JOURNAL OF THE DENTAL ASSOCIATION OF THAILAND

  • Issue 73 volume 4
  • Issue 73 volume 3
  • Issue 73 volume 2
  • Issue 1 volume 73
1
Page : 232-249

Title : Guideline on Caries Risk Assessment and Management

Author(s) : The Dental Association of Thailand

Keyword(s) : Risk Assessment,Risk Management,Risk Factors,Dental Caries,Risk Level

Manuscript Type : Review Article (บทความปริทัศน์)

Page : 232-249

Guideline on caries risk assessment is organized by age group; < 3, 3 - < 6, 6 - 12 and > 12 years. The risk assessment is considered from health status, oral examination and factors that related to dental caries by weighted
scoring system. The weighted scores of the factors are set according to the strength of association with caries. For children aged < 12 years old, the risk levels are classified as low, high and very high, whereas risk levels for > 12 years old are low, moderate and high. The management of caries risk is based on the risk level and age groups. The caries risk management includes 1) home care; healthy life style, plaque control and home use of fluoride. 2) professional care; risk factor modification, professionally applied fluoride, sealant, cavity management and recall.

2
Page : 250-259

Title : Factors Associated with Fake Braces Use Among Thai Adolescents Living in Bangkok

Author(s) : Saris Piyasuntorn, Pagaporn Pantuwadee Pisarnturakit, Tewarit Somkotra, Chintana Sirichompun

Keyword(s) : Adolescent,Fake braces,Orthodontic appliances

Manuscript Type : Original Article (บทวิทยาการ)

Page : 250-259

This study investigates the association between the underlying determinants for obtaining fake braces among adolescents in Bangkok. The study design was case-controlled. Participants included 45 cases of adolescents who
obtained fake braces and 336 controls who obtained professional braces. They were sampled from 12- to 18-year-old students who had experiences of orthodontic braces or fake braces. Independent variables like socioeconomic status, information support, subjective norm, knowledge, and attitude were assessed by a self-administered questionnaire. The univariate analyses were performed using chi-square tests and Kolmogorov-Smirnov tests to compare differences between groups then logistic regression was used to identify the influential factors. We found that the fake braces group was mostly of younger adolescents (93.3%). Information from friends, the influence of friends and famous persons, lack of knowledge, and lower socioeconomic status had statistically significant associations with fake braces obtaining (P < 0.05). As opposed to the professional braces group, most of the adolescents who obtained fake braces did not expect good tooth alignment results (P < 0.001). Their attitudes about the social class symbol of braces also were discordant with the professional braces group (P = 0.002). The logistic regression model showed the fake braces group tended to be younger (OR = 0.17; 95% CI: 0.002-0.112). They also tended to get braces information from friends (OR = 14.83; 95% CI: 3.44-63.91), ignore tooth alignment results (OR = 0.13; 95% CI: 0.05-0.31), accept braces as a social class symbol (OR = 2.20; 95% CI: 1.04-4.64), and have a lower knowledge score (OR = 0.70; 95% CI: 0.50-0.98). In conclusion, this study proved that peer influence, the expectation of esthetic results, social ladder, and knowledge among younger adolescents had strong associations with the type of braces obtained. The measures to alleviate the fake braces situation should be determined to include these significant factors.

3
Page : 260-268

Title : Accuracy Assessment of 3D Tooth Reconstruction with Novel Segmentation Technique

Author(s) : Thanatchaporn Permwatanachai, Kanit Dhanesuan

Keyword(s) : 3D reconstruction,3D tooth reconstruction,Accuracy,Segmentation,Thresholding segmentation

Manuscript Type : Original Article (บทวิทยาการ)

Page : 260-268

Nowadays, in modern medicine, three-dimensional (3D) reconstruction uses innovative new applications by building cost-effective patient-specific surgical models and prostheses. Concurrently, 3D reconstruction is useful in
dental and maxillofacial disciplines for pre-operative planning and surgical simulation. During the 3D reconstruction process, one of the significant procedures is segmentation, which involves extracting interesting structures from undesirable surroundings. In this case, if the digital segmentation is inaccurate, the physical model generated by the virtual model will not properly represent the anatomy of the structure, resulting in a discordance between the treatment plan and the outcome. The study aims to assess the segmental accuracy of the new threshold-based semi-automatic segmentation method for establishing 3D tooth reconstruction from cone-beam computed tomography (CBCT). Ten extracted teeth and corresponding pre-existing CBCT images were collected for this experimental study. The physical data of each extracted tooth was gathered as tooth length and volume, which were measured by an electronic digital caliper and a densitometer for solids, respectively. The new threshold-based semi-automatic segmentation method was performed by InVesalius software to establish 3D tooth reconstruction from corresponding pre-existing CBCT images. The outcomes were measured through linear (deviation of the tooth length) and volumetric (percentage of volume alteration) measurements between the 3D model and extracted tooth, using measurement tools in the Meshmixer software. The Wilcoxon signed rank test was used to investigate all parameters. The results revealed no significant difference in size between the 3D reconstruction and physical teeth in both linear and volumetric measurements. Moreover, the accuracy of the segmental procedure in the linear and volumetric assessments is 97.44% and 94.95%. In conclusion, the new segmental technique from this study exhibits good accuracy. However, further investigation in clinical application of the printing models established from this new method is recommended to confirm its efficacy.

4
Page : 269-277

Title : Loss of Muscle Mass in Patients Underwent Orthognathic Surgery

Author(s) : Naratorn Prachasartta, Kiti Siriwatana, Vorapat Trachoo, Suwimol Sapwarobol

Keyword(s) : Orthognathic surgery,Postoperative muscle mass loss,Postoperative weight loss

Manuscript Type : Original Article (บทวิทยาการ)

Page : 269-277

Orthognathic surgery, a surgical intervention to correct dentofacial deformities, imposes oral intake limitations on patients for a duration up to 8 weeks, leading to weight loss and decreased muscle mass. Reduced muscle mass
impairs the body’s ability to acquire essential amino acids and cytokines, affecting its defence mechanisms against infection. We aimed to study the impact of orthognathic surgery on muscle mass. A study was conducted to examine changes in weight, body mass index (BMI), and muscle mass in patients following orthognathic surgery. Twenty-nine patients were included in the study. The patients’ height, weight, BMI, and muscle mass were measured pre-operatively and 2 and 4 weeks post-operatively. Patients experienced an average weight loss of 3.5 kg at 2 weeks post-operation with only a marginal gain of 0.1 kg, resulting in a weight loss of 3.4 kg by the 4-week mark. The BMI decreased by an average of 1.3 at 2 weeks and remained unchanged at 4 weeks. Analysis of muscle mass revealed a drop of 2.0 kg at 2 weeks post-operation with subsequent marginal gain of 0.1 kg, leading to a total loss of 1.9 kg at the 4-week mark, accounting for 57.1 % and 55.9 % of the total weight loss. The site of the surgery, specifically the oral cavity, has a significant impact on the patients’ nutritional intake and wound healing processes. Surgical interventions can lead to protein catabolism and muscle mass loss. The findings highlight the need for further research and the development of a specific nutritional therapy protocol to minimise postoperative complications and help patients maintain a balanced diet while dealing with a metabolic load.

5
Page : 278-288

Title : Dentoskeletal Changes from Two Types of Anterior Bite Planes in Deep Bite Children: A Randomized Controlled Study

Author(s) : Nalin Prucktrakul, Passakorn Wasinwasukul, Udom Thongudomporn

Keyword(s) : Cephalometry,Child,Orthodontic appliances,Overbite,Prospective studies

Manuscript Type : Original Article (บทวิทยาการ)

Page : 278-288

This study aimed to compare the dentoskeletal changes after using anterior bite planes fabricated from acrylic resin (ABP) and thermoplastic materials (TBP) to correct deep bite in a group of children. Fifty-one deep bite
patients (aged 11.87 ± 1.35 years) were randomly allocated into an untreated control, ABP, and TBP groups. Cephalometric changes between before the treatment (T0) and the visit after normal overbite was achieved (T1) were analyzed (α = .05). Compared with the untreated control group at the average treatment duration of 5.05 ± 1.5 months, significant changes in overbite and lower facial height in both treatment groups were observed (P < .05). ABP and TBP reduced overbite by 2.57 ± 1.70 mm and 2.30 ± 1.75 mm, respectively (P ≥ .05). Lower facial height of ABP and TBP increased by 2.60 ± 2.50 mm and 1.90 ± 2.25 mm, respectively (P ≥ .05). Significant increases of the overjet and proclination of maxillary incisors were observed in the ABP group (P < .05), while significant decreases of overjet and retroclination of maxillary incisors were found in the TBP group (P <.05). Comparing the TBP group with the control and ABP groups, a significant reduction (P < .05) was observed in both overjet and maxillary incisor inclination. In conclusion, ABP and TBP successfully alleviated deep bite. However, overjet and maxillary incisor inclination of the ABP group increased, while both parameters of TBP group decreased.

6
Page : 289-299

Title : The Study of Surface Remaining Metal Ions and Surface Characteristics of Retrieved Stainless Steel Brackets in Swimming Athletes Undergoing Orthodontic Treatment

Author(s) : Noppadon Chanpongsaeng

Keyword(s) : Chloride,Bracket,Swimming pool,Stainless steel,Metal ion

Manuscript Type : Original Article (บทวิทยาการ)

Page : 289-299

This study aimed to examine the surface remaining metal ions of two types of stainless steel brackets in different chloride environments of two swimming pools by comparing the amount of ions found on the surface of
the brackets and comparing surface characteristics at bracket slots between the study groups after one year usage and analyzing the metallic composition of the two types of brackets. Two brands of brackets were studied (AM, KO). Participants included 28 swimmers from two different pools (CU, BC) and a control group of 14 orthodontic patients. Bracket brands were randomly allocated to all participants. The mandibular incisor brackets were removed after one year of treatment. The removed brackets were soaked in 17% EDTA and analyzed for iron ion (Fe), nickel ion (Ni), and chromium ion (Cr) using ICP-OES. Two-way ANOVA were used to examine the effects of brackets and pools on the amount of ions. Additionally, electron microscopy images were compared between the unused and used bracket surfaces and using EDX to detect metal composition. The results revealed no significant relationship between bracket types and pools. However, there were significant differences in the quantity of iron ion and nickel ion between the two types of brackets at a statistical significance level of 0.01. AM brackets exhibited distinct surface characteristics between the used and unused groups, while KO brackets did not show such differences. In conclusion, AM brackets exhibited higher surface remaining metal ions than KO brackets. The chloride environments of the swimming pools did not significantly affect the surface remaining metal ions of stainless steel brackets.

1
Page : 163-176

Title : Management of Edentulous Spaces with Autotransplantation of A Tooth with Complete Root Formation Using an Interdisciplinary Approach and with A Seven-year Follow-up

Author(s) : Sutti Malaivijitnond

Keyword(s) : Autotransplantation,Complete root formation,Orthodontic treatment

Manuscript Type : Case Report

Page : 163-176

This case report presents a successful interdisciplinary dental treatment to manage edentulous spaces in a skeletal class III case using camouflage orthodontic treatment with autotransplantation of a tooth with complete root
formation, by four specialties: prosthodontics, endodontics, oral surgery, and orthodontics. The treatment plan included extraction of the mandibular left first premolar and the maxillary right first premolar as well as autotransplantation of the maxillary right first premolar into the maxillary left premolar edentulous area. The keys to success of the autotransplantation were: (1) endodontic treatment of the donor tooth prior to orthodontic tooth alignment with round wire, (2) preapplication of orthodontic force before extraction, (3) preparation of the recipient socket guided by the periapical radiograph and study casts, (4) preservation of the donor tooth in its own bleeding socket during trying in, and (5) the use of a short-term suture splint. Comprehensive orthodontic treatment was completed, with favourable results. The treatment time was 38 months. The transplanted tooth was in excellent condition for a porcelain crown restoration, but the patient declined the treatment. After seven years of follow-up, the transplanted tooth was still in good condition with no signs of inflammation, or root resorption. This article thoroughly discusses the decision making for the treatment sequence and appropriate approaches from each specialist.

2
Page : 177-189

Title : Development and Testing of Oral Health Literacy Measuring Tool for Patients in Comprehensive Dental Clinic, Faculty of Dentistry, Chiang Mai University

Author(s) : Jongrak Naksisuk, Borriboon Kootrakul, Pinpinut Wanichsaithong, Piyanart Chatiketu

Keyword(s) : Health literacy,Oral health literacy,Comprehensive dental,Maintenance patient

Manuscript Type : Original Article (บทวิทยาการ)

Page : 177-189

This study aimed to develop and test the oral health literacy measuring tool for patients in the Comprehensive Dental Clinic, Faculty of Dentistry, Chiang Mai University. It was divided into two phases. In the first phase, the oral
health literacy measuring tool for patients in the Comprehensive Dental Clinic was developed from the literature reviews. In the second phase, the created tool was tested for its quality in comparison with the existing tool, namely the oral health literacy measuring tool for adult patients in the Thai version by Supasin Deeraksa (ThREALD-30). The multi-stage sampling was undertaken to obtain 112 samples as maintenance patients, aged over 50 years, in the Comprehensive Dental Clinic, Faculty of Dentistry, Chiang Mai University. The samples were required to answer the questions contained in both tools at the same time, whereby this process was completed within 15 minutes. Data collection was conducted from January 2021 to December 2021. The measuring tool consisted of 32 items, covering all six components: access to dental service information, understanding, questioning, decision-making, oral behavioral change, and retelling others. The study results showed that the tool contained face validity and concurrent validity. The convergent validity with ThREALD-30 was r=0.22 (p=0.022), the concurrent validity occurring regarding the education level (p=0.047). In addition, the reliability of the whole measurement form showed Cronbach’s alpha coefficient equal to 0.96. In conclusion, the developed oral health literacy measuring tool can be further used to evaluate oral health literacy among patients for dental treatment.

3
Page : 190-198

Title : Evaluation of 21-day Chatbot to Deliver Oral Hygiene Care for Caregivers in 0 - 5 Year- Children

Author(s) : Samerchit Pithpornchaiyakul, Walee Chukhadee

Keyword(s) : engagement,oral health care,satisfaction,child,chatbot

Manuscript Type : Original Article (บทวิทยาการ)

Page : 190-198

This study purposed to evaluate the effect of a 21-day Chatbot on caregivers’ knowledge, attitude and
practices for children aged 0 to 5 years old, as well as the chatbot’s engagement and satisfaction. This study has
2 parts; first was a retrospective quantitative research evaluating caregivers’ knowledge, attitude and practices for
children aged 0 to 5 years old and engagement, utilizing data from a 21-day Chatbot initiative in 7 provinces southern
Thai regions program by the Faculty of Dentistry at Prince of Songkla University and National Health Security Office
(NHSO). The second part was a prospective qualitative research to evaluate user satisfaction and motivations for utilizing chatbot. Two trained and calibrated interviewers performed online in-depth interviews with individuals
who attended chatbot for 7, 14, and 21 days. Results indicated that after using a 21-day Chatbot program, a high
percentage of parents were confident in their ability to clean their children’s teeth and understood the reasons,
consequence, and methods for avoiding child dental caries. All 21 days of the program were attended by 57.9% of
the caregivers. Almost of caregivers satisfied with simple assess to participate, features, replies, infographics, videos,
knowledge provided. Additionally, the could applied provided knowledge for daily practices. Discontinuation of use was
based on their own schedules and the stability of the platform, which may error and did not deliver messages every day.

4
Page : 199-211

Title : The Effectiveness of Dental Sealant Program among Schoolchildren in Thailand: Systematic Review and Meta-analysis

Author(s) : Utsanee Sanupong, Sukanya Tianviwat, Piyada Prasertsom, Warangkana Vejvithee, Songchai Thitasomakul

Keyword(s) : Dental Sealant,Complete retention,Primary school children,Effectiveness,Caries

Manuscript Type : Original Article (บทวิทยาการ)

Page : 199-211

The aim of this study was (1) to identify sealant retention and caries on sealed teeth among primary school
students by follow-up time, (2) to compare sealant retention between mobile dental clinic and hospital clinic and (3)
to compare caries between sealed and non-sealed teeth. The searching was done from two data sources; journals
related to dental health from 1993-2022, citation and PubMed database. Among the total of 3,832 publications, 17
were selected according to the inclusion criteria. The result showed that the percentages of complete retention at
6-12, 13-24 and 25-60 months were 53.80, 32.84 and 24.43, respectively and the percentages of caries on sealed
teeth at 6-12, 18-36 and 60 months were 5.78, 20.09 and 26.66. Compared between hospital and mobile dental
clinics at 12 months, the odd ratio of complete retention was 1.79 times (95% CI = 1.18, 2.61). The odd ratio of
caries on teeth receiving sealant and those not receiving sealant at 24 months was 1.44 (95% CI = 0.81, 2.69). In
conclusion, the effectiveness of the school sealant in Thai was low, both of sealant retention and caries prevention.
Dental sealants provided in hospital clinic showed more complete retention than mobile clinic. Caries on sealed
teeth lower than non-sealed teeth. This study suggested measures to increase the effectiveness of dental sealants;
assessment of dental sealant and re-sealant in needed children i.e. high-risk caries or loss of sealant retention.
Strategies to enhance accessibility to dental services should be considered along with ensuring service quality.

5
Page : 212-220

Title : Dental Service Cost of Three Oral Health Service Delivery Models in Contracted Unit of Primary Care: Provider Perspective

Author(s) : Suthasinee Sa-Nguanchuea, Sukanya Tianviwat, Songchai Thitasomakul

Keyword(s) : Contracted Unit of Primary Cares (CUPs),Provider cost,Oral health service model

Manuscript Type : Original Article (บทวิทยาการ)

Page : 212-220

The purpose of this study was to analyze the total provider cost of three oral health service delivery models.
Dental services were provided in sub-district health-promoting hospitals in three Contracted Units of Primary Care
(CUPs) by a fixation of dental nurses (Model 1), a rotation of dental personnel from the hospital once a week (Model 2),
or a combination of fixed dental nurses and rotation of dental personnel from the hospital once a month (Model
3). The design was a retrospective study. Population was all CUPs in the 11th health region of Thailand. Purposive
sampling of one CUP per model was carried out in accordance with the criteria, implementation of such models for
at least three fiscal years (Fiscal year 2018 - 2020) and high level of data collection cooperation. Total direct costs of
providers in fiscal year 2020, including capital costs, labor costs, and material costs, were collected by data collection
forms, which were tested for quality by the consensus agreement of the three experts. Data analysis consisted of total
provider cost analysis and sensitivity analysis using Microsoft Excel version 2016. The results showed that the total
provider cost per client and per visit for Model 1, Model 2, and Model 3 were 284, 188, and 319 baht per client and
171, 132, and 175 baht per visit, respectively. The results of a one-way sensitivity analysis of indirect cost percentage
and number of clients for the past three fiscal years present a similar trend as the base case. The lowest to highest
provider costs were as follows: Model 2, Model 1, and Model 3. In conclusion, A CUP that provided dental services
in sub-district health promoting hospitals by rotating dental personnel from the hospital once a week was the most
economically valuable of the three patterns.

6
Page : 221-231

Title : Effect of Silanized Nano-alumina Reinforcement on Flexural Strength of Auto-polymerized Acrylic Resins

Author(s) : Uraivichaikul Duangjai, Boonsiri Issarawan, Wattanasirmkit Kamolporn

Keyword(s) : Auto-polymerized acrylic resins,Flexural strength,Reinforcement,Alumina,Nano-alumina

Manuscript Type : Original Article (บทวิทยาการ)

Page : 221-231

Denture base fracture is often found as a primary clinical mode failure because of low flexural strength and
repetitive stress. The fabrication of new dentures incurs high expenses and is time-consuming. Purpose: The aim
of this study was to evaluate the flexural strength of auto-polymerized acrylic resins reinforced with 0.5, 1, 3, 10
weight % silane-treated nano-aluminum oxide particles. Seventy-two rectangular (ISO standard 20795-1) acrylic resins
were fabricated and divided into six groups (n=12). Two control groups were an unmodified heat-polymerized acrylic
resin group and auto-polymerized acrylic resin group. The others were experimental groups incorporated with 0.5, 1, 3
and 10 weight % silane-treated nano-aluminum oxide particles. The flexural strength was measured by a three-point
bending test. One-way ANOVA and Tukey Honestly Significant Difference (HSD) were used for statistical analysis. The
means flexural strength of silane-treated nano-alumina reinforced auto-polymerized groups (Groups SA0.5, SA1, SA3
and SA10) (136.63, 128.46, 125.61 and 121.53 MPa) were significantly improved compared to that of the control
self-cured group (Group SC) (111.49 MPa) (p<0.05). Group SA0.5 showed the highest mean flexural strength compared
to group SA10 and SC. Group SA0.5 also had the mean flexural strength almost as high as group HC. The flexural
strength of auto-polymerized acrylic resins with low weight percentages of silane-treated nano-alumina tended to be
higher than those with high weight percentages of silane-treated nano-alumina. Flexural strength of auto-polymerized
acrylic resins reinforced with nano-alumina at 0.5 weight percent was comparable to that of heat-cured acrylic resins.

1
Page : 92-103

Title : Guideline on Use of Fluoride in Dentistry

Author(s) : The Dental Association of Thailand

Keyword(s) : Prevention,Dentistry,Guideline,Dental caries,Fluoride,แนวทางการใช้ฟลูออไรด์ในทางทันตกรรม ทันตแพทยสมาคมแห่งประเทศไทย

Manuscript Type : Review Article (บทความปริทัศน์)

Page : 92-103

Guideline on Use of Fluoride in Dentistry was developed by the Dental Association of Thailand. It is an update from the last revision in 2017 by an expert dental panel to reach a consensus on use of fluoride in dentistry. This
document reflects a review of dental literature and sources of professional expertise including both academic and practicing communities in Thailand. The use of fluoride is categorized into 3 groups: 1) Home-use fluoride (fluoride toothpaste, fluoride mouthrinse, high concentration fluoride toothpaste, and dietary fluoride supplements), 2) Professionally applied fluoride (fluoride gel, fluoride varnish, and silver diamine fluoride), and 3) Community-use fluoride (milk fluoridation and water fluoridation). This following guideline includes clinical effectiveness, indications, instructions, precautions, and some adverse effects of fluoride.

2
Page : 104-112

Title : Factors Affecting 1-year Tooth Loss in Type 2 Diabetes Patients

Author(s) : Rungsinee Techawitoonwong, Angkana Thearmontree, Samerchit Pithpornchaiyakul

Keyword(s) : tooth loss,oral health,diabetes mellitus,drug induced xerostomia

Manuscript Type : Original Article (บทวิทยาการ)

Page : 104-112

This study is a retrospective cohort study that aimed to investigate the factors predicting tooth loss in type 2 diabetes patients. The sample consisted of 162 diabetes patients who visited diabetes clinic, Hat Yai Hospital, Songkla
province during october 2015 - september 2020. The data were obtained from electronic databases which included general data, medical history and oral health status. The data were analyzed using mean, standard deviation, chi-square and multiple logistic regression. The results showed that duration of diabetes mellitus, taking drug induced xerostomia and remaining teeth was associated tooth loss in 1 year statistically significant (p<0.05). All three factors were able to predict tooth loss in diabetes patients by 38.8 %. Remaining teeth was the most influencing factor in predicting tooth loss in 1 year (p<0.01). Diabetes patients who had less than 20 remaining teeth were 9.6 times (95% CI 4.5-20.7) more likely to have tooth loss in 1 year than those with remaining teeth ≥ 20 teeth. The results of this study can be used to screen the risk of tooth loss in diabetes patients and to promote proper oral health care plans to reduce tooth loss in these diabetes patients.

3
Page : 113-122

Title : Enabling Factors and Barriers for The Use of Silver Diamine Fluoride to Arrest Caries Among Elders by Providers’ Perspectives

Author(s) : Samerchit Pithpornchaiyakul, Nilubol Panabuth, Achara Watanapa

Keyword(s) : Arrested dental caries,Silver diamine fluoride,Elderly,Provider

Manuscript Type : Original Article (บทวิทยาการ)

Page : 113-122

This study aimed to explain enabling factors and barriers to the use of silver diamine fluoride among the elderly by dental practitioners in northeastern Thailand. Data were collected by in-depth interviews with eight
dental practitioners, six university lecturers and five lecturers from Sirindhorn College of Public Health, two silver diamine fluoride experts, and four dental policy makers were conducted to understand the enabling conditions and impediments to the use of silver diamine fluoride adapted from “The concept of access” by Penchansky and Thomas 1981. The findings revealed that the enabling factors are: the perception and experience with silver
diamine fluoride, which lead to confidence when applied; the efficacy of arresting caries; easy access to products; availability of products; simple procedures; the free cost for elderly people who have been included in universal
coverage program; and the acceptance of the majority of elderly. The COVID – 19 pandemic caused the inability to do aerosolizing treatments, which impelled dental practitioners curious about employing silver diamine fluoride. The barrier factors are : most dental practitioners don’t want to use silver diamine fluoride in the esthetics area as a consequence of black staining; having only one dealer company that seems to monopolize products caused purchasing problems; administration to use; that the substance is liquid, which is hard to control and causes blemishes in other areas; the lack of a silver diamine fluoride code for the medical treatment expense in hospital
record system; and that some elderly were not accepted in black staining. At present, there is no policy explicitly encouraging the use of silver diamine fluoride, but dental policy makers are considering including it in home visiting
programs for dependent elderly people through appropriate case selection.

4
Page : 123-132

Title : Shear Bond Strength of Self-etch and Self-adhesive Resin Cements to Dentin after Cleansing Blood-Hemostatic Agent-Contamination with Different Techniques

Author(s) : Yanee Tantilertanant, Paipis Sirithammapan

Keyword(s) : Blood contamination,Hemostatic agent,Resin cement,Shear bond strength

Manuscript Type : Original Article (บทวิทยาการ)

Page : 123-132

The study aimed to evaluate the effect of cleansing protocols for blood – hemostatic agent contaminated dentin on the shear bond strength (SBS) of self-etch or self-adhesive resin cements. Flat 50 buccal or lingual dental
surfaces obtained from intact human third molars were randomly allocated into two groups according to the type of resin cements (self-adhesive resin cement groups and self-etch resin cement groups). Specimens were then sub-divided into five subgroups according to contamination and cleansing protocols (Control, blood + aluminum chloride + water, blood + aluminum chloride + 17% ethylenediaminetetraacetic acid, blood + ferric sulfate + water, blood + ferric sulfate +17% ethylenediaminetetraacetic acid). In the self-etch resin cement group, Single BondTM Universal adhesive in self-etch mode was used. Cylindrical RelyXTM Ultimate or RelyXTM Unicem was built up by using SBS jig. After threemonth in distilled water storage at 37OC, all samples were performed SBS test. F-test one-way ANOVA followed by Tukey HSD post hoc test was used to analyzed data in the self-etch resin cement and Welch’s ANOVA followed by Games-Howell was used in the self-adhesive resin cement. Level of confident was set at 95%. Failure mode of fracture specimens was evaluated with a stereomicroscope. In the self-etch group, mean values of SBS in all investigated groups demonstrated no statistically significant difference compared to the control group (p=0.537). In the self-adhesive group, all test groups showed significantly decreased mean values of SBS compared to the control group (p<0.001). Cleansing with either water or 17%EDTA is suitable for blood-hemostatic agent contaminated dentin when using resin cement combined with self-etch universal adhesive. However, both methods are not recommended for cleaning such contamination when self-adhesive resin cement is used.

5
Page : 133-144

Title : Mandibular Position Changes Following Three Treatment Modalities in Class II Division 1 Growing Patients

Author(s) : Watjakorn Suadee, Smorntree Viteporn

Keyword(s) : Class II division 1 malocclusion,Cervical headgear,Extraction,Class II traction,Mandibular position

Manuscript Type : Original Article (บทวิทยาการ)

Page : 133-144

This retrospective study aimed to investigate the effects of different orthodontic treatment modalities on mandibular positions in Class II division 1 growing patients. The 96 patients, (48 boys, 48 girls) aged 11.7±1.6 years
were equally divided into three groups: the cervical headgear group, the extraction of four first premolars, and the Class II traction. Significant changes of the mandibular positions and related structures were evaluated from pre- and post-treatment lateral cephalograms by angular and linear measurements as well as the x-y coordinate system. The paired t-test or the Wilcoxon signed rank test was applied to investigate significant changes within groups, and differences between groups were evaluated by ANOVA or the Kruskal Wallis H test. Factors influencing the significant changes of mandibular positions were evaluated by stepwise multiple regression analysis at a P<0.05 significance level. The result indicated significant changes of mandibular position after treatment. Nonextraction treatment with cervical headgear followed by fixed edgewise appliance produced the most significantly forward and downward movements of the mandible with forward rotation. Mandibular rotation was the most important factor affecting the anterior position of the chin, followed by the horizontal growth of the condyle. Meanwhile, the downward movement of the maxilla at the A point and the vertical growth of the condyle were significantly affected by the vertical position of the chin. In conclusion, alterations of mandibular positions after treatment of Class II division 1 malocclusion could be expected depending on growth potential of the patient. Significant differences of mandibular positions between treatment groups could be detected when evaluated by the x-y coordinate system. Forward and downward displacements of the mandible with forward rotation were the most remarkable in the headgear group followed by the extraction and Class II traction groups, respectively.

6
Page : 145-152

Title : The Accuracy and Precision of Twelve-angle Camera Facial Scan System for Measurement of Facial Soft Tissue

Author(s) : Atiphan Pimkhaokham, Suwatchai Chalearnthongtakul, Sirida Arunjaroensuk, Boosana Kaboosaya, Kanit Dhanesuan, Borom Tunwatatanapong

Keyword(s) : 3D facial scan,anthropometry,digital vernier caliper,face,facial soft tissue,imaging,three-dimensional

Manuscript Type : Original Article (บทวิทยาการ)

Page : 145-152

The 3-Dimension treatment planning using database from cone beam computed tomography and surface scan of patients’ face could provide more information. However, the application of combined data is still limited.
Few reports are available since the novel of twelve-angle camera facial scan system was introduced for maxillofacial application. Twenty-five healthy volunteers were included to study accuracy and precision of the novel twelve-angle camera facial scan system compared to digital Vernier caliper. Anthropometry points and distances were identified and measured using the digital Vernier caliper and novel twelve-angle camera facial scan system (H3 lumio3D, Bangkok, Thailand). Mean absolute deviation and Relative error magnitude were analyzed for indicated accuracy. The Intra Class Correlation and Dahlberg’s error were analyzed for indicated precision. The accuracy from facial scan method demonstrated lower values than digital Vernier caliper method except left orbital fissure distance and intercanthal width. The excellence of precision was shown. The novel twelve-angle camera facial scan system demonstrated proper accuracy and precision due to these values were in a same range of previous systems. Nowadays, clinical applications of previous systems were reported. Twelve-angle camera facial scan system could be applied for clinical application too.

7
Page : 153-162

Title : Risk Indicators for Severe Periodontitis and Level of Oral Health Awareness in Type 2 Diabetic Patients Attending A Tertiary Bangkok Metropolitan Administration Hospital

Author(s) : Orakarn Sangkum

Keyword(s) : Awareness,Diabetes mellitus,Periodontal disease,Risk factors,Thailand

Manuscript Type : Original Article (บทวิทยาการ)

Page : 153-162

This cross-sectional study investigated the periodontal status and potential risk indicators for severe periodontitis in type 2 diabetic patients. The oral health knowledge and behaviors of the patients were also evaluated.
A systematic random sampling method was used to recruit 290 dentate patients with physician-diagnosed type 2 diabetes mellitus who visited a diabetic center at a Bangkok Metropolitan Administration (BMA) tertiary hospital.
Data on socioeconomic, diabetic status, oral health knowledge, and behaviors were collected using a questionnaire. The Periodontal Screening and Recording (PSR) Index was used to assess the periodontal status of the patients. The findings showed that 61.03 % of the diabetic patients had periodontitis (PSR code 3 = 26.89 % and PSR code 4 = 34.14 %). A univariate analysis found that increased age, lower education level, smoking, self-perceived “poor” blood glucose control, diabetes duration of ≥ 5 years, and diabetes complication increased the risk of severe periodontitis (PSR code 4). A multiple regression analysis determined that having primary education (odds ratio: OR = 3.75), being a former smoker (OR = 2.99) or current smoker (OR = 4.06), and a diabetes duration of 5–10 years (OR = 2.17) were significantly associated with severe periodontitis (p<0.05). Only 42.4 % of the patients had “adequate” oral health knowledge, 64.5% had never used interdental cleaning devices, and only 29.7 % went for a dental check-up every six months. Patients with type 2 diabetes at the BMA tertiary hospital had a high prevalence of periodontitis. Significant predictors of severe periodontitis were education level, smoking, and diabetes duration. Furthermore, most of the diabetic patients lacked oral health knowledge and had poor oral health behaviors.

1
Page : 1-11

Title : A Comparison of Pulp Necrosis and Root Resorption After Auto-transplantation Between Immature Teeth and Apicoectomized Mature Teeth

Author(s) : Ploypailin Manovilas, Chootima Ratisoontorn, Onanong Silkosessak, Anchana Panichuttra, Kanit Dhanesuan

Keyword(s) : Apicoectomy,Autotransplantation,Cone beam computed tomography,Revascularization,Root resorption

Manuscript Type : Original Article (บทวิทยาการ)

Page : 1-11

Success in pulp revascularization after autotransplantation tends to happen in a tooth with an incomplete root formation, while a tooth with a complete root formation needs a root canal treatment. However, recent studies
showed that apicoectomy facilitated the repair and revascularization process with promising outcomes. This study aimed to compare the incidences of pulp necrosis and root resorption of autotransplanted teeth with a complete root formation which underwent apicoectomy and teeth with an incomplete root formation. Patients with a history of autotransplantation received clinical and radiographic follow-up examination. The autotransplanted teeth were divided into two groups, the incomplete root formation group and the extraoral apicoectomized complete root formation group. Pulp and periradicular outcomes (pulp healing, pulp necrosis and presence of root resorption) were determined with an additional of cone-beam computed tomography investigation. The incidence of each outcome and prognostic factors were statistically compared. The result showed that the incomplete root formation group presented 40 % (4 of 10) pulp necrosis and 10 % (1 of 10) root resorption, while the extraoral apicoectomized complete root formation group presented 77.8 % (7 of 9) pulp necrosis and 66.7 % (6 of 9) root resorption. The periradicular status between the two groups was significantly different. No prognostic factor was found to be related to pulp outcome, however apicoectomy and recipient socket were found to be related to the periradicular outcome. Autotransplanted teeth with complete root formation undergoing extraoral apicoectomy increased the risk of pulp necrosis and root resorption. A totally prepared recipient socket without remaining periodontal ligament was also found to be related to root resorption.

2
Page : 12-20

Title : Assessment of Midpalatal Suture Maturation by Cone-beam Computed Tomography in Circumpubertal Age Group

Author(s) : Nopparat Chutasripanich, Korapin Mahatumarat, Soontra Panmekiate

Keyword(s) : Chronological age,Cone-beam computed tomography,Maturation stages,Midpalatal suture,Rapid maxillary expansion

Manuscript Type : Original Article (บทวิทยาการ)

Page : 12-20

This study evaluated the prevalence of midpalatal suture maturation stages in 8 to 18 years old patients and the relationship between chronological age and the suture maturation stages in a Thai population. The cone-beam
computed tomography (CBCT) images of the midpalatal suture from 240 subjects (110 males, 130 females) aged 8 to 18 years were classified into five stages (A-E). The distribution of the maturation stages was determined according to chronological age and sex. Chi-square test was used to compare the prevalence of maturation stages between male and female subjects. Spearman’s rank correlation analysis was performed to investigate the relationship between the maturation stage and chronological age. The results showed that the fused stages (D-E) were not seen in the prepubertal age group (8-11 years old). In the postpubertal age group (12-18 years old), the prevalence of nonfused stages (A-C) and fused stages (D-E) was 82.3% and 17.7% respectively. Stage C was the most prevalent (62.6%) in the postpubertal age group. Female showed a significantly higher prevalence of fusion than male (χ2 = 5.434, p=0.02). The correlation coefficient between chronological age and the suture maturation was 0.325 (p<0.001). In conclusion, fusion was not observed in females under 12 years old and males under 14 years old. Thus, CBCT might be recommended to verify the suture status before performing maxillary expansion in female ≥12 years old and males ≥14 years old. Overall, chronological age had a weak positive correlation with the suture maturation.

3
Page : 21-28

Title : A Retrospective Comparative Study of Mandibular Stability and the Anteroposterior Dimension of the Airway between the Surgery-early and the Conventional Orthognathic Surgery after Bilateral Sagittal Split Ramus Osteotomy Setback

Author(s) : Patcha Chooputtipong, Bancha Samruajbenjakun

Keyword(s) : Class III orthognathic surgery,Surgery-early,Upper airway

Manuscript Type : Original Article (บทวิทยาการ)

Page : 21-28

The purpose of this study was to compare the skeletal and upper airway stability at 6 months post-surgical treatment between the surgery-early approach and the conventional orthognathic surgery in patients with skeletal
Class III malocclusion who underwent one-jaw bilateral sagittal split ramus osteotomy setback surgery. Thirty-five patients were included and allocated into two groups based on pre-surgical orthodontic treatment: surgery-early
group (n = 15) and conventional orthognathic surgery (n = 20). Lateral cephalometric radiographs were taken before surgery (T0), immediately after surgery (T1), and 6 months after surgery (T2). Independent t-test and Mann-Whitney U test were used to analyze the data between the two groups. Paired t-tests and Wilcoxon signed-rank tests were used to analyze the data in each group. At 6 months after surgery (T1-T2), forward, upward, and counterclockwise rotational movements of the mandible in both groups were observed with no statistically significant difference. Changes in upper airway dimensions, when compared between the pre-post surgical phase (T2-T0) revealed that the surgery-early group showed a statistically significant decrease (p<0.05) in the oropharynx, while the conventional orthognathic surgery group showed statistically significant decrease (p<0.05) in the oropharynx and hypopharynx. A comparison between the two groups at 6 months post-surgical treatment revealed no statistically significant difference. Dental movement in both groups had no statistically significant difference in either the vertical or anteroposterior movement. Compared with the conventional orthognathic surgery group, the surgery-early group showed an equal amount of mandibular movement and upper airway change at 6 months post-surgical treatment.

4
Page : 29-36

Title : A Denture Cleansing Solution and Household Agents Differentially Affect the Surface Roughness of Acrylic Resin

Author(s) : Sita Thaworanunta, Naluemol Sriprasert, Chutimon Nanarong, Pichsinee Dittaratchaphong, Thananya Momin, Thanpitcha Krisanawong

Keyword(s) : Commercial denture cleansing solutions,Household agents,Heat-cured acrylic resin,Surface roughness

Manuscript Type : Original Article (บทวิทยาการ)

Page : 29-36

This article evaluated the surface roughness of heat-cured acrylic resin before and after immersion in 4 different household agent solutions and a commercial denture cleansing solution after simulated 6-month and
12- month durations. Seventy-two specimens were fabricated from heat-cured acrylic resin and were divided into 6 groups (n=12); namely 4 household agents (100% clear vinegar, 5% acetic acid 0.1%, and 0.5% Sodium hypochlorite), a commercial denture cleansing solution, Polident® (Block Drug Company Inc, Memphis, TN38113, USA.) and tap water. The acrylic resin specimens were immersed for 10 min/cycle, 5 times/day for 36 days representing 6-month of clinical service, and continued for another 36 days representing 12-month of clinical service. The surface roughness (Ra, nm) was measured before and after simulated immersion. The data were compared using repeated ANOVA and Tukey’s test. The mean difference in the Ra after the 6-month and 12-month immersions in the control group and the Polident®, 100% clear vinegar, and 5% acetic acid groups was not significantly different (P > 0.05). In contrast, the mean Ra in the 0.1% and 0.5% sodium hypochlorite groups was significantly higher (P < 0.05) after the 6-month immersion. However, the Ra increased with a diminishing value after the 12-month immersion. The Ra of the specimens immersed in 0.1% and 0.5% sodium hypochlorite was significantly increased after 6-month, which decreased by 12-month immersion. The Ra in the 100% clear vinegar and 5% acetic acid groups were not significantly different from that of the Polident® group. Therefore, 100% clear vinegar and 5% acetic acid, which are household agents, can be an alternative option for routine use. Further study should be performed to evaluate whether 0.1% and 0.5% sodium hypochlorite might be an alternative option for denture cleansing.

5
Page : 37-44

Title : Sensitivity of Brux Checker® in Grinding Bruxer

Author(s) : Donlatham Prommasen, Namrath Chatchaiyan, Somsak Mitrirattanakul

Keyword(s) : Diagnostic sensitivity,Grinding bruxer,Intraoral device,Oral parafunction,Sleep bruxism

Manuscript Type : Original Article (บทวิทยาการ)

Page : 37-44

Untreated bruxism can cause pathologic consequences to the components of the masticatory system leading to unnecessary treatments that are often complicated and costly. However, the damage could be prevented if the
condition is diagnosed earlier. Bruxism patients with asymptomatic or mild jaw symptoms usually refused to admit that they grind their teeth. Therefore, a reasonably priced tool with high sensitivity that is comfortable to wear
would be beneficial for early screening or diagnosing sleep bruxism. The aim of this clinical study is to investigate Bruxcore Plate (Brux Checker®) accuracy to diagnose sleep bruxism in known cases. Forty-four sleep bruxism participants with clear evidence of bruxofacets on the intraoral appliance were enrolled. Results showed that Brux Checker® had a sensitivity of 84.1% after one night of application and a sensitivity of 100% on four consecutive nights. In conclusion, at least four nights of Brux Checker® wearing is recommended for sleep bruxism diagnosis.

6
Page : 45-53

Title : Protein Expression after Gingival Injection of mRNA Encoding Platelet-derived Growth Factors-BB in Ligature-induced Periodontitis Model in Rats

Author(s) : Pimphorn Meekhantong, Wichaya Wisitrasameewong, Noppadol Sa-Ard-Iam, Theeraphat Chanamuangkon, Somchai Yodsanga, Pimprapa Rerkyen, Rangsini Mahanonda

Keyword(s) : ligature-induced periodontitis,LNPs,mRNA,PDGF,periodontitis

Manuscript Type : Original Article (บทวิทยาการ)

Page : 45-53

The year 2021 marks the breakthrough of the COVID-19 mRNA vaccine as a new class of medicine. The same fundamentals of the mRNA-based vaccine could facilitate the development of mRNA-based regenerative therapy. Our research group is working on mRNA encoding growth factors for periodontal regeneration in patients with periodontitis. The objective of this study was to investigate protein expression after local administration of mRNA encoding plateletderived growth factor-BB (PDGF) encapsulated in lipid nanoparticles (PDGF mRNA) in ligature-induced rat periodontitis. 3-0 silk was placed around the maxillary left second molar for two weeks and then removed, while the maxillary right second molar was left non-ligated. A significant bone loss analyzed by a stereomicroscope and micro-computerized tomography and gingival bleeding at the ligature sites were observed as compared to the non-ligature sites. To evaluate transfection and protein translation, different doses of PDGF mRNA including low dose (3 μg), medium dose (10 μg), high dose (30 μg), and DPBS (control) and LNPs alone were injected into rat gingiva at palatal side. The translated PDGF protein production was assessed 24 hours after the injection using enzyme-linked immunosorbent assay (ELISA). High levels of PDGF production were detected at both ligature and non-ligature sites. The mean PDGF levels in mRNA treated groups ranged from 10,912.54±1,893.94 to 51,883.91±7,415.45 pg/mg protein, whereas levels in DPBS control and LNPs alone were negligible. PDGF protein expression showed a trend of dose response but the differences between doses were not significant. Clinical findings at injected sites showed no erythema or swelling. The histological findings showed no evidence of LNPs and other foreign substances of mRNA formulation remaining in the tissues. In conclusion, this study of 24 hour-local delivery of PDGF mRNA-LNPs into rat periodontitis results in highly translated PDGF protein without profound local inflammatory response. However, further studies into the in vivo kinetics and therapeutic efficacy of mRNA are required.

7
Page : 54-65

Title : Expression of CLLD7 and CHC1L Proteins in Oral Potentially Malignant Disorders in A Group of Thais: A Preliminary Study

Author(s) : Sunisa Suchitanant, Rachai Juengsomjit, Sopee Poomsawat, Ounruean Meesakul, Bishwa Prakash Bhattarai, Boworn Klongnoi, Siribang-on Piboonniyom Khovidhunkit

Keyword(s) : CLLD7,CHC1L,Normal oral mucosa,Oral epithelial dysplasia

Manuscript Type : Original Article (บทวิทยาการ)

Page : 54-65

Chronic lymphocytic leukemia deletion 7 (CLLD7) and chromosome condensation 1-like (CHC1L) proteins are putative tumor suppressor proteins that have never been studied in oral potentially malignant disorders (OPMDs).
This study aimed to evaluate the expression of these two proteins in OPMDs which encompassed oral leukoplakia, oral lichen planus (OLP), and oral lichenoid lesions (OLL). The histopathological features of oral leukoplakia were
acanthosis with or without hyperkeratosis and mild to severe epithelial dysplasia. Therefore, five groups including acanthosis with or without hyperkeratosis, mild, moderate, and severe dysplasia and the last group OLP/OLL were subjected to immunohistochemistry using normal oral mucosa as a control. In each case, random areas were selected and photographed after immunohistochemistry, then at least 1000 cells were counted. For CLLD7 and CHC1L, nuclear, cytoplasmic, and/or membrane staining were considered positive. Positive cells at different locations were evaluated. SPSS version 18 was used to compare the variation of protein expression among groups with a statistical significance at p<0.05. CLLD7 and CHC1L proteins were expressed in all cases of NOM and OPMDs. Compared to the acanthosis group, nuclear staining of CLLD7 was significantly lower in the severe epithelial dysplasia and the OLP/OLL groups. Although increased cytoplasmic staining of CLLD7 was observed in all OPMDs groups compared to the NOM group, a statistically significant difference was observed between the mild and moderate epithelial dysplasia groups compared to the NOM group. Regarding CHC1L staining, the percentage of nuclear staining was reduced, whereas membrane staining was increased in all OPMD groups compared to the NOM group. However, a statistically significant difference was observed between the severe epithelial dysplasia and OPL/OLL groups compared to the NOM group. In conclusion, the altered subcellular localization of CLLD7 and CHC1L in OPMDs suggests that the expression of these putative tumor suppressor proteins might be dysregulated during the early malignant transformation processes of oral cancer.

8
Page : 66-74

Title : A Systematic Review of the Effectiveness of Laser Therapy in Prevention of Osteoradionecrosis of the Jaw

Author(s) : Thipok Sombutsirinun, Suwat Tanya, Sajee Sattayut

Keyword(s) : Osteoradionecrosis,Jaw,Laser therapy,Photobiomodulation,Photodynamic therapy

Manuscript Type : Original Article (บทวิทยาการ)

Page : 66-74

Osteoradionecrosis of the jaw is an incurable condition. Management of complete healing of the necrotic bone and clinical full mucosal coverage is challenging. Therefore, the prevention of osteoradionecrosis of the jaw
is worth considering. There was some evidence of using laser therapy for preventing osteoradionecrosis of the jaw. The purpose of this systematic review was to evaluate the effectiveness of laser therapy in the prevention of
osteoradionecrosis of the jaw. A systematic review was conducted on published articles in databases of MEDLINE, Embase, Cochrane Library, Scopus, Google Scholar and Thai-Journal Citation Index Center to identify the eligible
studies to compare the effectiveness to prevent osteoradionecrosis of the jaw. The latest search date was 29 May 2022. The included studies were assessed with two independent reviewers by using the Cochrane Risk of Bias Tool for randomized controlled trials or the Joanna Briggs Institute critical appraisal for case reports. Then the data was extracted by using the Cochrane Handbook for Systematic Reviews of Interventions. The two reviewers were calibrated. The agreement of assessment between the reviewers was 90 %. There were 24 articles included by title and abstract. Five articles were discarded because of duplication. Of 19 articles, there were four studies; one randomized controlled trial and three case reports, that met the eligible criteria. The level of the bias was low risk. In conclusion, there was a possibility of using laser therapy immediately after extraction to prevent osteoradionecrosis of the jaw by gaining faster tissue coverage. The combinations of using laser therapies; photobiomodulation and photodynamic therapy with antibiotics or pentoxifylline and tocopherol or platelet-rich fibrin allowed favorable clinical outcomes in prevention of osteoradionecrosis of the jaw.

9
Page : 75-83

Title : Creating A Gingival Color Database Among Thai Samples by Using Digital Images Processing

Author(s) : Suriyan Thammarat, Suttipalin Suwannakul, Sasitharee Nathamtong, Anuphan Sittichokechaiwut

Keyword(s) : Digital image analysis,Gingivitis,Gingival color

Manuscript Type : Original Article (บทวิทยาการ)

Page : 75-83

This research aims to analyze the digital color-coded values of clinical gingival color images and create a gingival color database using digital images to measure the clinical gingival color levels. Theories of RGB and HSB
color models were applied in the present study. The research model was cross-sectional descriptive. There were two research methods: 1) Digital gingival color code analysis and 2) Digital gingival color reliability analysis. In the
first part, photographs of the gingiva of 99 patients who were admitted to the dental hospital, Faculty of Dentistry, Naresuan University, were taken. Adobe Photoshop CS6 software was employed for digital color code analysis. The digital color codes of the gingiva collected from the 143 samples were then examined for their reliability. Data from the study exhibited the total numbers of digital areas from the gingival images were 3,700 areas, with slightly red being the majority, 35.51%, followed by pale pink, red, and bluish-red, for 27.46, 25.43, and 11.59%, respectively. The RGB and HSB color models revealed the frequency of one or two codes using the statistical mode. In contrast, the red code showing ten performed by the RGB model and more codes in the HSB model. The reliability analysis of digital gingiva was calculated with an alpha coefficient of 0.655, which is a moderate confidence level. The analysis of dental images in the present study shows the promising potential to create a database of gingival color. The digital image databases are created on the Windows operating system and Microsoft Access software that can display data such as frequency, percentage, gingival color code, and color samples. Performing the software, users can basically input data consisting of gingival images, color codes, filter inputs, and search the database of RGB and HSB color models.

10
Page : 84-91

Title : The Efficiency in Reducing the Dispersion Aerosols by Using Various Types of Intraoral and Extraoral Suctions

Author(s) : Mayurach Pipatphatsakorn, Anuphan Sittichokechaiwut, Pornsuda Norchai

Keyword(s) : Aerosol control,COVID-19,Dental aerosol,Dental aerosol reduction

Manuscript Type : Original Article (บทวิทยาการ)

Page : 84-91

Coronavirus disease 2019 (COVID-19) is an emerging disease that puts aerosolized dental treatments at a high risk of transmission; therefore, up-to-date knowledge of aerosol control plays an essential role in determining
standard regulation in dental practice. The objective of this study was to compare the efficiency in reducing the dispersion of aerosols by using various types of intraoral and extraoral suctions. The study was conducted in a
closed acrylic box. A high-speed handpiece (Airotor) was used to create aerosols. The intraoral and extraoral suctions were divided into six groups (saliva ejector, high-power suction tip, side-wing tip, dome- shaped tip, EasyPrep®, and Extraoral suction). The relative humidity in the box was monitored at 1, 5, and 10 mins with a hygrometer and was repeated three independent times. The videos were also recorded during the experiment. Results showed that the saliva ejector alone had the most aerosol diffusion outside the mouth. The mean of relative humidity was highest and was significantly higher than other groups using a saliva ejector in combination with other suctions. After 1 minute of the procedure, the mean relative humidity in the group using the saliva ejector plus extraoral suction was significantly lower than that of the group using the saliva ejector plus the high-power suction tip at P-value = 0.038. When the saliva ejector was used with the extraoral suction, the means relative humidity were not different between groups after 5-10 mins. In conclusion, the present study provided preliminary information for considering instruments as needed and the most effective one in reducing the dispersion of aerosols. The knowledge from this research could be used as a guideline to improve the workflow or regulation in dental practice for safety.