The aim of this article was to review the properties of the dentin conditioning agents for glass-ionomer cement, for example, clean the tooth surface, modify or remove the smear layer, demineralize the tooth surface, increase the surface area and increase mechanical and/or chemical bond strength between the tooth surface and glass-ionomer cement. For many years, various tooth surface treatment agents have been available. These include citric acid, demineralizing solution, polyacrylic acid, ethylenediamine tetraacetic acid (EDTA), phosphoric acid and many others. Different study designs have been tested for these tooth surface treatment agents; for example, rinsing or not rinsing the agent with water after application or testing the effect of different concentrations of the agent. The most popular and widely used dentin conditioning agent for glass-ionomer cements is 10–30 % polyacrylic acid because of its similar composition to the liquid mixture of the glassionomer cement. Polyacrylic acid is a weak acid with high molecular weight that is capable of cleaning the tooth surface, modifying the smear layer, without inducing dentinal tubule opening when the proper concentration and application time is used, roughening the tooth surface and promoting the formation of chemical bond between hydroxyapatite and glass-ionomer cement. Nowadays, suppliers tend to sell their dentin conditioning products along with the glass-ionomer cements. Each of which has different chemical composition and different treatment method. Therefore, it is best to strictly follow the manufacturer’s instruction for the best result.

A new calcium silicate-based cement, Biodentine™ (Septodont, Saint Maur des Fosses, France), has recently been introduced. With its biocompatibility and dentinal bridge-promoting properties comparable to those of the clinically well-accepted mineral trioxide aggregate (MTA), Biodentine™ could probably be an appropriate option for pulp capping procedures. However, clinical outcome studies on Biodentine™ are limited. Moreover, vital pulp therapy in cariously exposed permanent teeth is also controversial. These case reports describe clinical procedures and outcomes of partial pulpotomy using Biodentine™ as a pulp capping material in four cariously exposed adult permanent teeth in three patients aged 22 to 50 years. At 12 to 30 months follow-up, none of the patients experienced spontaneous pain, swelling or abscess formation. All teeth displayed a positive response to pulp testing and functioned normally. The radiographic evaluation revealed normal periapical areas.

Herpes zoster (HZ) is a disease caused by reactivation of varicella zoster virus (VZV). With the low immune condition, VZV was reactivated. It is characterized by multiple painful vesicles on skin that innervated by the affected nerve. The oral complications appear when the maxillary or mandibular divisions of the trigeminal nerve are involved. Oral complications are postherpitc neuralgia, devitalized teeth, resorption of root, and spontaneous exfoliation of teeth, osteomyelitis or alveolar bone necrosis. This paper presents a case of 54- year-old Thai male with underlying diabetic mellitus and hypertension presented with exposure of right mandibular alveolar bone necrosis and spontaneous exfoliation of right lower teeth after having vesicles at skin below right lower lip. Base on clinical features, a diagnosis of herpes zoster infection at right mandibular division of trigeminal nerve inducing alveolar bone necrosis with spontaneous exfoliation of teeth was given.

       Root-filled teeth must be restored with materials that prevent penetration of bacteria and fluids containing nutrients. Different liners materials and etching techniques are available for use with composite resins. The aim of this study was to compare dye penetration with two liners and two adhesive systems in access cavities of root-filled premolars whilst simultaneously subjected to functional loading. Extracted human premolars were accessed and root-filled. Teeth in groups I and II were lined Vitrebond while groups III and IV were lined with Ionosit. Groups I and III were etched primed with Optibond FL primer. Optibond FL adhesive was placed and filled with Premise composite resin. Groups II and IV had Optibond XLR primer, Optibond FL adhesive and the same composite. Specimens were then mounted and subjected to the equivalent of three months mastication whilst simultaneously immersed in India ink. Specimens were retrieved and sectioned. Dye penetration was measured and expressed as a ratio of the tooth length. Data were analysed by one-way ANOVA, followed by the Bonferroni test. The results showed that controls performed as designed. There was no statistically significant difference between the four experimental groups (p = 0.051). Neither Vitrebond nor Ionosit showed significant differences in preventing dye penetration (t-test, p = 0.663) but the total-etch system had significantly less dye penetration than the self-etch system (t-test, p = 0.007). In conclusions, there was no difference between the two liners in preventing dye penetration. The total-etch system was significantly better at preventing dye penetration than the self-etch system in ideal endodontic access cavities in root-filled premolar teeth.

This paper aimed to assess the changes on tobacco use, received cessation training and perceptions of policy banning smoking of dental students in Thailand by using the Global Health Professional Student Survey (GHPSS) conducted in 2006 and 2011. It was a census of 3rd year students from all 8 public dental schools in the country with 682 students in 2006 and 418 students in 2011 joining in the survey. The GHPSS results showed progresses in students’ learning experiences on smoking cessation. Their perception of being role model for smoking cessation increased from 98.0 % in 2006 to 98.3 % in 2011 and the need for cessation techniques increased from 80.9 % in 2006 to 91.9 % in 2011. Percentages of dental students reporting that they have learned cessation approaches to use with their patients increased from 14.1 % in 2006 to 32.7 % in 2011. In conclusion, the proportion of the 3rd year dental students that have learned the cessation approaches to use with their patients increased by double within 5 years. However, the contents of tobacco control training are different based on professors’ interest and there is a possible way to set a standard tobacco learning program among dental schools within the country.

The aims of this study were to investigate self-perceived competences in geriatric dentistry of Thammasat University dental graduates, to investigate employers’ opinion on graduates’ competences and to compare the results from the two groups. The study population consisted of 289 students who graduated in 2000 - 2010 and 90 employers. The data were collected via selfadministered questionnaires which were sent to the graduates by post and online survey. The questionnaires included 28 items in six-point rating scale from 5 = very good to 1 = very bad and 0 = not applicable. The rating scores were later categorized based on the proportion of respondents who rated items as ‘good’ and ‘very good’, ie, ≥ 70 % = ‘excellent’, 60 - 69 % = ‘average’ and < 60 % = ‘need improvement’. The response rates of graduates and employers were 73 % and 31 %
respectively. Most graduates had more than five years working experience and few attended postgraduate training. Most graduates rated themselves as ‘need improvement’ in 75 % of the items whereas employers rated 46 % of items in the same category. Both graduates and employers agreed that graduates had excellent competences in identifying indications of using antibiotic prophylaxis and epinephrine in patients with cardiovascular diseases, managing clinical features in patients with diabetes mellitus and who are taking antiplatelet agents. In addition, both groups agreed on competences rated as ‘need improvement’ including identifying types of herbal/dietary supplements that affect anticoagulation function, taking history from patients/carers to perform assessment of activities of daily living and instrumental activities of daily living and evaluating nutritional deficiency from patients’ treatment record or history taking. In conclusion, employers agreed on most competences as perceived by graduates. However, graduates rated themselves as ‘need improvement’ in most items and this finding should be addressed in the development of effective geriatric dental education.

This study aims to measure the fracture strength in molar region of new zirconia-reinforced lithium silicate (Celtra™ Duo, Dentsply) in comparison to lithium disilicate all-ceramic crowns (IPS e.max^® CAD, Ivoclar Vivadent) made with computer-aided design/computer-aided manufacturing. Thirty standardized crown resin models were prepared with the same dimensions and randomly assigned to either Celtra™ Duo or IPS e.max^® CAD group, fifteen each. Fractural load values were measured by a universal testing machine (Instron model 4464, USA) with a static load applied along the long axis of the specimen at a crosshead speed of 1 mm/min at room temperature until fracture. Fracture load values were recorded for each specimen and statistically analyzed by using unpaired t-test. The mean ± SD for the fracture load values were 1,696.67 ± 230.31 N and 1,569.87 ± 154.71 N for Celtra™ Duo and IPS e.max^® CAD, respectively. There was no statistically differences of fracture strength between Celtra™ Duo and IPS e.max^® CAD (p < 0.05).

The health problems concerning muscle, tendons, ligaments, skeleton, cartilage and nerves which are inclusively termed “Work-related musculoskeletal disorders” are induced by normal performing dental work activities, could lead to temporary disorders or permanent disabilities. The potential occupational risk factors for musculoskeletal disorders are repetition, force, vibration, stress and posture. This article also introduces some chairside stretching exercises for strengthen the muscles and minimizing the risk of such disorders.

The aim of this study was to evaluate the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on surface microhardness of demineralized enamel surface of human tooth. Twenty-six extracted human maxillary premolars were kept in 0.1% thymol solution for 2 weeks after extraction. The tooth was cut vertically into 2 halves; buccal and lingual using diamond tooth cutting device. Fifty two specimens were randomly divided into 2 groups; control and experimental groups (N = 26 each). For demineralization, all specimens were stored in 0.1 M lactic acid pH 4.8 for 4 days. All speciemens were subjected to Vicker’s microhardness measurement (VHN_C1 for control group and VHN_E1 for experimental group). The specimens in control and experimental groups were stored in 0.1 M lactic acid pH 4.75 for 10 minutes twice a day and then in artificial saliva at 37ºC for 14 days, except that in experimental group, the specimens were applied with CPP-ACP tooth mousse for 3 minutes before storage in artificial saliva. After 14 days storage, the VHN_C2, VHN_E2 were measured and ΔVHN_C and ΔVHN_E which were the difference between VHN_C1, VHN_C2 and VHN_E1, VHN_E2 were calculated. In control group, All the VHN are VHN_C1 = 242.07 kgf/mm², VHN_C2 = 201.69 kgf/mm² and ΔVHN_C = -40.37 kgf/mm². In experimental group, all the VHN are VHN_E1 = 245.31 kgf/mm², VHN_E2 = 259.62 kgf/mm² and ΔVHN_E = 14.31 kgf/mm². ΔVHN_C and ΔVHN_E were tested by paired t-test (p = 0.05). Mean average of surface microharness of control group significantly differenced to study group (p < 0.001). The specimens treated with CPP-ACP showed significantly more microhardness value than those not treated (p < 0.001). It is concluded that CPP-ACP tooth mousse increased human enamel surface microhardness.

The objective of this study was to evaluate the cytotoxicity and biocompatibility of two aluminum chloride containing local hemostatic agents, Racestyptine and a local hemostatic agent prototype, Dent-Chula100^®. To determine cytotoxicity, primary human gingival and pulpal fibroblasts were treated with the local homeostatic agents at concentrations of 0.1, 1.0, 2.5, 5.0 or 10.0 % (v/v) for 15 minutes. The MTT assay was used, with untreated cells serving as control. The biocompatibility test was performed using the lower incisors of twelve 8-week old male Sprague Dawley rats.The free gingival margin of the lower central incisors was temporarily displaced for 15 minutes using retraction cords soaked with Racestyptine or Dent-Chula100^®. Cords soaked with normal saline served as a control. Seven days after treatment, the lower jaws were dissected. The H&E stained tissue sections were histopathologically examined for four pathologic index scores; degree of sulcular epithelium damage, collagen fiber appearance and orientation, inflammation and vascular reaction. Two-way ANOVA and Kruskall-Wallis tests were performed for statistical analysis of the in vitro and in vivo studies, respectively (p < 0.05). Our data revealed that Dent-Chula100^® at 5.0 % - 10.0 % significantly reduced gingival fibroblast cell viability compared with the control group (p < 0.05), while Racestyptine at 2.5 % - 10.0 % significantly decreased cell viability (p < 0.05). Both Dent-Chula100^® and Racestyptine at 2.5 % significantly reduced pulpal fibroblast cell viability (p < 0.05). The histopathological data indicated that the periodontal tissues did not incur any significant damage after exposure to Dent-Chula100^® or Racestyptine. In conclusion, the cytotoxicity of Dent-Chula100^® and Racestyptine was dose-dependent. The in vivo study revealed that both Dent-Chula100^® and Racestyptine were biocompatible with gingival tissues.

The purpose of this study was evaluated dimensional accuracy and surface detail reproduction of polyvinylsiloxanether impression (Identium^®light) tested in dry, moist and wet conditions and compared with addition silicone (Panasil^®contact plus X-light) and polyether (Impregum^TMPenta^TMSoft). Ninety samples for each impression were replicated using stainless steel metal die according to American dental association (ADA) specification No. 19, 30 samples of each condition. Then, (1) dimensional accuracy of dry and moist samples was done by measuring the average length of the middle horizontal line of each impression by measuring microscope with 0.001 milimeters accuracy. Two-way analysis of variance (ANOVA) was used to compare the mean dimensional change of three impressions in dry and moist condition (α = 0.05) and studied about time factor by compared length of line between 1 hours and 24 hours by Paired t-test. (2) Surface detail reproduction of all above conditions was evaluated following the criteria specified in ADA standard for details reproduction: clear continuous replication at least 2 of 3 horizontal lines. Furthermore, this research also compared the amount of defects on impression. The change of length of dimension accuracy test after 24 hours compare with original model in each impression was signification and condition in dry and moist impression are not affected to dimensional change. Impegum^TMPenta^TMSoft impression in moist condition was found the most dimensional change value at 24 hours and there is difference in dimensional accuracy after 24 hours and 1 hours in all types of impression (p < 0.05). In dry conditions, all impressions showed a definitive continuous horizontal line with no deformities. In moist conditions, Identium^®light, Panasil^®contact plus X-light and Impegum^TMPenta^TMSoft showed a continuous line 86.7 %, 63.3 % and 100 % respectively. There were no difference in deformities in all three impression materials. In wet conditions, only the Impegum^TMPenta^TMSoft impression passed the ADA standard, however many deformities were seen. This study shows dimensional change accuracy for three impression materials was within ADA standard (< 0.5 %) and the polyvinylsiloxanether impression showed excellent detail reproduction in dry condition but not as well as Impegum^TMPenta^TMSoft in moist conditions.

The aim of this randomized controlled clinical study was to compare the efficacy of herbal toothpaste containing Piper betle, Psidium guajava and Garcinia mangostana with fluoridated toothpaste in the reduction of dental plaque and gingival inflammation. Fifty one healthy participants were randomly allocated to one of two groups, the control group (fluoridated toothpaste) and the test group (herbal toothpaste). The enclosed label toothpastes and new soft bristled toothbrushes were distributed to each participant according to their groups. All participants were instructed to brush their teeth with assigned toothpaste for 2 minutes, 2 times a day for 4 weeks. The plaque index and gingival index were examined and recorded on the first day (baseline), 14^th day and 28^th day (endpoint). The plaque index and gingival index scores were decreased statistically significant in both groups at the end of the study period (p < 0.05). However, these parameters were not statistically significant different between the groups.

Initial enamel caries is characterized as a whitish colored area with subsurface porosities that may have progressed to a more advanced lesion. Several approaches have been proposed to manage the non-cavitated enamel caries at different levels. This study aimed to determine the color improvement and surface hardness recovery of artificial white spot lesions after two conservative treatments - caries infiltration (Icon) and CPP-ACP containing paste (Tooth Mousse). Enamel carious lesions on extracted human premolars were created and underwent the two respective treatments following each manufacturer’s instructions. Groups with or without lesion formation, but no further treatments, were included as negative and positive controls. All specimens were subjected to the demineralization-remineralization pH cycles at 37 °C for 8 weeks. At designated time points, the surface microhardness of the lesions was assessed using Vickers diamond indenter and the difference in color of the lesions to the time before treatment was evaluated using a spectrophotometer. The lesions were also microscopically observed from both top and cross-sectional views using SEM. Parametric and non-parametric statistics were conducted to analyze all data at 95 % confidence level. Surface hardness of the lesions decreased significantly after artificial enamel caries formation. Following the caries infiltration treatment, hardness value recovered immediately and maintained throughout the period of pH cycles, even though not be comparable to that of the positive control. Difference in color of the lesions could be significantly detected after single treatment of the resin material. On the other hand, daily application of CPP-ACP containing paste did not regain the surface hardness of the lesions and the color change could not be significantly observed within 8 weeks of pH cycle. In conclusion, the caries infiltration is superior to the CPP-ACP treatment in color and surface hardness improvements of artificial white spot enamel lesions.

Oral squamous cell carcinoma (OSCC) is one of the major leading cancers worldwide. Generally, the incidence of OSCC remains constant globally but appears increasing in some parts of the world especially in the young group. Despite an easy access to early diagnosis and treatment, the mortality rate of patients with OSCC remains high due to delayed treatment and failure to control tumor recurrences and metastasis. The overall five-year survival rate for OSCC is considerably lower than other cancers and has not significantly changed during the last two decades. Recently, novel treatments, aiming to target specific molecules, aberrantly expressed during OSCC carcinogenesis, have been investigated and tested in clinical trials at several research settings. COX-2, in particular, is significantly overexpressed in OSCC and suggested to play a crucial role in OSCC carcinogenesis. This review will focus on the association between OSCC and COX-2 and the use of the COX-2 inhibitors as the targeted therapy for OSCC. This new approach in OSCC treatment offers hope that it may replace the conventional treatment modalities considered nonspecific and causing unwanted severe complications to patients.

This research aimed to study the pulpal responses in dog’s teeth when conventional GIC (Ketac Fil PlusTM) was used as partial pulpotomy medicament in comparison to MTA (ProRoot MTATM). Cavity preparations were performed on 24 dog teeth until pulpal exposure was observed. The pulp was removed at the depth of 1 mm at the exposure sites. Teeth were randomly assigned into four groups; namely 1) conventional GIC 7 days 2) MTA 7 days 3) conventional GIC 70 days 4) MTA 70 days.
All pulpotomized teeth were restored with conventional GIC. At the periods of 7 and 70 days, the teeth were surgically extracted for histopathologic evaluation. Two teeth were excluded due to complete loss of restorative material, resulted in 22 remaining teeth for histopathologic evaluation. At 7 days period, MTA group had desirable pulpal response in terms of pulpal biocompatibility as in conventional GIC group. At 70 days period, MTA group demonstrated mild level of pulpal response while conventional GIC group showed various levels of pulpal response either mild, moderate levels or pulp necrosis. Within the limitations of the experiment, MTA showed more desirable pulpal response in terms of pulpal biocompatibility than conventional GIC.

The aim of this study was to investigate the management of temporomandibular disorders (TMD) by Ministry of Public Health general dentists in the central Thailand. A questionnaire of TMDs management was developed and mailed to all Ministry of Public Health dentists in the central Thailand. The data were analyzed by descriptive statistics. Two hundred and seven general dentists
responded the questionnaire. The respondents comprised 57 (27.5 %) males and 150 (72.5 %) females, whose age ranged from 23 - 59 years (mean 31.7 years). One hundred and seventy one (82.6 %) respondents had encountered at least 1 TMD patient in the preceding year and 140 (67.6 %) managed TMD patients. The management provided by these 140 respondents were: providing patient education and self-care 140 (100.0 %), pharmacologic management 121 (86.4 %), physical therapy 129 (92.1 %), orthopedic appliance 66 (47.1 %), and occlusal treatment 52 (37.1 %). In conclusion, most general dentists had encountered and managed TMD patients. The dentists usually managed TMD patients with conservative and reversible treatment.

This study aims to examine (i) levels of dental students’ emotional intelligence (EI); (ii) associations of EI with gender, year of study, and type of graduated high school; and (iii) associations of EI with average scores of knowledge, laboratory skills, and clinical performance. Of 122 5th and 6th year dental students, academic year 2014, Prince of Songkla University, 116 students had agreed to participate in the study and were included in analysis. Each dental student completed the Department of Mental Health’s Emotional Intelligence Questionnaire (DMH-EI). The questionnaire comprised of 52 self-assessment items, 9 domains identified as self-control, sympathy, responsibility, selfmotivation, problem-solving, relationship, self-esteem, life satisfaction, and happiness. Descriptive statistics were used to describe distribution of overall and sub EI scores. Statistical analyses were carried out using Independent-samples T-test, Pearson’s correlation and Chi-square to evaluate associations between EI with average scores as well as other factors. In this study, mean total EI score was 161.72 ± 13.78. Compared to norm-reference score, all sub EI score was in a normal range, except for self-control, which was above the norm. DMH-happiness scores of the 6th were higher than the 5th year dental students (p = 0.039). DMH-sympathy scores in female were higher than male (p = 0.046), while DMH-sympathy (p = 0.011) and DMH-responsibility (p = 0.012) scores of dental students graduated from public schools were higher than those graduated from private schools. DMHproblem- solving (r = 0.297; p < 0.01), DMH-self-esteem (r = 0.277; p < 0.01), and DMH-relationship
(r = 0.199; p < 0.05) scores were positively correlated with average clinical grades. This study indicates that some aspects of EI is associated with a noncognitive factor associated with dental students’ clinical performance.
 

       Thailand has implemented the HBV vaccination program for all newborns since 1992. The aim of this study was to investigate the serological profiles of HBV among pre-clinical dental students who were born before and in or after 1992 at a dental school, and to identify factors related to HBV serology in this population prior to their clinical practice. One hundred and eighty seven pre-clinical dental students participated in the study in 2011 - 2012. The information on seroprevalence of HBV infection, history of vaccination and immunization status, personal data, birthplace, work history, and risk factors related to HBV infection were assessed through a self-administered form. Blood collection was performed to investigate the level of HBsAg, anti-HBs antibody, and anti-HBc antibody. Descriptive statistics, prevalence ratio, with 95 % confidence interval, Chi-square test, and Fisher’s exact test were used for statistical analysis. There was one subject (0.53 %) with positive anti-HBc antibody, and no subject with positive HBsAg. There was no significant difference in anti-HBs antibody protectivity between the group of dental students who were born before and after 1992 when omitting the history of recent vaccination. History of receiving recent vaccination increased anti-HBs antibody level significantly. The results from this study show that dental students who were born in or after the integration of HBV vaccine into the national immunization program still need HBV screening test for HBV serological profile. Those who are not immunized to HBV should receive vaccination, either a full 3-dose or 1 stimulation dose prior to exposure of clinical work.