This epidemiological study investigated the relationship between cardiovascular diseases (CVD) and periodontal status in workers of the Electricity Generating Authority of Thailand (EGAT). The medical and dental surveys were conducted in 49-72 years old subjects (N=2,276), who participated in the Cardiovascular Risk Factor Identification Project of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University and the Faculty of Dentistry, Chulalongkorn University. Data was collected by medical interviews, medical examinations and periodontal examinations. Partial recording protocols were performed in 2 randomly selected quadrants to evaluate the periodontal status by the percentage of dental plaque, probing depth and attachment level. The periodontal status was classified on the basis of the extent and severity of probing depth and attachment level. Diagnosis of CVD was done by cardiologist. The relationship between CVD and periodontal disease and the comparison of periodontal status between CVD and non-CVD groups were analyzed by Chi- square test and independent t-test. From 2005 subjects, 218 were diagnosed with CVD (10.9%). No difference in the prevalence of periodontitis was found between CVD (82.6%) and non-CVD groups (82.0%) (p < .05). Statistical analysis indicated that periodontal status was not significantly associated with CVD (p < .05). There was a trend of increasing odds ratio in subjects with mean probing depth (> 2.4 mm.), mean attachment loss (> 3.3 mm.) and high number of tooth loss (> 20 teeth). Clinical signs of periodontal disease were not associated with CVD. This study did not find the association between periodontitis and CVD in the elderly workers of EGAT. Further investigations are needed to clarify this relationship.This epidemiological study investigated the relationship between cardiovascular diseases (CVD) and periodontal status in workers of the Electricity Generating Authority of Thailand (EGAT). The medical and dental surveys were conducted in 49-72 years old subjects (N=2,276), who participated in the Cardiovascular Risk Factor Identification Project of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University and the Faculty of Dentistry, Chulalongkorn University. Data was collected by medical interviews, medical examinations and periodontal examinations. Partial recording protocols were performed in 2 randomly selected quadrants to evaluate the periodontal status by the percentage of dental plaque, probing depth and attachment level. The periodontal status was classified on the basis of the extent and severity of probing depth and attachment level. Diagnosis of CVD was done by cardiologist. The relationship between CVD and periodontal disease and the comparison of periodontal status between CVD and non-CVD groups were analyzed by Chi- square test and independent t-test. From 2005 subjects, 218 were diagnosed with CVD (10.9%). No difference in the prevalence of periodontitis was found between CVD (82.6%) and non-CVD groups (82.0%) (p < .05). Statistical analysis indicated that periodontal status was not significantly associated with CVD (p < .05). There was a trend of increasing odds ratio in subjects with mean probing depth (> 2.4 mm.), mean attachment loss (> 3.3 mm.) and high number of tooth loss (> 20 teeth). Clinical signs of periodontal disease were not associated with CVD. This study did not find the association between periodontitis and CVD in the elderly workers of EGAT. Further investigations are needed to clarify this relationship.

The purpose of this study was to investigate the prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia, and their distribution within age and gender groups of the subjects. The study was performed in 453 workers, aged 39-59 years old, from the Electricity Generating Authority of Thailand. Pooled subgingival plaque samples were collected from all teeth. The three targeted bacteria were identified using polymerase chain reaction analysis of 16S rRNA gene. The study revealed that 74.6% of the subjects were male and 26.4% were female. The average age was 47.6 years. The crude prevalences of A. actinomycetemcomitans, P. gingivalis and T. forsythia were 19.0%, 70.9% and 77.5%, respectively. Age- and gender-standardized prevalences (using the Thai population in 2004 as a standard) were 16.6%, 67.1% and 77.4%, respectively. The prevalence was much lower than that observed in the previous study conducted in a rural population of Southern Thailand. The prevalence of P. gingivalis was significantly higher in male than in female in subjects aged 39-44 and 50-54 years old. Furthermore, the prevalence of this microorganism was increased significantly with age in male subjects. On the contrary, there was no significant difference in the prevalence of A. actinomycetemcomitans and T. forsythia among age and gender groups of the subjects. In conclusion, the three periodontal pathogens were detected in this studied group. The prevalence of A. actinomycetemcomitans was much less than the other two microorganisms. The prevalence of P. gingivalis was different among age and gender groups. More studies are needed to fully understand the role of these bacteria in the pathogenesis of periodontal disease in Thai population.

The present study was conducted in order to determine factors influencing the number of remaining natural teeth and of functional teeth which included natural and prosthetic teeth. Data collection using questionnaire and oral examination were conducted in 189 patients aged 14-86 years who received dental treatment at the dental department, Pak Panang hospital, Nakorn Sri Thammarat between 2004-2005. Information on socio-demographic profile, attitude to oral health care, reasons for dental attendance and oral health behavior was collected prior to clinically examined by one dentist. Multiple regression analysis was used to identify the factors which contribute to remaining and functional teeth. This study demonstrated that mean number of remaining teeth had a statistically significant relationship with age, tooth brushing frequency and attitude to the quality of natural teeth. In addition to those factors, educational levels and employment status were also significantly associated with the number of functional teeth.

Candida biofilm on the surface of denture is a major causative agent of denture stomatits. Several denture-cleaning methods, both mechanical and chemical, are used for the reduction of denture plaque and debris. However, it has been reported that mechanical cleaning methods are insufficient for a complete reduction of microorganisms on denture plates. Polident® is a commercial immersion type chemical solution generally employed in Thailand. Polident® is claimed as an efficient antibacterial agent. However, the antifungal effect against Candida albicans, known as an important microorganism related to denture stomatits, is not specified by the company. The objective of this study was to evaluate the in vitro cleaning efficacy of Polident® in the reduction of Candida albicans biofilm on the surface of acrylic resin, in relation to dosage and soaking time. Candida albicans was grown in Sabouraud dextrose broth for 24 hours. Candida albicans biofilm was established for 6 days on the surface of heat cured acrylic resin plate size 10x10X2 mm before the antifungal effect of Polident® was examined. Control group was Candida coated-acrylic resin treated with distilled water. Optical density (OD520) was used for the quantitative measurement of the number of Candida remaining on the plate after immersion with Polident® for variation of time and dosage. OD520from test groups were compared to those of control groups and calculated as the percentage of Candida reduction using ANOVA. It was found that Polident® could significantly reduce the number of Candida albicans on the surface of acrylic resin (p < .05). The effectiveness of Polident® was positively correlated to the dosage being used. However, the longer immersion time could not increase the percentage of Candida reduction. In conclusion, the efficacy of Polident® against Candida biofilm on acrylic resin was dose-dependent.

The objective of this experimental research was to explore the effectiveness of the artificial saliva made from Aloevera with Xylitol and Fluoride in preventing gingivitis and xerostomia, in patients with head and neck cancer whose has been treated with radiotherapy, and combined radiotherapy with chemotherapy in Mahawajiralongkorn Cancer Center from January 2006 to June 2007. Total sample size was 57 participant patients. In the treatment group, 26 cases received artificial saliva made from Aloevera with Xylitol and Fluoride. In the control, group 31 cases received drinking water. ANCOVA was used for data analysis at an alpha-level of .05. The results showed that problems of low quantity of saliva and loss of taste in the treatment group were significantly lower than in the control group (p = .023 and p = .043, respectively). For swallowing efficacy and mucositis, there were no statistically difference between the two groups. (p = .164 and p = .363, respectively). The pathogens mostly found in the treatment group were Klebsiella pneumoniae (61.5%), Viridans streptococci (23.1%) and Pseudomonas aeroginosa (30.8%) but, in the control group, those pathogens were 46.1%, 38.5% and 15.4% respectively. In conclusion, the artificial saliva made from alovera with xylitol and fluoride could effectively reduce problems of low quantity of saliva, tasting capacity, and amounts of bacteria in patients with head and neck cancer undergoing radiotherapy and chemotherapy.

The purpose of this study was to compare the cytotoxicity of three dentine bonding agents, one-step (G-BondTM and ClearfilTM S3 Bond) and two-step (ClearfilTM SE Bond X), by agar overlay test. The number of 3x105 cells/ml of L929 in 10%D-MEM was seeded in 90 mm petri dish and incubated in 37 οC 5% CO2. After 24 hours, the monolayer cells reached confluency. Then, 3% of nutrient agar was poured on the monolayer cells in the petri dish and stained with 0.01% neutral red dye. Two microliter of each test material was dropped on the cellulose nitrate filter diameter 5 mm. and placed on the nutrient agar. For each test group, three samples along with one sample of the control group were tested. The same procedure was repeated 4 times. The cytotoxicity was graded according to the criteria of ISO 7405 after 24 hours of incubation period. It showed that the diffusions of ClearfilTM S3 Bond and G-BondTM were in the same rate but ClearfilTM SE Bond X had a higher diffusion rate than the former two dentine bonding agents. Furthermore, there was no difference among three materials on the cellular lysis (p > .05). In conclusion, there is no difference among three bonding agents based on the cytotoxicity. However this technique is the primary screening for toxicity of biomaterials. Further cytotoxic investigation of material that contacts dentine in clinical practice by using Dentine Barrier Test is recommended.

The purpose of this study was to investigate the effectiveness of K3 rotary files for removal of gutta-percha root canal filling compared with K-flex stainless steel files. Ninety extracted single-rooted teeth were instrumented using step-back technique and obturated using lateral condensation technique with gutta-percha and MU sealer. These teeth were randomly distributed into 3 groups of 30 each. Group 1: the gutta-percha was removed using K-flex file with eucalyptus oil. Group 2: the gutta-percha was removed using K3 rotary file. Group 3: the gutta-percha was removed using K3 rotary file with eucalyptus oil. The time for gutta-percha removal and fractured instruments were recorded. The teeth were then cut horizontally into 3 sections. Each section was split longitudinally into halves and photographed by a digital camera. The remaining of gutta-percha on the canal walls was traced and calculated using software KS 400. The results showed that there was no statistically significant difference (p = .516) in the cleanliness among the 3 groups. When compare the cleanliness of the canal walls in each level: the coronal level has significantly less remaining gutta-percha than the middle level (p = .001) and the apical level (p < .001). The middle level has significantly less remaining gutta-percha than the apical level (p < .001). There was a statistically significant difference in the time for gutta-percha removal (p < .001) among the 3 groups. Group 1 required significantly longer time (12.31±1.11 minutes) than group 2 (7.30±0.97 minutes) and group 3 (6.65± 0.89 minutes) (p < .001) and group 2 required significantly longer time than group 3 (p = .036). There was no fractured instrument in this study.

This study aimed to assess the dental caries status and behaviors of children in an isolated island with limited transportation to main land in Palian district, Trang Province in the southern part of Thailand. A total number of 131 children, stratified into 3 age groups: 2-4, 5-9 and 10-14 years, were randomly selected. All subjects were examined by trained dentists using WHO criteria. Data on oral health behaviors including knowledge, attitude and practice were collected by an interviewed questionnaire. The interview of 2-to 4-year-old group was done among their care The results showed that children in Sukorn island had high caries prevalence as 93.7, 100 and 85.9% respectively. In addition, the mean caries experienced (decayed, missing and filled teeth) of Sukorn island children were 8.78±5.03, 8.00±3.71 and 3.11±2.07 teeth per person, respectively which were significantly (p ≤ .003) higher than the data from Thailand National Oral Health Survey (2000-2001). More than 70% of child caretakers of 2-4 years old children believed that caries in primary dentition was normal and 84.4% thought that even any effort they had put into prevention of tooth decayed, their child would eventually had tooth decay. Only 17.2% of 10-14 years old group knew correctly how to prevent dental caries, while no one in 5-9 years old group knew about this issue. For appropriate food selection, only 8.6% of 5-9 years old group and 9.4% of 10-14 years old group could answer correctly. Oral health problem of children in Sukorn island is important and should be concerned. The children had high prevalence and severity of dental caries, that might be due to lack of oral health care knowledge, negative attitudes towards oral health care of child caretaker, and having few access to oral health services.

Dental extraction likely leads to anxiety in patients. The study aimed to evaluate the anxiety reduction effect between standard and annotated pre-operative instructions of dental extraction. Seventy-one patients who had simple tooth extraction at Thammasat Chalermprakiet Hospital were included in this study. Participants were stratified by sex and randomly assigned into either standard or annotated pre-operative instructions groups. Participants in the standard instructions group received instructions regarding indication for tooth extraction, local anesthetic application and post-operative care. Participants in the annotated instructions group received as above instructions plus operative procedure, healing process, possible complication and prevention. The Modified Dental Anxiety Score of Humphris was used to measure pre- and post-operative anxiety level. Post-operative pain was recorded via numeric rating scale. Statistical analyses were performed by using SPSS program version 12. The participants in the standard instructions group were 15 males, and 22 females, in annotated instructions group were 12 males and 22 females. Both groups were comparable (Chi-square test, p > .05). In the annotated instructions group, the mean anxiety score significantly decreased from 10.85 to 9.18 (p <.05), whereas it showed no significant difference in the standard instructions group. Post-operative anxiety and post-operative pain showed no significant difference in both groups. Moreover, postoperative anxiety and pain illustrated moderately correlated at 0.504 (p < .01) in standard instructions group, and correlated at 0.346 (p < .05) in annotated instructions group. The present study suggested that providing annotated instructions may be beneficial and result in less anxiety and pain for patients in dental extraction procedure.

The aim of this study was to assess the effect of closed fitting mouth guard with fluoride gel (1.1% NaF gel) or fluoride toothpaste (0.11% NaF) on surface hardness of enamel after soaking in chlorinated water at pH 3.4 for 2 hours. Fifty two human premolars extracted for orthodontic reasons were divided into 5 groups (13 specimens in each group): enamel slabs without mouth guard (control group; C), enamel slabs with mouth guard only (experimental group 1; E1), enamel slabs with mouth guard and fluoride gel (experimental group 2; E2), enamel slabs with mouth guard and fluoride toothpaste (experimental group 3; E3) and enamel slabs with mouth guard and Vaseline (experimental group 4; E4). Before and after soaking in chlorinated water, ten specimens of each group were measured for enamel microhardness and 3 specimens of each group were prepared to examine the enamel appearance using scanning electron microscope (SEM). The results showed that enamel microhardness decreased in all specimens significantly (p < .05) except E2. Group C had the highest means of difference Vickers microhardness number (VHN) before and after soaking in chlorinated water. (147.75±11.25) E1, E4, E3 and E2 had lower means of difference in VHN. The lowest one was E2 (10.36±6.74). There were significant differences between groups (p < .05) except between E3 and E4. After soaking in Chlorinated water, SEM revealed honeycomb-liked etched patterns on enamel surface only in group C. This study indicated that enamel which exposed to strong acidic water had decreased surface hardness and had changes in enamel surface significantly. Using mouth guard either with or without other agents could maintain enamel surface hardness and enamel appearance better than not using mouth guard. Using mouth guard with fluoride gel provides the most effective result.

Pharyngitis and dental infections are among the commonest indications for out-patient penicillin V potassium (Pen-VK) uses worldwide. Overuse of alternative antibiotics in Thailand, such as aminopenicillins, macrolides and cephalosporins has contributed to the spread of antimicrobial resistance, and would result in significant economic loss to the nation at large. A critical step in reducing the problem will be likely by giving careful diagnosis and using the drug of first choice by physicians and other paramedical personnels who take patient factors into consideration, which would enhance compliance of those patients. Important facts about group A betahemolytic streptococcal pharyngitis treatment as well as dental infections that needed judicious uses of the drug, the evidence supporting such uses and some discussions of the less frequent dosing of the drug and a number of other antibiotics needed before and after dental treatment of the conditions together with its use in acute rheumatic fever prevention are presented.

Thai child, aged 3 years 5 months, being diagnosed as cerebral palsy with spastic quadriplegia, schizencephaly, macrocephaly and lazy right eye was referred from Chulalongkorn Hospital for the comprehensive dental treatment. The child had the medical history of taking muscle relaxant, Sirdalud, regularly. According to the child’s lack of cooperation, the oral rehabilitation of his 10 carious teeth was performed under the general anesthesia. From the medical consultation, Sirdalud should be refrained 3 days before the operation and respiratory system should be closely monitored after the operation. Dental management for a child with cerebral palsy consisted of operative and preventive measures. For a better quality of life for children with cerebral palsy, parents and caregivers should take the major responsibility for the promotion of their children’s health and oral health by means of tooth cleansing and preparation of healthy food. In addition, dentists should advise the parents to bring their children to receive stimulation on cognitive skills, physical therapy and speech therapy.

Some edentulous patients who had an experience of wearing complete dentures might not be satisfied with their efficiency due to problems of easily dislodgement of the lower one caused by poor retention and instability. Further, some might have pain during mastication resulting in poor masticatory ability. If dentists understand these problems and can improve the retention and stability of the lower complete dentures, these patients will be able to use their complete dentures more efficiently. The purpose of this article was to provide an alternative treatment in fabricating of the complete dentures to general dentists. This case report demonstrated the utilization of dental implants in a mandible to be the abutments for the lower overdenture. Two dental implants with an abutment connection were placed in anterior portions of the mandible to stabilize the lower denture. The patient was more satisfied with the dentures because of the improvement of mastication, pain reduction and was more confident in talking and social life.

Root amputation after root canal treatment is an attempt to get rid of pathogenic granulation and infected tissue, necessary for drainage of the root canal apex, reducing pain and persistant post operative discomfort due failure of conventional endodontic therapy. Treatment with root amputation will recover and restored tooth to its normal function. This study reported a case of a 36 years old Thai male patient came with a sinus opening at buccal gingiva of the upper right first molar for 1 year with history of root canal treatment and crown since 2005. Radiograph revealed the diverted root and loss of root canal filling in the mesio-buccal root canal. A further root canal retreatment was performed using the crown-down technique, but it was not possible to mechanically enlarge the mesio-buccal root canal because it was obliterated because of an instrument was separated at the middle third of mesio-buccal root canal. Other canals were filled with a lateral condensation technique. The mesio-buccal root was carefully amputated without damaging marginal bone and crown to allow the patient to use the old crown. After 1 year followed up, the lesion was improved, sinus opening disappeared. The tooth could be normally functioned and there was no recurrence of sinus opening.

The objective of this descriptive survey was to determine the situation regarding the use of fluoride varnish by dental personnel in regional level, types of fluoride varnish, usage problems, and suggestions and opinions needed to promote effective use of fluoride varnish in the future. The survey was conducted between July-September 2006. Questionnaires were mailed to 900 dental personnel in community hospitals, general hospitals, regional hospitals, Somdejprayupraraj hospitals, and provincial health offices of the Ministry of Public Health all over Thailand. Five hundred and sixteen dental personnel returned the questionaires giving a response rate of 57.3%. The majority (86.8%) of the respondents worked in community hospitals. Seventy-nine percent of them were dentists and 20.3% were dental nurses. Sixty-two percent of the respondents have used fluoride varnish. Nowadays, fluoride varnish is used in 51.5% of public dental services. It was reported to use for prevention of tooth sensitivity (36%), for caries prevention in well baby clinic (28.3%), in child development centers (18%) and home visit (5.4%). The most used fluoride varnishes were Duraphat (75%), Bifluorid 12 (16.7%) and Fluor Protector (5.0%) respectively. The reasons that public dental services did not use fluoride varnish in preventive work included no action plan, no budget, or provision. The most common problems for dental personnel who had been using fluoride varnish were lack of cooperation of the children, saliva contamination in posterior teeth during application, uncontrollable food consumption after application, bad taste, and unconcerned parents. It was found that 62.8% of public health personnel trained by dental personnel with experience in using the varnish could apply fluoride varnish in well baby clinic in community hospitals. Most of the dental personnel (78.6%) agreed with using fluoride varnish by public health personnel who have closer contact with 0-3 year-old children in the community, because its application is easy and it does not require dental equipment. Fluoride varnish should be considered to be used as a caries prevention method in preschoolers in community-based services.

Biofilms are community of microorganisms that naturally occur in aquatic environments including dental unit waterlines (DUWL). Biofilms in DUWL harbor microorganisms that can eventually be transmitted to patients and dental health care workers. Although microorganisms found in DUWL’s biofilms are mostly weakly pathogenic, some of them can cause opportunistic infection in immunocompromised patients. There have been efforts to standardize the quality of water from DUWL in several countries. Usually they are based on drinking water standard by which degree of bacterial contamination of less than 200 CFU/ml is considered suitable for human consumption. Many methods for decontaminating DUWL have been proposed. Unfortunately, no currently available single approach can effectively eliminate biofilms. Therefore, it would be necessary to employ combination of methods; for example using anti-retraction valve to prevent retrograde aspiration of oral fluids, flushing of DUWL at the start of each clinic day and between each patient, drying DUWL at night and on weekend, using filter or independent water reservoir filled with sterile water, and the use of chemical disinfectants. Future developments in DUWL technology that prevent biofilms development or DUWL decontamination system which can be integrated into the dental unit are eagerly awaited.

The objective of this article was to explain the quality of zirconia ceramics and their benefits in dentistry. It has better mechanical properties as compared to other ceramic materials when used for all-ceramic posterior fixed partial dentures. The microstructures of zirconia ceramics in tetragonal phase can transform to monoclinic phase as temperature and stress changes. The effect of phase transformation or transformation toughening mechanisms enhances mechanical properties of zirconia ceramics which is suitable for clinical application in posterior fixed partial dentures. In addition, this article review the degradation of zirconia ceramics when exposed to water or other solutions for precaution in selecting zirconia ceramics for clinical uses.

Cone beam computed tomography is an extraoral radiography. The cone beam computed tomography radiograph demonstrates the relationship of interested tissue in all three planes and can be reformatted image in three dimensions, which could not be done by other conventional radiographs. This imaging modality is very useful in many dental diagnoses and treatment plannings, for example, dental implant, oral surgery and diagnosis of pathology of the temporomandibular joint and the jaw bone. A cone beam computed tomography machine has been developed by many companies. Each machine has a different specification, but all can be controlled by computer system. Using this system, the image acquisition is done in a short time. However, cone beam computed tomography has the limitation of soft tissue lesion scanning and it produces a relatively high radiation dose to the patient as compared to a conventional radiograph. Therefore, appropriate selection of the patient for using cone beam computed tomography for each patient should be considered.

Patient’s consent renders the medical treatment shall not be deemed wrongful act so long as the treatment thereof is within the scope of consent granted, whereby the patient fully awared of the likely results arising therefrom, subject to the fact that the dentist has done so under the normal cause of treatment and without any negligence. In this respect, if and adversely unexpected result occurs, the dentist shall have no liability. If damage is a result of negligence, the dentist shall assume liability and any criminal liability concerned. Prior written consent signed by the patient in order to exonerate the dentist from any damage caused by its negligence shall be deemed null and void, and is prohibited.

The promotion of internationally-focused Thai academic research and the consequent need to publish abstracts in English presents Thai academics with a number of languagerelated obstacles. The aims of this study were to investigate the format and type of English abstracts in Thai dental journals and the type and frequency of language and content errors which they contain. Forty-eight original research article abstracts were categorized according to format (structured or non-structured) and type (indicative or informative). Language errors, such as incorrect word choice and preposition mistakes, and information deficiencies, such as discrepancies between the main article and its abstract, were also identified by a native English-speaking linguistics professional. All abstracts were found to be the informative type but most were in non-structured format. Language errors were found in all 48 articles and content errors in 46 of them. The most frequent and widespread language problem was incorrect word use, while the most common content errors concerned unclear or incorrect information. Many errors were also found with article and preposition use. It is recommended that authors expand their knowledge of commonly-used academic English vocabulary, and check their writing carefully for factual and linguistic mistakes. The more complicated areas of article and preposition use perhaps require the attention of a native-English speaker.