The aim of this study was to explore factors related to orthodontist’s decision making in providing orthodontic treatment for cleft Lip and palate patients in Thai public hospitals. The cross-sectional descriptive survey was conducted by online self-assessment. Chi-square and Kruskal-Wallis tests were used to compare between 3 groups which consisted of orthodontists who decided to treat cleft patients in all age groups (n = 60), treated patients in some age groups (n=24) and refused to treat cleft patients (n = 14). Factors which were statistical different between  3 groups consisted of background knowledge received from orthodontic training program (p = 0.033), hospital size (p < 0.01), number of dentists in their hospital (p < 0.01), present of cleft team (p < 0.01), had 2 or more orthodontists in their hospital (p < 0.01), well-coordinated cleft team (p < 0.01), and availability of hospital equipment (p < 0.01). In the group of orthodontists who decided to treat cleft patients, 85.0% of them worked in hospitals with a capacity of 200 beds or larger with an average of 18.17 dentists. In the group of orthodontists who did not treat cleft patients, 14.3% worked in hospitals with a capacity of 200 beds or larger with an average of 6.36 dentists. There was no statistical difference found in gender, age, experience, workload, and attitude. In conclusion, background knowledge received from their training program and several environmental factors consist of hospitals size, number of dentists, and present of well-coordinated staff in multidisciplinary team related to orthodontist’s decision making in providing treatment for cleft Lip and palate patients. 

To evaluate the association between the histopathological diagnosis, clinical features and lesion volume in human radicular cysts and periapical granulomas. Periapical biopsies histopathologically diagnosed as radicular cysts (n = 30) and periapical granulomas (n = 30) from teeth with periapical lesions were recruited. Pathological diagnosis, patients’ age, gender, and location of the periapical lesion were obtained from treatment records. Preoperative CBCT images were obtained from the hospital database for measurement of lesion volume using OnDemand3D™ Dental software. The Mann-Whitney U test or Kruskal-Wallis H test was used to determine the association between lesion volume and pathological diagnosis: radicular cyst and periapical granuloma, and other clinical data. A P-value less than 0.05 was considered statistically significant. There was a significant association between lesion volume and pathological diagnosis of the periapical lesions. Radicular cysts showed a significantly higher median lesion volume compared to periapical granulomas, 693.58 (IQR 195.94 - 1449.75) and 67.41 (IQR 41.03 - 185.38), respectively (P<0.001). No significant association between the lesion volume of periapical lesions and other variables including the gender, age, and location of the periapical lesions was found. The higher periapical lesion volume was significantly associated with pathological diagnosis as radicular cyst. Gender, age, and location of periapical lesions were not associated with the volume of periapical lesions. 

This study aimed to evaluate the effect of ceramic translucency, ceramic thickness, and cement color on the final optical color of a CAD-CAM lithium disilicate ceramic. A total of 180 ceramic specimens were prepared into two thicknesses, 0.5 and 1.0 mm, from high translucency (HT), medium translucency (MT), and low translucency (LT) CAD-CAM lithium disilicate ceramics (IPS e.max CAD; Ivoclar Vivadent) in shade A1. Substrates were fabricated from resin composite in shade A3. Two shades of light-cure resin cement, neutral and light plus (Variolink Esthetic LC; Ivoclar Vivadent), were used for cementation, whereas glycerine was used for the control groups. CIE L*a*b* color coordinates for each combination were measured via a spectrophotometer (Ultrascan Pro, Hunter Lab). The data were calculated using the CIEDE2000 (ΔE₀₀) formula to find color differences and analyzed with three-way ANOVA and the Bonferroni post-hoc multiple comparison tests (α = 0.05). Additionally, ΔE₀₀ values were evaluated by comparing the perceptibility threshold (PT) and the acceptability threshold (AT) of 0.8 and 1.8, respectively. The results revealed that ceramic translucency, ceramic thickness, and cement color had statistically significant effects on the final colors of the ceramic veneers. Mean ΔE₀₀ values fell within the acceptable range for most groups, except those using 0.5 mm HT ceramics with light plus cement, which was also the highest mean ΔE₀₀ value (1.85 ± 0.14). The lowest mean ΔE₀₀ value was obtained from a group using 1.0 mm LT ceramics with light plus cement (0.35 ± 0.15). In conclusion, ceramic translucency, ceramic thickness, and cement color influenced the final color of lithium disilicate veneers. In most of the study groups, a decrease in ceramic translucency and an increase in ceramic thickness lessened color differences. A white, more opaque shade cement provided better color modification and brightness enhancement than a highly translucent shade cement. 

This study aimed to investigate and compare the proportions of dental care over the past six years, encompassing periods both before and during the COVID-19 pandemic. A retrospective study was conducted by selecting new dental patients of Chulalongkorn Dental Hospital who were presented between 2017 and 2022. A data collection form was designed as a standard guideline for information gathering including demographic data, clinical examination findings, and details of dental management. Four data collectors were assigned to gather information from the digital data system under specific instructions. The collected data was initially cleansed and subsequently analyzed using SPSS 29.0. The study recruited a total of 1,359 medical records. There were no significant differences in the proportions of sex, age, address, remaining teeth, underlying diseases, or drug allergies between patients who presented before (G1) and during (G2) the COVID-19 pandemic. G2 exhibited a higher prevalence of oral dysfunctional problems than G1 and underwent more extensive investigation using single-technique radiographs. The top two provisional modified ICD-10 diagnoses were impacted teeth and pulp disease, with no significant difference between G1 and G2. The COVID-19 pandemic resulted in a decrease in the correspondence between provisional and final diagnoses (p=0.011). The most common dental procedures performed included surgical removal, extraction, filling, and root canal treatment. In conclusion, the COVID-19 pandemic impacted some variables related to clinical examination, radiographic intervention, provisional and final diagnoses, and their management. 

 The aim of this systematic review was to compare the accuracy of implant impression techniques between conventional technique and intraoral scanner in partial edentulism. Systematic search was conducted in PubMed,
Scopus, and Cochrane, from January 2000 to January 2024. Among the total of 4,544 publications, 14 were selected according to inclusion and exclusion criteria. The sub-grouped meta-analysis was conducted following the accuracy parameters; inter-implant distance deviation favoring conventional techniques (p = 0.05), three-dimensional deviation  (trueness and precision) favoring digital techniques (p = 0.007). The results found that the numbers of studies were comparable between the studies favoring conventional techniques and the studies favoring digital techniques. However, technologies of intraoral scanner have been developed, resulting in improved accuracy of digital technique. Implant impression with digital techniques tend to performed better accuracy compared to conventional techniques in recent studies of partial edentulism. In case of two to three implants and inter-implant angulation under 20 degrees, both conventional and digital implant impression could be performed. Further studies that perform standardized methodologies both in laboratory and clinical condition are required to conduct meta-analysis. 

With short-fiber reinforced resin composite (SFRC), improved mechanical strength and good workability could be achieved within a single material. However, there remains concerns related to microleakage, which could restrict the application of this material in certain clinical situations. Thus, the aim of the study is to investigate microleakage of class II cavities restored with SFRC compared to other resin composites, in a simulated aging environment using thermocycling. Class II cavities were prepared in 80 premolars at the cementoenamel junction. Each group, consisting of 10 specimens, was restored with different materials: bulk-fill flowable SFRC (EverX Flow), bulk-fill SFRC (EverX Posterior), flowable bulk-fill resin composite (Tetric N-flow), and conventional resin composite (Filtek Z350XT). The specimens were divided into two subgroups: one underwent thermocycling of 20,000 cycles, while the other did not. All specimens were subjected to the dye penetration test and then assessed for microleakage scores. In the non-thermocycling group, no significant differences in microleakage scores were observed. In the thermocycling group, EverX Posterior showed a significant difference in microleakage scores compared to Tetric N-flow (p = 0.018) and all other tested materials (all p < 0.001). However, there was no significant difference in microleakage scores between EverX Posterior and Filtek Z350XT (p = 0.714), or between Filtek Z350XT with Tetric N-flow (p = 0.951). In conclusion, when restored with a universal adhesive, bulk-fill flowable SFRC achieved the highest microleakage score compared to other tested resin composite after thermocycling. In addition, all materials showed a significantly higher microleakage score after thermocycling. The materials could be ranked in ascending order of susceptibility to microleakage after aging by bulk-fill SFRC, conventional resin composite, flowable bulk-fill resin composite, and bulk-fill flowable SFRC, respectively.

The research aimed to assess the effectiveness of probiotic milk tablets in preventing dental caries in children attending 12 selected kindergartens in Phayao Province, Thailand, from June 2022 to May 2023. The goal was to determine if probiotic-fortified milk tablets could serve as a viable method for preventing dental caries in children aged 2-5 years. Study participants needed to meet specific inclusion criteria, including being aged 2-5 years, attending one of the designated daycare centers, and having parental consent. Exclusion criteria encompassed conditions like cow’s milk allergy, serious medical issues such as heart disease or asthma, oral and jaw abnormalities, the inability to undergo oral health assessments, or developmental delays. The participants were divided into control and treatment groups, with the treatment group receiving three milk tablets daily. Both groups received oral hygiene guidance. The milk tablets contained the probiotic Lactobacillus rhamnosus SD11. Each participant underwent oral examinations conducted by the dentists at the beginning of the study and subsequently every four months for 12 months to detect the presence of caries. The minimum required number of study participants was calculated to be 208 based on the estimated caries prevalence in the study population. Initially, 260 participants (136 males) were enrolled in the study, with 130 in the control group and 130 in the intervention group. The mean numbers of caries per participant in the control group at 4, 8, and 12 months were 5.74, 5.78, and 7.34, respectively. In contrast, the mean numbers of caries in the intervention group at 4, 8, and 12 months were 3.56, 3.33, and 3.43, respectively. Statistical analysis indicated that the differences in the mean caries numbers between the control and intervention groups at 4, 8, and 12 months were statistically significant (p=0.019, p=0.018, and p=0.001, respectively). In summary, the intervention group showed significantly fewer caries cases compared to the control group. Consequently, this intervention be considered for the study group to reduce caries. However, further research is needed to determine if this intervention can be extended to other populations of children of similar age, different age groups and multi-center study.

Heat-treated NiTi files express different properties at body temperature depending on the type of heat treatment. The aim of this study was to evaluate the reduction of root canal angulation using Blue, Gold and M wire
NiTi file systems at different temperatures in simulated severely curved root canals. Eighty-eight resin models with 45° curved root canals were divided into eight groups based on temperature during instrumentation and file type: WaveOne Gold primary file (WOG), WaveOne primary file (WO), Reciproc Blue file (RPB), and Reciproc file (RP) at room temperature (25°C), with four additional groups at intracanal temperature (35°C). Resin models and handpieces were mounted on a customized fixed stand with restricted vertical handpiece movement in a temperature-controlled incubator. The sample preparations were conducted consistently in terms of cycle and amplitude by one operator. Curvature angulation of the canal was analyzed by using ImageJ according to Schneider's method. Mean differences in curvature degrees before and after instrumentation were compared within each group. The results showed that both temperature and file type affected the reduction in canal angulation (p < 0.001). WOG and RPB showed the lowest mean angulation reduction, followed by RP and WO (p < 0.001). There was a significant difference between 25°C and 35°C instrumentation in the WO and RP groups (p < 0.001), but not in the WOG or RPB groups (P = 0.65, 0.17). In severely curved canals, reduction of canal angulation after preparation was influenced by file type especially with M-wire (WO, RP) and temperature (35°C) 

This study aimed to evaluate color differences of different translucencies of CAD/CAM lithium-disilicate ceramics on backgrounds with different values. Low translucency (LT) and medium translucency (MT) rectangular-shaped specimens (0.6 mm thickness, shade A1) were fabricated from IPS e.max CAD (EMC; Ivoclar Vivadent) and Amber Mill (AM; HASS). Six specimens of EMC-MT, EMC-LT, AM-MT, and AM-LT were fabricated, resulting in 24 specimens in total. The specimens were placed on six background colors (1M1(reference), 1M2, 2M2, 3M2, 4M2, and 5M2) made of light-cured resin composite (Vita VM LC Base Dentine, Vita Zahnfabrik) using glycerine as a medium. The CIE L*a*b* coordinates were evaluated using a spectrophotometer (Ultrascan PRO, Hunter Lab) and calculated using the CIEDE2000 formula to determine the color difference (ΔE₀₀) and translucency parameter (TP₀₀) of the materials. Mean ΔE₀₀ values were statistically analyzed using a two-way analysis of variance (ANOVA) and Bonferroni post-hoc tests (α=0.05), then qualitatively analyzed to consider the perceptibility threshold (PT) and acceptability threshold (AT). Mean TP₀₀ values were analyzed by an independent t-test (α=0.05). The results revealed that the ΔE₀₀ values significantly increased as darker backgrounds were used. The significantly higher ΔE₀₀ values of MT compared to LT were presented when EMC specimens were placed on 2M2, 3M2, 4M2, and 5M2 backgrounds. The ΔE₀₀ values below AT were found in the specimens placed on the 1M2 background. The TP₀₀ values showed that MT had a statistically significant higher value compared to LT in both EMC and AM, and values from AM were higher than EMC. In conclusion, the masking ability of specimens was lower when placed on darker backgrounds. For the 2M2 darker background, IPS e.max CAD in low translucency showed better masking ability than medium translucency. Amber Mill showed more translucency and poorer masking properties than IPS e.max CAD.

Patients with COVID-19 are predisposed to opportunistic fungal infections, particularly mucormycosis. This risk is heightened in individuals with specific systemic conditions, such as uncontrolled diabetes mellitus, immunocompromised status, or as a consequence of prescribed medications. Although mucormycosis typically presents acutely in the rhinocerebral region, originating from the upper turbinate and paranasal sinus, reported cases of mucormycosis in the jaws are scarce. This study presents a unique case involving a 60-year-old immunocompetent female with a history of COVID-19. Following discharge, she experienced mobility in the upper anterior teeth accompanied by pus discharge, leading to a diagnosis of maxillary mucormycosis upon histopathological investigation. Notably, the patient exhibited no prior immunocompromised status, emphasizing the need for heightened awareness even in immunocompetent individuals with a history of COVID-19. Globally, there has been an increase in fungal infections following the COVID-19 pandemic, with limited presentations. Prompt identification of maxillary mucormycosis post-SAR-CoV-2 infection is crucial for timely intervention. This study elucidates a case of COVID-19-associated mucormycosis (CAM) in an immunocompetent patient and reviews the existing medical literature on CAM affecting the jaw, thereby contributing to the understanding and management of this emerging issue.

The Periodontal Inflamed Surface Area (PISA) is a novel parameter which quantifies the extent of periodontal inflammation. This cross-sectional study aimed to explore the association between the PISA value and conventional
parameters, including mean probing pocket depth (PPD) and mean clinical attachment level (CAL). Additionally, the PISA value was compared across severity levels of periodontitis, as classified by the CPITN and CDC/AAP definitions in the Electricity Generating Authority of Thailand (EGAT) workers. PISA was calculated using full-mouth periodontal parameters including PPD, CAL, and bleeding on probing. Periodontitis, as defined by CPITN and CDC/AAP, was classified into no/mild, moderate, or severe periodontitis. The reliability of PISA compared with severity types of periodontitis defining by CPITN and CDC/AAP was explored by the Kruskal-Wallis test. Among a total of 2,643 participants aged 34-74 years, the median of PISA value was 319.4 mm2 with a range of 2.2 to 3624.4 mm2, and the mean of PISA value was 440.68±415.40 mm2. When defining periodontitis according to CPITN and CDC/AAP, the prevalence of severe periodontitis were 28.7% and 26.3%, respectively. Pearson’s correlation indicated that the correlation between PISA and mean PPD, as well as between PISA and mean CAL, was significant (p <0.001) with coefficients of 0.78 and 0.52, respectively. When comparing PISA values across severity levels, there were statistically significant (p <0.001) differences in PISA values among severity levels of periodontitis classified by CPITN and CDC/AAP. A dose-response relationship was also observed. Therefore, periodontal parameter represented by PISA had the significant association with conventional periodontal case definitions.

The aim of this study was to compare the agreement and reliability among visual, colorimeter and spectrophotometer for primary tooth shade matching. Tooth color measurement was performed on the middle one-third
of the primary maxillary right central incisor of 30 participants. The visual method was done by operator 1 and 2 using Vita Classical and Vita 3D-Master shade guide. The instrumental methods were performed by operator 1 using ShadeEye NCC® colorimeter and Vita Easyshade V® spectrophotometer. Data was analyzed using McNemar test to compare the agreement between two methods and Cohen’s kappa for reliability. The results shown that the shades of primary maxillary right central incisors were A1 B1 in Vita Classical system and 0M3 1M1 1M2 in Vita 3D-Master system. The agreement of shades matched between ShadeEye NCC® colorimeter and Vita Easyshade V® spectrophotometer was 90%. There was no significantly different in agreement between these instrumental methods (P=0.25). While the agreement of shades matched between visual and instrumental methods was 1/3 of the participants. The reliability of ShadeEye NCC® colorimeter and Vita Easyshade V® spectrophotometer was in the almost perfect strength of agreement (0.81-1.00) and visual method was in the substantial strength (0.61-0.80). It can be concluded that ShadeEye NCC® colorimeter and Vita Easyshade V® spectrophotometer were more agreeable of shades matched and more reliable than the visual method in primary tooth shade matching.

Patient expectations and satisfaction are indicators of success in healthcare service delivery. This research aims to study the expectations and satisfaction of patients treated at the Department of Oral and Maxillofacial
Surgery, Faculty of Dentistry, Chulalongkorn University. A secondary objective is to compare the levels of expectations and satisfaction between patients treated on National Oral Health Day and those treated at the teaching clinic, and to examine factors related to expectations and satisfaction. Patients were surveyed, including questions on general information, expectations, satisfaction regarding treatment processes, service quality, and facility and amenities. The survey received complete responses from 198 patients treated on National Oral Health Day and 206 patients from the teaching clinic. Patients’ expectations and satisfaction levels were high to very high in all aspects, with the highest levels in service quality, such as polite speech, cheerful demeanor, attentive care, service readiness, and the dentists’ expertise. Patients at the teaching clinic had higher expectations and satisfaction than those treated on National Oral Health Day. Factors related to expectations and satisfaction differed between the two groups. In the National Oral Health Day group, factors included dental care coverage and the providers related to service quality expectations. The regular dental clinic they visit and the providers were linked to satisfaction with service quality and facilities. For the teaching clinic group, income and regular dental clinic they visit were related to facility expectations, while age and income influenced satisfaction with the treatment process and service quality.

The objectives of this action research were to create a model for administering silver diamine fluoride to dependent elders in accordance with the concept of Kemmis & McTaggart (1988), and to study the dependent
elders’ acceptance and satisfaction following the application of silver diamine fluoride. The research methodology was divided into two sections. The first section was the development of model for using silver diamine fluoride
included studying details of the home visiting program from the dental nurse in the Muang Samsib district Ubon Ratchathani province, holding a workshop for 11 dental nurses to practice providing information before applying
silver diamine fluoride to patients and applying it to three elderly volunteers, following to the plan for applying silver diamine fluoride during home visits, and evaluation and participatory adjusting the model. The second section was the assessment of 17 dependent elders’ acceptance and satisfaction after being applied with silver diamine fluoride through interviews. The study’s findings demonstrated that the following elements should be included in the model of applying silver diamine fluoride for dependent elders combined with a home visiting program: 1. preparing knowledge and skills of silver diamine fluoride for dental practitioners, 2. supporting adequate amounts of silver diamine fluoride and equipment, and assigning a cooperator to rotate silver diamine fluoride, 3. having media to explain and illustrate about silver diamine fluoride to patients and caregivers, 4. building up a team composed of assistants to help in between operation, 5. dental practitioners should promote self-care oral hygiene for patients and caregivers and 6. the working group should have channel access to communicate about problems and learn from others. The elders and caregivers in this study accepted the use of silver diamine fluoride in the home visiting program and accepted the black staining in their both anterior and posterior teeth, after being applied with silver diamine fluoride. They believed that silver diamine fluoride can stop caries progression, reduce tooth pain and tooth sensitivity in the future, and decrease the chance of getting services in a hospital.

To compare the effectiveness of aerosols reduction during endodontic access opening (OC) procedure using a hand-free high-volume evacuation device (EasyPrep) versus a rubber dam. Thirty-eight patients who required endodontic treatments of posterior mandibular teeth were recruited and divided into two groups which are rubber dams with high-volume evacuation (HVE) and EasyPrep. Air samples were collected by settle-plate technique from five different locations and at three different time points - before operation (baseline), at operation, and after operation. The number of colony-forming units (CFU) was enumerated. The genus and species of bacteria were
identified by a proteomic fingerprint using a mass spectrometer. Statistical analysis was conducted using IBM SPSS Statistics version 29.0 (IBM). At and after operation, the total CFU count was significantly higher than the baseline in both groups across various locations (p<0.05). The total CFU in the EasyPrep group was slightly higher than the rubber dam group. However, there was no statistically significant difference in total CFU count at operation between the two groups at different locations. Gram-positive cocci species including Micrococcus luteus were the most found bacteria. A hand-free high-volume evacuation device provided comparable results to rubber dam in reducing aerosols during OC procedures.