During the life of a dentist, the accident of the teeth, which is often associated with periodontal tissues and jaws, is an unavoidable problem. Patients need to be treated correctly and urgently. History taking, physical examination, oral examination and other appropriate clinical examinations are important for the treatment. This article discusses the management of traumatized teeth which general dentists can provide treatment to deciduous teeth, permanent teeth and fracture of the alveolar processes.

The purpose of this study was to compare the porcelain surfaces after debonding with two debonding methods. Feldspathic porcelain discs (n = 68) were randomly assigned to one of four groups, seventeen specimens for each; 3MS: Gemini metal brackets with a mesh base (3M Unitek, USA) were debonded with shear force, 3MP: Gemini metal brackets were debonded with peel force, TMS: MicroLine metal brackets that have machined undercut base (TOMY, Japan) were debonded with shear force, TMP: MicroLine metal bracket were debonded with peel force. The peel force was produced by conventional ligature cutter and the shear force was produced by conventional debonding plier. All surface discs were treated with silane primer (porcelain primer, Ormco Corp., USA), and the Transbond XT adhesive system (3M Unitek, Monrovia, USA) was used to bond all brackets to the discs. After debonding, the amount of residual adhesive on porcelain discs were examined according to Adhesive Remnant Index (ARI) score under 10x magnification. Data were statistically analyzed by Kruskal-Wallis test and multiple comparisons test. The ARI scores were statistically significant difference (x2 = 19.612, p = 0.00) in bond failure pattern of 3MS-TMS, 3MS-TMP and 3MP-TMP groups. In general, brackets from the same company debonded with shear or peel force showed no statistically significant within group. About 5 – 10 % of porcelain damages were observed for 3 groups, while 0 % of porcelain damage was found in 3MP group. MicroLine brackets debonded with two techniques tended to leave a significant amount of all adhesive on porcelain surface.

The aim of this in vitro study was to evaluate the median of the mean of microleakage in three pit and fissure sealants. In this study, sealants used were resin-based sealant without fluoride releasing, with fluoride releasing and amorphous calcium phosphate. Ninety permanent maxillary premolars were randomly divided into 3 groups. The application of each sealant followed manufacturer’s instructions. All teeth were thermocycled for 500 cycles between 5°C and 55°C. After thermocycling the whole surface of each tooth was coated with nail varnish except for one millimeter around the sealant. The teeth were immersed in 0.5% methylene blue for 24 hours and then sectioned buccolingually by precision saw, model ISOMETTM. The sections were analyzed for microleakage under × 30 magnification of a stereomicroscope. The median of the mean of microleakage were analyzed by the Kruskal-Wallis statistic among 3 groups at 0.05 α level, the statistical differences in microleakage were found among three materials (p < 0.001). The comparison of the microleakage between two groups by the Mann-Whitney U statistic at 0.0167 α level resulted the no significant differences between sealants with and without fluoride groups (p = 0.082). There were significant differences between sealants with ACP and sealants without fluoride (p = 0.007), and also between sealants with ACP and with fluoride (p < 0.001) as well. In conclusion resin-based sealants with ACP had higher microleakage than resin-based sealants with and without fluoride releasing.

The aim of the study was to evaluate the correlation between the electronic and the radiographic working length determination in a simulated resin jaw model. Fifty-one extracted human upper central incisors of 3rd year dental students’ exercises were used in this experiment. After the access opening, students practiced to use the electronic apex locator (EAL) on teeth embedded in resin jaws and fixed in the phantom heads under the supervision of instructors. The working length (WL) determined by EAL was statistically compared with that obtained from a radiograph of the same tooth. The acceptable criteria for WL determination by EAL was for the file which is short and beyond the radiographic apex ± 0.50 mm. Intraclass correlation coefficient between EAL and radiograph according to the acceptable criteria revealed 0.710 (95% CI = 0.538, 0.825). The reliability coefficient equaled 0.7090. There was a good correlation between EAL and radiograph regarding the working length determination in the simulated resin jaw model. The use of electronic working length determination in the resin jaw model not only obtains suitable teaching purpose but also reduces the number of radiographs required for WL estimation.

A 5-year-old boy had injured his upper left deciduous central incisor from falling off the table. The tooth was extruded and luxated from the socket, but not yet avulsed. Thirty minutes after the accident, the patient was sent to Muang Pan Hospital, Lampang. The tooth was repositioned and stabilized by finger pressure. Six months later, the boy had another bicycle accident which caused extrusive luxation of upper right deciduous central incisor. The tooth was repositioned and stabilized by finger pressure. At 2-year follow-up visit, clinical examination of upper deciduous central incisors showed discoloration. No infection was found from the x-ray. Permanent teeth could erupt normally. Treatment outcome was satisfied.

The aim of this study was to compare the plaque removal efficacy around ball attachments of 4 cleaning aids: yarn (3 mm diameter), gauze strip, Superfloss®, and end-tufted brush. Thirty-two subjects, aged 60 years and over were recruited from the list of patients in the His Majesty the King’s 80th Birthday Anniversary Dental Implant Project (December 5th, 2007). All subjects were fully edentulous who had been treated with 2 unsplinted dental implants in the anterior mandible for mandibular implant overdenture. Each subject was randomly assigned by lucky drawing for the sequence of using cleaning aids. All subjects had to use each cleaning aid 2 times a day for 4 weeks. The experimental phases were separated by a 2-week wash-out period. Two weeks prior to each experimental phase, ball attachments were polished to remove all plaque and a standardized instruction in the use of each cleaning aid was given. The plaque scores, gingival index scores, and probing depths were determined at baseline and at the end of each experimental period. Overall, the results of this study demonstrated that 4 cleaning aids significantly reduced plaque scores and gingival index scores at the 4th week follow-up visits (p < 0.05). The highest percentage of the reductions in probing depths were observed in the use of yarn and end-tufted brush following the 4-week test period. No significant differences were found with respect to type of cleaning aid used. It was noted that the decreasing frequency distribution of plaque scores and gingival index scores were uppermost for yarn but not significantly differences among the 4 cleaning aids. It is concluded that yarn is an effective means of reducing plaque and gingivitis around dental implants as well as other 3 cleaning aids.

The aims of this study were to cephalometrically evaluate the skeletal, dental and soft tissue changes and to determine the change of the alveolar bone quantity of the upper incisors after use the light force partial fixed appliance in combination with short Class III elastics on the treatment of Class III malocclusion with anterior crossbite in non-growing patients. Ten patients (age 21.4 ± 4.2 years) were included in the study. Lateral cephalometric radiographs of pre- (T0) and post- (T1) anterior crossbite correction were analyzed. Changes of alveolar bone thickness and alveolar crest height were assessed from pre- (CT0) and post-anterior crossbite correction (CT1) using cone beam computed tomography images. Paired t - test with Bonferroni adjustment was used for comparison. Overjet was increased statistically significant 4.2 mm (p < 0.0025). SNB angle was decreased 0.7o. ANB angle was increased statistically significant (p < 0.0025). Upper incisors were significantly moved forward and downward (UIPP, Is-Sh, p < 0.0025) leading to significant improvement of upper incisors to upper lip relationship (IsSts-Sh, p < 0.0025). The upper lip position (Ls-Sv) was significantly improved (p < 0.0025). There was no statistically significant difference between labial and palatal alveolar bone thickness and alveolar crest height between CT0 and CT1. The present appliance not only produced forward and downward movement of upper incisors that is beneficial in the improvement of upper incisal display, but also was safe for alveolar bone of upper incisors.

The periodontium is composed of both soft and hard tissues, thus hard tissue regeneration is one of the most important processes in periodontal regeneration. Bone sialoprotein, osteocalcin, osteopontin and osteonectin are noncollagenous matrix proteins which play vital roles in the mineralization of hard tissue. Recent studies have demonstrated that acemannan, a polysaccharide extracted from Aloe vera gel, upregulated the expression of proteins involved in hard tissue regeneration. This study investigated effect of acemannan on bone sialoprotein, osteocalcin, osteopontin and osteonectin expression in human periodontal ligament cells. Primary periodontal ligament cells were isolated from impacted third molars and then treated with acemannan in vitro. The mRNA expression of bone sialoprotein and osteocalcin and the protein levels of osteopontin and osteonectin were determined using reverse transcription-polymerase chain reaction and western blot analysis, respectively. One-way analysis of variance and Dunnett multiple comparisons were performed to analyze the data. The results revealed that acemannan significantly increased the in vitro expression of bone sialoprotein, osteocalcin, osteopontin and osteonectin, which were 1.4, 1.2, 3.3 and 3.6 fold higher compared with the untreated control group, respectively. Our data indicate that acemannan is a bioactive molecule that can induce the expression of the non-collagenous matrix proteins; bone sialoprotein, osteocalcin, osteopontin and osteonectin in periodontal ligament cells.

The purpose of this study was to assess the effect of soft mouthguard with fluoride gel (1.1% NaF) in reducing hypersensitivity from erosion in swimmers and their attitude. Nineteen swimmers aged 9 years and older from one swimming pool in Bangkok, with moderate tooth hypersensitivity on visual analogue scale (VAS > 3), were participated in this study. Samples were randomly divided into 2 groups. Ten swimmers (mean age 14.7 ± 2.8 years) were assigned to wear mouthguard (MG group) and nine swimmers (mean age 17.9 ± 4.0 years) wear mouthguard with fluoride gel (MGF group) during swimming sessions. The average and maximum hypersensitivity (VASave / VASmax) was assessed, before and after mouthguard delivery, every 2 weeks, for 8 weeks using VAS. The hypersensitivity levels at baseline were not statistically different. Mean VASave of MG and MGF group were 4.6 ± 0.5 and 4.9 ± 0.6 where as mean VASmax were 5.6 ± 0.5 and 6.6 ± 0.5. VAS of both groups were reduced significantly after two weeks (p < 0.05). At the end of the study, VASave of MG and MGF groups were 1.3 ± 0.5 and 0.7 ± 0.3.The reduction of hypersensitivity level was greater in MGF group, especially the first 2 and 4 weeks, but not significantly different from MG group. The swimmers expressed good attitude in favor, comfort, convenience and interference.Taste and odor of fluoride gel were also acceptable. In conclusion, using mouthguard with 1.1% NaF gel can effectively reduce dental hypersensitivity in swimmers but not significantly different from using mouthguard alone.

Maxillary canine impaction is a frequent encountered clinical problem and the incidence is the second most common only to the mandibular third molar. Diagnosis and prevention of maxillary canine impaction can be accomplished by general practitioner, since early diagnosis of unerupted and potentially impacted permanent canine can decrease complication and adverse effect. This article reviews the etiology, diagnosis, clinical approach of maxillary canine impaction, and the rationale for proper management.

The purpose of this study was to clinically evaluate the accuracy of Apex Pointer and Root ZX electronic apex locators (EALs) in 86 root canals of primary molars. Each root canal was measured by both EALs to locate the apical foramen (EM) while the meter reading “APEX” bar. Then the tooth was extracted. The actual length (AL) of coronal part of apical foramen was examined using a stereo microscope at 40x magnification. The accuracy of both EALs, the value of differences between AL and EM within ± 0.5 mm. were 65.12% and 68.60% and within ± 1 mm. were 89.53% and 93.02%, respectively. However, there were no statistically significant differences between the two devices. (p > 0.05)

The objectives of this study were to examine the level of self-esteem and its association with individual information in adolescent with cleft lip and palate treated in orthodontic clinic, Dental hospital, Faculty of Dentistry, Prince of Songkla University. The study was carried out through descriptive analysis based on demographic data of 24 informants, aged 13 – 17, collected via questionnaire enumeration. The individual self-esteem was assessed through employing Ms. Nartaya Wongleekphai’s self-esteem inventory that developed from Coopersmith self-esteem inventory. The severity of cleft, speech and the effect of cleft on daily life and social functioning were evaluated using visual analogue scale. The result showed that out of the full score of 150, the mean of self-esteem score was found to be 105.42. When compared among the informants, 15 of them had moderate self-esteem, 5 had high self-esteem and 4 had low self-esteem. It was also found out that the correlation between the level of self-esteem and individual demographic data was not statistically significant. In conclusion, the level of self-esteem of the adolecent clefts was moderate and not statistically significant.

The objective of this study was to determine the differences of dental arch dimensions and tooth sizes between Class I malocclusion patients with and without anterior crossbite and also between the crossbite and non-crossbite side among Class I unilateral anterior crossbite patients. Arch widths, arch heights, and anterior tooth size ratios of 62 dental models of Class I malocclusion patients with anterior crossbite were compared with the other 62 Class I malocclusion models controlled for age, sex and amount of tooth size - arch length discrepancy, but without anterior crossbite. Independent t-tests were used to determine the differences. Moreover, arch widths and tooth sizes of 39 models of Class I unilateral anterior crossbite patients were compared between the crossbite and non-crossbite sides. Paired t-tests were used to analyze the differences.The results of this study demonstrated that patients with anterior crossbite had significantly shorter maxillary arch height than those without anterior crossbite (p < 0.001). Apart from that, none of the arch dimension or tooth size parameters were significantly different (p > 0.05). Among the unilateral crossbite patients, arch widths and tooth sizes were similar between the crossbite and non-crossbite side (p > 0.05). In conclusion, maxillary arch height was significantly shorter in anterior crossbite patients. Neither arch dimensions nor tooth sizes were found to be the influential factors.

Smoking is one of the important risk factors for periodontal diseases and affects periodontal treatment responses. Thus, smoking cessation has a beneficial effect on periodontal status. This study aims to evaluate the effect of smoking cessation on periodontal status following non-surgical periodontal treatment. Sixty-nine smokers with chronic periodontitis were recruited from periodontal patients at the Department of Oral Medicine, Faculty of Dentistry, Mahidol University. All patients received non-surgical periodontal therapy and providing either a brief smoking cessation programme (34 patients) or an explanation of the adverse effects of smoking (35 patients). Clinical periodontal status at baseline and the 6-month follow-up were assessed using probing depth, clinical attachment level, plaque score and bleeding on probing score. For the analysis of the treatment outcome, all subjects were categorized by their cigarette consumption status at the 6-month follow-up: no reductions in consumption (15 patients); partial reductions (38 patients); and abstinence (16 patients). It was found that at the 6-month follow-up all groups of subjects demonstrated the significant reduction from baseline in the mean of full mouth probing depth, full mouth clinical attachment level, plaque score and bleeding on probing score (p < 0.05). There was no significant reduction among all groups except for the reduction in full mouth mean probing depth. The reduction was significantly less in no reduction in consumption group compared to the partial reduction and abstinence groups (p < 0.05). Furthermore, clinical attachment level parameter demonstrated the reduction in the initial pockets which were ≥ 4 mm depth (p < 0.05), but no statistically significant difference between the three groups.The results indicate that quitting smoking and/or reducing cigarette consumption have a periodontal beneficial effect following non-surgical periodontal therapy. For the better periodontal treatment outcome, smokers with periodontitis should be advised to stop smoking.