The study aims to examine dental care utilization and the determinants contributing to the observed inequalities among Thai older adults during the demographic shift of Thailand to a complete-aged society, in which over 20% of the population are over the age of 60 years old, prior to the implementation of the national oral health plan for the older adults in 2015. This study analyzed data from the nationally representative Health and Welfare Surveys conducted in 2009 and 2015. Participants included individuals aged 60 years and older (N = 11,402 in 2009; N = 25,566 in 2015). Dental care utilization was measured by self-reported utilization within the past 12 months. Descriptive and logistic regression analyses were performed regarding the objective. Socioeconomic and geographic inequalities in dental care utilization persisted throughout the study period. Older adults with higher socioeconomic status were more likely to utilize dental care than their lower socioeconomic status peers.  Utilization was highest in Bangkok and lowest in the rural areas of each region. The beneficiaries of the Civil Servant Medical Scheme were twice as likely to use dental services compared to those under the Universal Coverage Scheme. The findings from the multivariate analysis identify several key factors that significantly influence the utilization of dental care. These factors provide valuable insights into how demographic, socioeconomic, geographic, and health-related factors can influence access to dental services. Demographic Factors: Women tend to use dental care services more than men. In 2009, their Adjusted Odds Ratio (OR_adj) was 1.19 (1.02, 1.38), which increased to 1.31 (1.18, 1.47) by 2015. Younger older adults (ages 65-74) also exhibit higher dental visit rates, with an OR_adj of 2.28 (1.76, 2.96) in 2009 and 1.93 (1.57, 2.35) in 2015. Middle-aged older adults (ages 75-84) experienced a significant increase in dental care utilization, with OR_adj values of 1.86 (1.42, 2.43) in 2009 and 1.61 (1.30, 1.98) in 2015. Socioeconomic Factors: Individuals in the highest income group (5th quintile) had an OR_adj of 1.96 (1.60, 2.41) in 2009, which increased to 2.25 (1.94, 2.60) in 2015. Higher education levels, particularly completing secondary school, are associated with more frequent dental visits, reflected by an OR_adj of 1.78 (1.30, 2.43) in 2009 and 2.68 (2.03, 3.54) in 2015. Geographic Factors: Residents of the Central region utilize dental services less frequently. Their OR_adj was 0.44 (0.33, 0.59) in 2009 and decreased to 0.34 (0.27, 0.41) in 2015. Those living in rural areas also reported lower utilization rates, with an OR_adj of 0.49 (0.32, 0.54) in 2009 and 0.34 (0.28, 0.41) in 2015. Health-Related Factors: Being enrolled in the Civil Servant Medical Benefit Scheme (CSMBS) is associated with more dental visits, with an OR_adj of 1.85 (1.59, 2.14) in 2009, increasing to 2.10 (1.88, 2.35) in 2015. Additionally, having a chronic illness is linked to increased dental care utilization, with an OR_adj of 1.25 (1.10, 1.43) in 2009 and 1.29 (1.16, 1.43) in 2015. During the transition of aged society, inequalities in dental care utilization among Thai older adults persist, particularly among those with low socioeconomic status and residents in rural areas. Targeted policy reforms, such as expanding preventive programs and integrating dental services into primary care, are essential to promote equitable oral health access among Thailand’s aging population.

This study aimed to compare knowledge, attitudes, practices in children oral healthcare, and caregiver satisfaction between two chatbots: 21-day and short-term. The study was a quasi-experimental design involving parents of children aged 2-5 years in urban areas of Songkla Province, divided into two groups: 21-day and short-term chatbot group. Google form surveys were used to gather research data before and after intervention. T-test and chi-square statistics were used to compare the knowledge, attitude, practice, and satisfaction scores. The two groups' differences before and after the intervention were compared in cases where the pre-intervention data showed a statistically significant difference. According to the study's findings, there were 75 participants in the 21-day chatbot group and 81 in the short-term group. There was a statistically significant difference between the knowledge and dietary behavior scores. The knowledge scores of the short-term and 21-day chatbot groups were 5.2 ± 1.8 and 6.8 ± 1.6, respectively (P-value < 0.001). The respective scores for dietary behavior were 2.5 ± 1.5 and 2.9 ± 1.2 (P-value = 0.004). The oral hygiene care and attitude scores were significantly different from the beginning of the study. However, when comparing the differences, the increased scores were not significantly different. The satisfaction scores showed significant difference, with values of 4.4 ± 0.9 and 4.1 ± 1.1, respectively (P-value = 0.033). In summary, 21-day chatbot showed different increases in knowledge, dietary behavior, and user satisfaction compared to the short-term chatbot. Meanwhile, the increases in oral hygiene care and attitude scores were not significantly different.

This research aims to develop and evaluate deep learning models for diagnosing Class III malocclusion in pediatric patients using lateral cephalometric radiographs. The study compared an artificial neural network (ANN) model and a convolutional neural network (CNN) model with image embedding and logistic regression. Radiographs from patients aged 3-12 years (2007-2023) were analyzed. Model performance was evaluated using classification accuracy, sensitivity, precision, F1 score, and area under the ROC curve (AUC). Contrary to expectations, the ANN model outperformed the CNN model. The ANN model achieved 90.3% classification accuracy, high sensitivity and precision, an F1 score of 0.902, and an AUC of 0.948, indicating excellent discrimination ability. In contrast, the CNN model showed a lower performance with 71.6% classification accuracy, an F1 score of 0.715, and an AUC of 0.750. Despite the underperformance of the CNN model, potential improvements include data augmentation, larger diverse datasets, and exploring advanced CNN architectures. The superior performance of the ANN model suggests its potential as a reliable diagnostic tool for general dentists in early screening of Class III malocclusion. This study demonstrates the promise of deep learning in orthodontic diagnosis, particularly the effectiveness of ANN models. Further research is needed to enhance CNN performance and validate findings with larger, diverse datasets. Developing such AI-based diagnostic tools could significantly impact early detection, timely referrals, and treatment planning for Class III malocclusion in pediatric patients.

To quantify Bifidobacterium longum and Fusobacterium nucleatum levels in the infected root canals of primary teeth and to analyse the association between these bacteria, clinical signs and symptoms, and radiographic findings. One hundred and twenty Thai children, aged 2 to 8 years old, were recruited from the Pediatric Dental Clinic, Maha Chakri Sirindhorn Dental Hospital, Mahidol University, Nakhon Pathom, Thailand. The treatment received was either pulpectomy or pulpotomy based on the diagnosis of the American Academy of Pediatric Dentistry (AAPD) guidelines. Clinical signs and symptoms and periapical radiographs of the infected primary teeth were recorded. A total of 120 samples were collected from primary molar teeth using aseptic techniques. DNA was extracted from samples and quantitative real-time PCR was performed using fluorescent dye (SYBR green). Participants included 62 boys (52%) and 58 girls (48%). Mean age±standard deviation was 5.62±1.22 years old. Eighty-three participants (69%) and 115 participants (96%) had clinical signs and symptoms and showed radiographic pathology of an infected root canal, respectively. There was a 100% (120/120) detection rate using the 16srRNA universal primers. B. longum and F. nucleatum were detected at 56% (67/120) and 57% (68/120), respectively. Range of total bacteria, B. longum and F. nucleatum detection were 1.63x10²-1.64x10⁷, 0-1.17x10⁶ and 0-2.02x10⁶ cells/ml, respectively. Range of the ratio of B. longum/total bacteria and F. nucleatum/total bacteria were 0-3.13x10^-1 and 0-7.13x10^-1, respectively. The ratio of B. longum/total bacteria correlated with clinical signs and symptoms in only the sensitivity to percussion (p=0.043) while the ratio of F. nucleatum/total bacteria were correlated with three clinical signs and symptoms which are sensitivity to percussion (p=0.027), sensitivity to palpation (p=0.001), and the presence of gingival abscess (p=0.001). The ratio of B. longum/total bacteria were not correlated with any of radiographic findings while the ratio of F. nucleatum/total bacteria were associated with the widening periodontal ligament (PDL) space (p=0.004), periapical lesion (p=0.028), furcation involvement (p=0.002), and root resorption (p=0.027). In conclusion, B. longum and F. nucleatum were detected higher than 50% in the infected root canal of primary teeth. F. nucleatum levels showed positive correlation with many clinical symptoms and radiograph pathology, while B. longum levels showed positive correlation with sensitivity to percussion.

In recent years, artificial intelligence (AI), particularly large language models (LLM), has advanced rapidly and been applied across various sectors, including healthcare and dentistry. A prominent application is the development of chatbots that simulate human-like conversations using natural language processing (NLP). These tools can assist in patient education, especially when providing accessible explanations of complex medical procedures. However, the quality of information they provide in non-English languages, such as Thai, remains underexplored. This study aimed to assess the quality of Thai-language responses generated by LLM-based chatbots regarding orthognathic surgery combined with orthodontic treatment (OGS). To evaluate the quality of information provided by Thai-language LLM-powered chatbots in response to frequently asked patient questions about orthognathic surgery with orthodontic treatment. Two board-certified oral and maxillofacial surgeons created a set of 10 frequently asked questions in Thai about OGS. These were submitted to four major AI chatbot platforms: ChatGPT (GPT-4o), Google Gemini (Gemini 2.0 Flash), Anthropic Claude (Claude 3.5 Sonnet), and Microsoft Copilot (standard version with o1 reasoning), using only their free or basic versions. Chatbot responses were anonymized and coded to blind the evaluators. Two experienced OGS specialists independently assessed each answer using the Global Quality Score (GQS), which evaluates five domains: accuracy, completeness, clarity, relevance, and consistency. Scores were recorded in Microsoft Excel and analyzed using descriptive statistics. Inter-rater reliability was measured using the intraclass correlation coefficient. Gemini 2.0 Flash scored highest in accuracy (3.90 ± 1.66), followed by Copilot (3.40 ± 1.58), GPT-4o (2.80 ± 1.23), and Claude 3.5 Sonnet (2.40 ± 1.07). For completeness, Gemini led again (4.70 ± 0.95), while Claude had the lowest score (3.90 ± 1.10). In clarity, Copilot ranked highest (4.50 ± 0.85), and Claude lowest (2.80 ± 0.79). In relevance, Gemini scored highest (4.40 ± 0.84), while Claude trailed (3.30 ± 0.67). Copilot achieved the highest consistency (4.70 ± 0.48), and Claude the lowest (3.80 ± 0.92). The overall inter-rater reliability for GQS was good. The quality of responses generated by Thai-language LLM chatbots on OGS-related topics varied between platforms. Google Gemini 2.0 Flash demonstrated the highest overall performance across multiple evaluation domains. While GPT-4o produced understandable content for general users. To enhance chatbot reliability, Thai healthcare professionals are encouraged to contribute high-quality, accessible Thai-language content for model training. Chatbots may serve as supplementary tools for patient education but should not replace professional medical consultation.

The transfer of Subdistrict Health Promoting Hospitals (SHPHs) to Local Administrative Organizations (LAOs) in Tak Province is part of Thailand’s decentralization strategy. In this process, five SHPHs, including their oral health services, moved under the jurisdiction of local municipalities and Subdistrict Administrative Organizations. This change brought a shift in command structure and required personnel to adapt to new organizational cultures and methods. To understand these changes, researchers conducted qualitative interviews with 26 stakeholders, including LAO executives, SHPH leaders, dental therapists, and district hospital dental heads. Through content analysis, three central themes emerged. Firstly, resistance surfaced during the transfer due to differing interpretations of readiness between national public health authorities and local bodies. Secondly, personnel were compelled to adapt and negotiate in their roles, carefully balancing official regulations, professional standards, and the welfare of local residents. These negotiations reflected a shift in power dynamics and information asymmetry between professionals and the community after the transfer. Lastly, the identity of oral health services evolved as local support increased, giving dental therapists to engage more in their profession, though oversight mechanisms remained somewhat unclear. In summary, while the transfer process faced friction, it highlighted the determination of both local authorities and SHPHs to succeed in the new arrangement. The differing notions of readiness underscored fundamental contrasts between public health and local administrative perspectives. For long-term success, personnel must be fluent in regulations, know their professional boundaries, and build strong negotiation skills. Importantly, as local organizations bolster their support for oral health services, clear and consistent oversight frameworks are needed to ensure quality and accountability in the system.

This study aimed to examine the level of sweet preference and the influencing factors, including social and cultural conditions, among pre-elderly Thai-Malay Muslims. A mixed methods design was employed. In the quantitative phase, 263 participants aged 40–59 years residing in Saiburi District, Pattani, were assessed for sweet preference using the free-choice method with six sucrose concentrations. Interviews were conducted to collect data on sex, education, income, occupation, residence (coastal/inland), urbanicity (urban/rural), body mass index (BMI), age, and self-perceived sweet preference. Data were analyzed using Chi-square tests, odds ratios and logistic regression. The qualitative study was conducted followed the quantitative study by selecting participants from each extreme group (highest and lowest) for semi-structured interviews on social and cultural influences. Among the 263 participants, most were female with low socioeconomic status. High sweet preference (>10 °Bx) was found in 37.3%. Logistic regression analysis showed that occupation and self-perceived sweet preference were significantly associated with the level of sweet preference. Labor-intensive workers were twice as likely to prefer higher sweetness level than non-labor workers (OR = 2.0, 95% CI: 1.1–3.5). Those perceiving themselves as sweet likers were 2.2 times more likely to prefer higher sweetness than those who were neutral or dislike (OR = 2.2, 95% CI: 1.3–3.9). In the qualitative phase, 10 participants from each group (highest and lowest sweet preference group were include, content analysis revealed that participants with high sweet preference perceived sweetness as refreshing and energizing during heavy work, sweet perception reinforced by family and environmental contexts. In contrast those with low sweet preference often mentioned health concerns or family influences discouraging sugar use. Cultural practices including sweet food consumption during Ramadan, serving sweet dishes to guests, and offering sugar in religious ceremonies were identified as additional factors shaping sweet preference. In conclusion, strategies to reduce sugar consumption should integrate social and cultural contexts to ensure sustainable behavior change.

Orthodontic treatment aims to enhance dental aesthetics and functionality. Its impact on masticatory performance, which encompasses the efficiency and effectiveness of chewing, remains an important area of study. Factors influencing masticatory performance include dental alignment, occlusal contact, and muscular coordination. This review aims to summarize both the relationship between masticatory performance after orthodontic treatment and the commonly used methods for measuring masticatory performance following orthodontic treatment. A systematic search of electronic databases (PubMed [including MEDLINE] and Scopus) was conducted for studies published from January 2000 up to May 2024, focusing on masticatory performance in patients undergoing orthodontic treatment. Studies were selected based on predefined eligibility criteria, data on study characteristics, orthodontic interventions, masticatory assessment methods, and key findings regarding masticatory changes that were extracted. Out of 797 records identified, 13 studies met the inclusion criteria. These studies evaluated masticatory performance before and after orthodontic treatment using both subjective and objective measurements, with maximum bite force and occlusal contact area being the most used methods. The review found that non-extraction orthodontic treatment generally improved masticatory performance, as evidenced by comminution tests and self-reported ability, although performance still lagged behind natural occlusion post-treatment. Extraction orthodontic treatment presented mixed results, with lower masticatory performance in the early retention phase that gradually increased, ultimately showing no significant differences in occlusal contact area or force between extraction and non-extraction groups over time. Orthognathic surgery enhanced masticatory function, but it still did not reach the levels observed in individuals with natural occlusion, despite improvements in bite force and occlusal contact area over time. Overall, non-extraction treatment showed improvements but remained inferior to controls, while extraction treatment had variable outcomes and orthognathic surgery improved function but fell short of natural occlusion.

This retrospective study analyzed the mandibular canal (MC) anatomy in relation to bilateral sagittal split ramus osteotomy (BSSRO) in mandibular prognathism patients, comparing measurements obtained from cone beam computed tomography (CBCT) and ortho-panoramic (OP) images. Twenty-seven pre-operative radiographs (12 males, 15 females; mean age 26.3 years) revealed significant differences in MC distances to the anterior border of the ramus and sigmoid notch between CBCT (13.80±2.20 and 15.89±2.00 mm) and OP (10.27±1.27 and 14.93±2.25 mm) at p<0.001 and p=0.007, respectively. However, measurements of MC distances to the alveolar crest and inferior border of the mandible were consistent. Side differences were observed in MC to ramus distances as well as in buccal/lingual bone thickness. There were no significant differences between males and females. However, the buccal bone at the second molar area was thicker than the first molar area. The findings emphasize the superiority of CBCT over OP in the ramus region, which is critical for avoiding inferior alveolar neurovascular injury during BSSRO, Based on this, performing vertical osteotomies in the second molar region may lead to safer surgical outcomes.

The effects of various concentrations of 0.01, 0.1, and 1.0 µg/mL of lipopolysaccharide (LPS) from Porphyromonas gingivalis (P. gingivalis) on inflammatory response and proliferation of stem cells isolated from human exfoliated deciduous teeth (SHEDs) were compared. The MTT test was utilized to assess cell growth. Our research indicated that P. gingivalis LPS administration did not influence the proliferation of SHEDs. The expression levels of IL1B, IL6, and IFNG escalated in a dose-dependent way. Statistical significance was noted in the expression of IL1B at a concentration of 0.1 µg/mL of P. gingivalis LPS (p<0.05) and in the expression of IL6 at a concentration of 1.0 µg/mL of P. gingivalis LPS (p<0.05). Moreover, treatment with P. gingivalis LPS at doses of 0.01 and 0.1 µg/mL resulted in enhanced TNF gene expression . Notably, at the maximum concentration (1.0 µg/mL), the gene expression level substantially diminished. Statistical significance was observed just in the expression of TNF at a concentration of 0.1 (p<0.05). In conclusion, within the limitation of this study, findings indicate that 0.1 µg/mL P. gingivalis LPS is the optimal concentration for subsequent experiments involving SHEDs.

The study aims to evaluate surface roughness and wear or volume loss of three direct restorative materials after brushing with oscillating and sonic-vibrating powered toothbrushes. Twenty specimens of each material: conventional nanofilled resin composite (FiltekZ350XT), flowable resin composite (Filtek Supreme flowable restorative) and resin-modified glass ionomer cement (Fuji II LC), were prepared and divided into two groups according to the type of powered toothbrush used. Brushing was conducted using a toothbrushing simulator that applied a consistent force of 1 newton (N) for one hour, simulating one year of brushing. Surface roughness and wear or volume loss tests were performed on each specimen before and after brushing to assess the impact of the different toothbrush types and materials. The surface roughness (Sa), the differences of roughness change (ΔSa) and volume loss were analysed using the paired t-test and two-way ANOVA with LSD post hoc tests. The results showed no statistically significant difference of roughness, roughness change and wear after one year of simulated tooth brushing by the powered toothbrush in all groups. Two-way ANOVA analysis showed that type of powered toothbrush and material do not significantly influence the surface roughness alteration of all three direct restorative materials. However, the type of materials significantly influenced the volume loss. A greater surface roughness value changes were observed in sonic-vibrating powered toothbrush groups. Resin-modified glass ionomer cement brushed by a sonic-vibrating powered toothbrush (GS) showed the most surface roughness change. The highest volume loss was detected in resin-modified glass ionomer cement brushed by the oscillating powered toothbrush (GO) group. There is a statistically significant difference in wear between resin-modified glass ionomer cement groups and resin composite groups in both powered toothbrush types. In conclusion, in this in vitro study, brushing with powered toothbrushes does not affect the surface roughness and wear of direct restorative materials.

Oral mucosal defects, especially in elderly patients with cancer, trauma, or post-surgical resections, require biomaterials that are biocompatible, promote tissue regeneration, and restore function. Collagen-based scaffolds are extensively researched due to their biocompatibility and structural similarities to natural tissue. However, characterizing the molecular integrity of these scaffolds is essential for ensuring their efficacy. This pilot study employed Fourier transform infrared spectroscopy (FTIR) as a fundamental analytical tool to investigate and compare two collagen-based scaffolds system as two distinct modification strategies: (1) fish scale-derived collagen crosslinked with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) and (2) porcine skin-derived collagen coated with acemannan (AceCol). FTIR was used to investigate structural features, specifically the maintenance of collagen’s triple-helix structure (Amide I–III bands) and the integration of bioactive polysaccharide groups. The spectra was analyzed for key vibrational peaks, such as hydroxyl (O–H), amide, and polysaccharide-specific regions. The results indicate that the EDC-crosslinked fish scale collagen scaffold exhibited intact Amide I–III bands, confirming the stability of the triple-helix structure. The acemannan-coated scaffold displayed additional peaks in the range of 1000–1100 cm^-1 and enhanced hydroxyl band intensity (3300–3400 cm^-1), which indicates successful polysaccharide integration. In conclusion, this pilot study demonstrated that FTIR spectroscopy can differentiate structural signatures between two scaffold modification s trategies. EDC crosslinking retained the triple-helix stability of fish scale-derived collagen, while acemannan coating introduced polysaccharide-related features in porcine collagen. These findings provide preliminary evidence supporting the complementary roles of crosslinking for stability and coating for bioactivity, warranting further validation for future applications in oral mucosal regeneration.

Implant success is strongly influenced by surgical technique and implant stability throughout the osseointegration process. This retrospective study aimed to compare implant stability in the posterior maxilla using three surgical approaches: freehand, static-guided, and dynamic navigation techniques. Patients who underwent delayed placement of a single Straumann implant between 2015 and 2022 were included. Insertion torque and primary implant stability were recorded at the time of surgery, and secondary stability was assessed approximately three months postoperatively. Additional variables—such as age, sex, healing duration, systemic conditions, implant site, dimensions, type, surface treatment, and adjunctive procedures—were also collected. A paired t-test was used to compare primary and secondary stability within each group, while a linear mixed-effects model identified factors associated with changes in implant stability. A total of 49 patients (57 implants) were analyzed. No significant differences were found among groups in terms of baseline characteristics, insertion torque, or primary stability. All groups showed an increase in secondary stability over time. However, the improvement was statistically significant only in the dynamic navigation group (9.32 ± 9.42 ISQ, p < 0.01) and the static-guided group (6.26 ± 8.01 ISQ, p = 0.003). Among the assessed variables, only the primary implant stability was significantly associated with the change in stability. Within the limitations of this study, both dynamic navigation and static-guided surgery demonstrated superior outcomes compared to the conventional freehand technique. These results underscore the clinical value of digital technologies in enhancing surgical accuracy and optimizing implant stability during osseointegration.

This study examined the impact of alkali-heat treatment on the surface properties of Ti-6Al-4V titanium implants fabricated by conventional machining and laser powder bed fusion (LPBF) additive manufacturing with horizontal and vertical build orientations. Disc-shaped specimens were produced, immersed in 10 M NaOH at 90 °C for 24 hours, and heat-treated at 600 °C. Scanning electron microscopy revealed uniform nanostructures, such as nanospikes and crevices, across all treated groups while preserving the original microtopography. Energy-dispersive X-ray spectroscopy and X-ray diffraction confirmed the formation of a sodium titanate layer, indicated by increased sodium and oxygen content and a new diffraction peak at 48.3°. Surface roughness analysis showed that LPBF samples had significantly higher roughness than machined ones (p < 0.0001), with horizontally printed specimens rougher than vertically printed counterparts (p < 0.05). Importantly, the treatment did not significantly alter the initial roughness in any group (p > 0.1). These findings demonstrate that alkali-heat treatment effectively creates bioactive nanostructures and modifies the surface chemistry of titanium implants without compromising their roughness or microtopography. Moreover, build orientation influences surface characteristics, highlighting the importance of optimizing manufacturing parameters. Overall, combining LPBF fabrication with alkali-heat treatment may enhance the bioactivity of complex titanium implants for dental applications.

Our previous results demonstrated that pretreatment with monocarbonyl analogue of curcumin compound 28 (MAC28) in lipopolysaccharides (LPS)-treated human dental pulp cells (HDPCs) could suppress inflammation. However, the pharmacological action of MAC28 co-incubated with LPS in HDPCs remained unclear. Furthermore, the impact of MAC28 in combination with Biodentine™ in LPS-treated HDPCs was still unclear. This study aimed to examine the cell viability and anti-inflammatory effects of Biodentine™ and MAC28 in LPS-treated HDPCs. HDPCs were assigned to five groups: (1) control, (2) LPS, (3) LPS + MAC28, (4) LPS + Biodentine™, and (5) LPS + MAC28 + Biodentine™. The concentration of LPS and MAC28 used in this study were 20 µg/mL and 10 µM, respectively. The Biodentine™ extract was mixed with Alpha modification of Minimum Essential Medium Eagle (α-MEM) at a 1:16 dilution ratio for cell treatments. Cell viability was assessed using the Alamar Blue assay. The expressions of toll-like receptor-4 (TLR-4), myeloid differentiation factor-2 (MD-2), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) mRNA were analyzed by qRT-PCR. Data was analyzed using one-way ANOVA with LSD post hoc tests at a 95% confidence interval. The results demonstrated that LPS treatment did not significantly affect HDPCs viability compared to the control (p > 0.05). Similarly, co-treatment with MAC28, Biodentine™, or both combined did not affect cell viability (p > 0.05 vs. control), indicating no cytotoxicity under the experimental conditions. LPS significantly upregulated TLR-4, MD-2, TNF-α, and IL-6 mRNAs when compared with the control (p < 0.05). However, LPS-induced HDPCs co-incubated with MAC28, Biodentine™, or their combination significantly reduced the expressions of TLR-4, MD-2, and TNF-α mRNAs (p < 0.05), while the expression of IL-6 mRNA levels remained unchanged when compared with the LPS group (p > 0.05). MAC28 and Biodentine™ exhibited anti-inflammatory effects without cytotoxicity in LPS-treated HDPCs, supporting their potential as adjunctive agents for the treatment of pulpitis.

Macrophages are key components of the innate immune system by eliminating pathogens through phagocytosis. Their activity can be influenced by various agents including plant-derived essential oil. Lemongrass essential oil (LG-EO) exhibits potent antifungal properties, however, its immunomodulatory effects on macrophage function remain unclear. Objective: This study aimed to evaluate the effect of LG-EO on the phagocytic activity of RAW 264.7 macrophages infected with C. albicans. The cytotoxicity of LG-EO was assessed using the MTT reduction method. Three concentrations--0.003% (1/20 MIC), 0.006% (1/10 MIC), and 0.03% (1/2 MIC) (v/v)--were selected to evaluate their effects on the phagocytosis of C. albicans-infected RAW 264.7 cells. Infected macrophages were treated with various concentrations of LG-EO for four, six, and eight hours, after which surviving fungal cells were quantified using a cultivation method. LG-EO exhibited dose-dependent cytotoxicity, with fewer than 5% of RAW 264.7 cells surviving at concentrations ≥ 0.03% (v/v). In the untreated control, fungal recovery (log₁₀ CFU/mL) was 2.08 (1.84-2.08), 2.48 (2.42-2.52), and 2.56 (1.93-2.66) after four, six, and eight hours of incubation, respectively. Treatment with 0.003% and 0.006% LG-EO showed no significant enhancement in phagocytosis, with fungal counts comparable or slightly higher than controls. In contrast, 0.03% LG-EO reduced fungal recovery to 1.48 (1.39-1.54), 1.7 (1.59-1.85), and 1.7 (1.5-1.83) at the respective time points, likely due to its cytotoxicity rather than enhanced phagocytic activity. At sub-cytotoxic concentrations, LG-EO did not significantly modulate the phagocytic activity of C. albicans-infected RAW 264.7 macrophages. These findings imply that LG-EO has limited immunomodulatory effects on macrophage mediated fungal clearance.

Peri-implant diseases, including peri-implant mucositis and peri-implantitis, are inflammatory conditions affecting the tissues around dental implants. Effective management of these diseases is crucial to ensuring the long-term success of implant therapy. Air polishing has emerged as a potential non-invasive treatment modality for managing peri-implant diseases, offering an alternative to traditional mechanical debridement methods like hand scaling or using ultrasonic devices. This technique utilizes a pressurized jet of air, water, and abrasive powder to disrupt biofilm with minimal damage to the implant surface or surrounding soft tissues. Glycine powder air polishing and erythritol powder air polishing have gained prominence in peri-implantitis treatment. In vitro studies suggest that glycine powder air polishing and erythritol powder air polishing are highly effective in reducing biofilm and bacterial load with minimal damage to the implant surface. However, clinical studies have demonstrated limited benefits in reducing bleeding on probing and probing depth in peri-implant mucositis and peri-implantitis treatment. Its efficacy may depend on the stage of the disease, the powder used, and the duration of the treatment. Additionally, peri-implantitis is a multifactorial disease. Air polishing holds promise as a valuable tool in the management of peri-implant diseases. Further research is required to determine and improve its clinical outcomes and to compare it with other established treatment modalities.

Chronic myofascial pain, often caused by trigger points in the masticatory muscles, results in significant muscle soreness due to factors such as muscle overuse, injury, poor posture, stress, and parafunctional habits. A 21-year-old woman presented with persistent pain in the right cheek and temple, rated eight out of 10 on the numeric rating scale (NRS), exacerbated by bruxism and stress. Clinical examination revealed tenderness in her masticatory muscles, trigger points, restricted mouth opening, and altered occlusion. She was diagnosed with myofascial pain. Treatment included patient education, self-care strategies, occlusal splint therapy, trigger point injection, and low-level laser therapy. After 10 months, her pain score was reduced to one on the NRS, with improved occlusion and decreased muscle soreness. This case highlights the effectiveness of conservative and minimally invasive treatments, including education, occlusal splint therapy, trigger point injection, and low-level laser therapy, in addressing chronic masticatory myofascial pain related to bruxism. Identifying and addressing the underlying causes are essential for successful management.

This study investigates the antifungal activity of a cleaning solution containing pandan leaf extract against Candida albicans (C. albicans) in a laboratory setting and evaluates its effect on the color and physical properties of a denture base material. Cleaning solutions with pandan leaf extract at concentrations of 8, 16, and 24 mg/ml were tested for their inhibitory effect on C. albicans and their impact on the physical properties of the denture base material including color change, surface hardness, surface roughness, and flexural strength. C. albicans counts (CFU/ml) were measured across test groups, including controls. Extracts at 16 and 24 mg/ml showed the greatest reduction in fungal presence, which is comparable to 0.5% sodium hypochlorite. After immersion in cleaning solutions for two 10-min cycles and seven days, the solution with pandan leaf extract showed no significant color change within the same group. Surface roughness and surface hardness changes were also insignificant within the same group and across groups after immersion for two 10-min cycles (t1) and seven days (t2). Similarly, flexural strength showed no significant difference among groups compared to the control group. A cleaning solution with pandan leaf extract at 16 and 24 mg/ml effectively inhibits C. albicans without impacting the color or physical properties of a denture base material, suggesting its potential as a safe and effective cleaning solution for denture bases.

This study aimed to evaluate the impact of toothbrushing with herbal toothpaste on the surface roughness and loss of aged dentin following toothbrushing with herbal toothpastes. Buccal root dentin specimens were prepared from molars of patients ≥ 60 years old. Specimens were allocated into four groups (n=10) according to the toothpaste used: three herbal toothpastes, HB1, HB2, HB3, and one non-herbal toothpaste, NHB. After undergoing 10,000 cycles of toothbrushing, the surface roughness and surface loss of the specimens were investigated using a contact profilometer. Toothbrushing resulted in a statistically significant increase in surface roughness relative to baseline measurements for all groups (p<0.001). Among these groups, the HB2 group exhibited the highest final surface roughness (Ra_f) value (9.81 ± 0.86 µm), while the NHB group demonstrated the lowest Ra_f value (0.78 ± 0.10 µm). Statistically significant differences in Ra_f values were observed among all groups (p<0.001). The highest surface loss of dentin was found in the HB2 group (0.047 ± 0.012 mm³), then HB3 (0.039 ± 0.012 mm³), NHB (0.029 ± 0.009 mm³), and the HB1 group (0.0197 ± 0.005 mm³). SEM revealed a scratched dentin surface of all specimens indicative of toothbrush bristle abrasion. Among the groups, dentin in the HB2 group exhibited a more pronounced concave area compared to the dentin in the other groups. Analyses of the toothpastes demonstrated variations in shape of their abrasive particles. In conclusion, the use of herbal toothpastes resulted in significantly greater dentin surface roughness compared to non-herbal toothpaste. These findings suggested that abrasive particles in herbal toothpastes may contribute to increased tooth surface wear.

This study aimed to compare the compressive strength of highly filled flowable resin composites, conventional resin composites, and combinations of flowable resin composite liners of different thicknesses with conventional resin composites. One hundred and twenty-one cylindrical specimens (3 mm diameter, 6 mm height) were fabricated from eleven different material combinations, including two highly filled flowable resin composites, three conventional resin composites, and six combinations of flowable resin composite liners (1.5 mm and 3 mm thicknesses) with conventional resin composites. After 24-hour storage in distilled water at 37°C, specimens underwent compressive strength testing using a universal testing machine. One-way ANOVA and Tukey’s multiple comparison test were used for statistical analysis, with significance set at P < 0.05. Results revealed significant differences in compressive strength among the groups. Clearfil AP-X Esthetic Flow demonstrated the highest mean compressive strength (251.80 MPa), while G-aenial universal injectable 3 mm with G-aenial Posterior showed the lowest (155.62 MPa). No significant differences were found between highly filled flowable resin composite groups or among conventional resin composite groups. The combination groups showed comparable compressive strength to conventional resin composites, regardless of liner thickness. However, 3 mm thick flowable resin composite liners exhibited significantly lower compressive strength than Clearfil AP-X Esthetic Flow alone. The study concluded that highly filled flowable resin composites demonstrate promising compressive strength and can be considered for stress-bearing areas, noting that their combination with conventional resin composites as liners neither enhances nor compromises strength significantly.

The study aimed to evaluate the effectiveness of an oral health education (OHE) program that utilized ready-to-use lesson plans in elementary school students. A total of 145 students participated in the program, which was delivered using from the "Healthy teeth, Beaming smile" lesson package over the course of one month. This package includes ready-to-use lesson plans, a teaching manual for teachers, and supplementary learning exercises for students. To assess the impact of the OHE, the knowledge of early (Grades 1-3) and late (Grades 4-6) elementary school students was evaluated before and after the program using 40 multiple-choice questions. Additionally, teachers' satisfaction with the ready-to-use lesson plans was measured using a self-administer questionnaire on a 5-point Likert scale. The results indicated a statistically significant increase in post-test knowledge average scores (Standard Deviation) (Level1 19.40(6.93) and Level2 21.50(5.30) more than their pre-test scores (Level1 11.46(3.76) and Level2 11.72(4.03)) among both early and late elementary students (p<0.001) as determined by a Paired T-Test. Satisfaction rating from 26 participating teachers showed a high level of satisfaction (score≥4) with the various aspects of the lesson plan, including contents of the lesson plan, activities, exercise for learning enhancement, configuration, and overall satisfaction. The findings suggest that ready-to-use lesson plans can effectively assist teachers in delivering Oral Health Education, thereby improving oral health knowledge among elementary school students.

This randomized split-mouth controlled clinical study aimed to examine the mean pixel grey values of early proximal caries lesions after the application of silver diamine fluoride (SDF) by digital subtraction radiographic analysis in 30 participants with at least two initial non-cavitated active proximal lesions of permanent posterior teeth in different quadrants, aged 13-30 years old. At baseline, the participants underwent digital bitewing radiographic examination using a radiographic positioning device combined with bite registration material. Participants received temporary tooth separation for two days. Following the removal of the orthodontic separators, the lesions were randomly assigned to SDF or sterile water (control group) application groups. All participants received oral care instruction (modified Bass brushing technique and dental floss). After a 6-month follow-up period, participants received digital bitewing radiographs using their individual positioning devices and bite registration materials, using the same equipment and settings as at baseline. There was no statistically significant difference between the SDF and control groups in the mean pixel grey values of initial proximal caries on the subtraction image of the baseline and 6-month radiograph (p>0.05). Therefore, the use of SDF has no additional effect compared to home oral care on initial proximal caries in permanent posterior teeth at 6-month follow-up.

Patients diagnosed with head and neck cancer often require various treatments, including radiation therapy. Dentists, as oral health specialists and members of the multidisciplinary cancer care team, must possess the knowledge to ensure accurate and timely dental management. This enables patients to receive cancer treatment within the required timeframe, especially for radiation or post-surgical radiation, while considering the limited time for dental care. Pre-radiation dental management involves eliminating sources of oral infection, educating patients, addressing the risk of dry mouth, masticatory muscle contracture, and making decisions about tooth extractions. During radiation, patients are advised to perform fluoride applications and practice jaw muscle exercises to maintain mobility. Post-radiation dental care extends throughout the patient's lifetime, focusing on caries and periodontal disease prevention. Proper coordination between dental and oncological treatments is essential to ensure the patient’s overall health and successful cancer treatment outcomes.

This report presents the use of palatal prostheses to restore the remaining palatal defects in eight patients with cleft lip-cleft palate. Two adult patients had small palatal defects, but they rejected surgical correction. Two pediatric patients had small palatal defects, but it was not a proper time for surgical repair. Four pediatric patients had palatal defects that could not be corrected surgically with an adjacent tissue. Their palatal defects were reconstructed with acrylic-based palatal prostheses, which were designed based on the principles of removable dentures, with additional considerations such as the tissue characteristics around the defects, forces acting on the prostheses, the condition of teeth, and caries risks. Other than this, there were chair-side relining and border molding procedures to improve adaptability and seal of the palatal prostheses. Using palatal prostheses improves patients’ overall quality of life.

Disc displacement can cause limited mouth opening, jaw locking, and joint pain. Although it can resolve on its own over months to years, timely conservative treatment is essential to prevent further disc deterioration and improve quality of life. A 25-year-old woman reported difficulty opening her mouth for six months, along with tightness and pain radiating to the right temple. She reported a history of joint clicking that later disappeared. Clinical examination and magnetic resonance imaging confirmed disc displacement without reduction. Additionally, she presented with right masseter muscle pain, rated seven out of ten on the pain scale, radiating to the temporal region during mouth opening, which was diagnosed as myofascial pain with referral. The combined treatment involved patient education, warm compresses on the masseter muscles, a hard upper occlusal splint with increased thickness, active jaw exercises in front of a mirror, and passive exercises using silicone tubes and wooden tongue depressors. After ten months, her mouth opening improved from 15 mm to 52 mm, with normal jaw movements and no pain. This case demonstrates that non-surgical management can effectively treat chronic disc displacement without reduction, along with myofascial pain with referral, resulting in significant improvements in mouth opening and jaw function.

Regular dental visits is important. Early treating disease prevents damage that is difficult to reverse. Whether the pandemic of coronavirus disease 2019 in Thailand affects dental visits or not, is of great interest. The purpose of this study is to detect the prevalence and related factors of dental visits during pandemic of coronavirus disease 2019. This study was a cross-sectional descriptive study. Data were collected from volunteers who received services at a university hospital, were of Thai race and nationality, and aged between 20-59 years. Using a questionnaire consisting of 4 sections of questions: general information, attitudes and knowledge about oral health, awareness of one's own health problems and dental visits during the pandemic of coronavirus disease 2019. Data were analyzed using descriptive statistics. Related factors were analyzed using multiple logistic regression. Data collected from 378 service recipients, revealed that the prevalence of dental visits during pandemic of coronavirus disease 2019 was 46.0 percent. Related factors were attitudes and oral health knowledge and oral problems that were necessary to receive dental treatment. The group considering that going for a dental check-up and scaling is important was 2.38 times more likely to have dental visits during the pandemic of coronavirus disease 2019 compared to the group reflecting that it is not important (95% CI =1.19, 4.73). The group which worried about or scared of having dental visits was 0.52 times less likely to have dental visits during the pandemic of coronavirus disease 2019 compared to the group with no worries or fears (95% CI = 0.29, 0.92). The group which wanted to cancel or postpone a dental appointment was 0.35 times less likely to have dental visits during the pandemic of coronavirus disease 2019 compared to the group which did not want to (95% CI = 0.21, 0.60). The group with oral problems that needed dental treatment was 2.70 times more likely to have dental visits during the pandemic of coronavirus disease 2019 compared to the group with no oral problems (95% CI = 1.66, 4.38). In conclusion, the prevalence of dental visits during pandemic of coronavirus disease 2019 was 46.0 percent. Related factors were attitudes and oral health knowledge and oral problems that were necessary to receive dental treatment.

The purpose of this study was to compare unloading force of glass fiber-reinforced wire (GF), non-coated superelastic NiTi wires (NC), epoxy-coated NiTi wire (EC), and Teflon-coated NiTi wire (TC) in ceramic passive self-ligating bracket. The modified three-point bending test was conducted on an ideal upper arch model with intentionally omitted maxillary right lateral incisor. Ceramic passive self-ligating brackets were bonded, and the model was set in a controlled-temperature water bath at 36±0.5° Celsius. The universal testing machine with 100 newton load cells was used. The arch-shaped preformed GF, NC, EC and TC wire was attached to the model and the indenter was set perpendicular to the middle portion of the space of maxillary right lateral incisor. The crosshead speed was 0.5mm/min and the deflection was settled at 1.5 mm for the GF wire and 3 mm for the NiTi wire. Then, the unloading force was measured at every 0.5 mm until the deflection was 0 mm. The experiment was repeated ten times per group and a new archwire was used on every test. The minimum and maximum unloading force measured from the GF group was 14.54 and 134.36 g, the NC group was 41.60 and 526.49 g, the EC group was 35.54 and 289.12 g and the TC group was 56.57 and 514.58 g. The loading and unloading curve of the GF group showed no hysteresis while the NC, EC, and TC groups presented the comparative style of a force-deflection curve with hysteresis and a steep plateau. The four types of wire listed from the lowest to highest unloading force are GF, EC, TC and NC groups.

Autistic children have difficulty understanding abstract concepts and responding to communication. This becomes even more challenging when they need to receive healthcare services, especially in dentistry, which is often a source of fear and anxiety for most people. Visual communication is therefore an effective method to increase understanding and help promote cooperation among autistic children in receiving dental services. This study aims to examine the level of cooperation of autistic children during dental examinations when using a social story book. The sample group consisted of 30 pairs of parents and autistic children aged 3 - 12 years who received dental services at the Queen Sirikit National Institute of Child Health, Rajanagarindra Institute of Child Development, and Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, selected through purposive sampling. The tools used in the study included a social story book titled "I Go to the Dentist," which parents used consistently with their children for 4 weeks before seeing the dentist, a general information record form, and Frankl's Behavior Rating Scale to record cooperation levels during dental examinations. Data were analyzed using descriptive statistics. The results showed that the average cooperation level of all participants was 3.03 (SD = 1.0), and the average cooperation level of the target group who had never experienced a dental visit before was 3.40 (SD = 0.9). The highest cooperation scores were for the steps of traveling to the hospital to see the dentist and sitting in the waiting room before entering the dental office. The lowest cooperation scores were for cooperation during the use of suction devices and dental examination tools. The study shows that using the social story book "I'm Going to the Dentist" can be used to promote preparation for autistic children to receive dental examinations and dental health services.

Various caries risk assessment (CRA) forms have been developed as an essential element in risk-based caries management. However, most established CRAs were developed based on the evidence in Western countries, potentially limiting their applicability to different demographic groups. This cross-sectional study aimed to evaluate the predictive performance of caries risk/protective factors from established CRA forms in predicting the presence of cavitated caries lesions in Thai preschool children and to compare the associations between these factors and caries status. A total of 122 children participated, with parental interviews conducted using a comprehensive questionnaire that integrated caries/protective factors from CRAs endorsed by AAPD, ADA, and DAT. Participants were categorized into two groups based on caries status: those with and without cavitated caries lesions. A Random Forest classifier was utilized for predictive model construction, and important factors were identified through the Boruta algorithm and Recursive Feature Elimination (RFE). Factors associated with the caries status included age, the educational level of the primary caregiver, visible plaque, and sibling’s caries status. The Out-of-Bag (OBB) error rates of models generated from individual CRA forms were comparable, with a slightly lower error rate observed in the model that combined all three CRA forms. Key factors identified as important for predicting caries status were the number of non-cavitated caries lesions, visible plaque, and sibling’s caries status. This study highlighted the importance of these factors in caries risk assessment among Thai preschool children. These findings, aligned with established CRAs, could guide the development of tailored CRA forms for this population. Further studies with larger, more diverse cohorts and a longitudinal design are recommended to validate these findings and enhance their utility as caries predictors.