This study was to assess the efficacy of toothpaste containing 5% Potassium Nitrate and 54% Sodium Bicarbonate on dentinal hypersensitivity comparing with the toothpaste containing 10% Strotium Chloride as a positive control and the toothpaste without anti-hypersensitivity ingredients as a negative control. Hundred and twenty four volunteer workers, aged 18-49 with 1-4 hypersensitivity teeth each (233 teeth), were randomly involved in this 2-month long study. The volunteers were divided into 3 groups; 42 persons with 81 teeth in the experimental group, 44 persons with 83 teeth in the positive control group, and 38 persons with 81 teeth in the experimental group, 44 persons with 83 teeth in the positive control group, and 38 persons with 69 teeth in the negative control group. Three measurement methods were used to test the hypersensitivity response including thermal stimulation using 20-5 °C cold air at 1 degree interval change, electronic pressure sensitive stimulator (Yeaple probe) adjustable form 10-70 g pressure at 10 g interval change and 3-scale subjective response of the individual tooth from the subjects. The measurements were recorded at 0 2 4 and 8 weeks. Toothpastes and toothbrush were given to subjects by duble blind technique Subjects performed brushing twice daily with given toothpastes and soft toothbrushes with no special instruction. The data was collected and statistically analysed. The results showed that there was a continually reduction in dentinal hypersensitivity in the experimental group and positive control groups. There was no statistically signficant differrence between the toothpaste containing 5% Potassium Nitrate and 54% Sodium Bicarbonate and the one containing 10% Strontium Chloride in reducing dentinal hypersensitivity when measured by thermal and pressure stimulation (p<.05). However, when measured by 3-scale subjective response, the experimental group was statistically significantly better than the positive and negative control groups(p<.05).

A case of invasive cervical resorption in mandibular right first premolar was clinically classified as class 3, the resorptive lesion was deep, large and extended to the cervical third of the root. Surgical crown lengthening procecdure was done in order to reveal the margin of the resorptive lesion. Subsequently, the lesion was treated by topical application of 90% trichloracetic acid and followed by curettage of the resorptive tissue. Trichloracetic acid could effectively destroy the resorptive tissue and control hemorrhage. Pulp exposure was observed after complete curettage of resorptive defect. The defect was restored with resin-modified glass ionomer cement and root canal treatment was performed. After one year recall, tooth was asymptomatic with normal gingival contour.

It is generally accepted that cell-mediated immunity (CMI) plays an important role in the
resistance to oral candidiasis, but little is known about the mechanisms that protect oral surfaces
against the dissease. The precise role of T cell response in oropharageal candidiasis also
requires clarification. The precise role of cellular immunity against oral infection with C. albicans,
with particular reference to the cytokine response.

The objective of this study is to determine the prevalence of periodontitis and relationships between cigarette smoking and periodontitis in the elderly workers of Electricity Generating Authority of Thailand. 2,005 subjects with at least 6 teeth in two randomly selected quadrants received periodontal examinations including plaque score, probing pocket depth and gingival recession. Smoking habits were obtained using quetionnarires. The results showed that 82.0% of subjects had periodontitis; 42.2% of mild, 29.3% of moderate and 10.5% of severe periodontitis. Current smokers had significantly deeper pocket depth (p<.01), more clinical attachment loss (p<.01), more missing teeth (p<.05) and more plaque score (p<.05) than former or non-smokers (one-way ANOVA). Multiple logistic regression analysis revealed that current smokers were 2.3 times more likely to have periodontitis than non-smokers and were 4.72 times more likely to have severe periodontitis than non-smokers (p<.01). Former smokers were 2.2 times more likely to have severe periodontitis than non-smokers (p<.01). There was significant relationships between life time exposure of cigarette smoking and the odds of having severe periodontitis (p<.01), ranging form OR = 3.8 for smokers of < 10 packyears to OR 5.7 for smokers of > 10 Packyears. The effect of smoking cessation on decreased prevalence of periodontitis was revealed after 6 years, especially in mild and moderate periodontitis cases. In conclusion, smoking is one of the risk indiicators for periodontitis in this population. Current smokers had significantly higher pervalence of periodontitis than former or non-smokers. Long-term smoking cessation is associated with the decreased risk of periodontitis.

The purpose of this article was to analyze the radiographic appearance of mandibular canal and
the position of mental foramen in group of Thai population. The panoramic radiographs on
patients 14 years of age and older during January through June 2005 were retrospectively
reviewed. The radiographic appearance of mandibular canal related to the mental foramen was
newly classified into six types. The position of mental foramen related to teeth was classified into
six positions. Of 1,316 radiographs, 1,156 were in selection criteria. The most common
radiographic appearance of mandibular canal was Type II, a distinctly continuous canal with
anterior loop (48.8%); followed by Type I, a distinctly continuous canal without anterior loop
(25.2%). The most common position of mental foramen was in vertical line with the second lower
premolar (63.2%); followed by a position between the lower premolars (22.4%). In agroup of
Thai population, the mandibular canal with anterior loop and the mental foramen at the position
in vertical line with the second lower premolar were usually observed on panaramic radiographs.

This study aims to develop a model of comprehensive oral health promotion to reduce early childhood caries (ECC) under the national health insurance scheme. Literature review on situation of ECC, strategies and appropriate interventions was first proceeded. Focusgroup interviews among stakeholders were conducted including primary-care providers from 8 MOPH Contracting unit of primary care, a group of parents or caretakers from 2 kindergartens in Bangkok. In addition, in-depth interview of community leaders to d\identify situation of children oral health promotion were used in the study. Comprehensive oral health promotion model consists of 3 main interventions; 1)professional oral health promotion intervention by adoption of a polocy to integrate oral health care policy into maternal and child health service with early intervention at primary care level of service. The provision of service needs to include oral screening and oral health risk assessment, oral health education, individualized preventive dental health program with fluoride vanish and pit and fissure sealant, and refreral system for further treatment. 2) callaborating with local authorities and community groups to promote oral health promotion activites in child care center and create oral health friendly environment. 3) Creating awareness and enabling parents and caretakers to apply the 10 oral preventive recommendations.

This study aimed to determine the lethal effect of Morinda citrifolia (Noni) fruit and leaf extracts on oral squamous carcinoma cell line in vitro. Noni fruit and leaf were extracted with water and lyophilized. The oral squamous carcinama cells, HSC-4 were maintained with DMEM complete medium as a negetive control. Fruit water and leaf water extracts diluted at various concentrations in the medium were added into culture as experimental groups whereas the medium containing 5-fluouracil was used as a positive control. After 24 hours of treatment, growth inhibition was analyzed to determine the inhibition concentration of 50% cell death (IC(50)) with MTT assay. Then cells were treated with IC(50) of noni extracts and 5-fluouracil,and were subjected to observe cell morphology and investigate cell death by staining with trypan blue and TUNEL method. It was found that the IC(50) of noni fruit extract, noni leaf extract and 5-fluouracil were 0.42% w/v, 0.78% w/v and 3.13% w/v, respectively. By chase contrast inverted microscope, both noni and 5-fluouracil treated HSC-4 cells exhibited cell shrinkage, cell membrane blebing chromatin condensation and margination. Moreover, they were positively stained with trypan blue and TUNEL method. In conclusion, Morinda citrifolia fruit and leaf extracts have cytotoxic effect and induce apoptosis in oral squamous carcinama cells, HSC-4.

The objective of this study is to determine learning accomplish ment for oral and maxillofacial surgery courses of 61 Thammasat University Dental Students, comparing between the 2002 academic year course which was lecture-based and the 2003 academic year course which was problem-based focusing on small group discussion (SGD) and self-directed learning (SDL). The scores from 6(th) year dentistry comprehensive examination, oral and maxillofacial surgery and allied subjects, were analyzed and compared by one-way anlysis of variance and Tukey-Kramer multiple comparison test. The SGD/SDL students' scores in patient evalution and differential diagnosis topic were higher than lecture-based student. The SGD/SDL high school graduates could achieve high score in basic science topic, whereas the SGD/SDL bacherlor graduates did well in clinical management topic. These rusults suggeted that the problem-based learning which focused on SGD/SDL was efficacious for oral and maxillofacial surgyry learning because it might promote the learners to think and collect data, then anlyze and solve the oral and maxillofacial surgery problems. However this learning accomplishment might relate to other factors, such as mode of adnission and student's competency. 

Implant restoration in maxillary anterior esthetic zone often presents challenges to the clinician. Alveolar ridge resorption, along with soft tissue recession from tooth loss, results in defects that compromise the ideal implant l\placement and the final esthetic outcome. Various augmentation techniques have been advocated as corective treament, however, procedures require long healing period and are unpredictable. For this reason, gingival recession, the common complication in anterior implant, is still occurred. This case report proposed esthetic periodontal approach using subepithelial connective tissue graft to esthetically correct gingival recession in the anterior implant. Additionally, various factors which contribute to peri-implant tissue recession in anterior implant were disscussed in this article.

The purpose of this in vitro study was to determine the chemical alterations occurring on dentin surface due to calcium hydroxide traetment by using Fourier Transform Infrared Spectroscopy Technique. Seven human sound single rooted premolars were collected. Their crowns and apical 1/3 of roots were removed. After mechanical instrumentation with file no.50, the roots were sectioned faciolingually. Half of each root was a tese sample and the other half served as its own control. The test specimens were immersed into 1 mm depth of calcium hydroxide paste and kept at 37 °C 100% humidity for 7, 14, 30, 60 day periods. The infrared spectra were recorded before and after treament to investigate the modifications in amide I spectra were recorded before and after treatment to investigate the modifications in amide I peak height (1650 cm­¹) and orthophosphate peak height (1050 cm­¹). The control specimens were placed on moist cotton pellet and kept in the same environment. The result revealed a significant decrease (p<.05)in amide I peak height and amide I-orthophosphate ratios after 14 days measurement. This result suggests that calcium hydroxide adversely affect the chemical composition of root dentin, which should be considered when studying dentin.

The aim of this study was to study the occlusal anatomy of the mandibular second premolars in a group of southern Thai people and compare anatomical differences in males and females. Two thosand and eight hundred thisty study casts (5660 teeth) with bilateral mandibular second premolars were screened. Occlusal anatomy, U, H and Y-type, then were recorded and statistical analyses between males and females were performed by Chi-square test at significance level .05. The results showed that one thousand and eight hundred seventy-seven teeth (69.82 per cent) in men and two thousand and forty-eight teeth (69.34 percent) in both men and woman were bilateral Y-type which the most occlusal anatomy of the mandibular second premolar. There was no significant difference in males and females for all anatomical details. This study, therefore, should be a basic data for further study of occlusal anatomy of the mandibular second premolars in Thai population.

The objectives of this study were to determine the effect of mouthwash containing zinc lactate on volatile sulfur compound (VSC) level, Plaque Index (PI) and Gingival Index (GI)in 60 subjects who were diagnosed as having gingivitis and had over 80 parts per billion (bbp) of VSC in the mouth air. Subjects were randomly distributed into 2 group, i.e., mouthwash containing zinc lactate (test) group and placebo (control) group. At baseline, VSC level, PI and GI were recorded. Then, subject were asked to rinse with the assigned mouthwash. VSC level was measured at 30 minutes and 3 hours post-rinsing. They were asked to rinse with the assin\gned mouthwash twice daily after toothbrushing for the following 2 weeks. All parameters were recorded again at Day 15. The result showed that, at baseline, VSC level, PI and GI were not significantly different between groups. At 30 minutes, VSC level was reduced by 15.6% in the test group and 5.08% in the control group. VSC level in the test group was significantly different when dompared to baseline (p<.05). At 3 hours, VSC level was not significant reduction in the VSC level, PI and GI were found when compared to baseline in both groups (p<.05). However, when compared between groups, no significant differences were found (p>.05).

The purpost of this study was to evaluate the effectiveness of a dental device used in the treatment of 31 patients (24 males and 7 females) who were diagnosed with obstructive sleep apnea clinic, ENT department B.M.A. Medical College and Vajira Hospital from June 2004 to June 2005. After serveral medical examinations consisting of evaluated degree of snoring, daytime sleepiness, degree of apnea by polysomnography, lateral cephalometric analysis and dental examination, dental devices were made and inserted as a mandibular advancement for these patients. These patients were then re-evaluted 5 months later with jthe same examination procedures. As a result of the device dilivery, significant improvenments of all medical assessment were noticed: posterior airway space increased from 5.2±0.8 to 10.1±2.4 millimeters, degree of snoring decreased more than 50% in 23 patients (74.2%) from 8.2±1.2% to 3.5±0.8%, degree of daytime sleepiness decreased from 12.9±2.4% to 8.1±1.0% and sleep apnea and hypopnea from polysomnogram resulted in more than 50% decrease in 19 patients (61.3%) from 31.5±8.1 time per hour to 12.2±4.3 time per hour. Although some studies reported occlusal changes and other side effects, these were not presented in this study. However, long-term evaluation of the effectiveness of the dental device for the treatment of obstruction sleep apnea should be further studied.

This study aimed to assess dental treatment need of 12-year-old, Grade-6 primary school Thai children using the normative approach. Across-sectional survey including all 1126 children in a municipal area of Suphaburi province. Direct treatment plan was used to assess 6 types of normative needs: need for treating dental caries, traumatic dental injuries, enamel defects and dental anomalies, periodontal, orthodontic and prosthodontic treatment needs. Demograhic information was collected through a self-administered questionaire. 99.4% of the sample had at least one type of normative needs 43.2%, 84.4% and 35.0% had needs for treating caries, scaling and orthodontic treatment respectively. For every 100 children, 28539 sextants needed scaling.Number of teeth needing treatment due to dental caries, dental injuries, enamel defects and dental anomalies were 97.7, 30 and 92.7 teeth respectively. In addition, 3.5 removable partial dentures were required per 100 children. the amount of unmet need of this Thai child population was very high. It showed that the traditional dental health service based on the normative apporach was not successful. Such high amount of needs is impossivle to be met and therefore, using the normative approach to assessing dental need is inappropriate and not practical. The traditional method of dental  needs assessment should be extended in order to capture the multi-dimension of oral health needs. A new method that combines clinical index with orther relevent factors, such as perceived oral impacts on quality of life, oral behaviours and the issue of effectiveness of intervention, is required.

The purpose of this study was to modify four different light protective shields by the placement of three window films (V-Kool®,Scotchtint®and Sun-Gard®) onto either one or two sides of the shields. Four light protective shields, two being colored translucent plastic plates (orange and red) and two being imported light protective shields from 2 different light curing unit (Visilux2®and Spectrum®), were evaluated for their percentage of light transmittance (%T) before and after modification using an ultraviolet and visble spectrophotometer at wavelengths between 190-910 nm. The results showed that in ultraviolet (190-390 nm.) and blue light (410-490 nm.) range, almost all light protective shieds allowed less than 1% of light transmittance, except for the Visilux2® shield which allowed about 1-18%. However, at higher wavelengths up to infrared range (710-910 nm.), light transmittance increased to 80-90% After shield modification, reduction in light transmittance occured in all shields at all wavelenghts. Interestingly, infraed range, V-Kool®and Scotchtint® placement had obviously light transmittance reduction and approximately  light transmittance when films were placed onto one and two sides of shields were as followed: 20-50% and 5-30% in V-Kool®,40-50% and 20-30% in Scotchtint® and 40-90% and 20-80% in Sun-Gard®. In conclusion, window films placement help shields to reduce light transmittance and the most reduction was from both-side film placement.

This study aims to investigate the release of nystatin from nystatin incorporated tissue conditioner by varying the dosage and time. Five specimens of GC-softiner® mixed with nystatin 11 mg and 23 mg were immersed into artificial salva. Samples were withdrawn at 7 timed intervals and analyzed for the released nystatin using the absorbance at 305 nm. The released nystatin samples were incubated with Candida albicans (ATCC 10231) and the cell killing percentage was determined. There was an initial high release of nystatin in 1 d followed by a slow release and reaching the equilibrium in 6-8 d. There was a significantly higher concertration of released nystatin from the specimens with 23 mg nystatin than those with 11 mg at all time incorporated dosage were not different. The released nystatin form tissue conditioner with 11 mg nystatin caused 90.70% killing at 6 h whereas that from the tissue conditioner with 23 mg nystatin caused 99.24% killing at 1 h, after that, complete killing was obtained. The mean concentrations of released nystatin were close to the minimum fungicidal concentration of standard nystatin. The dosage of incorporated nystatin in the tissue conditioner had an effect on tis release but not on the percentage of release comparative to its incorporated dosage. The fungicidal efficiency of the released nystatin from tissue conditioners with 11 and 23 mg on Candida albicans was comparable to that of the standard nystatin.

The aim of this study was to identify factors associated with self-roported painful symptoms related to TMD by examining relationships between these symptoms and various variables from demography as well as medical history and oral habit. A total of 128 subjects with self-reported symptoms relaqted to TMD were classified into 2 groups comprised of painful and non-painful symptoms. Univeriated logistic regression identified stress, headache, clenching habits and sleep disturbance as associated tactor for self-reported painful symptoms related to TMD with an odds ratio of 7.72, 3.62, 3.63 and 7.09, respectively. However, simultaneous anlysis of these four variables by forward multivariated logistic regression revealed that only strees and sleep disturbance played a major role in predicting the self-reported painful symptoms related to TMD with the sentitivity of 74.60%, specificity of 73.85%.

The curvature of prepared root canals using NiTi rotary file (ProFile®) by inexperienced in NiTi rotary instrument postgraduate students were compared with those prepared by using hand stainless steel K-file in clinic. Either mesial roots of mandibular or messio-buccal root of maxillary molar from 32 molars were randomly assigned into two groups. Group 1 was prepared using K-file with dodified stepback technique and Group 2 using ProFile® with modifiled crown-down technique and then both groups were obturated. The pre-instrumentation and post-instrumentation canal angle on radiographic images of root canals and root canal filling  were blindly evaluated and the mean differences in angle were statistically compared between groups. The result showed that the original canal curvature was significantly less straightened by Profile® than hand K-file (p>.05. It may be concluded from this study that NiTi rotary instrument (Profile®) technique better demonstrated the maintenance of canal curvature than hand stainless steel file, although the technique was performed by performed by inexperienced dentists.

Oral candidiasis is a common oral caused by overgrowth of fungal species in the genus Candida. These microorganisms reside in the oral cavity as a part of normal microflora, but can cause disease when the host is predisposed. Several local and systemic host factors, particularly impaired immunity, can facilitate opportunistic infection by Candida species. Therefore, the rising number of population with immunocompromising conditions including HIV infection, old age, malignancies and other critical illnesses-may have led to the gradual increase in the prevalence of oral candidiasis over the past decade. Clinical manifestations of oralcandidiasis can vary considerably, and may pose difficulties in clinical diagnosis in certain cases. These lesions may cause burning sensation and interfere with food intake, thus adversely affect the patients' general health and quality of life. Furthermore, oral candidiasis reflects problems in underlying health status, which may not have previously been recagnized. Therefore, dentists play an important role in the diagnosis, treatment, and health maintenance of and increasing number of patients at risk. To achieve therapeutic success, dentists need to recognize the importance of determining host factors contributing to the infection so that they can be corrected simultaneously with antifungal treatment. In Part 1, the artical discusses the various clinacal manifestations of oral candidiasis and its etiology with respect to both the host's predisposing factors and the causative microorganisms and their virulence factors. Current guidelines for the treatment and prophylaxis of oral candidiasis will be discussed in the following Part 2 article.

The incidence of oral candidiasis is continually increasing during the past decades. Therefore, dentist may encounter this oral lesion more frequently and play an important role in the treatment and prophylaxis of such infection in an increasing number of immunocompromising patients at resk. Several groups of antifungal drugs are currently available. The most efficient ones for the treatment of oral candidiasis are the polyenes and the azoles. Topical antifungal drugs are effective against primary lesions without underlying systemic conditions. Howerver, in immunocompromised patients, management of underlying conditions is required together with systemic antifungal therapy for successful treatment. This Part2 article will give an overview of currently avilable antifungal drug and guidelines for the treament of oral candidiasis and for prophyasix in high risk populations. Current antifungal agents are considered efficacious with some offering a good safety profile. However, the choices are still rather limited, especially when there in a rise in antifungal resistance due to an increase in the use of these drugs for the treatment and prevention of opportunistic fungal drug discovery, new drug delivery systems, and mechanisms drug resistance is, therefore, of great importance to the fight against fungal infections in the future.