induced gingival hyperplasia was confirmed. This is the first case report of Nifedipine-induced gingival hyperplasia in a child.

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