JOURNAL OF THE DENTAL ASSOCIATION OF THAILAND

  • Issue 1 volume 73
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.