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● Cephalometric assessment in anterior open bite patients treated with and without mini-implantanchorages

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assessment in anterior open bite patients treated with and without mini-implant anchorages

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Cephalometric assessment in anterior open bite patients treated with and without mini-implant anchoragesPenprapa Chiewcharat Suwannee Luppanapornlarp Supatchai Boonpratham Pongstorn Putongkam

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∑—πμ·æ∑¬»“ μ√å¡À‘¥≈MAHIDOL DENTAL JOURNAL

Original article

«‘∑¬“ “√

Cephalometric assessment in anterior open bite patients

treated with and without mini-implant anchorages

Correspondence author:

Suwannee Luppanapornlarp

Assistant Professor

Department of Orthodontics,

Faculty of Dentistry, Mahidol University

6 Yothi Street, Rachathewi,

Bangkok 10400, Thailand

Tel: 02-203-6431-2

Fax: 02-203-6430

E-mail: [email protected]

Research grant: -

Received: 15 August 2011

Accepted: 16 December 2011

AbstractObjective: The aims of this study were to determine pre- and posttreat

ment of cephalometric measurements in the skeletal anterior open bite

patients with and without mini-implant anchorages (MIAs), and to compare

the measurements between both groups. The hypothesis is that there

are differences of treatment changes between groups.

Materials and methods: A retrospective study was performed in fifteen

skeletal anterior open bite patients. The MIAs were used to intrude molars

in six patients (mean age of 25±8.1 years). Another nine patients (mean

age of 24.3±2.6 years) were treated without MIAs and served as a

control group. Paired t-test and Mann-Whitney U test were used to

determine changes within and between groups, respectively (P<0.05).

Results: There were no significant differences of skeletal and soft tissue

profile changes between the 2 groups, except LL-E plane. For dental

changes, both groups show successful open bite correction with significant

treatment changes of U1-NA, overbite, overjet (P<0.05). It was found that

the upper first molars in the MIAs group were more intruded significantly

when compared with the control group (P<0.05). Upper incisors in the

control group seem to be more extruded but not significantly.

Conclusion: Molar intrusion using MIAs could be another choice of treatment

for skeletal anterior open bite patients with minimal patient cooperation.

Key words: cephalometric, mini-implant anchorages, open bite, orthodontic

treatment

Penprapa Chiewcharat

Postgraduate Student of Orthodontic

Residency Training Programme



Suwannee Luppanapornlarp

B.Sc., D.D.S., M.Sc. (Orthodontics),

A.B.O., Tha.B.O., Ph.D. (Dental Sciences)

Assistant Professor,



Supatchai Boonpratham

D.D.S., Ph.D. (Dental Sciences)



Pongstorn Putongkam

D.D.S., M.Sc., Dip. Thai Board

(Orthodontics)




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123

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IntroductionAnterior open bite occurs when there is no

incisor contact and no vertical overlap of the upper

and lower incisors. The etiology of this type of malocclu-

sion is reported to be multifactorial. It can be influ-

enced by genetic and environmental factors.1-2 Anterior

open bite has been divided into 2 categories: skeletal

and dental anterior open bites. Dental anterior open

bite is often related to recessive dentoalveolar height

in the anterior teeth region, while skeletal open bite

is commonly related to excessive dentoalveolar height

especially in the posterior teeth region.3-4

Anterior open bite malocclusion especially the

skeletal type is thought to be more difficult to correct,

because of their high relapse tendencies. Therefore

most of the cases are considerably treated with

orthognathic surgery.5 Numerous treatment options

have been introduced based on the neuromuscular

and morphologic features and on the etiologic and the

environmental factors.6-7 In general, extrusion or

eruption of anterior teeth is a common method of bite

closure. However, correcting an anterior open bite

with anterior teeth extrusion might compromise the

esthetics. Such methods to extrude upper and lower

anterior teeth are extrusion arches, vertical elastics in

compliance patient, multiloop edgewise archwire

appliance or MEAW, and etc.6, 8-12

Another treatment strategy for closing the

anterioropen bite is to intrude posterior teeth and allow

the mandible to auto-rotate. For every 1 millimeter of

molar intrusion, approximately 3 millimeters of open

bite is reduced.13 Some devices were developed to

intrude the posterior regions such as high pull headgear

with transpalatal arch and posterior bite block.13-15 It

has been thought that this method is difficult to

decrease the posterior dentoalveolar height. Moreover,

most cases resulted in reciprocal extrusion of the

anchor teeth instead. Thus, a surgical approach is

often chosen to intrude posterior teeth and to decrease

the total facial height. However, if the patients are

unwilling to undergo surgical treatment, an alternative

method must be considered to treat the anterior open

bite.16-17

Mini-implant anchorages (MIAs) are now fre-

quently used for establishing absolute anchorage for

orthodontic tooth movement which extends the range

of tooth movement and lessens invasive treatment

options. Many reports of MIAs show the possibility

to orthodontically intrude posterior teeth with the

accompanying changes in occlusal plane, mandibular

plane, lower anterior face height, and anterior

dental overbite in order to close the patientûs open

bite.18-21

The objectives of this study were to evaluate

dental and skeletal effects of the treatment and to

compare cephalometrically changes in anterior open

bite patients treated with and without MIAs.

Materials and MethodsThis retrospective study had been approved by

the Ethic Committee of Mahidol University (COA. No.

MU-IRB 2010/336.0912). The selection criteria of

the samples in this study were: (1) non-growing

patients (ages ranging from 17 to 33 yrs), (2)

anterior open bite with skeletal type I and II tendency

and open configuration (MP-PP : 24-38 degrees),

(3) no orthognathic surgery in the treatment, (4)

premolars extraction for the orthodontic treatment

plan, (5) the use of conventional technique or

MIAs to intrude molars, (6) good quality of the

cephalograms to identify landmarks for all measure-

ments. MIAs were recently used in the orthodontic

clinic at the Faculty of Dentistry, Mahidol University

and many incomplete document records were exclu-

ded from the study. Finally, charts of 15 anterior

open bite patients were used in this study.


124

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

The samples were divided into 2 groups accord-

ing to the treatment procedure. The MIAs were used

to intrude molars in 6 patients (mean age, 25±8.1

years). Nine patients treated without MIAs (mean age,

24.3±2.6 years) were evaluated and served as a

control group. Pre- and post-treatment cephalograms

of all samples were traced and evaluated.

Each lateral cephalometric radiograph was

traced on a 0.03 inch acetate paper, with a sharp

black pencil (diameter 0.3 mm.) on a view box with

a background illumination. The location of each land-

mark was indicated by a single fine pencil dot. When

bilateral structure gave rise to double images, the

midpoint by estimation or construction was chosen.

The lateral cephalograms used in this study had been

obtained from the same x-ray machines. All radiographs

were traced and measured by one investigator and

checked by an experienced orthodontist (Luppana-

pornlarp S.). The pre- and post-treatment tracings

from each patient were superimposed and evaluated

the treatment changes using anatomic best fit tech-

nique.22 All cephalometric variables were measured

and calculated.

In order to determine whether all measurements

are reproducible, errors of measurement were

examined for intra-examiner reliability. Ten randomly

selected cephalograms from both groups were retraced

and remeasured 3 weeks after the first tracing.

Paired t-test showed there was no significant

difference in all measurements between the first and

the second times (P>0.05).

Statistical analysisStatistical analysis was performed using the

Statistical Package for Social Sciences (Version 17.0,

SPSS Inc, Chicago, Illinois USA). Data distributions

were reported using means and standard deviations

for each group. Paired t-test was used to determine

statistically changes occurring in the same groups

(pre- and post-treatment). When the data was not

in normal distribution from the Kolmogorov-Smirnov

test, then Mann-Whitney U test was used to deter-

mine statistically changes occurring among the two

groups. The level of probability for statistical signifi-

cance was set at P value <0.05.

Errors of measurement were examined for

intra-examiner reliability. Ten radiographs were

selected by random technique and then retraced and

remeasured after 3 weeks intervals. The differences

between the first and the second times of measure-

ments were determined by paired t-test (P<0.05) and

the results show no significant differences in all mea-

surements.

ResultsThere were no significant differences in any

variables of pre-treatment cephalograms between the

control and MIAs groups (Table1). Comparison of

pre- and post-treatment measurements of both

groups was shown in Table 2. In the control group, it

showed that there were no significant differences in

skeletal changes. For the dental changes, the upper

and lower incisors were retracted significantly (P<

0.05). The overbite was increased significantly for

an average of 4.61±1.69 mm The upper incisors

were extruded significantly for an average of 1.67±

1.66 mm and lower incisors were also extruded for

1.11±1.45 mm but not significantly (P value=.051).

The upper molars were also slightly extruded signifi-

cantly for an average of 0.61±.65 mm. The lower lips

to E-plane were significantly decreased for 2.50±1.79

mm.

In comparison of the pre- and post-treatment

evaluation of the MIAs group, there were no significant

differences in skeletal changes and the upper incisors

were retracted significantly. The lower incisors were


125

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

slightly retracted nonsignificantly. The overbite was

increased significantly for an average 4.25±1.70 mm

without significant elongation of the upper incisors.

The upper molars were significantly intruded for an

average 1.50±1.04 mm. The lower incisors and

molars were slightly extruded but not significantly.

From Table 3, there were no significant differ-

ences in skeletal changes between the control and

the MIAs groups. However, there were slightly more

increasing in skeletal vertical changes of the control

Control MIAs

Variable Norm SD Mean SD Mean SD P value

Skeletal

SNA 84 3.58 83.94 3.28 81.08 4.01 0.15

SNB 81 3.59 79.11 4.53 75.67 3.45 0.21

ANB 3 2.50 4.72 2.96 5.42 3.26 0.40

SN-Pg 82 3.09 79.28 4.76 75.67 3.67 0.21

SN-MP 30 5.61 37.00 9.43 39.75 5.46 0.67

SN-PP 9 3.03 7.33 2.99 6.58 1.50 0.38

MP-PP 21 5.25 29.67 7.67 33.17 4.71 0.38

FH-FO 9 4.38 13.67 4.97 13.17 4.70 0.86

NS-Gn 68 3.29 70.94 4.02 73.17 3.76 0.32

(PFH/AFH)x100% 65 2.88 62.95 6.54 61.82 3.78 0.95

Facial index 81 6.54 77.45 6.47 77.99 4.55 0.68

Dental

U1 to NA 22 5.94 28.94 0.67 28.67 4.76 0.76

U1 to NA (mm) 5 2.13 7.22 2.21 6.33 1.97 0.33

L1 to NB 30 5.61 38.94 7.39 33.58 1.97 0.37

L1 to NB (mm) 7 2.22 10.06 3.00 8.00 2.28 0.36

L1 to MP 97 5.97 102.28 8.37 97.42 7.88 0.31

Overbite 2 1.06 -2.83 1.48 -2.33 1.17 0.51

Overjet 3 0.62 3.33 2.06 5.17 2.14 0.10

U1 to PP (mm) 28 2.64 31.61 2.77 32.67 2.88 0.63

U6 to PP (mm) 22 2.13 26.28 1.72 26.67 3.01 0.85

L1 to MP (mm) 41.40 13.43 45.56 2.96 0.36

L6 to MP (mm) 36.61 2.47 35.33 3.01 0.25

Soft tissue 91 7.98 93.17 11.72 94.50 15.57 0.86

Nasolabial angle 14 3.83 13.89 4.04 12.33 5.64 0.45

H-angle 2 2.03 4.72 2.54 2.42 3.07 0.18

Lower lip to E-plane

Table1 Comparison of the pre-treatment measurements between the control and the MIAs groups


126

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Cont

rol

MIA

sVa

riabl

eNo

rmSD

Pre-

trea

tmen

tPo

st-t

reat

men

tDi

ffere

nce

Pre-

trea

tmen

tPo

st-t

reat

men

tDi

ffere

nce

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Skel

etal

SNA

84

3.5

88

3.9

43

.28

84

.22

3.5

90

.28

1.0

08

1.0

84

.01

81

.25

4.1

30

.17

0.2

6SN

B8

13

.59

79

.11

4.5

37

9.0

04

.00

-0.1

11

.52

75

.67

3.4

57

5.1

73

.72

-0.5

01

.41

ANB

32

.50

4.7

22

.96

5.2

22

.53

0.5

01

.30

5.4

23

.26

6.0

82

.22

0.6

71

.33

SN-P

g8

23

.09

79

.28

4.7

67

9.6

14

.39

0.3

31

.84

75

.67

3.6

77

5.9

23

.85

0.2

50

.61

SN-M

P3

05

.61

37

.00

9.4

33

8.5

06

.94

1.5

04

.05

39

.75

5.4

63

9.9

26

.67

0.1

71

.81

SN-P

P9

3.0

37

.33

2.9

97

.33

2.9

50

.00

1.6

66

.58

1.5

06

.83

1.8

30

.25

0.8

8M

P-PP

21

5.2

52

9.6

77

.67

31

.06

5.6

61

.39

3.2

23

3.1

74

.71

33

.42

6.3

00

.25

2.3

2FH

-FO

94

.38

13

.67

4.9

71

3.1

76

.03

-0.5

03

.77

13

.17

4.7

01

4.1

75

.45

1.0

02

.17

NS-G

n6

83

.29

70

.94

4.0

27

1.0

63

.75

0.1

11

.76

73

.17

3.7

67

3.3

33

.89

0.1

71

.29

(PFH

/AFH

)x1

00

%6

52

.88

61

.82

3.7

86

0.5

84

.92

-1.2

51

.90

62

.95

6.5

46

3.2

06

.33

0.2

50

.79

Faci

al in

dex

81

6.5

47

7.9

94

.55

75

.64

4.7

9-2

.36

4.6

17

7.4

56

.47

77

.34

5.8

4-0

.11

3.5

3De

ntal

U1 to

NA

22

5.9

42

8.9

46

.67

15

.00

7.1

6-1

3.9

4*

6.4

22

8.6

74

.76

13

.67

5.0

5-1

5.0

0*

4.9

4U1

to N

A (m

m)

52

.13

7.2

22

.21

1.7

23

.33

-5.5

0*

2.7

56

.33

1.9

73

.50

2.1

9-2

.83

*2

.50

L1 to

NB

30

5.6

13

8.9

47

.39

28

.78

8.5

7-1

0.1

7*

8.0

23

3.5

87

.32

32

.58

6.6

5-1

.00

6.7

6L1

to N

B (m

m)

72

.22

10

.05

3.0

06

.56

2.9

6-3

.50

*2

.29

8.0

02

.28

8.1

72

.25

0.1

71

.81

L1 to

MP

97

5.9

71

02

.27

8.3

79

2.1

18

.73

-10

.17

*6

.05

97

.42

7.8

89

6.9

26

.20

-0.5

06

.12

Over

bite

21

.06

-2.8

31

.48

1.7

80

.71

4.6

1*

1.6

9-2

.33

1.1

71

.92

0.8

64

.25

*1

.70

Over

jet

30

.62

3.3

32

.06

2.3

30

.43

-1.0

0*

2.2

55

.17

2.1

42

.25

0.4

22

.92

*1

.86

U1 to

PP

(mm

)2

82

.64

31

.61

2.7

73

3.2

82

.77

1.6

7*

1.6

63

2.6

72

.88

33

.50

3.7

90

.83

1.0

3U6

to P

P (m

m)

22

2.1

32

6.2

81

.72

26

.89

1.6

70

.61

*0

.65

26

.67

3.0

12

5.1

72

.79

-1.5

0*

1.0

4L1

to M

P (m

m)

45

.56

2.9

64

6.6

72

.87

1.1

11

.45

45

.56

2.9

64

5.3

33

.88

0.1

71

.94

L6 to

MP

(mm

)3

6.6

12

.47

37

.67

2.0

61

.06

*1

.07

35

.33

3.0

13

6.1

72

.86

0.8

31

.33

Soft t

issu

eNa

sola

bial

ang

le9

17

.98

93

.17

11

.72

97

.61

10

.12

4.4

47

.56

94

.50

15

.57

99

.33

17

.01

4.8

35

.60

H-an

gle

14

3.8

31

3.8

94

.04

12

.33

4.6

3-1

.56

2.1

11

2.3

35

.64

12

.25

6.6

0-0

.08

2.8

9Lo

wer l

ip to

E-p

lane

22

.03

4.7

22

.54

2.2

22

.37

-2.5

0*

1.7

92

.42

3.0

71

.58

3.1

4-0

.83

0.9

3*P

<.0

5

Tabl

e 2

Com

paris

on o

f pre

- an

d po

st-t

reat

men

t mea

sure

men

ts o

f the

con

trol a

nd th

e M

IAs

grou

ps


127

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

group than in the MIAs group but not significant

differences. Comparison of the dental changes between

the control and the MIAs groups showed that the

lower incisors were significantly more retracted in the

control group which resulted in more retruded position

of the lower lips to E-planes. The upper and lower

incisors were more extruded in control group but not

significant difference. The upper molars were signifi-

cantly more intruded in the MIAs group (1.5±1.04 mm).

There were no significant differences in overbite

Control MIAs

Variable Mean SD Mean SD P-value

Skeletal

SNA 0.28 1.00 0.17 0.26 0.86 NS

SNB -0.11 1.52 -0.50 1.41 0.60 NS

ANB 0.50 1.30 0.67 1.33 0.86 NS

SN-Pg 0.33 1.84 0.25 0.61 0.38 NS

SN-MP 1.50 4.05 0.17 1.81 1.00 NS

SN-PP 0.00 1.66 0.25 0.88 0.68 NS

MP-PP 1.39 3.22 0.25 2.32 0.86 NS

FH-FO -0.50 3.77 1.00 2.17 0.52 NS

NS-Gn 0.11 1.76 0.17 1.29 0.77 NS

(PFH/AFH)100% -1.25 1.90 0.25 0.79 0.06 NS

Facial index -2.36 4.61 -0.11 3.53 0.32 NS

Dental

U1 to NA -13.94 6.42 -15.00 4.94 0.95 NS

U1 to NA(mm.) -5.50 2.75 -2.83 2.50 0.11 NS

L1 to NB -10.17 8.02 -1.00 6.76 0.02 *

L1 to NB(mm.) -3.50 2.29 0.17 1.81 0.01 *

L1 to MP -10.17 6.05 -0.50 6.12 0.01 *

Overbite 4.61 1.69 4.25 1.70 0.77 NS

Overjet -1.00 2.25 -2.92 1.86 0.08 NS

U1 to PP (mm.) 1.67 1.66 0.83 1.03 0.14 NS

U6 to PP(mm.) 0.61 0.65 -1.50 1.04 0.00 *

L1 to MP (mm.) 1.11 1.45 1.17 1.94 0.77 NS

L6 to MP(mm.) 1.06 1.07 0.83 1.33 0.86 NS

Soft tissue

Nasolabial angle 4.44 7.56 4.83 5.60 0.95 NS

H-angle -1.56 2.11 -0.08 2.89 0.22 NS

Lower lip to E-plane -2.50 1.79 -0.83 0.93 0.01 *

*P<.05, NS = Not significant

Table 3 Comparison of the treatment changes between the control and the MIAs groups


128

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

correction between the two groups. These treatments

were both effective in correcting anterior open bite

with approximately 4 mm increase in overbite.

DiscussionIn this study, no skeletal and dental variables

showed significant differences between the control

and the MIAs groups at start of treatment. This implied

that the pre-treatment characteristics of the two

groups were similar. The patients had skeletal type I

and type II tendency (ANB = 4.72±2.96 degrees in

the control group and 5.42±3.26 degrees in the

MIAs group) with anterior open bite (2.83±1.48 mm;

2.33±1.17mm, respectively) and were tendency high

angle cases (MP-PP: 24-38 degrees). The upper

incisors were protruded, and lower incisors were also

slightly protruded in both groups. Moreover, the soft

tissue profile was found to be in the normal range.

Slightly protruded lower lips to E-plane were found in

the control group but not significantly.

Because the objectives to correct the open bite

malocclusion usually include proper vertical dimension

of the maxillary and mandibular plane together with

the positioning of the upper and/or lower incisors,

therefore conventional biomechanical techniques

commonly involve with various devices such as a

high-pull chin cup, an utility intrusion arch, the use

of MEAW and etc.6, 11-12, 15, 24 In this study, the control

group was treated with a combination of those

methods including intermaxillary elastics. In the

MIAs group, all patients selected the orthodontic plan

of using MIAs to intrude molars. In this study, we

found that there were no significant differences in the

skeletal characteristics of both groups when compared

the post-treatment with the pre-treatment variables.

For the dental changes, the overbite of both groups

was significantly corrected by extrusion and retraction

of the upper and lower incisors, more in the control than

in the MIAs group. The elongation from extrusion of

upper incisors and lower incisors in the control group

was approximately 1.67±1.66 mm and 1.11±1.45 mm

respectively, while the MIAs group shows 0.83±1.03

mm and 1.17±1.94 mm. Many studies have reported

that retraction of incisors would result in uprighting

and relative extrusion of incisor crown.23-25

From previous studies16,18-21,25, MIAs were used

to intrude the posterior teeth which resulted in

counterclockwise rotation of the mandible and

decrease in anterior facial height. In this study, open

bite of the MIAs group was apparently corrected by

intrusion of the upper molars (1.50±1.04 mm)

without significant elongation of the upper incisors,

while in the control group upper molars were slightly

extruded (0.61±0.65 mm). However, the lower molars

of the control and the MIAs groups were extruded by

mean of 1.06±1.07 mm and 0.83±1.33 mm respec-

tively, but significantly only in the control group. The

extrusion of lower molars might be a result of class II

mechanic with intermaxillary elastics, or might be

because, in this study, the MIAs had been used only in

the maxillary arch.

The comparison of treatment changes between

the control and the MIAs groups showed that there

was a decrease in posterior facial height/anterior

facial height proportion (PFH/AFH) in the control

group. In contrast, an increase in this measurement

of the MIAs group was found. This may imply that

the increase in the anterior facial height was found

in the control group but not found in the MIAs group.

In addition, there was more decrease in facial index

variable of the control group, which means that the

lower anterior facial heights of control group were

more increased than the MIAs group. However, these

treatment changes were not significantly different

when compared between groups. It might be because

the amount of molar intrusion might not be large


129

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

enough to cause skeletal changes. Moreover, the

sample size in this study might not be able to result in

the significant difference of skeletal vertical changes

or show counterclockwise rotation of mandible. The

functional occlusal planes related to Frankfurt

horizontal plane (FH-FO) were slightly decrease in

the control group and slightly increase in the MIAs group

but not significant differences in comparison between

the two groups.

For dental changes, the upper incisors were re-

tracted in both groups, but not significantly when

compared between groups. In contrast, the lower

incisors were significantly more retracted in the control

group which may be resulted from slightly more pro-

truded position of the lower incisors before treatment.

This may caused the lower molars to be more protracted

in the MIAs group and the wedging effect occurred

to close the bite. Kuhn et al6 suggested that for every

1 millimeter of molar intrusion, approximately 3 milli-

meters of open bite is reduced. In this study, the

result of this study was consistent with this previous

study. The mean of molar intrusion was 1.5±1.04 mm

and the overbite was reduced by 4.25±1.7 mm.

However, the limitation of this study was a small

sample size. Further research on a larger sample group

is needed.

ConclusionsFrom this study, correction of skeletal anterior

open bite treated with or without MIAs could be

achieved. Both treatment strategies produced

satisfactory and similar results. However, there were

some different treatment effects between both groups.

To correct the open bite using conventional technique

without MIAs, extrusion and retraction of the upper and

lower incisors were found more than in the MIAs group.

The use of MIAs to intrude molars was found to be

useful in correction of skeletal anterior open bite

without the significant extrusion of the upper incisors.

Therefore, using MIAs could be another choice of

treatment for these types of patients. This study implies

that the MIAs were effective for molar intrusion,

correction of anterior open bite with minimal patient

cooperation.

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«—μ∂ÿª√– ß§å: ‡æ◊ËÕ»÷°…“ª√– ‘∑∏‘¿“æ°“√μâ“π‡™◊ÈÕ·∫§∑’‡√’¬¢Õß‚ª√æÕ≈‘ μàÕ

‡™◊ÈÕ·∫§∑’‡√’¬∑’Ëæ∫‰¥â„π§≈Õß√“°øíπ∑’Ëμ‘¥‡™◊ÈÕ 2 ™π‘¥

«— ¥ÿÕÿª°√≥å·≈–«‘∏’°“√»÷°…“: π”‚ª√æÕ≈‘ (‚°≈∫Õ≈ μ“√å‚ª√æÕ≈‘ ) ÷Ëß

ª√–°Õ∫¥â«¬‚ª√æÕ≈‘ ≈–≈“¬„πμ—«∑”≈–≈“¬‚¡‚π‚æ√‰æ≈’π‰°≈§Õ≈ „π

ª√‘¡“≥ 1:1 ‚¥¬πÈ”Àπ—° ‡μ√’¬¡ “√≈–≈“¬‚ª√æÕ≈‘ ®“°‚ª√æÕ≈‘ ¢â“ßμâπ

‚¥¬‡μ‘¡¥’‡ÕÁ¡‡Õ ‚Õ√âÕ¬≈– 5 §‘¥‡ªìπ “√≈–≈“¬μ—Èßμâπ¢Õß‚ª√æÕ≈‘ 515

¡‘≈≈‘°√—¡μàÕ¡‘≈≈‘≈‘μ√ ®“°π—Èπ‡®◊Õ®“ß¥â«¬πÈ”°≈—Ëπ„Àâ‰¥â “√≈–≈“¬‚ª√æÕ≈‘

§«“¡‡¢â¡¢âπ 103, 20.6 ·≈– 4.12 ¡‘≈≈‘°√—¡/¡‘≈≈‘≈‘μ√ ∑¥ Õ∫§«“¡ “¡“√∂

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¥â«¬«‘∏’¥‘ §å¥‘øøî«™—Ëπ ‚¥¬¡’§≈Õ√å‡Œ° ‘¥’π√âÕ¬≈– 0.2 ‡ªìπμ—«§«∫§ÿ¡∫«°

·≈–À“§à“§«“¡‡¢â¡¢âπ¢Õß‚ª√æÕ≈‘ ∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë¡’º≈∑”≈“¬‡™◊ÈÕ∑—Èß 2 ™π‘¥

¥â«¬«‘∏’∫√Õ∏‰¥≈Ÿ™—Ëπ

º≈°“√»÷°…“: ‚ª√æÕ≈‘ “¡“√∂¬—∫¬—Èß·≈–∑”≈“¬‡™◊ÈÕ·∫§∑’‡√’¬∑—Èß 2 ™π‘¥‰¥â

‚¥¬§à“§«“¡‡¢â¡¢âπ¢Õß‚ª√æÕ≈‘ ∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë¡’º≈∑”≈“¬‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§—

øï§—≈≈‘ ·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ §◊Õ 34.33 ·≈– 3.22 ¡‘≈≈‘°√—¡

μàÕ¡‘≈≈‘≈‘μ√ μ“¡≈”¥—∫

∫∑ √ÿª: ‚ª√æÕ≈‘ “¡“√∂¬—∫¬—Èß·≈–∑”≈“¬‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘

·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ·μà¡’ª√– ‘∑∏‘¿“æπâÕ¬°«à“§≈Õ√å‡Œ°´‘¥’π

√âÕ¬≈– 0.2

√À— §”: §à“§«“¡‡¢â¡¢âπ¢Õß “√∑¥ Õ∫∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë¡’º≈¬—∫¬—Èß‡™◊ÈÕ, §à“§«“¡

‡¢â¡¢âπ¢Õß “√∑¥ Õ∫∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë¡’º≈∑”≈“¬‡™◊ÈÕ, ª√– ‘∑∏‘¿“æ°“√μâ“π‡™◊ÈÕ

·∫§∑’‡√’¬, ‚ª√æÕ≈‘

μ‘¥μàÕ‡°’Ë¬«°—∫∫∑§«“¡:

®‘πμπ“ “√–∫√√®ß

°≈ÿà¡ß“π∑—πμ°√√¡

‚√ßæ¬“∫“≈‡®√‘≠°√ÿßª√–™“√—°…å

8 ∂.‡®√‘≠°√ÿß ‡¢μ∫“ß§Õ·À≈¡

°√ÿß‡∑æœ 10120

‚∑√»—æ∑å: 02-289-7049

‚∑√ “√: 02-289-7649



«—π∑’Ë√—∫‡√◊ËÕß: 15 ‘ßÀ“§¡ 2554

«—π¬Õ¡√—∫μ’æ‘¡æå: 26 ∏—π«“§¡ 2554


132

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554«‘∑¬“ “√


Original article

«‘∑¬“ “√

Antimicrobial Efficacy of Propolis against

Enterococcus faecalis and Porphyromonas gingivalis

AbstractObjective: To evaluate antimicrobial efficacy of propolis against two species

of bacteria found in endodontic infections.

Materials and methods: Propolis (Global star propolis) which composed of

50% propolis and 50% monopropylene glycol (w/w) was dissolved in

5% DMSO to obtain the concentration of 515 mg/ml as the working

solution. Then this solution further was diluted in distilled water to obtain

the concentration of 103, 20.6 and 4.12 mg/ml. The antimicrobial

activities of propolis on Enterococcus faecalis and Porphyromonas

gingivalis were tested by the disc diffusion technique, using 0.2%

chlorhexidine as a positive control. Minimal bactericidal concentrations

were determined by using the broth dilution method.

Results: Propolis was effective against Enterococcus faecalis and

Porphyromonas gingivalis. Minimal bactericidal concentrations of propolis

were 34.33 mg/ml for Enterococcus faecalis and 3.22 mg/ml for

Porphyromonas gingivalis.

Conclusion: Propolis was effective against Enterococcus faecalis and

Porphyromonas gingivalis but less efficient than 0.2% chlorhexidine.

Key words: antimicrobial efficacy, minimal bactericidal concentration,

minimal inhibitory concentration, propolis .

Jintana Sarabunchong

D.D.S., Cert. in Endodontics

Dental Department,

Charoenkrung Pracharak Hospital

Thaniya Muadcheingka

M.Sc. (Public Health)

Department of Oral Microbiology,



Jintana Sarabunchong

Dental Department,

Charoenkrung Pracharak Hospital

8 Charoenkrung Road Bangkholaem,

Bangkok, 10120 Thailand.

Tel: 02-289-7049

Fax: 02-289-7649


Research grant: -

Received: 15 August 2011


« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


133

∫∑π”°“√μ‘¥‡™◊ÈÕ·∫§∑’‡√’¬„π§≈Õß√“°øíπ‡ªìπ “‡Àμÿ

À≈—°¢Õß°“√Õ—°‡ ∫∫√‘‡«≥ª≈“¬√“°øíπ1 ‚¥¬Õ“®æ∫‡™◊ÈÕ

‰¥âμ—Èß·μà 1-12 ™π‘¥ „π§≈Õß√“°øíπ∑’Ë‡ªìπ°“√μ‘¥‡™◊ÈÕ

§√—Èß·√° (primary infection) ‡™◊ÈÕ∑’Ëæ∫¡—°‡ªìπ™π‘¥

·∫§∑’‡√’¬°√—¡∫«°·≈–°√—¡≈∫„π —¥ à«π„°≈â‡§’¬ß°—π ·≈–

‡ªìπ‡™◊ÈÕ™π‘¥∑’Ë∑πÕÕ°´‘‡®π‰¡à‰¥â (obligate anaerobe)

‰¥â·°à ‡™◊ÈÕ„π°≈ÿà¡æÕ√åøî‚√‚¡·π (porphyromonas) ‚¥¬

‡©æ“–æÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ (Porphyromonas

gingivalis) ÷Ëß‡ªìπ·∫§∑’‡√’¬°√—¡≈∫ ‡™◊ÈÕπ’Èæ∫‰¥âª√–¡“≥

√âÕ¬≈– 28 ®“°μ—«Õ¬à“ß‡π◊ÈÕ‡¬◊ËÕ„π (pulp) ∑’Ëμ“¬·≈â«2,3,4

à«π‡™◊ÈÕ„π§≈Õß√“°øíπ∑’Ë≈â¡‡À≈«®“°°“√√—°…“§≈Õß

√“°øíπ·≈–μâÕß‰¥â√—∫°“√√—°…“§≈Õß√“°øíπ´È” (retreat-

ment) ¡—°æ∫™π‘¥¢Õß‡™◊ÈÕπâÕ¬°«à“ à«π„À≠à‡ªìπ

·∫§∑’‡√’¬°√—¡∫«° ·≈–‡ªìπ·∫§∑’‡√’¬∑’Ë‡®√‘≠‰¥â∑—Èß¿“«–

∑’Ë¡’·≈–‰¡à¡’ÕÕ°´‘‡®π (facultative anaerobic) ‡™àπ

‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°‰§ (enterococci) ·≈– ‡μ√Á∫‚μ§Õ°‰§

(streptococci) ‚¥¬„π°≈ÿà¡‡ÕÁπ‡∑Õ‚√§Õ°‰§ æ∫‡™◊ÈÕ

‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ (Enterococcus faecalis) ¡“°

∑’Ë ÿ¥ ´÷Ëß‡ªìπ‡™◊ÈÕ∑’Ë¡—°∑πμàÕ “√μâ“π®ÿ≈™’æ„π§≈Õß√“°øíπ

(intracanal medicament)2,5,6

‡™◊ÈÕ·∫§∑’‡√’¬„π§≈Õß√“°øíπ‰¡à‰¥âÕ¬Ÿà ‡©æ“–

„π§≈Õß√“°À≈—° ·μà¬—ßæ∫‰¥â„π∑àÕ‡π◊ÈÕøíπ (dentinal

tubules)3 ª≈“¬√“°øíπ∑’Ë¡’°“√·μ°·¢πß (apical canal

ramification) √Õ¬§Õ¥ (isthmus) ·≈–≈—°…≥–∑’Ëº‘¥ª°μ‘

¢Õß√“°øíπÕ◊ËπÊ ÷Ëß„π°“√√—°…“§≈Õß√“°øíπ ‡§√◊ËÕß¡◊Õ

¢¬“¬®–‰¡à “¡“√∂‡¢â“‰ª¢¬“¬‡Õ“‡π◊ÈÕ‡¬◊ËÕ„π ·∫§∑’‡√’¬

·≈– ‘Ëß °ª√°„π∫√‘‡«≥¥—ß°≈à“«ÕÕ°‰¥â4 ®÷ß®”‡ªìπμâÕß

„™âπÈ”¬“≈â“ß§≈Õß√“°øíπ√à«¡°—∫°“√¢¬“¬§≈Õß√“° ‡æ◊ËÕ

™à«¬∑”§«“¡ –Õ“¥„π§≈Õß√“°øíπ„Àâ¥’¬‘Ëß¢÷Èπ3,4,7,8 πÈ”¬“

≈â“ß§≈Õß√“°øíπ∑’Ë¥’ §«√¡’ƒ∑∏‘Ï„π°“√∑”≈“¬·∫§∑’‡√’¬

‰¥âÕ¬à“ß°«â“ß¢«“ß “¡“√∂≈–≈“¬‡π◊ÈÕ‡¬◊ËÕ„π∑’Ëμ“¬·≈â«

∑”≈“¬æ‘…„π§≈Õß√“°øíπ ™à«¬°”®—¥™—Èπ ‡¡’¬√å (smear

layer) ·≈–‰¡à‡ªìπÕ—πμ√“¬μàÕ‡π◊ÈÕ‡¬◊ËÕ√Õ∫ª≈“¬√“°øíπ

´÷Ëß„πªí®®ÿ∫—π¬—ß‰¡à¡’πÈ”¬“μ—«„¥∑’Ë¡’≈—°…≥–∑’Ë¥’¥—ß°≈à“«

πÈ”¬“≈â“ß§≈Õß√“°øíπ∑’Ëπ‘¬¡„™âÕ¬à“ß·æ√àÀ≈“¬ §◊Õ

‚´‡¥’¬¡‰Œ‚ª§≈Õ‰√∑å (sodium hypochlorite) ‡æ√“–¡’

§ÿ≥ ¡∫—μ‘∑’Ë¥’„π°“√∑”≈“¬‡™◊ÈÕ·∫§∑’‡√’¬ ≈–≈“¬‡π◊ÈÕ‡¬◊ËÕ„π

πÕ°®“°π’È¬—ßÀ“‰¥âßà“¬·≈–√“§“∂Ÿ° ·μà¡’§«“¡‡ªìπæ‘…μàÕ

‡´≈≈å ·≈–∑”Õ—πμ√“¬μàÕ‡π◊ÈÕ‡¬◊ËÕ„π·≈–‡π◊ÈÕ‡¬◊ËÕ√Õ∫ª≈“¬

√“°øíπ¡“°7,8,9,10 ¡’√“¬ß“π«à“‚´‡¥’¬¡‰Œ‚ª§≈Õ‰√∑å∑”„Àâ

‡°‘¥Õ“°“√·∑√°´âÕπ‡¡◊ËÕπÈ”¬“∂Ÿ°¥—πÕÕ°‰ªπÕ°ª≈“¬

√“°øíπ√–À«à“ß°“√≈â“ß§≈Õß√“°øíπÀ√◊Õ√—Ë«ºà“π·ºàπ¬“ß

°—ππÈ”≈“¬ ‚¥¬ºŸâªÉ«¬®–‡°‘¥Õ“°“√ª«¥Õ¬à“ß√ÿπ·√ß ¡’°“√

∫«¡¢Õß‡π◊ÈÕ‡¬◊ËÕ√Õ∫Ê ‡°‘¥°“√μ“¬¢Õß‡π◊ÈÕ‡¬◊ËÕ ¡’‡≈◊Õ¥

ÕÕ°„μâº‘«Àπ—ß·≈–‡¬◊ËÕ∫ÿ ºŸâªÉ«¬∫“ß√“¬‡°‘¥°“√∑”ß“π∑’Ë

º‘¥ª°μ‘¢Õß‡ âπª√– “∑∑’Ë¡“‡≈’È¬ß„∫Àπâ“ πÕ°®“°π—Èπ

ºŸâªÉ«¬Õ’°√“¬Àπ÷Ëß¬—ß‡°‘¥Õ“°“√∫«¡¢Õßæ◊Èπª“° (floor of

the mouth) ∑”„Àâªî¥°—Èπ∑“ß‡¥‘πÀ“¬„®10,11,12 πÈ”¬“Õ’°

™π‘¥Àπ÷Ëß∑’Ëπ”¡“„™â≈â“ß§≈Õß√“°øíπ§◊Õ §≈Õ√å‡Œ°´‘¥’π

(chlorhexidine) ´÷Ëß¡’º≈„π°“√μâ“π∑“π‡™◊ÈÕ·∫§∑’‡√’¬

∑’Ë∑πÕÕ°´‘‡®π‰¡à‰¥â (anaerobic bacteria) ¥’°«à“‚´‡¥’¬¡

‰Œ‚ª§≈Õ‰√∑å ·≈–¡’§«“¡‡ªìπæ‘…μàÕ‡´≈≈åπâÕ¬°«à“ ·μà

§≈Õ√å‡Œ° ‘¥’π‰¡à “¡“√∂≈–≈“¬‡π◊ÈÕ‡¬◊ËÕ„π∑’Ëμ“¬·≈â« ·≈–

¡’º≈μàÕ‡™◊ÈÕ·∫§∑’‡√’¬°√—¡≈∫πâÕ¬°«à“·∫§∑’‡√’¬°√—¡∫«°8,9

‚ª√æÕ≈‘ (propolis) ‡ªìπ à«πº ¡¢Õß¢’Èº÷Èß·≈–

‡√´‘π (resin) ∑’Ë‰¥â®“°º÷Èß “¬æ—π∏ÿå‡Õæ‘ ‡¡≈≈‘‡øÕ≈“

(Apis mellifera) ´÷Ëß‡ªìπº÷Èß„π ’°‚≈°μ–«—πμ° √«∫√«¡

®“°æ◊™À≈“¬™π‘¥‚¥¬‡©æ“–®“°¥Õ°‰¡â √Õ¬·μ°¢Õß

‡ª≈◊Õ°‰¡â·≈–μ“„∫ „π¢—ÈπμÕπ°“√√«∫√«¡‡√ ‘π º÷Èß®–

º ¡‡ÕÁπ‰´¡å®“°πÈ”≈“¬º÷Èß·≈–¢’Èº÷Èß≈ß‰ª¥â«¬ º÷Èßπ”

‚ª√æÕ≈‘ ¡“„™âªî¥√Õ¬·μ°¢Õß√—ß·≈–∑”„Àâ∑“ß‡¢â“√—ß

‡≈Á°≈ß ‡æ◊ËÕªÑÕß°—πºŸâ√ÿ°√“π ·≈–„™âÀàÕÀÿâ¡´“° —μ«å∑’Ëμ“¬

¿“¬„π√—ß·≈–„À≠à‡°‘π°«à“∑’Ëº÷Èß®–‡Õ“ÕÕ°®“°√—ß‰¥â‡æ◊ËÕ

ªÑÕß°—π‡™◊ÈÕ‚√§ πÕ°®“°π—Èπ¬—ß„™âªî¥™àÕß∑’Ë«“ß‰¢à‡æ◊ËÕ

ªÑÕß°—π°“√μ‘¥‡™◊ÈÕ¢Õßμ—«ÕàÕπ13 ≈—°…≥–¢Õß‚ª√æÕ≈‘

®–ÕàÕπ ·≈–‡Àπ’¬«¡“°‡¡◊ËÕÕÿ≥À¿Ÿ¡‘ Ÿß°«à“ 20 Õß»“-

‡´≈‡´’¬ ·μà‡¡◊ËÕÕ¬Ÿà„πÕÿ≥À¿Ÿ¡‘∑’ËμË”°«à“π—Èπ®–·¢Áß·≈–

‡ª√“– à«π ’∑’Ëæ∫®–¡’ ’‰¥âμ—Èß·μà ’‡À≈◊ÕßÕàÕπ ’‡¢’¬«

®π∂÷ß ’πÈ”μ“≈‡¢â¡ ·≈–Õ“®æ∫≈—°…≥–„ ¥â«¬ ‚¥¬ ’

°≈‘Ëπ·≈–§ÿ≥ ¡∫—μ‘∑“ß¬“ ¢÷Èπ°—∫·À≈àß¢Õß‡√ ‘π·≈–

ƒ¥Ÿ°“≈13,14,15 à«πª√–°Õ∫¢Õß‚ª√æÕ≈‘ ¢÷Èπ°—∫™π‘¥

¢Õßæ◊™∑’Ëº÷Èß‡°Á∫√«∫√«¡¡“ ª°μ‘ª√–°Õ∫¥â«¬ ‡√´‘π·≈–

¬“ßÀÕ¡ (balsam) √âÕ¬≈– 50 ¢’Èº÷Èß√âÕ¬≈– 30 πÈ”¡—π

ÀÕ¡√–‡À¬ (essential and aromatic oil) √âÕ¬≈– 10

≈–ÕÕß‡° √√âÕ¬≈– 5 ·≈– “√Õ◊ËπÊ ‡™àπ«‘μ“¡‘π·≈–·√à∏“μÿ


134

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Õ’°√âÕ¬≈– 514 ´÷Ëß„π‡√´‘π à«π„À≠à¡’ à«πª√–°Õ∫

∑“ß‡§¡’§◊Õø≈“‚«πÕ¬¥å (flavonoid) °√¥øï‚π≈‘§

·≈–‡Õ ‡∑Õ√å (phenolic acid and ester)13 ¡’°“√„™â

‚ª√æÕ≈‘ ¡“‡ªìπ‡«≈“π“π°«à“ 300 ªï °àÕπ§√‘ μ°“≈

®π∂÷ßªí®®ÿ∫—π ‚¥¬™“«°√’°·≈–‚√¡—π„™â√—°…“μÿà¡ÀπÕß∑’Ë

º‘«Àπ—ß Õ’¬‘ªμå‚∫√“≥„™â‡ªìπ¬“ à«π™“«Õ—ø√‘°—π„™â‡ªìπ¬“

‡™àπ°—π πÕ°®“°π—Èπ¬—ß„™â¬÷¥°≈Õß ªî¥√Õ¬·μ°„π¿“™π–

„ àπÈ”·≈–‡√◊Õ·§πŸ ·≈–‡ªìππÈ”¡—π™—°‡ß“‰«‚Õ≈‘π ªí®®ÿ∫—π

‚ª√æÕ≈‘ ∂Ÿ°π”¡“„™â√—°…“∑’Ëº‘«Àπ—ß·≈–„™â‡ªìπ‡§√◊ËÕß

”Õ“ß¡“°∑’Ë ÿ¥ ‡™àπ §√’¡∑“Àπâ“ §√’¡√—°…“ ‘« à«π

°“√√—°…“∑“ßº‘«Àπ—ß ‡™àπ √—°…“∫“¥·º≈·≈–·º≈‰ø≈«°

°“√øóôπøŸ‡π◊ÈÕ‡¬◊ËÕ (tissue regeneration) ‡ªìπμâπ

πÕ°®“°π—Èπ¬—ß„™â‡ªìπÕ“À“√‡ √‘¡·≈–√—°…“‚√§Õ◊ËπÊ ‡™àπ

√–∫∫À—«„®·≈–À≈Õ¥‡≈◊Õ¥ (‚√§‡≈◊Õ¥®“ß) √–∫∫∑“ß‡¥‘π

À“¬„® ‚√§‡°’Ë¬«°—∫ÀŸ §Õ ®¡Ÿ°·≈–°≈àÕß‡ ’¬ß √–∫∫¿Ÿ¡‘

§ÿâ¡°—π °“√√—°…“¡–‡√Áß °“√μ‘¥‡™◊ÈÕ·≈–·º≈¢Õß∑“ß‡¥‘π

Õ“À“√ ‚√§¢âÕμàÕÕ—°‡ ∫·≈–Õ◊ËπÊ „π∑“ß∑—πμ°√√¡

‚ª√æÕ≈‘ ∂Ÿ°„™â‡ªìπ à«πº ¡„π¬“ ’øíπ ‰À¡¢—¥øíπ πÈ”¬“

∫â«πª“° À¡“°Ω√—Ëß ‡æ◊ËÕ√—°…“‚√§‡Àß◊Õ°Õ—°‡ ∫ √‘¡Ωïª“°

Õ—°‡ ∫ (cheilitis) ª“°Õ—°‡ ∫ (stomatitis) ·≈–¡’

§ÿ≥ ¡∫—μ‘‡ªìπ¬“™“13,14 ¡’√“¬ß“π°“√»÷°…“«à“‚ª√æÕ≈‘

“¡“√∂§«∫§ÿ¡øíπºÿ‰¥â„π —μ«å∑¥≈Õß ≈¥°“√ – ¡¢Õß

§√“∫®ÿ≈‘π∑√’¬å16,17 ·≈–‰¡à∑”Õ—πμ√“¬μàÕ‡π◊ÈÕ‡¬◊ËÕ„π·≈–

‡π◊ÈÕ‡¬◊ËÕ√Õ∫ª≈“¬√“°øíπ ‚¥¬¡’√“¬ß“π°“√»÷°…“§«“¡

¡’™’«‘μ¢Õß‡´≈≈å‡π◊ÈÕ‡¬◊ËÕ√Õ∫ª≈“¬√“°øíπ¢Õßøíπ∑’ËÀ≈ÿ¥

®“°‡∫â“øíπ‡¡◊ËÕ·™à„ππÈ”¬“™π‘¥μà“ßÊ æ∫«à“‚ª√æÕ≈‘

√âÕ¬≈– 10 ¡’§ÿ≥ ¡∫—μ‘¥’°«à“‡Õ™ ∫’ ‡Õ ‡Õ (HBSS,

Hankûs balanced salt solution) ÷Ëß‡Õ™ ∫’ ‡Õ ‡Õ

‡ªìππÈ”¬“ ”À√—∫·™àøíπ∑’ËÀ≈ÿ¥®“°‡∫â“øíπ ·π–π”‚¥¬

¡“§¡∑—πμ·æ∑¬å ‡ÕÁπ‚¥¥Õπμå¢Õß À√—∞Õ‡¡√‘°“

(American Association of Endodontists)18,19 ·≈–

¡’√“¬ß“πª√– ‘∑∏‘¿“æ„π°“√μâ“π‡™◊ÈÕ·∫§∑’‡√’¬∑’Ëæ∫‰¥â

„π§≈Õß√“°øíπ∑’Ëμ‘¥‡™◊ÈÕ20,21,22 à«π„π‡∑§‚π‚≈¬’¥â“π

Õ“À“√ ¡’°“√„™â‚ª√æÕ≈‘ „π°“√∂πÕ¡Õ“À“√ ™à«¬¬◊¥

Õ“¬ÿ¢Õßª≈“·™à·¢ÁßÕÕ°‰ª‰¥âÕ’° 2-3 ‡∑à“ ‡æ‘Ë¡º≈º≈‘μ

¢Õß‰¢à‰°à ·≈–‡æ‘Ë¡πÈ”Àπ—°¢Õß‰°à‡≈’È¬ß13 ®“°º≈¢Õß

‚ª√æÕ≈‘ ∑’Ëπ”¡“„™âª√–‚¬™πå„π°“√√—°…“‡π◊ËÕß®“°

§ÿ≥ ¡∫—μ‘„π°“√μâ“π‡™◊ÈÕ·∫§∑’‡√’¬ ‡™◊ÈÕ√“·≈–‰«√— 23,24

´÷Ëß “√∑’Ë¡’º≈μâ“π‡™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ‰«√— §◊Õø≈“‚«πÕ¬¥å

(flavonoid) °√¥Õ‚√¡“μ‘§ (aromatic acid ) ·≈–‡Õ ‡∑Õ√å

(ester)24 à«π “√∑’Ë¡’º≈μàÕ§«“¡‡ªìπæ‘…¢Õß‡´≈≈å¡–‡√Áß

§◊Õ´’‡Õæ’Õ’ (CAPE, caffeic acid phenyl ester) πÕ°®“°

π’È‚ª√æÕ≈‘ ¬—ß¡’ƒ∑∏‘Ïμâ“π°“√Õ—°‡ ∫ ‚¥¬æ∫«à“ “√∑’Ë∑”„Àâ

¡’º≈π’È§◊Õ´’‡Õæ’Õ’·≈–ø≈“‚«πÕ¬¥å14,25

ø≈“‚«πÕ¬¥åæ∫‰¥â„π‡´≈≈åæ◊™∑’Ë —ß‡§√“–Àå· ß ‡¡◊ËÕ

‡´≈≈åμ“¬ ø≈“‚«πÕ¬¥å®–∂Ÿ°ª≈¥ª≈àÕ¬Õ¬Ÿà„π¢Õß‡À≈«

¢Õßæ◊™·≈–‡√´‘π ø≈“‚«πÕ¬¥å¡’ª√–¡“≥ 500 ™π‘¥ ·μà

„π‚ª√æÕ≈‘ æ∫‰¥âª√–¡“≥ 150 ™π‘¥ ø≈“‚«πÕ¬¥å

¡’§ÿ≥ ¡∫—μ‘‡ªìπμ—«¢—∫Õπÿ¡Ÿ≈Õ‘ √–∑’Ë¥’·≈–≈¥°“√‡°‘¥Õπÿ¡Ÿ≈

Õ‘ √–‚¥¬√«¡°—∫‚≈À–Àπ—° ·≈–¡’Õ‘∑∏‘æ≈μàÕ°“√´÷¡ºà“π

¢Õß‡¬◊ËÕ (permeability of membrane) ‡ªìπº≈∑”„Àâ

¡’ƒ∑∏‘Ï¶à“‡™◊ÈÕ·∫§∑’‡√’¬ πÕ°®“°π—Èπ¬—ß¡’ƒ∑∏‘Ïμâ“π°“√

Õ—°‡ ∫ ‚¥¬¬—∫¬—Èßæ√Õ μ“·°≈π¥‘π (prostaglandin)

∑”„Àâ≈¥‰¢â·°âª«¥‰¥â25

®“°§ÿ≥ ¡∫—μ‘¥—ß°≈à“«¢Õß‚ª√æÕ≈‘ ®÷ß‡ªìπ‡√◊ËÕß

πà“ π„®∑’Ë®–‰¥â¡’°“√»÷°…“ª√– ‘∑∏‘¿“æ°“√μâ“π‡™◊ÈÕ

·∫§∑’‡√’¬¢Õß‚ª√æÕ≈‘ ∑’Ë¡’®”Àπà“¬„πª√–‡∑»‰∑¬μàÕ‡™◊ÈÕ

„π§≈Õß√“°øíπ 2 ™π‘¥ §◊Õ ‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘

·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ‡æ◊ËÕ‡ª√’¬∫‡∑’¬∫º≈

°—∫°“√»÷°…“∑’Ëºà“π¡“ ‡π◊ËÕß®“°ª√– ‘∑∏‘¿“æ¢Õß‚ª√æÕ≈‘

®“°·À≈àß∑’Ë¡“∑’Ë·μ°μà“ß°—πÕ“®¡’ª√– ‘∑∏‘¿“æ‰¡à‡À¡◊Õπ°—π

·≈–‡æ◊ËÕ‡ªìπ·π«∑“ß°“√π”‚ª√æÕ≈‘ ¡“„™â√à«¡„π°“√

√—°…“§≈Õß√“°øíπ„Àâ¡’ª√– ‘∑∏‘¿“æ¥’¬‘Ëß¢÷Èπ

«— ¥ÿÕÿª°√≥å·≈–«‘∏’°“√»÷°…“°“√‡μ√’¬¡ “√≈–≈“¬‚ª√æÕ≈‘

‚ª√æÕ≈‘ ®“°∫√‘…—∑‚°≈∫Õ≈ μ“√åÕ‘π‡μÕ√å‡π™—Ëπ-

·π≈®”°—¥ (Global Star International Co.,Ltd) ª√–‡∑»

Õ—ß°ƒ… ≈—°…≥–‡ªìπ¢Õß‡À≈« ’πÈ”μ“≈‡¢â¡ ‚¥¬¡’

‚ª√æÕ≈‘ ≈–≈“¬„πμ—«∑”≈–≈“¬‚¡‚π‚æ√‰æ≈’π‰°≈§Õ≈

(monopropylene glycol) „πª√‘¡“≥ 1:1 ‚¥¬πÈ”Àπ—°

‡μ√’¬¡ “√≈–≈“¬‚ª√æÕ≈‘ ®“°‚ª√æÕ≈‘ ¢â“ßμâπ‚¥¬‡μ‘¡

¥’‡ÕÁ¡‡Õ ‚Õ (DMSO) √âÕ¬≈– 5 §‘¥‡ªìπ “√≈–≈“¬μ—Èßμâπ

¢Õß‚ª√æÕ≈‘ 515 ¡‘≈≈‘°√—¡μàÕ¡‘≈≈‘≈‘μ√ ®“°π—Èπ∑”°“√

‡®◊Õ®“ß¥â«¬πÈ”°≈—Ëπª√“»®“°‡™◊ÈÕ„Àâ‰¥â‚ª√æÕ≈‘ §«“¡

‡¢â¡¢âπ 103, 20.6 ·≈– 4.12 ¡‘≈≈‘°√—¡μàÕ¡‘≈≈‘≈‘μ√

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


135

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‡™◊ÈÕ∑’Ë∑¥ Õ∫ §◊Õ ‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘

“¬æ—π∏ÿå¡“μ√∞“π ATCC 19433 ·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π

®‘π®‘«“≈‘ “¬æ—π∏ÿå¡“μ√∞“π W 50

°“√‡æ“–‡≈’È¬ß‡™◊ÈÕ π”‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§—

øï§—≈≈‘ ¡“‡æ“–‡≈’È¬ß„πÕ“À“√‡≈’È¬ß‡™◊ÈÕ‡∫√πŒ“√å∑

Õ‘πøî«™—ËπÕ–°“√å (Brain heart infusion agar) Õ∫„πμŸâ

∫à¡‡™◊ÈÕ∑’ËÕÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡ ’¬ π“π 24 ™—Ë«‚¡ß

à«π‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ®–π”¡“‡æ“–‡≈’È¬ß„π

Õ“À“√‡≈’È¬ß‡™◊ÈÕ·Õπ·Õ‚√∫‡∫ —≈Õ–°“√å (Anaerobe basal

agar) (Oxoid, Hampshire, England) ‚¥¬‡μ‘¡‡≈◊Õ¥·°–

√âÕ¬≈– 5 Õ∫„πμŸâ∫à¡‡™◊ÈÕ∑’ËÕÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡ ’¬

„π∫√√¬“°“»∑’Ë¡’‰Œ‚¥√‡®π (hydrogen) √âÕ¬≈– 5

§“√å∫Õπ‰¥ÕÕ°‰´¥å‰π‚μ√‡®π ∫“≈“π å (carbon dioxide

nitrogen balance) √âÕ¬≈– 10 ·≈–‰π‚μ√‡®π∫√‘ ÿ∑∏‘Ï

(√âÕ¬≈– 99.99) π“π 5-7 «—π

«‘∏’°“√»÷°…“

°“√∑¥ Õ∫§«“¡ “¡“√∂„π°“√¬—∫¬—Èß‡™◊ÈÕ¥â«¬

«‘∏’¥‘ §å¥‘øøî«™—π (Disc diffusion)

‡μ√’¬¡ “√≈–≈“¬®ÿ≈‘π∑√’¬å∑—Èß Õß™π‘¥„ππÈ”‡°≈◊Õ

ª√“»®“°‡™◊ÈÕ„Àâ¡’§«“¡¢ÿàπ‡∑à“°—∫·¡§ø“√å·≈π¥å 0.5

(McFarland No. 0.5) ´÷Ëß§‘¥‡∑’¬∫‡ªìπª√‘¡“≥‡™◊ÈÕ

0.5x108 μ—«μàÕ¡‘≈≈‘≈‘μ√ ·≈â«‡°≈’Ë¬∫πÕ“À“√‡≈’È¬ß‡™◊ÈÕ

„Àâ∑—Ë«‚¥¬„™â‰¡âæ—π ”≈’ª√“»®“°‡™◊ÈÕ Õ“À“√‡≈’È¬ß‡™◊ÈÕ¢Õß

‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ ®–„™â‡∫√πŒ“√å∑Õ‘πøî«™—Ëπ

Õ–°“√å à«π‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ®–„™â·Õπ-

·Õ‚√∫‡∫´—≈Õ–°“√å ‚¥¬¡’§«“¡Àπ“¢ÕßÕ–°“√å‡∑à“°—∫

4 ¡‘≈≈‘‡¡μ√ ·≈–§«∫§ÿ¡§«“¡Àπ“‚¥¬„ àª√‘¡“μ√¢Õß

Õ–°“√å‡∑à“°—∫ 25 ¡‘≈≈‘≈‘μ√

π” “√≈–≈“¬‚ª√æÕ≈‘ §«“¡‡¢â¡¢âπ 515, 103,

20.6 ·≈– 4.12 ¡‘≈≈‘°√—¡μàÕ¡‘≈≈‘≈‘μ√ ª√‘¡“≥

25 ‰¡‚§√≈‘μ√ À¬¥≈ß∫π°√–¥“…°√Õßª√“»®“°‡™◊ÈÕ

(sterile disc) ™π‘¥‡°√¥‡Õ‡Õ (AA discs) ¢π“¥ 6 ¡‘≈≈‘-

‡¡μ√ ¢Õß∫√‘…—∑«Õ∑·¡π (Whatman) ª√–‡∑»Õ—ß°ƒ…

°“√∑¥ Õ∫π’È®–„™â “√≈–≈“¬§≈Õ√å‡Œ° ‘¥’π√âÕ¬≈–

0.2 ‡ªìπμ—«§«∫§ÿ¡∫«°·≈– “√≈–≈“¬¥’‡ÕÁ¡‡Õ ‚Õ

√âÕ¬≈– 5 „ππÈ”‡ªìπμ—«§«∫§ÿ¡≈∫ π”·ºàπ°√–¥“…°√Õß

∑’Ë¡’ “√∑¥ Õ∫·≈–μ—«§«∫§ÿ¡·μà≈–™π‘¥«“ß≈ß∫πÕ“À“√

‡≈’È¬ß‡™◊ÈÕ ”À√—∫‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ ®–Õ∫

„πμŸâ∫à¡‡™◊ÈÕ∑’ËÕÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡ ’¬ π“π 24 ™—Ë«‚¡ß

à«π‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ®–Õ∫„πμŸâ∫à¡‡™◊ÈÕ∑’Ë

Õÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡ ’¬ „π∫√√¬“°“»∑’Ë¡’‰Œ‚¥√‡®π

√âÕ¬≈– 5 §“√å∫Õπ‰¥ÕÕ°‰´¥å ‰π‚μ√‡®π ∫“≈“π å

√âÕ¬≈– 10 ·≈–‰π‚μ√‡®π∫√‘ ÿ∑∏‘Ï (√âÕ¬≈– 99.99)

π“π 5-7 «—π ®“°π—Èππ”®“π‡æ“–‡™◊ÈÕ¡“μ√«®¥Ÿ°“√‡®√‘≠

‡μ‘∫‚μ¢Õß‡™◊ÈÕ ·≈–«—¥¢π“¥¢Õß¢Õ∫‡¢μ°“√¬—∫¬—Èß‡™◊ÈÕ

(Inhibition zone) ‚¥¬°“√∑¥≈Õß∑” È” 2 §√—Èß

°“√À“§«“¡‡¢â¡¢âπ¢Õß‚ª√æÕ≈‘ ∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë¡’

º≈∑”≈“¬À√◊Õ§à“‡ÕÁ¡∫’´’ (MBC, minimal bactericidal

concentration) ‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ ·≈–‡™◊ÈÕ

æÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ‚¥¬«‘∏’∫√Õ∏‰¥≈Ÿ™—Ëπ (Broth

dilution)

‡μ√’¬¡ “√≈–≈“¬‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘

·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ „Àâ¡’§«“¡¢ÿàπ‡∑à“°—∫

·¡§ø“√å·≈π¥å 0.5 „πÕ“À“√‡≈’È¬ß‡™◊ÈÕ ‡∫√πŒ“√å∑

Õ‘πøî«™—Ëπ∫√Õ∏ ·≈–‡™¥‡≈Õ√å·Õπ·Õ‚√∫∫√Õ∏ (Schaedler

anaerobe broth) μ“¡≈”¥—∫ ´÷Ëß®–¡’‡™◊ÈÕª√–¡“≥

0.5x108 μ—«μàÕ¡‘≈≈‘≈‘μ√ ®“°π—Èπ„ à “√≈–≈“¬‚ª√æÕ≈‘

§«“¡‡¢â¡¢âπμà“ßÊ μ—Èß·μà 103 ®π∂÷ß 3.22 ¡‘≈≈‘°√—¡

μàÕ¡‘≈≈‘≈‘μ√ „π “√≈–≈“¬‡™◊ÈÕ·μà≈–™π‘¥„πÀ≈Õ¥∑¥≈Õß

π”‰ªÕ∫„πμŸâ∫à¡‡™◊ÈÕ∑’ËÕÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡´’¬ ∑’Ë

∫√√¬“°“»‡À¡“– ¡π“π 24 ™—Ë«‚¡ß ”À√—∫‡™◊ÈÕ‡ÕÁπ‡∑Õ

‚√§Õ°§— øï§—≈≈‘ à«π‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘

Õ∫„πμŸâ∫à¡‡™◊ÈÕ∑’ËÕÿ≥À¿Ÿ¡‘ 37 Õß»“‡´≈‡´’¬ „π∫√√¬“°“»

∑’Ë¡’‰Œ‚¥√‡®π √âÕ¬≈– 5 §“√å∫Õπ‰¥ÕÕ°‰´¥å ‰π‚μ√‡®π

∫“≈“π å √âÕ¬≈– 10 ·≈–‰π‚μ√‡®π∫√‘ ÿ∑∏‘Ï (√âÕ¬≈–

99.99) π“π 5-7 «—π ®“°π—Èππ”¡“μ√«®¥Ÿ°“√‡®√‘≠

‡μ‘∫‚μ¢Õß‡™◊ÈÕ„πÕ“À“√‡≈’È¬ß‡™◊ÈÕ‡À≈«¥—ß°≈à“« ‚¥¬ —ß‡°μ

®“°§«“¡¢ÿàπ¢ÕßÕ“À“√‡≈’È¬ß‡™◊ÈÕ∑’Ë‡°‘¥®“°°“√‡®√‘≠‡μ‘∫‚μ

¢Õß‡™◊ÈÕ‡ª√’¬∫‡∑’¬∫°—∫°≈ÿà¡§«∫§ÿ¡ ‡æ◊ËÕÀ“§«“¡‡¢â¡¢âπ

∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë “¡“√∂¬—∫¬—Èß‡™◊ÈÕ‰¥âÀ√◊Õ§à“‡ÕÁ¡‰Õ´’ (MIC,

minimal inhibitory concentration) ®“°π—Èππ”Õ“À“√‡≈’È¬ß

‡™◊ÈÕ‡À≈«À≈Õ¥∑’Ë‰¡àæ∫«à“¡’§«“¡¢ÿàπ ¡“‡æ“–‡≈’È¬ß∫π®“π

Õ“À“√‡æ“–‡™◊ÈÕ‡∫√πŒ“√å∑Õ‘πøî«™—Ëπ ·≈–·Õπ·Õ‚√∫-

‡∫´—≈Õ–°“√å ‡æ◊ËÕμ√«®¥Ÿ°“√‡®√‘≠‡μ‘∫‚μ¢Õß‡™◊ÈÕ‡ÕÁπ‡∑Õ


136

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‚√§Õ°§— øï§—≈≈‘ ·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘

μ“¡≈”¥—∫ À“°‰¡àæ∫«à“¡’‚§‚≈π’ (colony) ¢Õß‡™◊ÈÕ

ª√“°Ø∫πÕ“À“√‡æ“–‡™◊ÈÕ ®–∂◊Õ«à“ “√≈–≈“¬‚ª√æÕ≈‘

§«“¡‡¢â¡¢âππ—Èπ “¡“√∂∑”≈“¬‡™◊ÈÕ‰¥â ∑”„Àâ “¡“√∂

À“§«“¡‡¢â¡¢âπ∑’ËπâÕ¬∑’Ë ÿ¥∑’Ë∑”≈“¬‡™◊ÈÕ‰¥â

°“√∑¥≈Õß∑—ÈßÀ¡¥®–∑”´È” “¡§√—Èß ‚¥¬·μà≈–§√—Èß

®–∑”°“√∑¥≈Õß„π≈—°…≥– triplicate

º≈°“√»÷°…“®“°°“√∑¥ Õ∫¥â«¬«‘∏’¥‘ §å¥‘øøî«™—Ëπ æ∫«à“

‚ª√æÕ≈‘ ¡’º≈¬—∫¬—Èß‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ ·≈–

‡™◊ÈÕæÕ√åøî‚√‚¡·π ®‘π®‘«“≈‘ ‚¥¬¡’¢π“¥¢Õß¢Õ∫‡¢μ

°“√¬—∫¬—Èß‡™◊ÈÕ ¥—ßμ“√“ß∑’Ë 1 √Ÿª∑’Ë 1 ·≈–√Ÿª∑’Ë 2

°“√À“§à“‡ÕÁ¡‰Õ ’¢Õß‚ª√æÕ≈‘ μàÕ‡™◊ÈÕ‡ÕÁπ‡∑Õ

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Table 1 Inhibition zones (mm) of propolis against Enterococcus faecalis and Porphyromonas gingivalis

0.2% concentrations of propolis (mg/ml)

Bacterial strains chlorhexidine 515 103 20.6 4.12

Enterococcus faecalis 15.5±0.5 8.75±0.25 7±0 - -

ATCC 19433

Porphyromonas gingivalis 22±1 13.5±1.5 9.5±0.5 8±0 -

W 50

- means no inhibition zone

Fig. 1 Inhibition zones of propolis against Enterococcus

faecalis

A) 5% DMSO, B) 0.2% chlorhexidine,

C) propolis 515 mg/ml, D) propolis 103 mg/ml,

E) propolis 20.6 mg/ml, F) propolis 4.12 mg/ml

Fig. 2 Inhibition zones of propolis against Porphyro-

monas gingivalis

A) 5% DMSO, B) 0.2% chlorhexidine,

C) propolis 515 mg/ml, D) propolis 103 mg/ml,

E) propolis 20.6 mg/ml, F) propolis 4.12 mg/ml

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« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554«‘∑¬“ “√


Original article

«‘∑¬“ “√

Sexual dimorphism in Thais using canine index


Tawepong Arayapisit

Department of Anatomy,

Faculty of Dentistry, Mahidol University.

6 Yothi Street, Rachathewi,

Bangkok 10400, Thailand.

Tel: -

Fax: -


Research grant: Supported by Faculty of

Dentistry, Mahidol University

Received: 31 January 2011


AbstractObjective: Canine index is used as a sex determination in forensic

odontology by comparing the individual canine index with standard canine

index calculating from the local population. However, the standard canine

index in Thai population is not well established. This report was aimed to

study on sex identity based on the standard canine index and evaluate its

accuracy in a group of Thais

Materials and methods: Thai subjects, 200 males and 200 females,

aged 18-22 years old who had fully erupted, caries-free, normal and

non-worn upper as well as lower anterior teeth with correct dental alignment

were selected. Male and female subjects were randomly allocated into

2 groups each. Canine widths and intercanine widths in both jaws were

measured using digital vernier calipers. Data from the first group

(100 males and 100 females) were used to calculate standard canine

index according to Rao et al. Data of another group (100 males and

100 females) was used to assess the accuracy of the previously estab-

lished standard canine index. Descriptive statistical data were obtained

and the potential of sexual dimorphism of the canine and intercanine

widths were analyzed by t-test (α=.05).

Results: Canine widths and intercanine widths of males were significantly

greater than those of female (p<.001). The standard canine indices

calculated with upper right, upper left, lower right and lower left canines

were 0.216, 0.214, 0.257 and 0.250, respectively. The respective index

values showed accuracy for sex determination at 53.5%, 60.0%, 61.5%

and 67.0%

Conclusion: It was plausible that the canine index from left mandibular

canine, in particular, could be applied as an additional method for sex

identity in Thai population.

Keyword: Canine index, sexual dimorphism, Thais

Tawepong Arayapisit

DDS



Wanida Sripairojthikoon

Ph.D. (Cell Biology & Anatomy)



Akkarin Panusatid

Dental student,


Naiwinit Somsuktaweekoon

Dental student,


Pongstit Bundit

Dental student,


Nipit Supajarupan

Dental student,


« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


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“¡“√∂§ß∑π‰¥âπ“ππ—∫æ—πªï ·¡âª√– ∫Õÿ∫—μ‘¿—¬√â“¬·√ß

∂Ÿ°Ωíß‰«â„μâ¥‘π ∑πÕÿ≥À¿Ÿ¡‘‰¥â Ÿß∂÷ß 1600 Õß»“‡´≈‡´’¬

®÷ß‰¡à∂Ÿ°∑”≈“¬„πÕ—§§’¿—¬2 ·≈–‰¡à‡πà“‡ªóòÕ¬‡ ◊ËÕ¡ ≈“¬®“°

·∫§∑’‡√’¬‡À¡◊ÕπÕ«—¬«–Õ◊Ëπ2,10-12 ª√–°Õ∫°—∫√Ÿª√à“ß·≈–

°“√‡√’¬ßμ—«¢Õßøíπ´÷Ëß¡’§«“¡‡ªìπ‡Õ°≈—°…≥å™—¥‡®π °√–∑—Ëß

·Ω¥·∑â (identical twin) ∑’Ë¡’≈”¥—∫¢Õß “√æ—π∏ÿ°√√¡

‡À¡◊Õπ°—π °ÁÕ“®¡’°“√‡√’¬ßμ—«¢Õßøíπ∑’Ë·μ°μà“ß°—π‰¥â

‡π◊ËÕß®“°§«“¡·μ°μà“ß¢Õßπ‘ —¬°“√∫¥‡§’È¬«·≈–°“√°≈◊π

Õ“À“√ √«¡∑—Èß§«“¡·μ°μà“ß¢Õß°“√√—°…“·≈–°“√ Ÿ≠‡ ’¬

øíπ ∑”„Àâ®”π«π·≈–√Ÿª·∫∫¢Õßøíπ¡’≈—°…≥–®”‡æ“–

∫ÿ§§≈ ≈Õ°‡≈’¬π‰¥â¬“°8 πÕ°®“°π’È¬—ßæ∫«à“¢π“¥øíπ¢Õß

ºŸâ™“¬„À≠à°«à“ºŸâÀ≠‘ßÕ¬à“ß¡’π—¬ ”§—≠13,14 ¥â«¬‡Àμÿº≈

¥—ß°≈à“«øíπ®÷ß¡’∫∑∫“∑ ”§—≠„π°“√æ‘ Ÿ®πå∫ÿ§§≈„πÀ≈“¬

¥â“π√«¡∑—Èß°“√∑”π“¬‡æ»„π»æπ‘√π“¡

øíπ‡¢’È¬«‡ªìπøíπ∑’Ë¡’§«“¡ “¡“√∂„π°“√®”·π°‡æ»

Ÿß∑’Ë ÿ¥ ∫“ß°“√»÷°…“æ∫«à“øíπ‡¢’È¬«≈à“ß¡’§«“¡ “¡“√∂

„π°“√®”·π°‡æ»‰¥â Ÿß°«à“øíπ‡¢’È¬«∫π13-15 „π¢≥–∑’ËÕ’°

À≈“¬°“√»÷°…“√“¬ß“πº≈„π∑“ßμ√ß°—π¢â“¡16,17 ‚¥¬æ∫«à“

øíπ‡¢’È¬«∫π¡’§«“¡ “¡“√∂„π°“√®”·π°‡æ» Ÿß°«à“øíπ

‡¢’È¬«≈à“ß πÕ°®“°π’Èøíπ‡¢’È¬«¬—ß‡ªìπøíπ∑’Ëª√– ∫ªí≠À“∑“ß

ª√‘∑—πμ«‘∑¬“πâÕ¬∑’Ë ÿ¥ ·≈–¡—°∂Ÿ°∂Õπ‡ªìπ´’Ë ÿ¥∑â“¬18,19

¥—ßπ—Èπøíπ‡¢’È¬«®÷ß‡ªìπøíπ∑’Ë‡À¡“– ¡ ”À√—∫°“√®”·π°‡æ»20

Õ¬à“ß‰√°Áμ“¡¬—ß¡’¢âÕ‚μâ·¬âß„π°“√π”§«“¡°«â“ß¢Õßøíπ

‡æ’¬ßÕ¬à“ß‡¥’¬«¡“‡ªìπ‡§√◊ËÕß¡◊Õ„π°“√®”·π°‡æ»21,22 ®÷ß

¡’°“√π”√–¬–√–À«à“ßøíπ‡¢’È¬« (intercanine width) ÷Ëß

‡ªìπÕ’°√–¬–Àπ÷Ëß∑’Ë¡’§«“¡·μ°μà“ß√–À«à“ß‡æ»Õ¬à“ß¡’π—¬

”§—≠23,24 ¡“æ—≤π“√à«¡°—∫¢π“¥øíπ‡¢’È¬«§”π«≥‡ªìπ


144

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

¥—™π’øíπ‡¢’È¬« (canine index) ‡æ◊ËÕ‡ √‘¡§«“¡∂Ÿ°μâÕß

„π°“√∑”π“¬‡æ»

¥—™π’øíπ‡¢’È¬«‡ªìπ —¥ à«π√–À«à“ß§«“¡°«â“ßøíπ

‡¢’È¬«·∑â„π·π«„°≈â°≈“ß‰°≈°≈“ß (mesiodistal width)

°—∫√–¬–√–À«à“ßøíπ‡¢’È¬«À√◊Õ√–¬–∑’Ë —Èπ∑’Ë ÿ¥„π·π«√–π“∫

√–À«à“ß¬Õ¥ªÿÉ¡øíπ‡¢’È¬« â“¬·≈–¢«“ ‚¥¬¥—™π’øíπ‡¢’È¬«

¢Õß·μà≈–∫ÿ§§≈∑’Ë§”π«≥‰¥â®–π”‰ª‡ª√’¬∫‡∑’¬∫°—∫¥—™π’

øíπ‡¢’È¬«¡“μ√∞“π (standard canine index) À“°¡’§à“

πâÕ¬°«à“À√◊Õ‡∑à“°—∫¥—™π’øíπ‡¢’È¬«¡“μ√∞“π®–∑”π“¬‡ªìπ

‡æ»À≠‘ß ·μà∂â“¡’§à“¡“°°«à“®–∑”π“¬‡ªìπ‡æ»™“¬25

¥—™π’øíπ‡¢’È¬«∂Ÿ°‡ πÕ§√—Èß·√°„πªï §.». 1989

‚¥¬ Rao ·≈–§≥–25 ·≈–æ∫«à“¥—™π’øíπ‡¢’È¬«¡’§«“¡·¡àπ

„π°“√∑”π“¬‡æ»√âÕ¬≈– 84.3 „π‡æ»™“¬·≈–√âÕ¬≈–

87.5 „π‡æ»À≠‘ß °“√„™â¥—™π’øíπ‡¢’È¬«„π°“√·¬°‡æ»π—Èπ

∑”‰¥âßà“¬ –¥«°√«¥‡√Á« ·≈–¡’§«“¡∂Ÿ°μâÕß„π°“√∑”π“¬

‡ªìπ∑’Ëπà“æÕ„® ·μà°Á¡’¢âÕ®”°—¥∑’ËμâÕß¡’øíπ‡¢’È¬«∑—Èß Õß¢â“ß

¡’°“√‡√’¬ßμ—«ª°μ‘ ‰¡à´âÕπ‡° ‡æ◊ËÕ„™â„π°“√«—¥√–¬–√–À«à“ß

øíπ‡¢’È¬« πÕ°®“°π’È¬—ß¡’§«“¡·μ°μà“ß¢Õß¢π“¥¢Õßøíπ

„π·μà≈–‡™◊ÈÕ™“μ‘26 ¥—ßπ—Èπ°“√¡’¥—™π’øíπ‡¢’È¬«¡“μ√∞“π

”À√—∫·μà≈–°≈ÿà¡ª√–™“°√™à«¬„Àâ°“√∑”π“¬‡æ»¢Õß°≈ÿà¡

ª√–™“°√π—Èπ Ê ¡’§«“¡∂Ÿ°μâÕß‡æ‘Ë¡¢÷ÈπÕ’°¥â«¬27,28 Õ¬à“ß‰√

°Áμ“¡¬—ß‰¡àæ∫√“¬ß“π¥—™π’øíπ‡¢’È¬«¡“μ√∞“π¢Õß§π‰∑¬

¥—ßπ—Èπ°“√»÷°…“π’È®÷ß¡’«—μ∂ÿª√– ß§å‡æ◊ËÕ √â“ß¥—™π’øíπ‡¢’È¬«

¡“μ√∞“π √«¡∑—Èßª√–‡¡‘πª√– ‘∑∏‘¿“æ¢Õß¥—™π’øíπ‡¢’È¬«

„π°“√∑”π“¬‡æ»„π§π‰∑¬

«‘∏’¥”‡π‘π°“√«‘®—¬ª√–™“°√»÷°…“

°“√»÷°…“π’È‰¥â√—∫°“√√—∫√Õß®“°§≥–°√√¡°“√

®√‘¬∏√√¡°“√«‘®—¬„π§π¢Õß¡À“«‘∑¬“≈—¬¡À‘¥≈ μ“¡

Àπ—ß ◊Õ√—∫√Õß‡≈¢∑’Ë MU-IRB 2008/137.1905 ‚¥¬

¥”‡π‘π°“√‡°Á∫¢âÕ¡Ÿ≈®“°Õ“ “ ¡—§√™“«‰∑¬Õ“¬ÿ 18 ∂÷ß

22 ªï ®”π«π 400 §π‡ªìπ‡æ»™“¬ 200 §π·≈–‡æ»

À≠‘ß 200 §π ∑’Ë¡’øíπÀπâ“∫π·≈–øíπÀπâ“≈à“ß√Ÿª√à“ß

ª°μ‘§√∫ 12 ’Ë ¡’°“√‡√’¬ßμ—«¢Õßøíπª°μ‘‰¡à¡’°“√´âÕπ‡°

¡’°“√ ∫øíπμ“¡°“√®”·π°·∫∫·Õß‡°‘≈ª√–‡¿∑∑’Ë 1

(Angle classification I) øíπÀπâ“∫π·≈–≈à“ß∑ÿ°´’Ë

‰¡à¡’°“√·μ°À—° ·≈–‰¡à‡§¬‰¥â√—∫°“√∫Ÿ√≥–∑“ß¥â“π

ª√–™‘¥ πÕ°®“°π’ÈÕ“ “ ¡—§√μâÕß‰¡àÕ¬Ÿà„π√–À«à“ß°“√

√—°…“∑“ß∑—πμ°√√¡®—¥øíπ ·∫àßÕ“ “ ¡—§√∑—ÈßÀ¡¥‡ªìπ

2 °≈ÿà¡ °≈ÿà¡·√°‡ªìπ‡æ»™“¬ 100 §π ·≈–‡æ»À≠‘ß

100 §π ”À√—∫°“√ √â“ß¥—™π’øíπ‡¢’È¬«¡“μ√∞“π ·≈–

°≈ÿà¡∑’Ë Õß ‡ªìπ‡æ»™“¬ 100 §π ·≈–‡æ»À≠‘ß 100 §π

”À√—∫°“√«—¥§«“¡·¡àπ (accuracy) ¢Õß¥—™π’øíπ‡¢’È¬«

„π§π‰∑¬

¥—™π’øíπ‡¢’È¬«¡“μ√∞“π¢Õß§π‰∑¬

¥”‡π‘π°“√‡°Á∫¢âÕ¡Ÿ≈„πÕ“ “ ¡—§√°≈ÿà¡∑’ËÀπ÷Ëß

¥â«¬°“√«—¥√–¬– 2 √–¬–‚¥¬μ√ß„π™àÕßª“° ‰¥â·°à §«“¡

°«â“ßøíπ‡¢’È¬« ‚¥¬«—¥ à«π°«â“ß∑’Ë ÿ¥„π·π«„°≈â°≈“ß‰°≈

°≈“ß¢Õßøíπ‡¢’È¬«∑—Èß 4 ´’Ë ·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«

‚¥¬«—¥√–¬–√–À«à“ß¬Õ¥ªÿÉ¡øíπ‡¢’È¬«´â“¬·≈–¢«“∑—Èß„π

¢“°√√‰°√∫π·≈–≈à“ß ¥â«¬‡«Õ‡π’¬√å §“≈‘‡ªÕ√ å ™π‘¥

¥‘®‘μÕ≈ (Digimatic calipers, Mitutoyo, Japan)

π”¢âÕ¡Ÿ≈∑’Ë«—¥‰¥â¡“§”π«≥¥—™π’øíπ‡¢’È¬« ·≈–¥—™π’

øíπ‡¢’È¬«¡“μ√∞“π¢Õßøíπ‡¢’È¬«∑—Èß 4 ’Ë μ“¡«‘∏’°“√¢Õß

Rao ·≈–§≥–25

¥—™π’øíπ‡¢’È¬« =§«“¡°«â“ßøíπ‡¢’È¬«„π·π«‰°≈°≈“ß‰°≈°≈“ß

√–¬–√–À«à“ßøíπ‡¢’È¬«

¥—™π’øíπ‡¢’È¬«¡“μ√∞“π = (Xm+SDm) + (Xf-SDf)

2

‡¡◊ËÕ Xm §◊Õ §à“‡©≈’Ë¬¢Õß¥—™π’øíπ‡¢’È¬«‡æ»™“¬

Xf §◊Õ §à“‡©≈’Ë¬¢Õß¥—™π’øíπ‡¢’È¬«‡æ»À≠‘ß

SDm §◊Õ à«π‡∫’Ë¬ß‡∫π¡“μ√∞“π¢Õß¥—™π’øíπ‡¢’È¬«

‡æ»™“¬

SDf §◊Õ à«π‡∫’Ë¬ß‡∫π¡“μ√∞“π¢Õß¥—™π’øíπ‡¢’È¬«

‡æ»À≠‘ß

§«“¡·¡àπ„π°“√∑”π“¬‡æ»¢Õß¥—™π’øíπ‡¢’È¬«

„π§π‰∑¬

«—¥§«“¡°«â“ßøíπ‡¢’È¬«·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«

„πÕ“ “ ¡—§√°≈ÿà¡∑’Ë Õß ·≈–§”π«≥¥—™π’øíπ‡¢’È¬«¢Õß

Õ“ “ ¡—§√·μà≈–∫ÿ§§≈μ“¡«‘∏’∑’Ë‰¥â°≈à“«¡“·≈â« ®“°π—Èπ

π”¥—™π’∑’Ë§”π«≥‰¥â‰ª‡ª√’¬∫‡∑’¬∫°—∫¥—™π’øíπ‡¢’È¬«

¡“μ√∞“π¢Õß§π‰∑¬∑’Ë √â“ß¢÷Èπ ‚¥¬À“°¥—™π’øíπ‡¢’È¬«

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


145

¢ÕßÕ“ “ ¡—§√πâÕ¬°«à“À√◊Õ‡∑à“°—∫¥—™π’øíπ‡¢’È¬«¡“μ√∞“π

®–∑”π“¬‡ªìπ‡æ»À≠‘ß ·μà∂â“¥—™π’øíπ‡¢’È¬«¢ÕßÕ“ “ ¡—§√

¡“°°«à“¥—™π’øíπ‡¢’È¬«¡“μ√∞“π®–∑”π“¬‡ªìπ‡æ»™“¬

§”π«≥§«“¡·¡àπ¢Õß¥—™π’øíπ‡¢’È¬«®“°√âÕ¬≈–¢Õß®”π«π

Õ“ “ ¡—§√∑’Ë∑”π“¬‡æ»‰¥â∂Ÿ°μâÕßμàÕ®”π«πÕ“ “ ¡—§√

∑—ÈßÀ¡¥„π°≈ÿà¡∑’Ë Õß

πÕ°®“°π—Èπ ‡ª√’¬∫‡∑’¬∫§«“¡·μ°μà“ß√–À«à“ß‡æ»

¢Õß§«“¡°«â“ßøíπ‡¢’È¬« ·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«¢Õß

Õ“ “ ¡—§√∑—Èß Õß°≈ÿà¡¥â«¬ ∂‘μ‘∑¥ Õ∫§à“∑’ (t-test) ∑’Ë

√–¥—∫π—¬ ”§—≠ .05

º≈°“√»÷°…“°“√»÷°…“„πÕ“ “ ¡—§√°≈ÿà¡·√° ‡ªìπ™“¬®”π«π

100 §π Õ“¬ÿ‡©≈’Ë¬ 19.89±1.69 ªï ·≈–‡ªìπÀ≠‘ß®”π«π

100 §πÕ“¬ÿ‡©≈’Ë¬ 19.46±1.45 ªï ·≈–Õ“ “ ¡—§√°≈ÿà¡

∑’Ë Õß ‡ªìπ™“¬ 100 §π Õ“¬ÿ‡©≈’Ë¬19.45±1.30 ªï ·≈–

À≠‘ß 100 §π Õ“¬ÿ‡©≈’Ë¬ 19.03±1.12 ªï æ∫«à“øíπ‡¢’È¬«

∫π¢«“ øíπ‡¢’È¬«∫π´â“¬ øíπ‡¢’È¬«≈à“ß¢«“ ·≈–øíπ‡¢’È¬«≈à“ß

´â“¬·μà≈–´’Ë„π‡æ»™“¬ ¡’§«“¡°«â“ß‡©≈’Ë¬‡ªìπ 8.05±0.51

¡‘≈≈‘‡¡μ√, 8.01±0.52 ¡‘≈≈‘‡¡μ√, 7.30±0.42 ¡‘≈≈‘‡¡μ√

·≈– 7.28±0.38 ¡‘≈≈‘‡¡μ√ μ“¡≈”¥—∫ ·≈–„π‡æ»À≠‘ß

¡’§«“¡°«â“ß‡©≈’Ë¬‡ªìπ 7.62±0.57 ¡‘≈≈‘‡¡μ√, 7.47±0.50

¡‘≈≈‘‡¡μ√, 6.89±0.47 ¡‘≈≈‘‡¡μ√ ·≈– 6.77±0.57

¡‘≈≈‘‡¡μ√ μ“¡≈”¥—∫ (μ“√“ß∑’Ë 1) „π¢≥–∑’Ë√–¬–√–À«à“ß

øíπ‡¢’È¬«‡©≈’Ë¬„π¢“°√√‰°√∫π·≈–¢“°√√‰°√≈à“ß„π

‡æ»™“¬ ‡ªìπ 36.84±2.28 ¡‘≈≈‘‡¡μ√ ·≈– 28.31±2.24

¡‘≈≈‘‡¡μ√ μ“¡≈”¥—∫ ·≈–„π‡æ»À≠‘ß¡’√–¬–‡©≈’Ë¬‡ªìπ

35.10±2.32 ¡‘≈≈‘‡¡μ√ ·≈– 27.42±1.78 ¡‘≈≈‘‡¡μ√

μ“¡≈”¥—∫ (μ“√“ß∑’Ë 2)

º≈°“√‡ª√’¬∫‡∑’¬∫§«“¡·μ°μà“ß√–À«à“ß‡æ»

¥â«¬ ∂‘μ‘∑¥ Õ∫∑’ ∑’Ë√–¥—∫π—¬ ”§—≠ .05 æ∫«à“ §«“¡

°«â“ßøíπ‡¢’È¬«∑ÿ°´’Ë ·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«∑—Èß¢“°√√‰°√

∫π·≈–¢“°√√‰°√≈à“ß„π‡æ»™“¬¡’§à“¡“°°«à“„π‡æ»À≠‘ß

Õ¬à“ß¡’π—¬ ”§—≠ (p<.001)

‡¡◊ËÕπ”√–¬–μà“ß Ê ∑’Ë«—¥„πÕ“ “ ¡—§√°≈ÿà¡·√°

§”π«≥À“¥—™π’øíπ‡¢’È¬«¡“μ√∞“π μ“¡ Ÿμ√¢â“ßμâπ º≈

Group SexUpper right canine Upper left canine Lower right canine Lower left canine

Mean±SD P value Mean±SD P value Mean±SD P value Mean±SD P value

Table 1 Mean and standard deviation (SD) of canine widths of males and females (mm)

1 Male 8.07±0.51 <.001 8.01±0.51 <.001 7.32±0.42 <.001 7.27±0.40 <.001

Female 7.63±0.62 7.48±0.52 6.90±0.51 6.76±0.61

2 Male 8.03±0.52 <.001 8.01±0.52 <.001 7.29±0.41 <.001 7.28±0.37 <.001

Female 7.62±0.53 7.46±0.47 6.88±0.45 6.77±0.54

Total Male 8.05±0.51 <.001 8.01±0.52 <.001 7.30±0.42 <.001 7.28±0.38 <.001

Female 7.62±0.57 7.47±0.50 6.89±0.47 6.77±0.57

Table 2 Mean and standard deviation (SD) of intercanine widths of males and females (mm)

Group Sex Maxillary arch Mandibular arch

Mean±SD P value Mean±SD P value

1Male 36.90±2.19 <.001 28.27±2.15 <.001

Female 35.28±2.38 27.56±1.85

2Male 36.77±2.37 <.001 28.36±2.34 <.001

Female 34.91±2.25 27.28±1.71

TotalMale 36.84±2.28 <.001 28.31±2.24 <.001

Female 35.10±2.32 27.42±1.78


146

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

°“√§”π«≥æ∫«à“ ¥—™π’øíπ‡¢’È¬«¡“μ√∞“π∑’Ë √â“ß¢÷Èπ®“°

øíπ‡¢’È¬«∫π¢«“ øíπ‡¢’È¬«∫π´â“¬ øíπ‡¢’È¬«≈à“ß¢«“ ·≈–

øíπ‡¢’È¬«≈à“ß´â“¬ ¡’§à“ 0.216, 0.214, 0.257 ·≈–

0.250 μ“¡≈”¥—∫ (Table 3)

º≈°“√μ√«® Õ∫§«“¡·¡àπ„π°“√∑”π“¬‡æ»¢Õß

¥—™π’øíπ‡¢’È¬«¡“μ√∞“π¢Õßøíπ·μà≈– ’Ë„πÕ“ “ ¡—§√°≈ÿà¡

∑’Ë Õß æ∫«à“¥—™π’øíπ‡¢’È¬«¡“μ√∞“π¢Õßøíπ‡¢’È¬«≈à“ß´â“¬

¡’§«“¡·¡àπ„π°“√∑”π“¬ Ÿß ÿ¥·μà¥—™π’øíπ‡¢’È¬«¡“μ√∞“π

¢Õßøíπ‡¢’È¬«∫π¢«“¡’§«“¡·¡àπ„π°“√∑”π“¬πâÕ¬∑’Ë ÿ¥

‚¥¬√âÕ¬≈–¢Õß§«“¡·¡àπ„π°“√∑”π“¬‡æ»¢Õß¥—™π’øíπ

‡¢’È¬«¡“μ√∞“π¢Õßøíπ‡¢’È¬«∫π¢«“ øíπ‡¢’È¬«∫π â“¬ øíπ

‡¢’È¬«≈à“ß¢«“ ·≈–øíπ‡¢’È¬«≈à“ß´â“¬¡’§à“√âÕ¬≈– 53.5, 60.0,

61.5 ·≈– 67.0 μ“¡≈”¥—∫ (μ“√“ß∑’Ë 3)

«‘®“√≥å¢π“¥¢Õßøíπ‡¢’È¬« ·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«‡ªìπ

μ—«·ª√ ”§—≠„π°“√§”π«≥¥—™π’øíπ‡¢’È¬« ·μà√–¬–√–À«à“ß

øíπ‡¢’È¬«®–‡ª≈’Ë¬π·ª≈ßμ“¡Õ“¬ÿ‡π◊ËÕß®“°°“√‡®√‘≠¢Õß

¢“°√√‰°√ ®π°√–∑—Ëßøíπ‡¢’È¬«·∑â¢÷Èπ ¡∫Ÿ√≥å √–¬–π’È

®÷ß§ß∑’ËÀ√◊ÕÕ“®¡’°“√‡ª≈’Ë¬π·ª≈ß‡æ’¬ß‡≈Á°πâÕ¬29,30

πÕ°®“°π’È¬—ß¡’°“√»÷°…“æ∫«à“§«“¡´âÕπ‡°¢ÕßøíπÀπâ“

®–∑”„Àâ§«“¡·¡àπ¢Õß¥—™π’øíπ‡¢’È¬«„π°“√∑”π“¬‡æ»

≈¥≈ß27 ¥—ßπ—Èπ°“√»÷°…“π’È®÷ß‡≈◊Õ°Õ“ “ ¡—§√∑’Ë¡’°“√

‡√’¬ßμ—«¢ÕßøíπÀπâ“‡ªìπª°μ‘ Õ“¬ÿ¡“°°«à“ 15 ªï ‡π◊ËÕß®“°

‡ªìπ™à«ßÕ“¬ÿ∑’Ëøíπ‡¢’È¬«·∑â¢÷Èπ‡μÁ¡´’Ë„π™àÕßª“° ·≈–¡’√–¬–

√–À«à“ßøíπ‡¢’È¬«§ß∑’Ë29,30

º≈°“√»÷°…“æ∫«à“§«“¡°«â“ßøíπ‡¢’È¬«∑ÿ°´’Ë¡’§«“¡

·μ°μà“ß√–À«à“ß‡æ»Õ¬à“ß¡’π—¬ ”§—≠„π§π‰∑¬ ´÷Ëß

Õ¥§≈âÕß°—∫°“√»÷°…“Õ◊ËπÊ „πÀ≈“¬‡™◊ÈÕ™“μ‘ ∑—Èß„π∑«’ª

‡Õ‡™’¬31,32 ·≈– À√—∞Õ‡¡√‘°“13,14 º≈°“√»÷°…“‡À≈à“π’È

™à«¬¬◊π¬—π§«“¡ “¡“√∂¢Õßøíπ‡¢’È¬«„π°“√®”·π°‡æ»

∑—Èßπ’È§«“¡·μ°μà“ß√–À«à“ß‡æ»¢Õßøíπ‡™◊ËÕ«à“‡ªìπº≈®“°

§«“¡·μ°μà“ß∑“ßæ—π∏ÿ°√√¡ ‚¥¬°“√§«∫§ÿ¡¢Õß¬’π

∑’Ë‡°’Ë¬«‡π◊ËÕß°—∫‡æ» (sex-linked gene)33 ¡’√“¬ß“π«à“

¬’πÕ‡¡‚≈®’π‘π (amelogenin gene) ∫π‚§√‚¡‚´¡‡Õ°´å

(X chromosome) ¡’º≈μàÕ¢π“¥¢Õßøíπ ∑”„Àâ§«“¡

Àπ“¢Õß‡§≈◊Õ∫øíπ (enamel thickness) ‡æ‘Ë¡¢÷Èπ ·μà

‰¡à¡’º≈μàÕ°“√‡ª≈’Ë¬π·ª≈ß§«“¡Àπ“¢Õß‡π◊ÈÕøíπ (dentine

thickness)34 ´÷Ëß Õ¥§≈âÕß°—∫°“√»÷°…“„πºŸâªÉ«¬°≈ÿà¡

Õ“°“√‡∑Õ√å‡πÕ√å (Turner syndrome) ∑’Ë¡’‚§√‚¡‚´¡‡Õ°´å

‡æ’¬ßÕ—π‡¥’¬«‡ªìπ‚§√‚¡‚´¡‡æ» (45,XO) æ∫«à“

‡§≈◊Õ∫øíπ¢ÕßºŸâªÉ«¬∫“ß¡“°·μà‡π◊ÈÕøíπ¡’§«“¡Àπ“ª°μ‘35

πÕ°®“°π’È ¬—ßæ∫«à“‚§√‚¡‚´¡«“¬ (Y chromosome)

¡’º≈‡æ‘Ë¡∑—È ß§«“¡Àπ“¢Õß‡§≈◊Õ∫øíπ·≈–§«“¡Àπ“

¢Õß‡π◊ÈÕøíπ36 ¥—ßπ—Èπ‡π◊ÈÕøíπ¢Õß‡æ»™“¬®÷ß¡’¢π“¥„À≠à°«à“

‡æ»À≠‘ßÕ¬à“ß¡’π—¬ ”§—≠37-39 ®“°‡Àμÿº≈∑’Ë°≈à“«¡“

π—∫ πÿπ«à“øíπ∑ÿ°´’Ëπà“®–„™â®”·π°‡æ»‰¥â Õ¬à“ß‰√°Áμ“¡

√“¬ß“π°“√»÷°…“μà“ß Ê °≈—∫æ∫«à“øíπ·μà≈–´’Ë¡’§«“¡

“¡“√∂„π°“√®”·π°‡æ»·μ°μà“ß°—π13,15,26,31,41,42

‡π◊ËÕß®“°‚§√‚¡‚´¡‡æ»¡’Õ‘∑∏‘æ≈μàÕ°“√ √â“ßøíπ·μà≈–´’Ë

‰¡à‡∑à“°—π40 ”À√—∫øíπ‡¢’È¬« ÷ËßÀ≈“¬°“√»÷°…“™’È„Àâ‡ÀÁπ«à“

¡’§«“¡ “¡“√∂„π°“√®”·π°‡æ» Ÿ ß°«à “øíπ´’Ë Õ◊Ë π

π—È π13,15,41,42 æ∫«à“§«“¡Àπ“¢Õß‡π◊ÈÕøíπ¢Õßøíπ‡¢’È¬«

„π‡æ»À≠‘ß∫“ß°«à“„π‡æ»™“¬Õ¬à“ß¡’π—¬ ”§—≠36,43 ·μà

¬—ß¡’§«“¡¢—¥·¬âß°—πÕ¬Ÿà‡°’Ë¬«°—∫§«“¡Àπ“¢Õß‡§≈◊Õ∫øíπ

¢Õßøíπ‡¢’È¬«π—Èπ ∫“ß°“√»÷°…“‰¡àæ∫§«“¡·μ°μà“ß¢Õß

§«“¡Àπ“¢Õß‡§≈◊Õ∫øíπ„π√–À«à“ß‡æ»38 „π¢≥–∑’Ë∫“ß

°“√»÷°…“æ∫«à“‡§≈◊Õ∫øíπ„π‡æ»À≠‘ßÀπ“°«à“‡æ»™“¬

‡≈Á°πâÕ¬36,43,44

√–¬–√–À«à“ßøíπ‡¢’È¬«∑—Èß„π¢“°√√‰°√∫π·≈–¢“

Table 3 The standard canine index and its accuracy

Tooth Standard canine indexAccuracy (%)

Male Female Total

Upper right canine 0.216 55.00 52.00 53.50

Upper left canine 0.214 65.00 55.00 60.00

Lower right canine 0.257 59.00 64.00 61.50

Lower left canine 0.250 75.00 59.00 67.00

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


147

°√√‰°√≈à“ß‡ªìπÕ’°μ—«·ª√Àπ÷Ëß∑’Ë¡’√“¬ß“π«à“„π‡æ»™“¬

¡’√–¬–°«â“ß°«à“„π‡æ»À≠‘ßÕ¬à“ß¡’π—¬ ”§—≠27,28,45-47

´÷Ëß π—∫ πÿπº≈°“√»÷°…“„π§√—Èßπ’È ∑—Èßπ’Èæ∫«à“§«“¡°«â“ß

¢Õßøíπ‡¢’È¬«·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«¡’§«“¡ —¡æ—π∏å°—π

Õ¬à“ß¡’π—¬ ”§—≠14 ‚¥¬‡©æ“–„πÕ“ “ ¡—§√∑’Ë¡’°“√‡√’¬ßμ—«

¢ÕßøíπÀπâ“ª°μ‘√–¬–√–À«à“ßøíπ‡¢’È¬«‰¥â√—∫Õ‘∑∏‘æ≈

∫“ß à«π®“°¢π“¥¢ÕßøíπÀπâ“25 ¥—ßπ—Èπ§«“¡·μ°μà“ß

√–À«à“ß‡æ»¢Õß¢π“¥øíπ®÷ß àßº≈„Àâ√–¬–√–À«à“ßøíπ‡¢’È¬«

¡’§«“¡·μ°μà“ß√–À«à“ß‡æ»¥â«¬

§«“¡·μ°μà“ß√–À«à“ß‡æ»∑’Ë™—¥‡®π¢Õßøíπ‡¢’È¬«

∑”„Àâ¡’°“√π”øíπ‡¢’È¬«¡“»÷°…“‡æ◊ËÕæ—≤π“«‘∏’∑”π“¬‡æ»

„π∑“ßπ‘μ‘«‘∑¬“»“ μ√å ‡™àπ Õ“»—¬°“√»÷°…“√“¬≈–‡Õ’¬¥

‡©æ“– à«π (Moiré topography)16 À√◊Õ °“√«‘‡§√“–Àå

øŸ‡√’¬√å (Fourier analysis)17 ∂÷ß·¡â«à“«‘∏’°“√‡À≈à“π’È„Àâº≈

°“√∑”π“¬‡æ»∑’Ë·¡àπ¬” ·μà«‘∏’‡À≈à“π’È‡ªìπ«‘∏’∑’Ë¬ÿàß¬“°

´—∫´âÕπ μâÕßÕ“»—¬§«“¡™”π“≠‡©æ“–„π°“√«‘‡§√“–Àå

‰¡à‡À¡“– ¡°—∫°“√„™âß“π„πª√–™“°√°≈ÿà¡„À≠à ®÷ß¡’

°“√æ—≤π“«‘∏’∑’Ë‡À¡“– ¡°«à“

¥—™π’øíπ‡¢’È¬«‡ªìπÕ’°«‘∏’°“√∑’Ë„™âß“π –¥«° √«¥‡√Á«

∑”‰¥âßà“¬‡π◊ËÕß®“°Õ“»—¬μ—«·ª√‡æ’¬ß 2 §à“ ‰¡àμâÕß°“√

§«“¡™”π“≠‡©æ“– √«¡∑—Èß„Àâº≈∑’Ëπà“‡™◊ËÕ∂◊Õ ®÷ß‡À¡“– ¡

°—∫°“√ª√–¬ÿ°μå„™â„π°≈ÿà¡ª√–™“°√¢π“¥„À≠à‰¥â7,46 ·μà

¢âÕ®”°—¥ª√–°“√ ”§—≠¢Õß¥—™π’øíπ‡¢’È¬«§◊Õ¥—™π’øíπ‡¢’È¬«

¡“μ√∞“π§«√‡ªìπ§à“‡©æ“–∑’Ë§”π«≥¢÷Èπ ”À√—∫ª√–™“°√

·μà≈–∑âÕß∂‘Ëπ ‡æ◊ËÕ„Àâ°“√∑”π“¬¡’§«“¡·¡àπ¬”¡“°¢÷Èπ27

¥—ßπ—Èπ °“√»÷°…“π’È®÷ß‰¥â √â“ß¥—™π’øíπ‡¢’È¬«¡“μ√∞“π

„π§π‰∑¬ √«¡∑—Èßª√–‡¡‘π§«“¡·¡àπ¢Õß¥—™π’¥—ß°≈à“«

‡æ◊ËÕ‡æ‘Ë¡ª√– ‘∑∏‘¿“æ¢Õß¥—™π’øíπ‡¢’È¬«„π§π‰∑¬

º≈°“√π”¥—™π’øíπ‡¢’È¬«¡“μ√∞“π∑’Ë§”π«≥‰¥â®“°

Õ“ “ ¡—§√°≈ÿà¡·√° ¡“„™â„π°“√∑”π“¬‡æ»„πÕ“ “

¡—§√°≈ÿà¡∑’Ë Õß æ∫«à“¥—™π’øíπ‡¢’È¬«∑’Ë§”π«≥®“°øíπ

‡¢’È¬«≈à“ß¡’§«“¡·¡àπ„π°“√∑”π“¬‡æ»¡“°°«à“¥—™π’

∑’Ë§”π«≥®“°øíπ‡¢’È¬«∫π º≈°“√»÷°…“π’È Õ¥§≈âÕß°“√

»÷°…“„πª√–™“°√ª√–‡∑»´“Õÿ¥‘Õ“√‡∫’¬ ∑’Ë√“¬ß“π«à“¥—™π’

øíπ‡¢’È¬«∑’Ë§”π«≥®“°øíπ‡¢’È¬«∫π¡’Õ—μ√“§«“¡º‘¥æ≈“¥

(rate of misclassification) √âÕ¬≈– 12.6 „π¢≥–∑’Ë¥—™π’

∑’Ë§”π«≥®“°øíπ‡¢’È¬«≈à“ß¡’Õ—μ√“§«“¡º‘¥æ≈“¥‡æ’¬ß

√âÕ¬≈– 4.6546 πÕ°®“°π’Èº≈°“√»÷°…“„π§√—Èßπ’È¬—ß™’È

„Àâ‡ÀÁπ«à“¥—™π’∑’Ë§”π«≥®“°øíπ‡¢’È¬« â“¬¡’§«“¡·¡àπ

„π°“√∑”π“¬¡“°°«à“¥—™π’∑’Ë§”π«≥®“°øíπ‡¢’È¬«¢«“

Õ¥§≈âÕß°—∫°“√»÷°…“„πÕ¥’μ∑’Ëæ∫«à“øíπ‡¢’È¬«≈à“ß´â“¬

¡’§«“¡ “¡“√∂„π°“√®”·π°‡æ» (sexual dimorphism)

Ÿß°«à“øíπ‡¢’È¬«≈à“ß¢«“13,15,41

°“√»÷°…“„πª√–‡∑»Õ‘π‡¥’¬√“¬ß“π«à“¥—™π’øíπ

‡¢’È¬«≈à“ß¡’§«“¡·¡àπ„π°“√∑”π“¬‡æ»√âÕ¬≈– 72.0 ∂÷ß

85.914,28,48,49 ´÷Ëß Ÿß°«à“°“√»÷°…“„πª√–‡∑»Õ◊Ëπ ‡™àπ

°“√»÷°…“„πª√–‡∑»‡πª“≈°≈—∫æ∫«à“¥—™π’øíπ‡¢’È¬«≈à“ß

¡’§«“¡·¡àπ„π°“√∑”π“¬‡æ»‡æ’¬ß√âÕ¬≈– 51.2847 ·≈–

°“√»÷°…“„πª√–‡∑»Ω√—Ëß‡» æ∫«à“¥—™π’øíπ‡¢’È¬«≈à“ß

¡’§«“¡·¡àπ„π°“√∑”π“¬‡æ» Ÿß ÿ¥√âÕ¬≈– 65.4827

´÷Ëß„°≈â‡§’¬ß°—∫°“√»÷°…“„πª√–‡∑»‰∑¬§√—Èßπ’È∑’Ëæ∫«à“

§«“¡·¡àπ„π°“√∑”π“¬‡æ»¢Õß¥—™π’øíπ‡¢’È¬« Ÿß ÿ¥

√âÕ¬≈– 67.0

∑—Èß∑’Ë§«“¡°«â“ßøíπ‡¢’È¬«·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«

¡’§«“¡·μ°μà“ß√–À«à“ß‡æ»∑“ß ∂‘μ‘Õ¬à“ß™—¥‡®π ·μà

‡¡◊ËÕπ”¡“§”π«≥‡ªìπ¥—™π’øíπ‡¢’È¬«°≈—∫¡’§«“¡ “¡“√∂

„π°“√∑”π“¬‡æ»„π§π‰∑¬‰¥â‰¡à Ÿß¡“° ∑—Èßπ’ÈÕ“®

‡π◊ËÕß®“°¥—™π’øíπ‡¢’È¬«‡ªìπ§à“ —¡æ—∑∏å (relative value)

∑’Ë‡°‘¥®“° —¥ à«π√–À«à“ß§à“ —¡∫Ÿ√≥å (absolute value)

2 §à“ ‰¥â·°à §«“¡°«â“ßøíπ‡¢’È¬«·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«

∑”„Àâ§«“¡·μ°μà“ß√–À«à“ß‡æ»¢Õß§à“ —¡∫Ÿ√≥å∂Ÿ°≈¥

∑Õπ≈ß47 μ—«Õ¬à“ß‡™àπ ∂â“ºŸâ™“¬¡’§«“¡°«â“ßøíπ‡¢’È¬«

9 ¡‘≈≈‘‡¡μ√ ·≈–¡’√–¬–√–À«à“ßøíπ‡¢’È¬« 30 ¡‘≈≈‘‡¡μ√

·μàºŸâÀ≠‘ß¡’§«“¡°«â“ßøíπ‡¢’È¬« 7.5 ¡‘≈≈‘‡¡μ√ ·≈–¡’√–¬–

√–À«à“ßøíπ‡¢’È¬« 25 ¡‘≈≈‘‡¡μ√ ∑—Èß§«“¡°«â“ßøíπ‡¢’È¬«

·≈–√–¬–√–À«à“ßøíπ‡¢’È¬«„πºŸâ™“¬¡’§à“¡“°°«à“„πºŸâÀ≠‘ß

Õ¬à“ß™—¥‡®π ·μà‡¡◊ËÕ§”π«≥¥—™π’øíπ‡¢’È¬«·≈â«°≈—∫æ∫«à“

∑—ÈßºŸâ™“¬·≈–ºŸâÀ≠‘ßμà“ß¡’¥—™π’øíπ‡¢’È¬«‡∑à“°—π§◊Õ 0.3

· ¥ß„Àâ‡ÀÁπ«à“¥—™π’øíπ‡¢’È¬«Õ“®¬—ß¡’¢âÕ®”°—¥„π°“√

®”·π°§«“¡·μ°μà“ß√–À«à“ß‡æ»

º≈®“°°“√»÷°…“π’Èæ∫«à“¥—™π’øíπ‡¢’È¬«„π°“√

∑”π“¬‡æ»¡’§«“¡·¡àπ‰¡à Ÿß¡“°π—°„π§π‰∑¬ ®÷ß

‰¡à‡À¡“– ¡∑’Ë®–‡≈◊Õ°¥—™π’øíπ‡¢’È¬«‡ªìπ‡§√◊ËÕß¡◊Õ≈”¥—∫·√°

„π°“√∑”π“¬‡æ»»æπ‘√π“¡ ·μà§«√„™â√à«¡°—∫«‘∏’Õ◊Ëπ

‡∑à“∑’Ë “¡“√∂°√–∑”‰¥âμ“¡ ¿“æ»æ∑’Ëæ∫ ‡æ◊ËÕ™à«¬‡ √‘¡

§«“¡∂Ÿ°μâÕß¢Õßº≈°“√∑”π“¬ ‡™àπ °“√„™â°√–¥Ÿ°„∫Àπâ“


148

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

¢“°√√‰°√≈à“ß À√◊Õ°√–¥Ÿ°‡™‘ß°√“π ´÷Ëß¡’√“¬ß“π§«“¡

·¡àπ„π°“√∑”π“¬ Ÿß50,51 Õ¬à“ß‰√°Áμ“¡øíπ¬—ß§ß‡ªìπ

‡§√◊ËÕß¡◊Õ∑“ßπ‘μ‘«‘∑¬“»“ μ√å∑’Ë¥’„π°“√æ‘ Ÿ®πå∫ÿ§§≈

®÷ß§«√∑”°“√»÷°…“ª√–¬ÿ°μå„™âøíπ„π√Ÿª·∫∫Õ◊ËπμàÕ‰ª ‡™àπ

°“√«‘‡§√“–Àå®”·π°ª√–‡¿∑ (discriminant analysis)

´÷ËßÕ“®™à«¬ √â“ß«‘∏’∑’Ë¡’ª√– ‘∑∏‘¿“æ¡“°¢÷Èπ„π°“√®”·π°

‡æ»‰¥âμàÕ‰ª

∫∑ √ÿª¥—™π’øíπ‡¢’È¬«¡’§«“¡·¡àπ„π°“√∑”π“¬‡æ»§π‰∑¬

‰¥â Ÿß ÿ¥ª√–¡“≥√âÕ¬≈– 67.0 ‡¡◊ËÕ„™âøíπ‡¢’È¬«≈à“ß´â“¬

Õ¬à“ß‰√°Áμ“¡º≈°“√»÷°…“· ¥ß„Àâ‡ÀÁπ«à“§«“¡·¡àπ¢Õß

°“√∑”π“¬‡æ»¥â«¬¥—™π’øíπ‡¢’È¬«π’È‰¡à Ÿß¡“°π—° ®÷ß‰¡à

§«√„™â‡ªìπ«‘∏’À≈—°„π°“√∑”π“¬‡æ»∑“ßπ‘μ‘«‘∑¬“»“ μ√å

·μà§«√„™â√à«¡°—∫«‘∏’Õ◊Ëπ ‡æ◊ËÕ‡ √‘¡ª√– ‘∑∏‘¿“æ„π°“√

∑”π“¬‡æ» À√◊Õ„™â‡©æ“–„π°√≥’∑’Ë‰¡à “¡“√∂∑”π“¬‡æ»

¥â«¬«‘∏’Õ◊Ëπ‰¥â‡∑à“π—Èπ

°‘μμ‘°√√¡ª√–°“»¢Õ¢Õ∫§ÿ≥§≥–∑—πμ·æ∑¬»“ μ√å ¡À“«‘∑¬“≈—¬

¡À‘¥≈ ”À√—∫∑ÿπ π—∫ πÿπ°“√«‘®—¬ ·≈–Õ“ “ ¡—§√

∑ÿ°∑à“π∑’Ë„Àâ§«“¡Õπÿ‡§√“–Àå„π°“√‡°Á∫¢âÕ¡Ÿ≈

‡Õ° “√Õâ“ßÕ‘ß1. Pretty IA, Sweet D. A look at forensic dentistry-

Part 1: The role of teeth in the determination of

human identity. Br Dent J 2001; 190: 359-66.

2. Rothwell BR. Principles of dental identification.

Dent Clin North Am 2001; 45: 253-70.

3. Bushick RD. Forensic dentistry: An overview for

the general dentist. Gen dent 2006; 54: 48-52.

4. Hirsch CS, Morris RC, Moritz AR. Handbook of

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« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Physical properties of dental stones available in ThailandPotchaman Sinavarat Kallaya Suputtamongkol Chatcharee Suchatlampong

151


Original article

«‘∑¬“ “√

Physical properties of dental stones available in Thailand

AbstractObjective: To compare the physical properties of ten dental stones available

in Thailand.

Materials and methods: Ten dental stones used in this study were Comet 3,

Planet Universal, Hard Stone (pink), Hard Stone (green), Pana Super Stone,

Dentamerica, G10 Universal, Hydrock, Labstone and Quick Stone. The

properties of dental stones were studied according to ISO 6873 Dental

gypsum products, i.e., initial setting time, setting expansion, compressive

strength and reproduction of detail. Statistical analyses of the mean setting

time, setting expansion and compressive strength were performed using

one-way ANOVA and Tukeyûs multiple comparison tests. All properties

were also determined according to ISO guidelines.

Results: The mean setting time of seven dental stones were complied

with the international standard. The products which showed the least

expansion were Quick Stone, G10 Universal, Comet 3 and Labstone

while setting expansion of Dentamerica, Planet Universal and Hard Stone

(green and pink) exceeded the standard value recommended by the ISO

6873 Dental gypsum products. The mean values of compressive strength

of all groups tested were at an acceptable limit. The compressive strength

of Planet Universal, Quick Stone and Hydrock Model Stone were the highest

and significantly different from the others (p<0.05). All products showed

acceptable detail reproduction.

Conclusion: Five of ten dental stones tested in this study possessed the

acceptable properties except Dentamerica, Planet Universal, Quick stone

and Hard Stone (green and pink) of which their setting time and setting

expansion did not comply with the standard criteria.

Key words: Dental stone, gypsum, calcium sulphate, hemihydrate


Potchaman Sinavarat

Department of Prosthodontics


6 Yothi Street, Ratchathewi,


Tel: 02-203-6441

Fax: 02-203-6440

E-mail: -

Research Grant: -

Received: 23 March 2009

Accepted: December 2011

Potchaman Sinavarat

BSc, D.D.S, M.Sc



Kallaya Suputtamongkol

D.D.S, Ph.D.



Chatcharee Suchatlampong

D.D.S, M.Phil (Dental Matcrials),

Diplamate, Thai Board in Prosthodontics




152

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Universal, Hydrock, Labstone ·≈– Quick Stone °“√»÷°…“¥”‡π‘π°“√μ“¡

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¡“μ√∞“π°”Àπ¥ °≈ÿà¡ Quick Stone, G10 Universal, Comet 3 ·≈– Labstone

¡’°“√¢¬“¬μ—«¢≥–°àÕμ—«μË” ÿ¥ ·μà Dentamerica Planet Universal·≈– Hard

Stone(green ·≈– pink) ¢¬“¬μ—«¡“°°«à“‡°≥±å¡“μ√∞“π°”Àπ¥ §«“¡∑π

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Planet Universal, Quick Stone·≈– Hard Stone (green ·≈– pink) ∑’Ë¡’‡«≈“

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« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


153

IntroductionGypsum is a natural white mineral with the

chemical name calcium sulphate dihydrate. It has been

used as a building material since the time of the

Egyptians1. Dental plaster or plaster of Paris is

made from the mineral gypsum by heating in open

kettles to 120 ÌC. This produces large, irregular,

porous particles which are referred to as beta hemihy-

drate particles2. Plaster as used in dentistry is

usually the best grade of commercial plaster

modified with additives to adjust the setting time,

lower the setting expansion or both. Laboratory plaster

is relatively weak and fragile when used for working

casts. Thus, plaster is often used for mounting stone

models onto articulators and for preparing study

models.

In 1933, a newer form of hemihydrate (alpha

hemihydrate) was produced by calcining gypsum

under steam pressure in an autoclave at 120 ÌC

-130 ÌC. This dental stone consists of small, regular,

dense, and well-formed elongated crystals with

some porosity. Its strength is about double that of

plaster3. When strength, hardness and accuracy

are required, dental stones are normally used

in preference to dental plaster. Dental stones are

commonly utilized to produce working casts used to

construct acrylic dentures and other dental appliances.

In Thailand,high quality natural gypsum mineral is

found in Pichit, Nakhorn Sawan, Surat Tanee and

Nakhorn Srithammarat provinces4. Gypsum has been

widely used for table ware, sanitary ware, ceramic

roof tile, gypsum fiberboard and specially for dental

use as dental plaster and dental stone. With the

lingering economic crisis, reducing costs by using

locally-produced products is appropriate. For this

reason, Suchatlampong et al5 studied the physical

properties of three dental plasters that are locally

produced. The study was conducted in accordance

with the American Dental Association guideline for

dental gypsum products. The results indicated that

those dental plasters were acceptable for dental use.

However, the physical properties of dental stone

produced in Thailand have not been previously studied.

The objectives of this study was to compare the

physical properties of ten dental stones, 5 of which

were locally produced in Thailand and the rest were

imported.

Materials and MethodsTen brands of dental stone used in this study

are shown in Table1. Properties of dental stones

were evaluated according to ISO 6873 Dental gypsum

products6, i.e., setting time, setting expansion,

compressive strength and reproduction of detail.

Characteristics of dental stone powder were observed

using a scanning electron microscopy (Jeol 5410,

Jeol, Japan). The mean compressive strength, setting

time, and setting expansion values of stone products

were statistically analysed using one-way ANOVA and

Tukeyûs multiple comparison tests. The mean com-

pressive strength, setting time, and setting expansion

values of stone products were also evaluated according

to the ISO 6873 requirements, including the detail

reproduction quality of these stones.

Setting time

Setting time was determined using a Vicat

need le apparatus. Each material was mixed according

to the manufacturerûs instruction. A metal mould,

having an inside diameter of 70 mm and a height of

40 mm, was completely filled with the mixed gypsum

product and the material was leveled to the top of

the mould6. The test began one or two minutes prior

to manufacturersû recommended setting time and the

needle was allowed to penetrate into the material at

15±1 second intervals.


154

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

gauge capable of measuring to within 0.01 mm and

the setting expansion was calculated as a percentage

of the original gauge length. Each group was tested

five times and the mean values of setting expansion

of all materials were calculated.

Compressive strength

Each material was mixed and poured into a

mould having a diameter of 20±0.2 mm and a length

of 40±0.4 mm6. The material was vibrated gently for

30 seconds during filling in the mould in order to

minimize the formation of bubbles. Then a glass plate

was placed to cover the top of the over-filled mould

and the material was allowed to solidify for 45 minutes

The setting time was recorded as the total time from

the start of mixing to the time when the needle failed

to penetrate the specimen to a depth of at least 2 mm.

The tests were carried out five times and the mean

setting time of each material was calculated. According

to the ISO requirements, the mean setting time of

each material should be within 20% of the value

claimed by the manufacturer.

Setting expansion

The mixed sample was added to completely

fill the trough of setting expansion apparatus6 and

allowed to expand unrestrained for two hours at one

end. The change in length was recorded by a dial

Table 1 Details and properties as stated from manufacturers of 10 dental stones used in this study.

Brand Manufacturer Lot. No./ Water/Powder Setting time

Color 100 cc/gm time(min)

Comet 3 High quality Lafarge Prestia Co. LTD., 5417, yellow 28 11-13

model stone Thailand*

Dentamerica Model Stone Dentamerica Royal USA NA, yellow 30 9

G 10 Universal

Dental Stone Plaster ADA, USA NA, Green 23-25 10

Hard Stone High Quality Siam Gypsum Plaster NA, Green 28 10

Public Co. Ltd., Thailand*

Hard Stone High Quality Siam Gypsum Plaster NA, Pink 28 10

Public Co. Ltd., Thailand*

Hydrock Model Stone SDS KERR Sybron Dental Lot# 1-23134 30 10

Specialties, USA Yellow

Labstone Bayer, USA 9601002, 30 10-13

blue

Pana Super Stone Pana Mix Plus, Thailand* 60000005, 30 10

Green

Planet Universal Lafarge Prestia Co. LTD., 5428, Green 31 10

Dental stone Thailand*

Quick Stone Whip Mix Corporation, NA, Blue 28-30 10-13

USA

*Products of Thailand

NA=NOT ACCESSIBLE

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


155

after the start of mixing. The specimen was then

removed from the mould and the excess was removed.

The specimen was crushed to fracture using a universal

testing machine (Instron Model 8516, USA) at a

loading rate of 5±2 kN/min after the start of mixing for

one hour. Ten specimens of each brand were tested.

Reproduction of detail

Reproduction of detail was determined using a

metal block having three parallel lines on the surface6.

Each line was 25 mm long and 2.5 mm away from

each other. The widths of these lines were 20±4,

50±8, and 75±8 μm. Each material was mixed and

poured onto a block under vibration for five seconds

to minimize the formation of air bubbles. After 45

minutes from the start of mixing, the specimen was

removed from the mould and examined using a light

microscope at 6X magnification. (MM-11C, Nikon,

Japan)

According to ISO 6873, the stone specimen

should be capable of reproducing the full length of

the 50±8 μm line. Five specimens of each brand were

tested in this study.

Characteristics of dental stone powder

The characteristics of dental stone powder

were observed using a scanning electron microscope

(Jeol 5410, Jeol, Japan). The stone powder was

evenly distributed on the carbon-coated metal base.

Then the specimen was sputter-coated with gold

powder before examining with a scanning electron

microscope. The size and shape of each dental stone

powder were examined and recorded.

ResultsThe mean setting time, setting expansion and

compressive strength of ten dental stones are shown

in Table 2.

Comet 3 High quality 12.8 (±0.4) 0.12 (±0.03) a 29.5 (±3.3) b

model stone

Dentamerica Model Stone 5.2 (±0.1) a* 0.39 (±0.01) b* 23.2 (±2.5) b

G 10 Universal 8.2 (±0.4) b 0.11 (±0.01) a 29.3 (±2.8) b

Hard Stone High Quality 10.97 (±0.4) d 0.24 (±0.01) c* 27.7 (±2.8) b

(Green)

Hard Stone High Quality 5.1 (±0.3) a* 0.37 (±0.02) b* 28.2 (±5.7) b

(Pink)

Hydrock Model Stone 11.3 (±0.4) d 0.20 (±0.01) c 32.2 (±1.7) a

Labstone 8.7 (±0.4) b 0.13 (±0.01) a 27.99 (±2.7) b

Pana Super Stone 9.9 (±0.5) c 0.17 (±0.01) c 23.2 (±2.3) b

Planet Universal Dental 9.5 (±0.3) c 0.25 (±0.01) c* 35.0 (±1.6) a

stone

Quick Stone 7.7 (±0.3) b* 0.10 (±0.01) a 35.0 (±2.8) a

Table 2 Mean values of setting time, setting expansion and compressive strength of ten dental stones.

Brands Setting time Setting expansion Compressive

(min) (%) strength (MPa)

* Not comply with the ISO Criteria

Same letter within each property means no significant difference.


156

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Setting timeThere was a large variation of the mean setting

time of 10 dental stones tested in this study, which

ranged from 5.1 to 12.8 minutes. The setting times

of seven products were with in the acceptable limit

according to ISO criteria. The pink Hard Stone, Den-

tamerica and Quick stone exhibited faster setting

time than the values stated by the manufacturers.

The setting time of Comet 3 was the longest (12.8±

0.4 min.).

Setting expansion

The setting expansion values of six dental

stones were within the values recommended by the

ISO standard (0-0.2%) as shown in Table 2.

Dentamerica, Hard Stone (pink and green), and

Planet Universal Dental Stone presented higher

values of expansion (0.24-0.39%) which were

higher than the recommended values. The mean setting

expansion of Quick Stone, G10 Universal, Comet 3

and Labstone were the lowest and significantly

different from the others (p<0.05).

Compressive strength

The mean compressive strength of all products

exceeded the minimum value (20 MPa) required for

type 3 stone. Planet Universal, Quick Stone and

Hydrock presented the highest strength. No significant

difference was found among the mean compressive

strengths in the remaining seven dental stones

(p>0.05).

Reproduction of detail

All dental stones were capable of reproduc-

ing the full length of 50 and 75 μm lines which

were acceptable according to the ISO requirements.

The reproduction of 25 μm line were also observed

for Hydrock, Dentamerica, G10 Universal, Labstone

and Quickstone.

Characteristics of dental stone powder

The sizes of powder of all stones were varied,

composing of fine and large particles. Their shapes

were irregular with some rod and prismatic crystals as

shown in Figure 1.

DiscussionTen dental stones were tested in this study.

Five stones were imported and five stones were

produced locally. Water to powder ratios of all stones

ranged from 3.2 to 4.3 cc/gm. Their setting times

were 5 to 12 minutes. A short setting time may

be suitable for some specific laboratory or clinical

procedures, but a longer setting time is easier for

handling of a material. Because of the wide range of

setting times of these dental stones, technicians or

dentists should be aware of these diverse values

before selecting a material. For example, the products

that set faster may be more appropriate for pouring

models than the one that set slower. On the other

hand, if it is used for flasking, the selection may be

differing. However, this is always depended on the

individual preferences.

The compressive strength of all dental stones

exceeded the ISO requirement, so they were all

acceptable for this property. One imported and three

locally produced stones had excessive setting expan-

sion. In general, imported dental stones were superior

in terms of low setting expansion and high compressive

strength, except one stone (Dentamerica). The high

setting expansion of this stone could result from its

faster setting time. After dissolution of the powder,

dihydrate crystals grow outward. It is known that during

the crystallization process of a gypsum product, an

outward stress develops as a result of the crystal

growth and entanglement of crystals7. A rapid

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


157

Fig. 1 Powder of ten dental stones used in the study.


158

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

setting time would provide less time to rearrange

these crystals and cause more stress. More outward

stress would result in a highly expanded structure

and the set material would also be porous. This

could also explain the low compressive strength of

this stone.

Three local dental stones had excessive setting

expansion. This could be a source of error for an unfit

dental prosthesis. High setting expansion stone pro-

duces a larger dental model, and a larger prosthesis.

This error should be taken into consideration when

selecting a gypsum product.

All products showed acceptable detail repro-

duction in that they could provide a clear continuous

line of 50 μm without a disruption. Therefore, the

reproduction of detail of all groups satisfied and

passed the requirement for this property. Among

ten dental stones tested, Hydrock showed the best

result for this property.

The characteristics of dental stone powder

observed by scanning electron microscope showed

fine and large irregular particles mixed with rod type

crystals. Some of them were an admix of larger, rod-

shaped type, such as Quick Stone, while powders of

Planet Universal dental stone appeared to be smaller.

However, it was difficult to distinguish the differences

between the shape and size of the gypsum powders

that could affect the properties.

Most of the dental stones tested in this study

showed acceptable properties. However, four products,

Dentamerica, Planet Universaland Hard Stone (green

and pink) failed to pass the ISO standard for setting

expansion. This property is important as it can

result in the inaccuracy of a stone model. Therefore,

these four products should be used with caution in

dental applications. Hydrock could be considered one

of the high quality dental stones due to its excel-

lent detail reproduction, high compressive strength

and reasonable setting expansion. G10 Universal

and Labstone were also found acceptable for dental

use.

Five products were produced in Thailand by

three companies. Comet 3 and Planet Universal Dental

Stone were produced by Lafarge Prestia, Hard Stone,

both pink and green were produced by Siam Gypsum

Plaster Ltd. The manufacturer in Thailand for Pana

Super Stone could not be identified. Concerning the

cost of materials, Hard stone (Green), a product of

Siam Gypsum Plaster Ltd, Thailand, was more

economical to use with fair properties.

ConclusionThe properties of five dental stones presented

acceptable results. The mean setting expansion of

Dentamerica, Planet Universal and Hard Stone (green

and pink) were excessive and did not pass the ISO

standard requirement for setting expansion. The

compressive strength and detail reproduction of all

materials were in an acceptable range in accordance

with ISO 6873 Dental gypsum products. Hydrock

Model Stone had the highest quality among all groups,

while G 10 Universal and Labstone exhibited accept-

able properties.

AcknowledgmentsThe authors wish to thank Ms. Nongnuch

Tienchai and Mr. Apiwat Rittapai for their work on

SEM photographs.

References1. American Dental Association. Guide to dental

materials and devices. 4th ed., Chicago; 1968:

76-9.

2. McCabe JF. Andersonûs applied dental materials.

6th ed, Oxford, London: Blackwell Scientific

Publications; 1985; 27-32.

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


159

3. Smith BGN, Wright PS and Brown D. The clinical

handling of dental materials.Bristol: Wright;

1986: 189-94.

4. ¿“°“√‡À¡◊Õß·√à. ¬‘ª´—¡·√àÕÿμ “À°√√¡. ‡Õ° “√

«‘™“°“√ ©∫—∫∑’Ë 4 æ». 2534: Àπâ“ 1-20.

5. ™—™√’ ÿ™“μ‘≈È”æß»å, æ®¡“π »√’π«√—μπå, ®ÿ‰√ π“§–-

ªí°…‘≥. §ÿ≥ ¡∫—μ‘ ∑“ß°“¬¿“æ ¢ÕßªŸπª≈“ ‡μÕ√å

∫“ß™π‘¥∑’Ëº≈‘μ„πª√–‡∑»‰∑¬.« ∑—πμ ¡À‘¥≈ 2536;

13: 80-5.

6. International Organization for Standardization

6873/1998. Dental gypsum products.

7. Anusavice KJ. Phillipsû Science of dental materials.

11th ed, Philadelphia: WB Saunders Company;

2003: 255-81.


160

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

ø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™∑‘æπ“∂ «‘™≠“≥√—μπå

161


∫∑§«“¡ª√‘∑—»πå

«‘∑¬“ “√

μ‘¥μàÕ‡°’Ë¬«°—∫∫∑§«“¡:

∑‘æπ“∂ «‘™≠“≥√—μπå

¿“§«‘™“∑—πμ°√√¡™ÿ¡™π

§≥–∑—πμ·æ∑¬»“ μ√å ¡À“«‘∑¬“≈—¬¡À‘¥≈

6 ∂.‚¬∏’ ‡¢μ√“™‡∑«’ °√ÿß‡∑æœ 10400

‚∑√»—æ∑å: 02-203-6420

·ø°´å: 02-203-6423



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«—π¬Õ¡√—∫μ’æ‘¡æå: 16 ∏—π«“§¡ 2554

∫∑§—¥¬àÕ

°“√„™âø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™‡ªìπ¡“μ√°“√∑’Ë ”§—≠„π°“√™à«¬

ªÑÕß°—πøíπºÿ„π√–¥—∫∫ÿ§§≈·≈–°≈ÿà¡ª√–™“°√∑’Ë¡’§«“¡‡ ’Ë¬ß„π°“√‡°‘¥øíπºÿ

‡π◊ËÕß®“°„πª√–‡∑»‰∑¬π—Èπæ∫«à“ª√–™“°√‡¥Á° à«π„À≠à¬—ß¡’§«“¡‡ ’Ë¬ß Ÿß

„π°“√‡°‘¥øíπºÿ ¥—ßπ—Èπ ®÷ß¡’§«“¡®”‡ªìπ∑’Ë∑—πμ∫ÿ§≈“°√§«√μ√–Àπ—°∂÷ß°“√„™â

ø≈ŸÕÕ‰√¥å∑’Ë¡’§«“¡‡¢â¡¢âπ ŸßÕ¬à“ß‡À¡“– ¡ ‡æ◊ËÕ„Àâ‡°‘¥ª√–‚¬™πå Ÿß ÿ¥„π°“√

ªÑÕß°—πøíπºÿ·≈–≈¥°“√‡°‘¥º≈¢â“ß‡§’¬ß∑’ËÕ“®‡°‘¥¢÷Èπ ∫∑§«“¡π’È‰¥âª√–¡«≈

§«“¡√Ÿâ®“°À≈—°∞“π°“√»÷°…“∑’Ëºà“π¡“ ‚¥¬°≈à“«∂÷ß°≈‰°„π°“√ªÑÕß°—πøíπºÿ

¢Õßø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë ª√– ‘∑∏‘¿“æ„π°“√ªÑÕß°—πøíπºÿ ¢âÕ∫àß™’È «‘∏’°“√„™â

¢âÕ¥’ ¢âÕ¥âÕ¬ ·≈–¢âÕ·π–π”°“√„™â„π‡¥Á°‰∑¬ ‡æ◊ËÕ‡ªìπ·π«∑“ß„π°“√„™â

ø≈ŸÕÕ‰√¥å„π√Ÿª·∫∫‡®≈·≈–«“√åπ‘™Õ¬à“ß‡À¡“– ¡ √«¡∂÷ß¢âÕ‡ πÕ·π–°“√

»÷°…“„πÕπ“§μ

√À— §”: ø≈ŸÕÕ‰√¥å‡®≈, ø≈ŸÕÕ‰√¥å«“√åπ‘™, ªÑÕß°—πøíπºÿ, §«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥

øíπºÿ, ‡¥Á°‰∑¬

ø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™

∑‘æπ“∂ «‘™≠“≥√—μπå

CAGS (Pediatric Dentistry),

M.S.D (Dental Public Health)

¿“§«‘™“∑—πμ°√√¡™ÿ¡™π

§≥–∑—πμ·æ∑¬»“ μ√å ¡À“«‘∑¬“≈—¬¡À‘¥≈


162

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Fluoride Gel and Fluoride Varnish


Tippanart Vichayanrat

Department of Community Dentistry



Bangkok 10400, Thailand

Tel: 02-203-6420

Fax: 02-203-6423


Research Grant: -

Received: 2 November 2011


AbstractThe use of fluoride gels and fluoride varnishes is an effective

caries preventive measure for caries susceptible individuals and population.

Since the majorities of Thai children are still at high-risk caries, it is crucial

that dental practitioners should be aware of the appropriate use of high-

dose fluoride to maximize its benefit and minimize the adverse effects

that may occur. This article provides a comprehensive review of the topical

fluoride mechanism, the effectiveness of caries prevention, indication,

methods of use, advantages, and disadvantages of fluoride gels and

fluoride varnishes. The uses of fluoride gels and varnishes for Thai children

and future research are recommended.

Key words: fluoride gel, fluoride varnish, caries prevention, high-risk

caries, Thai children


CAGS (Pediatric Dentistry),

M.S.D (Dental Public Health)

Department of Community Dentistry,



Review article

«‘∑¬“ “√

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


163

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μ°°√–„πª√–‡∑»∑’Ëæ—≤π“·≈â«1,2,4 ·μà„π¢≥–‡¥’¬«°—π¡’

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¡’·π«‚πâ¡ Ÿß¢÷Èπ‚¥¬‡©æ“–„π°≈ÿà¡ºŸâ∑’Ë‡ªìπ™π°≈ÿà¡πâÕ¬À√◊Õ

¡’∞“π–¬“°®π5 „πª√–‡∑»‰∑¬π—Èπæ∫«à“ª√–™“°√‡¥Á°

à«π„À≠à¬—ß¡’Õ—μ√“°“√‡°‘¥øíπºÿ Ÿß ®“°°“√ ”√«® ¿“«–

∑—πμ ÿ¢¿“æ§√—Èß∑’Ë 66 æ∫«à“‡¥Á°‰∑¬Õ“¬ÿ 3 ªï·≈– 5 ªï

¡’øíπºÿ√âÕ¬≈– 61.4 ·≈– 80.6 μ“¡≈”¥—∫ „πøíπ·∑âæ∫«à“

‡¥Á°Õ“¬ÿ 12 ªï ¡’øíπºÿ√âÕ¬≈– 56.87 ·≈–¬—ß¡’√“¬ß“π«à“

‡§¬ª«¥øíπ„π√Õ∫ªï∑’ºà“π¡“√âÕ¬≈– 30.77 º≈°“√

—¡¿“…≥å„π‡¥Á°Õ“¬ÿ 15 ªï æ∫«à“‡§¬¢“¥‡√’¬π„π

¿“§‡√’¬π∑’Ëºà“π¡“‡æ√“–ª«¥øíπ‡©≈’Ë¬ 4.46 «—π ¥—ßπ—Èπ

ªí≠À“‚√§øíπºÿ¬— ß ‡ªìπªí≠À“ “∏“√≥ ÿ¢∑’Ë ”§—≠∑’Ë

°√–∑∫μàÕ ¿“«– ÿ¢¿“æ·≈–§ÿ≥¿“æ™’«‘μ¢Õß‡¥Á°‰∑¬

°“√„™âø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë‡ªìπ¡“μ√°“√∑’Ë ”§—≠

„π°“√ªÑÕß°—πøíπºÿ ·¡â«à“ªí®®ÿ∫—π®–¡’°“√ àß‡ √‘¡°“√„™â

ø≈ŸÕÕ‰√¥å∑’Ë¡’§«“¡‡¢â¡¢âπμË”„π§«“¡∂’Ë Ÿß¥â«¬μπ‡Õß ‡™àπ

°“√„™â¬“ ’øíπº ¡ø≈ŸÕÕ‰√¥å‡ªìπª√–®”‡æ◊ËÕªÑÕß°—πøíπºÿ

„π∑ÿ°«—¬ ·μà°“√„™âø≈ŸÕÕ‰√¥å∑’Ë¡’§«“¡‡¢â¡¢âπ Ÿß´÷Ëß‰¥â·°à

ø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™π—Èπ ¬—ß§ß¡’∫∑∫“∑

∑’Ë ”§—≠·≈–¡’ª√– ‘∑∏‘¿“æ„π°“√ªÑÕß°—πøíπºÿ„π°≈ÿà¡ºŸâ∑’Ë¡’

§«“¡‡ ’Ë¬ß„π°“√‡°‘¥øíπºÿ√–¥—∫ª“π°≈“ß·≈–√–¥—∫ Ÿß

∫∑§«“¡π’È ‰¥âª√–¡«≈§«“¡√Ÿâ ‡°’Ë ¬«°—∫°“√„™â

ø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™ ‚¥¬°≈à“«∂÷ß°≈‰°

„π°“√ªÑÕß°—πøíπºÿ¢Õßø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë ª√– ‘∑∏‘¿“æ

„π°“√ªÑÕß°—πøíπºÿ ¢âÕ∫àß™’È «‘∏’°“√„™â ¢âÕ¥’ ¢âÕ¥âÕ¬ ·≈–

¢âÕ‡ πÕ·π–°“√„™â„π‡¥Á°‰∑¬

°≈‰°°“√ªÑÕß°—πøíπºÿ¢Õßø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë°“√∑“ø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë (topical fluoride) ®–

™à«¬‡æ‘Ë¡°“√π”ø≈ŸÕÕ‰√¥å‡¢â“ Ÿàº‘«‡§≈◊Õ∫øíπ‚¥¬ √â“ß‡ªìπ

º≈÷°ø≈ŸÕÕ‚√Õ“æ“‰∑¥å (fluoroapatite) ∑’Ë¡’§«“¡·¢Áß·√ß

´÷Ëß™à«¬¬—∫¬—Èß°“√≈–≈“¬μ—«¢Õßº‘«‡§≈◊Õ∫øíπ (enamel

solubility) ·≈–≈¥°“√ Ÿ≠‡ ’¬·√à∏“μÿ (demineralization)

®“°º‘«øíπ7-9 Õ¬à“ß‰√°Á¥’·π«§‘¥‡°’Ë¬«°—∫°≈‰°°“√ªÑÕß°—π

øíπºÿ‚¥¬ø≈ŸÕÕ‰√¥å„π™à«ßÀ≈“¬ ‘∫ªï∑’Ëºà“π¡“æ∫«à“

πÕ°®“°°≈‰°¥—ß°≈à“«·≈â« °√–∫«π°“√À≈—°„π°“√ªÑÕß°—π

øíπºÿπ—Èπ‡°‘¥®“°°“√∑’Ëø≈ŸÕÕ‰√¥å∑”ªØ‘°√‘¬“°—∫πÈ”≈“¬

·≈– √â“ß‡ªìπ·§≈‡ ’¬¡ø≈ŸÕÕ‰√¥å (CaF2) ´÷ËßÀ≈—°∞“π

°“√»÷°…“μ—Èß·μà™à«ßªï 1980 ‡ªìπμâπ¡“10-12 · ¥ß„Àâ

‡ÀÁπ«à“·§≈‡´’¬¡ø≈ŸÕÕ‰√¥åπ’È®–§ßÕ¬Ÿà∫√‘‡«≥º‘«πÕ°¢Õßøíπ

‡¡◊ËÕ√–¥—∫ pH „π™àÕßª“°‡ªìπ°≈“ß ·≈–‡¡◊ËÕ√–¥—∫ pH

„π™àÕßª“°≈¥μË”≈ß ·§≈‡´’¬¡ø≈ŸÕÕ‰√¥å®– ≈“¬μ—«·≈–

ª≈àÕ¬ª√–®ÿø≈ŸÕÕ‰√¥å (fluoride ion) ÷Ëß®–∑”Àπâ“∑’Ë‡ªìπ

·À≈àßª≈¥ª≈àÕ¬ø≈ŸÕÕ‰√¥å∑’Ë¬“«π“π¿“¬À≈—ß°“√∑“

ø≈ŸÕÕ‰√¥å ‚¥¬°≈‰°π’È®–™à«¬ àß‡ √‘¡°√–∫«π°“√¬âÕπ

°≈—∫¢Õß·√à∏“μÿ (remineralization) ÷Ëßªí®®ÿ∫—π∂◊Õ«à“

‡ªìπ°≈‰°∑’Ë ”§—≠¢Õß°“√ªÑÕß°—πøíπºÿ‚¥¬°“√„™âø≈ŸÕÕ‰√¥å

‡©æ“–∑’Ë

°“√„™âø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™ ´÷Ëß¡’

§«“¡‡¢â¡¢âπ Ÿß (high-dose fluoride) ¡’°≈‰°°“√ªÑÕß°—π

øíπºÿ‡™àπ‡¥’¬«°—π°—∫°“√„™âø≈ŸÕÕ‰√¥å∑’Ë¡’§«“¡‡¢â¡¢âπμË”

(low-dose fluoride) ‡™àπ¬“ ’øíπ∑’Ëº ¡ø≈ŸÕÕ‰√¥å ´÷Ëß¡’

§«“¡®”‡ªìπ„π°“√ —¡º— º‘«øíπ´È” Ê ‡æ◊ËÕ§ß§«“¡‡¢â¡¢âπ

¢Õßø≈ŸÕÕ‰√¥å∫πº‘«‡§≈◊Õ∫øíπ ·μà„™â„π§«“¡∂’Ë∑’ËπâÕ¬°«à“

‡¡◊ËÕ¡’°“√„™âø≈ŸÕÕ‰√¥å§«“¡‡¢â¡¢âπμË”„π√–¥—∫∑’Ë‡À¡“– ¡

·≈– “¡“√∂§ß ¡¥ÿ≈√–À«à“ß°“√ Ÿ≠‡ ’¬·√à∏“μÿ·≈–

°“√ – ¡¢Õß·√à∏“μÿ°≈—∫§◊π °“√„™âø≈ŸÕÕ‰√¥å§«“¡‡¢â¡¢âπ

Ÿßπ—Èπ®–‰¡à‰¥â‡æ‘Ë¡°“√ªÑÕß°—πøíπºÿ∑’Ë‡æ‘Ë¡‡μ‘¡13-15 ¥—ßπ—Èπ

°“√∑“ø≈ŸÕÕ‰√¥å‡©æ“–∑’Ë∑—Èß√Ÿª·∫∫‡®≈·≈–«“√åπ‘™®–¡’

ª√–‚¬™πå„πºŸâ∑’Ë¡’§«“¡‡ ’Ë¬ßª“π°≈“ßÀ√◊Õ§«“¡‡ ’Ë¬ß Ÿß

„π°“√‡°‘¥øíπºÿ

ø≈ŸÕÕ‰√¥å‡®≈ø≈ŸÕÕ‰√¥å‡®≈∂Ÿ°æ—≤π“¢÷Èπ‡æ◊ËÕ„Àâ –¥«°„π°“√

„™âß“π ´÷Ëß„πÕ¥’μ¡’°“√„™âø≈ŸÕÕ‰√¥å„π√Ÿª·∫∫πÈ” (fluoride

solution) ∑“∫πº‘«øíπ·μà≈–´’Ë·≈–∑‘Èß‰«â„Àâ™ÿà¡„π·μà≈–

μ”·Àπàßª√–¡“≥ 3-4 π“∑’16 ≈—°…≥–∑’Ë¢âπ¢Õß‡®≈

∑”„Àâ “¡“√∂„ à„π∂“¥‡æ◊ËÕ§√Õ∫§≈ÿ¡øíπ∑’Ë®–‡§≈◊Õ∫‰¥â

„π§√—Èß‡¥’¬« ®÷ß∑”„Àâ„™âß“πßà“¬·≈–√«¥‡√Á«¡“°¢÷Èπ

ø≈ŸÕÕ‰√¥å‡®≈¡’„™âÕ¬à“ß·æ√àÀ≈“¬„πª√–‡∑»μà“ß Ê ∑—Èß

„π¬ÿ‚√ª·≈– À√—∞Õ‡¡√‘°“√«¡∂÷ßª√–‡∑»‰∑¬ √Ÿª·∫∫∑’Ë„™â


164

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∑—Ë«‰ª„π§≈‘π‘° (office use) ‰¥â·°à 1.23 % Õ–´‘¥Ÿ‡≈∑

øÕ ‡øμø≈ŸÕÕ‰√¥å (acidulated phosphate fluoride,

APF) ÷Ëß¡’ø≈ŸÕÕ‰√¥å 12,300 à«π„π≈â“π à«π (ppm)

·≈– 2.2% ‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å (sodium fluoride, NaF)

´÷Ëß¡’ø≈ŸÕÕ‰√¥å 9,200 à«π„π≈â“π à«π ”À√—∫°“√„™â

8-10% ·μππ— ø≈ŸÕÕ‰√¥å (stannous fluoride, SnF2)

π—Èπ‰¥â√—∫°“√»÷°…“∂÷ßª√– ‘∑∏‘¿“æ„π°“√ªÑÕß°—πøíπºÿ

„πÕ¥’μ17,18 ´÷Ëß„™â„π√Ÿª·∫∫ºßº ¡πÈ” ·μà‡π◊ËÕß®“°¡’√ ¢¡

¢Õß‚≈À– μ‘¥ ’øíπ·≈–¢Õ∫«— ¥ÿ∫Ÿ√≥–øíπ √«¡∂÷ß‰¡à§ßμ—«

®”‡ªìπμâÕßº ¡„À¡à∑ÿ°§√—Èß°àÕπ°“√„™â ´÷Ëß‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫

°—∫Õ–´‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å´÷Ëß¡’√ ™“μ‘∑’Ë¥’°«à“ ·≈–

¡’§«“¡§ßμ—« “¡“√∂‡°Á∫‰«â‰¥âπ“π°«à“ √«¡∂÷ß§à“ pH ∑’ËμË”

´÷Ëß™à«¬°“√π”ø≈ŸÕÕ‰√¥å‡¢â“ Ÿàº‘«‡§≈◊Õ∫øíπ‰¥â¥’ ¥—ßπ—Èπ

Õ–´‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å®÷ß‡ªìπ√Ÿª·∫∫∑’Ëπ‘¬¡¡“°°«à“19

∑—Èßπ’ÈÕ– ‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å¡’¢âÕ¥âÕ¬§◊Õ Õ“®∑”„Àâ

º‘««— ¥ÿ∫Ÿ√≥–øíπ∑’Ë¡’„π™àÕßª“°‡™àπ ‡√ ‘π (resin) ·≈–

æÕ´‡≈π (porcelain) ¡’º‘«¢√ÿ¢√–·≈– Ÿ≠‡ ’¬§«“¡ «¬ß“¡

¥—ßπ—Èπ®÷ß‰¡à·π–π”„Àâ„™â Õ– ‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å

„π°≈ÿà¡ºŸâªÉ«¬∑’Ë¡’«— ¥ÿ‡À≈à“π’È„π™àÕßª“°20 ·μà§«√„™â‚´‡¥’¬¡

ø≈ŸÕÕ‰√¥å‡®≈‡æ◊ËÕªÑÕß°—π°“√°—¥°√àÕπ¢Õßº‘««— ¥ÿ μ“√“ß

∑’Ë 1 ‡ª√’¬∫‡∑’¬∫§ÿ≥≈—°…≥–¢Õß‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å

·μππ— ø≈ŸÕÕ‰√¥å ·≈–Õ–´‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å

πÕ°®“°π’È¬—ß¡’ø≈ŸÕÕ‰√¥å‡®≈ ”À√—∫ºŸâªÉ«¬„™â‡Õß

∑ÿ°«—π∑’Ë∫â“π †(home use) ÷Ëß “¡“√∂ —Ëß®à“¬„ÀâºŸâ∑’Ë¡’

§«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥øíπºÿ ‚¥¬·π–π”„ÀâºŸâªÉ«¬„™â·ª√ß

’øíπªÑ“¬„Àâ∑—Ë«øíπ∑ÿ°´’Ë¿“¬À≈—ß°“√·ª√ßøíπ°àÕππÕπ

·≈–„Àâ∫â«π∑‘Èß‚¥¬‰¡àμâÕß∫â«ππÈ” √Ÿª·∫∫∑’Ë„™â‰¥â·°à 1.1%

‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å 0.5% Õ– ‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å

·≈– 0.4% ·μππ— ø≈ŸÕÕ‰√¥å 21

ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å‡®≈„π°“√ªÑÕß°—π

øíπºÿ

°“√»÷°…“ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å‡®≈‚¥¬

°“√«‘‡§√“–Àå‡™‘ßÕ¿‘¡“π (meta-analysis)22 æ∫§à“‡©≈’Ë¬

°“√ªÑÕß°—πøíπºÿ„πøíπ·∑â 22% (95% CI = 18-25%)

´÷Ëß∑ÿ°°“√»÷°…“„™âÕ–´‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å‡®≈ ·≈–

¡’§«“¡∂’Ë„π°“√∑“ 1-2 §√—ÈßμàÕªï ‚¥¬»÷°…“„π°≈ÿà¡Õ“¬ÿ

μ—Èß·μà 6 ∂÷ß 15 ªï ‡π◊ËÕß®“°„πªí®®ÿ∫—π¬—ß‰¡à¡’À≈—°∞“π

∑’Ë‡æ’¬ßæÕ„π°“√ √ÿªª√– ‘∑∏‘¿“æ°“√ªÑÕß°—πøíπºÿ‡¡◊ËÕ

°“√∑“ø≈ŸÕÕ‰√¥å‡®≈‡æ’¬ßÀπ÷Ëß§√—ÈßμàÕªï ¥—ßπ—Èπ®÷ß¬—ß

π—∫ πÿπ°“√·π–π”„Àâ∑“Õ¬à“ßπâÕ¬ Õß§√—ÈßμàÕªï ‡æ◊ËÕ

ª√– ‘∑∏‘¿“æ„π°“√ªÑÕß°—πøíπºÿ23

®“°√“¬ß“π°“√∑∫∑«π«√√≥°√√¡Õ¬à“ß‡ªìπ√–∫∫

(systematic review) ‚¥¬ Marinho „πªï §.». 2008

· ¥ßº≈¢Õßø≈ŸÕÕ‰√¥å‡®≈∑’Ë Õ¥§≈âÕß°—π24 ‚¥¬æ∫

ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å‡®≈„π°“√ªÑÕß°—πøíπºÿ Õÿ¥

∂Õπ „π√–¥—∫¥â“π¢Õßøíπ·∑â (DMFS) 28% (95% CI =

19-37%) ®“°®”π«π 23 °“√»÷°…“∑’Ëπ”¡“«‘‡§√“–Àåπ—Èπ

¡’°“√„™â™π‘¥¢Õßø≈ŸÕÕ‰√¥å‡®≈∑’ËÀ≈“°À≈“¬ ‰¥â·°à Õ–´‘-

¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å ‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å ‡Õ¡’π

ø≈ŸÕÕ‰√¥å ·≈– ‡μππ— ø≈ŸÕÕ‰√¥å ·μà à«π„À≠à‡ªìπÕ–´‘¥Ÿ

‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å·≈–∑”°“√»÷°…“„π™à«ßÕ“¬ÿ 6 ∂÷ß

15 ªï ¡’‡æ’¬ß Õß°“√«‘®—¬„π°“√«‘‡§√“–Àåπ’È∑’Ë· ¥ßº≈

¢Õßø≈ŸÕÕ‰√¥å‡®≈„πøíππÈ”π¡ ‚¥¬»÷°…“„π™à«ßÕ“¬ÿ 2 ∂÷ß

6 ªï ´÷Ëß¬—ß‰¡à¡’À≈—°∞“π‡æ’¬ßæÕ∑’Ë®– √ÿªº≈¢Õß§«“¡∂’Ë

„π°“√„™âø≈ŸÕÕ‰√¥å‡®≈ ·≈–º≈¢Õß°“√ªÑÕß°—πøíπºÿ„πøíπ

πÈ”π¡‰¥â

Table 1 Characteristics of NaF, SnF2, and APF

Characteristics NaF SnF2

APF

Note: adapted from Horowitz and Ismail16

Percent F- (ppm) 2% (9,200) 8% (19,500) 1.23% (12,300)

Taste Bland Metalic, disagreeable Acidic

Stability Stable Unstable Stable in plastic

container

Tooth pigmentation No Yes No

Gingival irritation No Occasional, transient No

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ø≈ŸÕÕ‰√¥å·≈– 1.2% Õ– ‘¥Ÿ‡≈∑øÕ ‡øμø≈ŸÕÕ‰√¥å

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„π°“√‡°‘¥øíπºÿπ—Èπ ®–‰¡à‰¥â√—∫‡æ‘Ë¡ª√–‚¬™πå®“°ø≈ŸÕÕ‰√¥å

‡æ‘Ë¡‡μ‘¡27,28

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∑’Ë¡’§«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥øíπºÿ26,30 °“√‡§≈◊Õ∫ø≈ŸÕÕ‰√¥å

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‚¥¬‡√‘Ë¡·√°¡’°“√π”‡ πÕ°“√∑“‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å (NaF)

„π “√≈–≈“¬‚§‚≈‚øπ’ (colophony base) ∑’Ë “¡“√∂¬÷¥

μ‘¥°—∫μ—«øíπ‰¥â¥’„π ¿“«–∑’Ë¡’πÈ”≈“¬33 ø≈ŸÕÕ‰√¥å«“√åπ‘™

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‡π‡«’¬·≈–·§π“¥“ ·≈–„π™à«ßÀ≈—ß¡’√“¬ß“π°“√„™â

ø≈ŸÕÕ‰√¥å«“√åπ‘™„πª√–‡∑»Õ◊Ëπ Ê ‡æ‘Ë¡¡“°¢÷Èπ34-36

√Ÿª·∫∫¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™∑’Ëæ∫ ‰¥â·°à37 5% ‚´‡¥’¬¡

ø≈ŸÕÕ‰√¥å ÷Ëß¡’ª√‘¡“≥ø≈ŸÕÕ‰√¥å 22.6 ¡‘≈≈‘°√—¡„π

1 ¡‘≈≈‘≈‘μ√ À√◊Õ 22,600 à«π„π≈â“π à«π ·≈– 1%

‰¥ø≈ŸÕÕ‚√‰´‡≈π (difluorosilane) ÷Ëß¡’ª√‘¡“≥ø≈ŸÕÕ‰√¥å

1 ¡‘≈≈‘°√—¡„π 1 ¡‘≈≈‘≈‘μ√ À√◊Õ 1,000 à«π„π≈â“π à«π

ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™„π°“√ªÑÕß°—π

øíπº ÿ

„π™à«ß Õß∑»«√√…∑’Ëºà“π¡“ ¡’√“¬ß“πº≈°“√

»÷°…“∑“ß§≈‘π‘°¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™®”π«π¡“° ‚¥¬

‡©æ“–Õ¬à“ß¬‘Ëß 5% ‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å ´÷Ëß· ¥ßº≈°“√

ªÑÕß°—πøíπºÿ·≈–¬—∫¬—Èß°“√≈ÿ°≈“¡¢Õßøíπºÿ∑—Èß„πøíπ·∑â

·≈–øíππÈ”π¡38-41 ‚¥¬°“√»÷°…“ à«π„À≠à∑”„π‡¥Á°·≈–

«—¬√ÿàπ ¡’‡æ’¬ßÀπ÷Ëß°“√»÷°…“∑’Ë Petersson ·≈–§≥–42

· ¥ßº≈¢Õß 1% ‰¥ø≈ŸÕÕ‚√‰´‡≈π „π°“√ªÑÕß°—πøíπºÿ

∫√‘‡«≥¥â“πª√–™‘¥„π‡¥Á°°àÕπ«—¬‡√’¬πÕ¬à“ß¡’π—¬ ”§—≠

¿“¬À≈—ß°“√∑“ø≈ŸÕÕ‰√¥å«“√åπ‘™∑ÿ° 6 ‡¥◊Õπ‡ªìπ√–¬–

‡«≈“ 2 ªï ´÷Ëß‚¥¬¿“æ√«¡º≈¢Õßª√– ‘∑∏‘¿“æ„π°“√

ªÑÕß°—πøíπºÿ¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™∑’Ë»÷°…“„π™à«ßÀ≈—ß

§.». 1990 ‡ªìπμâπ¡“ ®–· ¥ßª√– ‘∑∏‘¿“æ∑’ËμË”°«à“º≈

°“√»÷°…“„π™à«ß°àÕπÀπâ“π—Èπ43,44 ÷ËßÕ“®‡ªìπº≈‡π◊ËÕß®“°

°“√‰¥â√—∫¡“μ√°“√ªÑÕß°—πøíπºÿÕ◊Ëπ Ê ∑’Ë·æ√àÀ≈“¬¡“°¢÷Èπ

„πª√–‡∑»∑’Ë∑”°“√»÷°…“π—Èπ45

ªí®®ÿ∫—π»Ÿπ¬å§«∫§ÿ¡·≈–ªÑÕß°—π‚√§ (The Center

of Disease Control and Prevention)46 ·≈– ¡“§¡

∑—πμ·æ∑¬åª√–‡∑» À√—∞Õ‡¡√‘°“26 ‰¥â„Àâ°“√ π—∫ πÿπ

ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™„π°“√ªÑÕß°—π·≈–

§«∫§ÿ¡‚√§øíπºÿ„πøíπ·∑â„π°≈ÿà¡∑’Ë¡’§«“¡‡ ’Ë¬ß„π°“√‡°‘¥

øíπºÿ„π√–¥—∫ª“π°≈“ß·≈– Ÿß ·≈–°“√ªÑÕß°—π·≈–§«∫§ÿ¡

øíπºÿ„πøíππÈ”π¡„π°≈ÿà¡∑’Ë¡’§«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥øíπºÿ

º≈¢Õß°“√ªÑÕß°—πøíπºÿ„πøíπ·∑â

√“¬ß“π°“√«‘‡§√“–Àå‡™‘ßÕ¿‘¡“π‚¥¬ Helfenstein

·≈– Steiner47 · ¥ßª√– ‘∑∏‘¿“æ°“√≈¥°“√‡°‘¥øíπºÿ

„πøíπ·∑â 38% (95% CI, 19-57%) ´÷Ëß°“√»÷°…“∑’Ë

π”¡“«‘‡§√“–Àåπ’È à«π„À≠à¡’§«“¡∂’Ë„π°“√∑“ø≈ŸÕÕ‰√¥å

«“√åπ‘™ªï≈– 2 §√—Èß ·≈–»÷°…“μàÕ‡π◊ËÕßÕ¬à“ßπâÕ¬ 2 ªï

º≈°“√»÷°…“¡’§«“¡ Õ¥§≈âÕß°—∫√“¬ß“π„π™à«ß‡«≈“μàÕ

¡“‚¥¬ Zimmer ·≈–§≥–41 ´÷Ëß√“¬ß“πª√– ‘∑∏‘¿“æ¢Õß

ø≈ŸÕÕ‰√¥å«“√åπ‘™„π°“√ªÑÕß°—πøíπºÿ„πøíπ·∑â‰¥â 37%

„π°≈ÿà¡‡¥Á°∑’Ë¡’§«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥øíπºÿ∑’Ë‰¥â√—∫°“√∑“

ø≈ŸÕÕ‰√¥å«“√åπ‘™ 2 §√—ÈßμàÕªï‡ªìπ√–¬–‡«≈“ 4 ªï ·≈–

„πªï 2002 Marinho ·≈–§≥–48 ‰¥â√“¬ß“πª√– ‘∑∏‘¿“æ

°“√ªÑÕß°—πøíπºÿ¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™„πøíπ·∑â√–¥—∫

¥â“π∑’Ë 46% (95% CI, 30-63%) ·¡â®–¡’°“√»÷°…“

∑’Ë· ¥ß„Àâ‡ÀÁπ«à“ø≈ŸÕÕ‰√¥å«“√åπ‘™≈¥°“√‡æ‘Ë¡¢÷Èπ¢Õßøíπºÿ

„πøíπ·∑â‰¥â¡“°°«à“ø≈ŸÕÕ‰√¥å‡®≈ ·μàº≈¢Õßª√– ‘∑∏‘¿“æ

π—Èπ‰¡àæ∫§«“¡·μ°μà“ßÕ¬à“ß¡’π—¬ ”§—≠49

°“√»÷°…“ ¢Õß Moberg ·≈–§≥–50 æ∫«à“°“√∑“

ø≈ŸÕÕ‰√¥å«“√åπ‘™‡¥◊Õπ≈–Àπ÷Ëß§√—Èß®”π«π 8 §√—ÈßμàÕªï

‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫°—∫°“√∑“ 3 §√—Èß„πÀπ÷Ëßªï¿“¬„πÀπ÷Ëß

—ª¥“Àå ·≈–°“√∑“ªï≈– Õß§√—Èß ‰¡à¡’§«“¡·μ°μà“ßÕ¬à“ß

¡’π—¬ ”§—≠„π°“√ªÑÕß°—πøíπºÿ ·≈–°“√μ‘¥μ“¡º≈°“√

»÷°…“„π√–¬– “¡ªï · ¥ß„Àâ‡ÀÁπ«à“°“√∑“ø≈ŸÕÕ‰√¥å

«“√åπ‘™∑ÿ°Ê 6 ‡¥◊Õπ‡ªìπ«‘∏’∑’Ë¡’§«“¡§ÿâ¡§à“·≈– “¡“√∂

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øíπºÿ Ÿß

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‚¥¬ Bravo ·≈–§≥–51 „π√–¬–‡«≈“ 24 ‡¥◊Õπ·≈–

48 ‡¥◊Õπ æ∫«à“ª√– ‘∑∏‘¿“æ¢Õß°“√‡§≈◊Õ∫À≈ÿ¡√àÕßøíπ

„π°“√ªÑÕß°—πøíπºÿ¥â“π∫¥‡§’È¬«π—Èπ Ÿß°«à“°“√„™âø≈ŸÕÕ‰√¥å

«“√åπ‘™„π∑—Èß Õß√“¬ß“π51,52 ªí®®ÿ∫—π¬—ß‰¡à¡’À≈—°∞“π

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‡∑’¬∫√–À«à“ß 5% ‚´‡¥’¬¡ø≈ŸÕÕ‰√¥å·≈– 1 % ‰¥ø≈Ÿ-

ÕÕ‚√‰´‡≈π

º≈°“√ªÑÕß°—πøíπºÿ„πøíππÈ”π¡

„π™à«ß√–¬–‡«≈“∑’Ëºà“π¡“¡’°“√»÷°…“‡°’Ë¬«°—∫

ª√– ‘∑∏‘¿“æ¢Õßø≈ŸÕÕ‰√¥å«“√åπ‘™„πøíππÈ”π¡¡“°

¢÷Èπ38,53-55 ®“°°“√«‘‡§√“–Àå‡™‘ßÕ¿‘¡“π ‚¥¬ Marinho

·≈–§≥–48 æ∫ª√– ‘∑∏‘¿“æ°“√ªÑÕß°—πøíπºÿ ¢Õß§à“øíπºÿ

Õÿ¥∂Õπ„πøíππÈ”π¡√–¥—∫¥â“π ∑’Ë 33% (95% CI, 19-

48%)

Lawrence ·≈–§≥–55 ‰¥â∑”°“√»÷°…“„π‡¥Á°∑’Ë¡’

§«“¡‡ ’Ë¬ß Ÿß„π°“√‡°‘¥øíπºÿ®”π«π 1,275 §π Õ“¬ÿ

μ—Èß·μà 6 ‡¥◊Õπ∂÷ß 5 ªï ‡ªìπ√–¬–‡«≈“ Õßªï æ∫«à“°“√∑“

ø≈ŸÕÕ‰√¥å«“√åπ‘™Õ¬à“ßπâÕ¬ Õß§√—ÈßμàÕªï √à«¡°—∫°“√„Àâ

§”ª√÷°…“·°àºŸâ‡≈’È¬ß‡¥Á° “¡“√∂≈¥°“√‡°‘¥øíπºÿ„πøíπ

πÈ”π¡ ‚¥¬æ∫ª√– ‘∑∏‘¿“æ°“√ªÑÕß°—πøíπºÿÕ¬Ÿà„π™à«ß

√–À«à“ß 18-25% ÷Ëßº≈¢Õß°“√ªÑÕß°—πøíπºÿπ—Èπ®–¡’¡“°

∑’Ë ÿ¥ ‡¡◊ËÕ∑“ø≈ŸÕÕ‰√¥å«“√åπ‘™°àÕπ°“√‡√‘Ë¡¡’√Õ¬‚√§øíπºÿ

Weintraub ·≈–§≥–56 ‰¥â»÷°…“º≈¢Õß°“√„™â

ø≈ŸÕÕ‰√¥å«“√åπ‘™„π°“√ªÑÕß°—πøíπºÿ„πøíππÈ”π¡ ‚¥¬

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„π™à«ß 12, 24, 36 ‡¥◊ÕπÀ≈—ß®“°‡√‘Ë¡°“√»÷°…“ æ∫«à“

§à“‡©≈’Ë¬„π°“√‡°‘¥øíπºÿ„À¡à„πøíππÈ”π¡√–À«à“ß Õß°≈ÿà¡

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ø≈ŸÕÕ‰√¥å«“√åπ‘™¡’¢âÕ∫àß™’È ”À√—∫ºŸâ∑’Ë¡’§«“¡‡ ’Ë¬ß

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‡√‘Ë¡·√°∑’Ë¬—ß‰¡à‡ªìπ‚æ√ß (non-cavitated lesion) ∫√‘‡«≥

º‘«‡√’¬∫ ∑’Ë¬—ß¡’°“√¥”‡π‘π¢Õß‚√§ (active lesion) ·≈–

¢âÕ∫àß„™â∑’ËÕ“®‡ªìπ‰ª‰¥â §◊Õ°“√„™âø≈ŸÕÕ‰√¥å«“√åπ‘™„π°≈ÿà¡

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ø≈ŸÕÕ‰√¥å«“√åπ‘™‰¡à·π–π”„Àâ„™â„πºŸâ∑’Ë¡’ ¿“«–

‡Àß◊Õ°Õ—°‡ ∫‡ªìπ·º≈ (ulcerative gingivitis) ·≈– ™àÕß

ª“°Õ—°‡ ∫ (stomatitis) √«¡∂÷ß‰¡à·π–π”„Àâ„™â„πºŸâ¡’

ª√–«—μ‘ÀÕ∫À◊¥ (bronchial asthma) ·¡â«à“∑’Ëºà“π¡“®–

‰¡à¡’√“¬ß“π°“√·æâ®“°ø≈ŸÕÕ‰√¥å ·μàªØ‘°√‘¬“°“√·æâ

“¡“√∂‡°‘¥„πºŸâ∑’Ë¡’Õ“°“√‰«μàÕ‚§‚≈‚øπ’ (colophony) ∑’Ë

„™â‡ªìπ à«πª√–°Õ∫„πø≈ŸÕÕ‰√¥å«“√åπ‘™ ®“°√“¬ß“π¢Õß

Sharma57 æ∫ºŸâªÉ«¬∑’Ë· ¥ßÕ“°“√º‘«Àπ—ßÕ—°‡ ∫®“°°“√

—¡º— (contact dermatitis) ¿“¬À≈—ß°“√√—°…“∑“ß

∑—πμ°√√¡∑’Ë„™â«— ¥ÿ∑’Ë¡’ ‚§‚≈‚øπ’‡ªìπ à«πª√–°Õ∫ ·≈–

‡∫◊ÈÕßμâπºŸâªÉ«¬·®âß«à“¡’ª√–«—μ‘‡·æâ°“«¢Õßæ≈“ ‡μÕ√å¬“

°àÕπÀπâ“π’È Isaksson ·≈–§≥–58 ‰¥â√“¬ß“π°“√‡°‘¥

¿“«–º‘«Àπ—ßÕ—°‡ ∫∫π¡◊Õ¢ÕßºŸâ™à«¬∑—πμ·æ∑¬å ·≈–°“√

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«“√åπ‘™ ¥—ßπ—Èπ°“√„™âø≈ŸÕÕ‰√¥å«“√åπ‘™®÷ß§«√√–¡—¥√–«—ß

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dressing), ´’‡¡πμå (dental cements) ·≈– “√¬÷¥μ‘¥

μà“ß Ê (adhesive)57

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Ekstrand and §≥–59 ‰¥â∑”°“√«‘‡§√“–Àå√–¥—∫

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12 ·≈– 14 ªï ¿“¬À≈—ß°“√∑“ø≈ŸÕÕ‰√¥å«“√åπ‘™ ÷Ëß

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« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


169

Table 2 Caries risk assessment for children less than 3 years

Indicators High risk Low risk

Part I. General Health Assessment

- Children with special health care needs, or Yes No

have any systemic diseases

Part II. Oral examination

- Visible plaque on anterior teeth Yes No

- Cavitated carious lesion Yes No

- White spot lesion Yes No

Note : from the Dental Association of Thailand71

The presence of a single risk indicator in any area of the çhigh-riské category is classified as high caries risk

Table 3 Caries risk assessment for children 3 years and older

Indicators High Moderate Low

Part I. General Health Assessment

- Children with special health care needs, Yes No

or have any systemic diseases

Part II. Oral examination and radiographic findings

- Cavitated carious lesion Yes No

- Visible plaque Yes No

- White spot lesion >1 area 1 area None

- Enamel defects and/or deep pits and fissure Yes No

in permanent molars

- Interproximal lesion from radiography Yes No

- Newly developed carious lesion <12 months 12-24 months >24 months

Part III. Risk and protective factors

- Regular dental chseck up <once/year once a years ≥twice/year

- Intraoral appliance (e.g. orthodontic appliance, Yes No

space maintainer, dentures)

- Cariogenic diet between meals ≥3 1-2 times/day None/only

- Bottle feeding times/day within meals

- Tooth brushing Yes No

- Use of fluoride toothpaste <once/day once a day >once a day

Yes No

Note : from the Dental Association of Thailand71

- The presence of a single risk indicator is classified as high caries risk

- The presence of at least 1 çmoderate riské indicator and no çhigh riské indicators is classified as moderate caries risk

- The child who has none of çmoderate riské or çhigh riské indicators is classified as low caries risk


170

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»÷°…“‡æ◊ËÕæ—≤π“º≈‘μ¿—≥±å À√◊Õ√–∫∫°“√„™âø≈ŸÕÕ‰√¥å

∑’Ë¡’°“√ª≈àÕ¬ø≈ŸÕÕ‰√¥åÕ¬à“ß™â“ Ê ‡æ◊ËÕ‡æ‘Ë¡ª√– ‘∑∏‘¿“æ

„π°“√ªÑÕß°—πøíπºÿ

Types Fluoride Concentration

mgF/ml % F ion ppm

Fluoride Gel

- Office use 1.23% APF 12.3 1.23 12,300

2% NaF 9.2 0.92 9,200

- Home use 0.5% APF 5 0.5 5,000

1.1% NaF 5 0.5 5,000

0.4% SnF2

1 0.1 1,000

Fluoride Varnish 5% NaF 22.6 2.26 22,600

1% Difluorosilane 1 0.1 1,000

Table 4 Types and concentration of fluoride gel and varnish

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


171

‡Õ° “√Õâ“ßÕ‘ß1. Petersson G, Bratthal D. The caries decline: a

review of reviews. Eur J of Oral Sci 1996; 104:

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Caries Risk Age

Categories* <3 years ≥3 years

Low May not have additional benefit from May not have additional benefit from

professional topical fluoride professional topical fluoride

Moderate Fluoride varnish application at 6-month Fluoride varnish OR gel application

intervals at 6-month intervals**

High Fluoride varnish application at 3-6-month Fluoride varnish OR gel application at

intervals 3-6-month intervals**Note :

*All age and risk groups are recommended to use an appropriate amount of fluoride toothpaste and brushing twice a day.

**Fluoride varnish application should be considered if patients cannot tolerate 4-minute fluoride tray.


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71. ∑—πμ·æ∑¬ ¡“§¡·Ààßª√–‡∑»‰∑¬„πæ√–∫√¡

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net/download/caries_risk.pdf.

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‡¢Á¡∑Õß ¡‘μ√°Ÿ≈

D.D.S., Cert. in Pediatric Dentistry,

D.Sc.D

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‚∑√»—æ∑å: 02-203-6450-3 μàÕ 114

‚∑√ “√: 02-203-6450

‚∑√»—æ∑å¡◊Õ∂◊Õ: 085-256-2922



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176

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Black tooth Stains in Children: An update

AbstractBlack tooth stain is one of common problems in pediatric dentistry.

Even though it does not result in pain but it associates with esthetic which

most parents are concern about. In this article, etiology, prevalence,

possible causes, associated oral microflora, diagnosis and ongoing

researches on black stain were reviewed. Many studies demonstrated a

positive association between black stain and decreased dental caries

prevalence as well as the relationship between degree of black stain and

caries severity. As a dental professional, we should capable of providing

an updated knowledge in this aspect as well as delivering a high quality of

dental treatment.

Keywords: black tooth stain in children, bacteria, dental plaque, dental

caries


Kemthong Mitrakul

Department of Pediatric Dentistry




Tel: 02-203-6450-3 extension 114

Fax: 02-203-6450

Mobile phone: 085-256-2922


Research grant: -

Received: 7 October 2011


Kemthong Mitrakul

D.D.S., Cert. in Pediatric Dentistry,

D.Sc.D

Department of Pediatric Dentistry,



Review article

«‘∑¬“ “√

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


177

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„πªí®®ÿ∫—π æ∫ºŸâªÉ«¬‡¥Á°À√◊ÕºŸâª°§√Õß ¡“¥â«¬Õ“°“√

”§—≠ (chief complaint) «à“¡’√Õ¬§√“∫ ’¥”∫πøíπ

„πÕ—μ√“∑’Ë Ÿß¢÷Èπ°«à“∑’Ëºà“π¡“ ‚¥¬ºŸâª°§√Õß à«π„À≠à¡—°

°—ß«≈«à“√Õ¬§√“∫π’È„™à√ŸºÿÀ√◊Õ‰¡à ®“°°“√»÷°…“„πª√–‡∑»

À√“™Õ“≥“®—°√‚¥¬„Àâ°≈ÿà¡Õ“ “ ¡—§√°√Õ°·∫∫ Õ∫∂“¡

‡√’¬ß≈”¥—∫ªí≠À“„π™àÕßª“°∑’Ë àßº≈μàÕ§«“¡ «¬ß“¡®“°

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‡ªìπªí≠À“Õ—π¥—∫∑’Ë 3 √Õß®“°‚√§øíπºÿ·≈–°“√‡ÀÁπ¢Õ∫

§√Õ∫øíπ‡«≈“¬‘È¡ μ“¡≈”¥—∫1

°“√‡ª≈’Ë¬π ’¢Õßøíπ (tooth staining/discolora-

tion) À√◊Õ√Õ¬§√“∫∫πøíππ—Èπ·μ°μà“ß°—π„π·ßà¥—ßμàÕ‰ªπ’È

‰¥â·°à ¡ÿØ∞“π«‘∑¬“ (etiology) ≈—°…≥–∑“ß§≈‘π‘° (clini-

cal appearance) μ”·Àπàß∑’Ëæ∫„π™àÕßª“° (location)

à«πª√–°Õ∫„π√Õ¬§√“∫ (composition) §«“¡√ÿπ·√ß

(severity) ·≈–§«“¡ “¡“√∂„π°“√¬÷¥‡°“–∫πøíπ¢Õß

§√“∫‡À≈à“π—Èπ (degree of adherence)

ª√–‡¿∑¢Õß°“√‡ª≈’Ë¬π ’¢Õßøíπ (type of tooth

staining/discoloration) ¥—ß· ¥ß‰«â„πμ“√“ß∑’Ë 1 “¡“√∂

·∫àß‰¥â ¥—ßπ’È 2

1. √Õ¬§√“∫¿“¬πÕ°øíπ·∫∫‰¡àμ‘¥·πàπ (extrinsic

tooth stain) ‡ªìπ§√“∫∑’Ë‡°“–Õ¬Ÿà∫πº‘«‡§≈◊Õ∫øíπ ‡°‘¥¢÷Èπ

®“° “‡Àμÿ¿“¬πÕ° ‡™àπ °“√ Ÿ∫∫ÿÀ√’Ë ‡æ√“–„π¬“ Ÿ∫

¡’ “√®”æ«°∑“√å∑’Ë∑”„Àâ‡°‘¥°“√μ‘¥ ’∫πøíπ °“√∫√‘‚¿§

Õ“À“√∫“ß™π‘¥ ‰¥â·°à πÈ”™“ °“·ø À√◊ÕÕ“À“√∑’Ë¡’

‡§√◊ËÕß‡∑»¡“°Ê ‡æ√“–„πÕ“À“√À√◊Õ‡§√◊ËÕß¥◊Ë¡‡À≈à“π’È

¡’ “√·∑ππ‘π (tannin) ∑’Ë∑”„Àâ‡°‘¥°“√μ‘¥ ’∫πøíπ ·≈–

ÿ¥∑â“¬§◊Õ§√“∫À‘πªŸπ ‚¥¬ “¡“√∂æ∫√Õ¬§√“∫·∫∫π’È

‰¥âÀ≈“¬ ’ μ—«Õ¬à“ß‡™àπ

1.1. √Õ¬§√“∫ ’πÈ”μ“≈ ¡—°æ∫„πºŸâ∑’Ë·ª√ßøíπ

‰¡à –Õ“¥À√◊Õ·ª√ß‚¥¬‰¡à„™â¬“ ’øíπ “¡“√∂æ∫√Õ¬

§√“∫ ’πÈ”μ“≈Õ¬à“ßÀπ“∫√‘‡«≥¥â“π·°â¡¢Õßøíπ°√“¡

∫π·≈–≈à“ß ¥â“π≈‘Èπ¢ÕßøíπÀπâ“≈à“ß

1.2. √Õ¬§√“∫ ’‚≈À– ‡°‘¥®“°°“√√—∫ª√–∑“π

¬“∑’Ë¡’ à«πº ¡¢Õß‚≈À–3 À√◊ÕÀ“¬„®‡Õ“ΩÿÉπ∏“μÿ¢Õß‚≈À–

‡¢â“‰ª ‡™àπ ∏“μÿ∑Õß·¥ß ∑”„Àâ‡°‘¥§√“∫ ’‡¢’¬«∏“μÿ‡ß‘π

∑”„Àâ‡°‘¥§√“∫ ’¥” ‡ªìπμâπ

°“√∑”§«“¡ –Õ“¥‚¥¬°“√·ª√ßøíπ “¡“√∂

¢®—¥√Õ¬§√“∫¿“¬πÕ°øíππ’ÈÕÕ°‰¥â‡ªìπ à«π¡“°

2. √Õ¬§√“∫¿“¬πÕ°øíπ·∫∫μ‘¥·πàπ (tenacious

tooth stain) §√“∫‡À≈à“π’È¡—°‡°‘¥®“°°“√ Ÿ∫∫ÿÀ√’Ë‡ªìπ√–¬–

‡«≈“π“πÊ ∫√‘‡«≥∑’Ëæ∫‰¥âπ—Èπ πÕ°®“°®–æ∫„π∫√‘‡«≥

¥â“π·°â¡¢Õßøíπ°√“¡∫π·≈–≈à“ß ¥â“π≈‘Èπ¢ÕßøíπÀπâ“≈à“ß

·≈â«®–æ∫∫√‘‡«≥„πÀ≈ÿ¡√àÕßøíπ°√“¡À≈—ß ‚¥¬¡“°¡—°¡’

’πÈ”μ“≈‡¢â¡‡°◊Õ∫¥” √Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ

¢Õ∫‡Àß◊Õ°®—¥Õ¬Ÿà„π√Õ¬§√“∫ª√–‡¿∑π’È °“√∑”§«“¡

–Õ“¥¥â«¬°“√·ª√ßøíπ ·¡â®–„™â·ª√ß‰øøÑ“ °Á‰¡à “¡“√∂

¢®—¥§√“∫π’ÈÕÕ°‰¥â 2, 4, 5 μâÕß‰¥â√—∫°“√¢—¥øíπ®“°∑—πμ-

·æ∑¬å´÷ËßμâÕß„™âÀ—«¬“ß (rubber cup) ·≈–ºß¢—¥ (pumice)

ÕÕ°·√ß°¥‡≈Á°πâÕ¬¢≥–¢—¥À√◊Õ∂â“§√“∫μ‘¥·πàπ¡“°Ê

μâÕß„™â‡§√◊ËÕß¢Ÿ¥À‘ππÈ”≈“¬Õ—≈μ√“‚´π‘° å (ultrasonic

scaler) √à«¡¥â«¬‡æ◊ËÕ¢®—¥ÕÕ°

3. √Õ¬§√“∫¿“¬„πøíπ (intrinsic tooth stain) ‡ªìπ

√Õ¬§√“∫∑’Ë‡°‘¥¿“¬„π™—Èπ‡§≈◊Õ∫øíπ·≈–‡π◊ÈÕøíπ æ∫‰¥â

∑—Èß„πºŸâ„À≠à·≈–‡¥Á° ‡°‘¥‰¥â®“°À≈“¬ “‡Àμÿ „π«—¬ºŸâ„À≠à

Õ“®¡“®“° “‡ÀμÿμàÕ‰ªπ’È ‰¥â·°à °“√‡ª≈’Ë¬π·ª≈ß¢Õß«—¬

(aging) °“√√—∫ª√–∑“πÕ“À“√À√◊Õ¬“∑’Ë¡’ à«πº ¡¢Õß

∏“μÿ‚≈À–‡ªìπ√–¬–‡«≈“π“πÊ °“√ Ÿ∫∫ÿÀ√’Ë·≈–¡’º‘«‡§≈◊Õ∫

øíπ·μ° (crack enamel) „π‡¥Á°‡°‘¥‰¥â®“° 2 “‡Àμÿ„À≠à

‰¥â·°à ®“°§«“¡º‘¥ª°μ‘·μà°”‡π‘¥ (congenital causes)

‰¥â·°à ¡’§«“¡º‘¥ª°μ‘¢Õß‡´≈≈å∑’Ë§«∫§ÿ¡°“√ √â“ßº‘«

‡§≈◊Õ∫øíπÀ√◊Õ‡π◊ÈÕøíπ¢≥– √â“ßÕ—π‡π◊ËÕß¡“®“°√à“ß°“¬

ÕàÕπ·Õ ´÷Ëß‡°‘¥‰¥â®“°À≈“¬ “‡Àμÿ ‡™àπ °“√μ‘¥‡™◊ÈÕ ‡ªìπ

¿“«–¥’´à“π·∫∫√ÿπ·√ß„π«—¬∑“√° (severe jaundice in

infancy) ·≈–°“√‰¥â√—∫¬“ªØ‘™’«π–∫“ß™π‘¥ ‡™àπ ‡μμ√â“-

‰´§≈‘π “‡Àμÿ∑’Ë 2 §◊Õ§«“¡º‘¥ª°μ‘À≈—ß°”‡π‘¥ (acquired

causes) ‰¥â·°à °“√‰¥â√—∫ “√ø≈ŸÕÕ‰√¥å (fluoride) ¡“°

‡°‘π‰ª5-9 ·≈–°“√‡ª≈’Ë¬π ’¢Õßøíπ‡π◊ËÕß¡“®“°√Õ¬‚√§

øíπºÿ (√Ÿª∑’Ë 4) √Õ¬§√“∫¿“¬„πøíππ’È‰¡à “¡“√∂¢—¥ÕÕ°

‰¥â °“√√—°…“‰¥â·°à °“√øÕ° ’øíπ (tooth bleaching) °“√

∫Ÿ√≥–øíπ¥â«¬§√Õ∫øíπ ∫“ß§√—Èß√Õ¬§√“∫¿“¬πÕ°øíπ

∑’Ëμ‘¥·πàπÕ¬Ÿà∫πøíπ‡ªìπ√–¬–‡«≈“π“πÊ°Á°≈“¬‡ªìπ√Õ¬

§√“∫¿“¬„πøíπ‰¥â


178

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

1.

Extri

nsic

toot

h st

ain

thin

, bac

teria

-fre

e, p

ellic

le-l

ike

film

gene

raliz

esm

okin

g, p

laqu

e or

visu

al in

spec

tion,

vigo

rous

bru

shin

g,

calc

ulus

, cer

tain

scra

tch

test

ing

prof

essi

onal

cle

anin

g

kind

of f

ood

i.e.

tann

ins

in te

a,

coffe

e an

d ot

her

beve

rage

s

1.1

Brow

n an

d/or

heav

y gr

ey to

gre

en, s

oft a

nd ùf

urry

ûbu

ccal

sur

face

s of

poor

OH

care

,pr

ofes

sion

al c

lean

ing

gree

n st

ain

film

, fou

nd b

acte

ria a

nd fu

ngi

post

erio

r tee

th,

impr

oper

toot

h

lingu

al s

urfa

ces

ofbr

ushi

ng, p

reva

lenc

e:

lowe

r ant

erio

r tee

thM

>F

1.2.

Met

al s

tain

1.2.

1.si

lver;

blac

k st

ain

gene

raliz

em

etal

lic c

ompo

unds

visu

al in

spec

tion,

prof

essi

onal

1.2.

2.m

ercu

ry a

nd le

ad d

ust;

blue

-sc

ratc

h te

stin

gcl

eani

ng

gree

n st

ain

1.2.

3.co

pper

and

nic

kel;

gree

n to

blu

egr

een

stai

n1.

2.4.

chro

mic

aci

d fu

mes

; dee

por

ange

sta

in1.

2.5.

Iodi

ne s

olut

ion;

bro

wn s

tain

2.

Tena

ciou

s to

oth

stai

nth

in, b

lack

pig

men

ted

line

not e

xten

dge

nera

lize,

pit

and

long

term

sm

okin

g,vi

sual

insp

ectio

n,pr

ofes

sion

al c

lean

ing

beyo

nd c

ervi

cal 1

/3, f

ollo

wing

con

tour

fissu

re o

f pos

terio

rpl

aque

or c

alcu

lus,

scra

tch

test

ing

pum

ice

or c

ombi

ne

of th

e gi

ngiv

al o

r inc

ompl

etel

yte

eth

certa

in k

ind

of fo

odwi

th a

n ul

traso

nic

coal

esce

nt d

ark

dots

rare

ly ex

tend

i.e. t

ea, c

offe

e, w

ine

with

rubb

er c

up a

nd

beyo

nd c

ervi

cal 1

/3

3.

Intri

nsic

toot

h st

ain

In a

dult:

Agi

ng, s

ome

med

icat

ions

con

tain

met

allic

com

poun

ds, s

mok

ing,

cra

ckfib

er o

ptic

, UV

light

prof

essi

onal

toot

h

enam

el; I

n ch

ildre

n: C

onge

nita

l and

acq

uire

d ca

uses

i.e.

sta

nnou

s flu

orid

e,ex

posu

rebl

each

ing,

rest

orat

ive

chlo

rhex

idin

e, h

emat

opoi

etic

dis

orde

rs (

sick

le c

ell a

nem

ia, t

hala

ssem

ia),

or

i.e. v

enee

r or f

ull

deve

lopm

enta

l dis

orde

rs (

amel

ogen

esis

impe

rfect

a, d

entin

ogen

esis

impe

rfect

a),

crow

n

diet

ary

mou

th ri

nse,

and

den

tal c

arie

s

Tabl

e 1

Sum

mar

y of

type

and

nat

ure

of to

oth

stai

ning

/dis

colo

ratio

n

Type

Char

acte

ristic

Area

Caus

esCl

inic

al e

xam

inat

ion

Trea

tmen

t

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


179

Fig. 1 Clinical aspect of black tooth stains in primary

dentition. Stain shown a continuous pigmented

line limited to half of cervical third of the tooth

surfaces6

Fig. 2 Mixed dentition of 8-yr.-old Thai boy presented

with black tooth stains

Fig. 3 Clinical presentation of black tooth stains in per-

manent dentition6

Fig. 4 Intrinsic tooth stain which is represented in a

non-continuous pigmented line extending beyond

half of the cervical third of the tooth surfaces6

Fig. 5 Clinical aspect of black tooth stains score 26

with is a continuous pigmented lines limited to

half of the cervical third of the tooth surfaces

Fig. 6 Clinical aspect of black tooth stains score 36

with a pigmented stains extending beyond half

of the cervical third of the tooth surfaces


180

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

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Tabl

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Sum

mar

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sea

rch

publ

icat

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sta

in in

chi

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n

Auth

ors

Coun

try

Subj

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Addi

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BSBS

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ant

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


181

√Õ¬§√“∫∫πøíπ∑—Èß 3 ª√–‡¿∑π’È„™â·√ß„π°“√¬÷¥

‡°“–∫πøíπ∑’Ë·μ°μà“ß°—π‰ªμ“¡ª√–‡¿∑ μ—«Õ¬à“ß‡™àπ

·√ß«“≈‡¥Õ«“« (van der Waals forces) ·√ß‰Œ‡¥√™—Ëπ

(hydration forces) ·√ß‰Œ‚¥√‡®π (hydrogen bonds) ·≈–

°“√¬÷¥¥â«¬¢—È«‡¥’¬«°—π ‡™àπ ¢—È«ªØ‘°‘√‘¬“∑’Ë‰¡à™Õ∫πÈ”

(hydrophobic interactions) Õ¬à“ß‰√°Áμ“¡ °≈‰°‡À≈à“π’È

¬—ß§ß¡’°“√»÷°…“«‘®—¬Õ¬Ÿà 10

≈—°…≥–∑“ß§≈‘π‘°¢Õß√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°

√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°π’È

¡’§«“¡‡Àπ’¬«·≈– “¡“√∂¬÷¥‡°“–°—∫øíπ‰¥â¥’°«à“√Õ¬

§√“∫¿“¬πÕ°øíπ·∫∫‰¡àμ‘¥·πàπ æ∫‰¥â∫àÕ¬§√—Èß„π‡¥Á°

™à«ßÕ“¬ÿøíππÈ”π¡·≈–™à«ßÕ“¬ÿøíπ™ÿ¥º ¡5-8, 10-13 ∑’Ë

πà“ π„®§◊Õ ‡¡◊ËÕøíπ·∑â¢÷Èπ¡“§√∫·≈â«„π™àÕßª“° √Õ¬

§√“∫π’È®–®“ß≈ßÀ√◊Õæ∫‰¥âπâÕ¬≈ß¡“° ∫“ß°“√»÷°…“

°≈à“««à“∑’Ë “¡“√∂æ∫√Õ¬§√“∫·∫∫π’È„πÕ—μ√“∑’Ë Ÿß„π‡¥Á°

π—Èπ ‡π◊ËÕß¡“®“°≈—°…≥–¢Õßº‘«‡§≈◊Õ∫øíπ„π‡¥Á°¡’√Ÿæ√ÿπ

‡À¡“–·°à°“√¬÷¥‡°“–¢Õß√Õ¬§√“∫π’È¡“°°«à“‡¡◊ËÕ‡∑’¬∫°—∫

°≈ÿà¡ºŸâ„À≠à 10 √Õ¬§√“∫π’È¡’≈—°…≥–‡©æ“–μ—« ¥—ßπ’È √Õ¬

¥”¡—°®–μàÕ‡π◊ËÕß°—π‡ªìπ·∂∫À√◊Õ ‡ªìπ®ÿ¥‡≈Á°Ê ‡™◊ËÕ¡

μàÕ°—π‚¥¬¡’‡ âπºà“π»πŸ¬å°≈“ßπâÕ¬°«à“ 0.5 ¡‘≈≈‘‡¡μ√

¡—°®–‡ ¡Õ°—π·≈–‡™◊ËÕ¡°—π∫πæ◊Èπº‘« (surfaces) ¢Õßøíπ

Õ¬à“ßπâÕ¬ 2 ´’Ë¢÷Èπ‰ª “¡“√∂æ∫‰¥â¡“°∫√‘‡«≥„°≈â¢Õ∫

‡Àß◊Õ° (gingival margin) ‚¥¬®–‡°“–Õ¬Ÿà∑’Ëº‘«øíπ‡Àπ◊Õ

¢Õ∫‡Àß◊Õ°ª√–¡“≥ 1 ∂÷ß 2 ¡‘≈≈‘‡¡μ√ ¡’≈—°…≥–¢π“π

‰ª°—∫¢Õ∫‡Àß◊Õ° ‚¥¬ à«π„À≠à·≈â«®–‰¡à‡°‘π à«π∑’ËªÉÕß

∑’Ë ÿ¥¢Õßμ—«øíπÀ√◊Õ∑’Ë‡√’¬°«à“ à«π∑’Ë 3 ¢Õßμ—«øíπ∑“ß§≈‘π‘°

(cervical third) ‚¥¬‰¡à‡≈¬‰ª∂÷ß∫√‘‡«≥¥â“πª√–™‘¥ (proxi-

mal surface) ¢Õßøíπ (√Ÿª∑’Ë 1 ·≈– 5) ¡—°®–‰¡à¡’§«“¡

Àπ“ (thinkness) ¡’§«“¡·¢Áß„°≈â‡§’¬ß°—∫À‘ππÈ”≈“¬·≈–

¡—°®–‡°‘¥¢÷Èπ„À¡à (reform) Õ¬à“ß√«¥‡√Á«¿“¬„π√–¬– 2 ∂÷ß

3 ‡¥◊ÕπÀ≈—ß®“°¢—¥ÕÕ°‰ª·≈â« ∫√‘‡«≥∑’Ëæ∫‰¥â¡“°∑’Ë ÿ¥

‰¥â·°à ¥â“π≈‘Èπ¢ÕßøíπÀπâ“≈à“ß (lingual of lower anterior

teeth) ÷Ëß‡ªìπ∫√‘‡«≥∑’Ë„°≈â°—∫√Ÿ‡ªî¥¢Õß∑àÕμàÕ¡πÈ”≈“¬„μâ≈‘Èπ

(opening sublingual duct) ·≈–‡¡◊ËÕ¢—¥ÕÕ°·≈â« º‘«

‡§≈◊Õ∫øíπ∑’ËÕ¬Ÿà„μâ√Õ¬§√“∫π’È®–ª°μ‘ ‰¡à¡’°“√ Ÿ≠‡ ’¬

·√à∏“μÿ´÷Ëßμà“ß®“°º‘«‡§≈◊Õ∫øíπ„π√–¬–√Õ¬‚√§ ’¢“«

(white spot lesion) ∑’Ë¡’°“√ Ÿ≠‡ ’¬·√à∏“μÿ (decalcifica-

tions7)

°“√«‘π‘®©—¬ (diagnosis) ·≈–°“√®—¥ª√–‡¿∑(classification) ¢Õß√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°

·√°‡√‘Ë¡π—Èπ Shourie14 ·π–π”°“√®—¥ª√–‡¿∑

·≈–§«“¡√ÿπ·√ß¢Õß√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ

¢Õ∫‡Àß◊Õ°‚¥¬°“√·∑π¥â«¬μ—«‡≈¢Õ¬à“ß‡ªìπ√–∫∫ ‡æ◊ËÕ„Àâ

ßà“¬μàÕ°“√ ◊ËÕ “√√–À«à“ß∑—πμ·æ∑¬å ¥—ßμ“√“ß∑’Ë 4 μàÕ¡“

Leung15 ‰¥â·π–π”‡æ‘Ë¡‡μ‘¡ ‚¥¬‡æ‘Ë¡§–·ππ¢÷Èπ¡“Õ’° 1

§–·ππ‡√’¬°«à“ four-point scale μàÕ¡“ Gasparetto

·≈–§≥–6 ‰¥â‡æ‘Ë¡À≈—°‡°≥∑å‚¥¬∂◊Õæ◊Èπ∑’Ë∑’Ë√Õ¬§√“∫ ’¥”

§√Õ∫§≈ÿ¡μ—«øíπ‡æ‘Ë¡‡μ‘¡„π‡«≈“μàÕ¡“

«‘∏’°“√μ√«® ”À√—∫«‘∏’°“√μ√«®‡æ◊ËÕ™à«¬·¬°·¬–«à“‡ªìπ√Õ¬

§√“∫ª√–‡¿∑„¥π—Èπ “¡“√∂·∫àß‰¥â ¥—ßπ’È 2, 7

1. °“√μ√«®¥â«¬°“√¥Ÿ (visual inspection) ‚¥¬

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“¡“√∂·¬°·¬–‚∑π ’ (shades) ∑’Ëμ‘¥øíπ‰¥â

2. °“√μ√«®¥â«¬°“√„™â· ß àÕßºà“π (transillumi-

nation) ∑”‰¥â‚¥¬°“√„™â‡§√◊ËÕß¡◊Õ ‡™àπ fiber optic probe

‚¥¬∑”°“√ àÕßºà“π®“°¥â“π¢â“ß·°â¡‰ª¬—ß¥â“π≈‘Èπ «‘∏’π’È

„™â‡ªìπ«‘∏’‡ √‘¡®“°°“√μ√«®¥â«¬°“√¥Ÿ·≈–°“√„™â‡§√◊ËÕß¡◊Õ

μ√«®øíπ (explorer) ‡æ◊ËÕ·¬°ª√–‡¿∑¢Õß°“√μ‘¥ ’∫πøíπ

„πøíπ∑’Ë ß —¬«à“‡ªìπ√Õ¬ºÿÀ√◊Õ‰¡à

3. °“√μ√«®¥â«¬°“√„™â· ßÕ—≈μ√“‰«‚Õ‡≈Áμ (ultra-

violet light exposure) «‘∏’π’È‰¡à§àÕ¬‡ªìπ∑’Ëπ‘¬¡π—° ·μà

“¡“√∂„™â‡ √‘¡‡æ◊ËÕ™à«¬·¬°·¬–ª√–‡¿∑¢Õß°“√μ‘¥ ’

∫πøíπ‚¥¬‡©æ“–√Õ¬§√“∫¿“¬„πøíπ‡æ√“–· ß®– àÕß

ºà“π„πÕ—μ√“∑’Ë‰¡à‡∑à“°—π

4. °“√μ√«®¥â«¬«‘∏’¢Ÿ¥∑’Ëº‘«‡§≈◊Õ∫øíπ (scratch

testing) ‚¥¬°“√¢Ÿ¥‡∫“Ê∑’Ëº‘«‡§≈◊Õ∫øíπ∑’Ëª°§≈ÿ¡¥â«¬√Õ¬

§√“∫¥â«¬‡§√◊ËÕß¡◊Õμ√«®øíπÀ√◊Õ‡§√◊ËÕß¡◊Õ¢Ÿ¥À‘ππÈ”≈“¬

(sickle) ”À√—∫§√“∫¿“¬πÕ°øíπ·∫∫‰¡àμ‘¥·πàπÀ√◊Õ

‡ªìπ·§à·ºàπ§√“∫®ÿ≈‘π∑√’¬åπ—Èπ®– “¡“√∂¢Ÿ¥ÕÕ°‰¥â¥â«¬

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182

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°“√ÕÕ°·√ß¢Ÿ¥¡“°¢÷Èπ∂÷ß®–¢Ÿ¥ÕÕ°‰¥â

§«“¡™ÿ° (prevalence) ¢Õß√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°„π‡¥Á°

„π√–¬–10 ªï∑’Ëºà“π¡“ „πª√–‡∑» À√—∞Õ‡¡√‘°“

¡’√“¬ß“π§«“¡™ÿ°¢Õß√Õ¬§√“∫ ’¥”∑’Ë Ÿß¢÷ÈπÕ¬à“ß¡’π—¬

”§—≠11 ‚¥¬ „π√“¬ß“π à«π„À≠à √ÿª«à“∑’Ë°“√‡æ‘Ë¡¢÷Èπ

¢ÕßÕ—μ√“§«“¡™ÿ°π—Èπ‡π◊ËÕß¡“®“°¡’ºŸâÕæ¬æ (immi-

grants) ®”π«π¡“°¢÷Èπ ‡æ√“–«à“Õ—μ√“§«“¡™ÿ°®– Ÿß„π

°≈ÿà¡μ—«Õ¬à“ß∑’Ë ‡ªìπºŸâÕæ¬æ ‚¥¬‡©æ“–ºŸâÕæ¬æ®“°

ª√–‡∑»∑’Ë‡ªìπÀ¡Ÿà‡°“–∑’ËÕ¬Ÿà„°≈â‡§’¬ßª√–‡∑» À√—∞Õ‡¡√‘°“

(islands bases) ‰¥â·°à ª√–‡∑»‡Œμ‘ (Haiti) ª√–‡∑»

„π·∂∫∑–‡≈§“√‘∫‡∫’¬π (Caribbean) ‡ªìπμâπ °“√»÷°…“

√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°‡√‘Ë¡‡ªìπ

∑’Ë π„®„π¬ÿ§»μ«√√…∑’Ë 50 ∂÷ß 70 ‚¥¬‡√‘Ë¡μâπ¡“®“°

√“¬ß“π§«“¡™ÿ°„πª√–™“°√Õ‘π‡¥’¬‚¥¬ Shourie14

»÷°…“„π°≈ÿà¡‡¥Á°™“¬®”π«π 1,097 §π Õ“¬ÿ√–À«à“ß 13

∂÷ß 16 ªï ‚¥¬„π‡«≈“π—ÈπºŸâ∑”°“√«‘®—¬‡√’¬°√Õ¬§√“∫ ’¥”

π’È«à“·ºàπ§√“∫®ÿ≈‘π∑√’¬åμ‘¥ ’ (pigmented plaque) æ∫

§«“¡™ÿ°‡∑à“°—∫√âÕ¬≈– 14 ‚¥¬°≈ÿà¡∑’Ë‰¡àæ∫·ºàπ§√“∫

®ÿ≈‘π∑√’¬åμ‘¥ ’‡ªìπ°≈ÿà¡‡¥Á°∑’Ë¡’øíππÈ”π¡·≈–°≈ÿà¡‡¥Á°∑’Ë¡’

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√“¬ß“π‡æ‘Ë¡‡μ‘¡∂÷ßÕ—μ√“°“√‡°‘¥øíπºÿ ‚¥¬„π°≈ÿà¡∑’Ëæ∫

·ºàπ§√“∫®ÿ≈‘π∑√’¬åμ‘¥ ’¡’Õ—μ√“°“√‡°‘¥øíπºÿ√âÕ¬≈– 14

·≈– 5 „π°≈ÿà¡‡¥Á°∑’Ë¡’øíππÈ”π¡·≈–°≈ÿà¡‡¥Á°∑’Ë¡’øíπ·∑â

μ“¡≈”¥—∫ ºŸâ«‘®—¬ √ÿª«à“·ºàπ§√“∫®ÿ≈‘π∑√’¬åμ‘¥ ’¡’§«“¡

—¡æ—π∏å°—∫Õ—μ√“°“√‡°‘¥øíπºÿ∑’ËπâÕ¬≈ß „π√“¬ß“ππ’È¬—ß

‡ πÕ°“√‡°≥∑å°“√®—¥ª√–‡¿∑§«“¡√ÿπ·√ß¢Õß·ºàπ§√“∫

®ÿ≈‘π∑√’¬åμ‘¥ ’ (degree of pigmentation) ‡ªìπ√–∫∫μ—«‡≈¢

Õ’°¥â«¬ (μ“√“ß∑’Ë 3 ·≈– 4) ‚¥¬„π°“√»÷°…“μàÕ¡“

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∂÷ß 14 ¡’§«“¡™ÿ°¢Õß√Õ¬§√“∫ ’¥” Ÿß ÿ¥·≈â«≈¥≈ßÀ≈—ß

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ÿ¢¿“æ™àÕßª“°∑’Ë¥’¢÷Èπ ‚¥¬¡’√“¬ß“π‡æ‘Ë¡‡μ‘¡μàÕ¡“∑’Ë„Àâº≈

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°≈ÿà¡Õ“¬ÿ∑’Ë»÷°…“π—ÈπÕ¬Ÿà„π™à«ß‡¢â“ Ÿà«—¬√ÿàπ´÷ËßÕ¬Ÿà„π™ÿ¥øíπ

º ¡μÕπª≈“¬ ®÷ßÕ“®®–∑”„Àâº≈∑’Ë‰¥â·μ°μà“ß°—∫°≈ÿà¡

™à«ßÕ“¬ÿÕ◊Ëπ∑’Ë¡’‡æ’¬ß™ÿ¥øíππÈ”π¡ ‚¥¬μàÕ¡“ Koch ·≈–

Table 3 Summary of search retrieval on the detection of Actinobacillus actinomycetemcomitans and Porphyromonas

gingivalis in children

Authors Technique Sample Age (yr.) Total subject Results

•NA=not applicable, Aa=Actinobacillus actinomycetemcomitans, Pg=Porphyromonas gingivalis, assoc.= associate, CF=caries-free, Pm=............

Watson et al, 199124 BANA, ELISA Subgingival NA 135 Pg was detected in one

plaque subject

Morinushi et al, 200025 immunoblotting, Plaque, saliva 2 - 18 40 Pg was detected >60%

ELISA

Saba et al, 200613 PCR Plaque NA 100 Pg, Pm: not assoc.

Aa : assoc.

Okuda et al, 200026 PCR Plaque 2-12 104 Aa, Pg were not

detected in CF subjects

Lamell et al, 200028 PCR NA 0-18 222 Aa was not assoc. with

age Pg level was more

stable when age

increased

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


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§√“∫ ’¥”π’È‡ªìπ·∫∫À≈—°∞“π (evidence based) À√◊Õ

º≈ √ÿª‡Õ°©—π∑å (consensus report) Õ¬à“ß‰√°Áμ“¡

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References Number Description

Table 4 Summary of the criteria for the diagnosis of black stain

Shourie14 1 No line

2 Incomplete coalescence of pigmented spots

3 Continuous line of pigmented spots

Gasparetto et al6 1 Corresponds to the presence of pigmented dots or thin lines with incomplete

coalescence6 parallel to the gingival margin

2 Continuous pigmented lines, limited to 1/2 of cervical third of the tooth surface

3 Continuous pigmented stains extending beyond 1/2 of cervical third of the tooth surface

Leung15 1 Thin line of 1 mm. or less in width across the surface

2 Equalling staining of 1/3 of the tooth surface

3 Equalling staining of 2/3 of the tooth surface

4 The entire of gingivo-occlusal surface


184

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‡π’¬¡ §≈Õ‰√¥å (cetylpyridinium chloride) ∑’Ë‡ªìπ

à«πº ¡„ππÈ”¬“∫â«πª“°∫“ß¬’ËÀâÕ∑’Ë«“ß®”Àπà“¬„πª√–‡∑»

À√—∞Õ‡¡√‘°“ ‡™àπ Cepacol ·≈– Scope Õ¬à“ß‰√°Áμ“¡

¬—ß‰¡à¡’√“¬ß“π°“√„™âπÈ”¬“∫â«πª“° Õß¬’ËÀâÕπ’È„πª√–‡∑»

‰∑¬

3. ‡™◊ÈÕ·∫§∑’‡√’¬5, 7, 13, 18 ‡π◊ËÕß®“°√Õ¬§√“∫

’¥”æ∫∫πº‘«øíπ¥—ßπ—Èπ®÷ßμâÕß —¡æ—π∏åÕ¬à“ß„°≈â™‘¥°—∫

·ºàπ§√“∫®ÿ≈‘π∑√’¬å (dental plaque) ¥—ß∑’Ë∑√“∫°—π¥’

«à“·ºàπ§√“∫®ÿ≈‘π∑√’¬å‡ªìπ‰∫‚Õøî≈¡å™π‘¥Àπ÷Ëß∑’Ëæ∫„π

™àÕßª“° (oral biofilm) ‰∫‚Õøî≈¡å‡ªìπ°“√Õ¬Ÿà√à«¡°—π¢Õß

‡™◊ÈÕ®ÿ≈™’æ (microorganism) „π ¿“«–·«¥≈âÕ¡∑’Ë

‡À¡“– ¡ ”À√—∫°“√‡®√‘≠‡μ‘∫‚μ·∫∫æ÷Ëßæ“Õ“»—¬°—π ¡’

§«“¡‡ªìπ‡Õ°≈—°…≥å (unique) ¢Õß√–∫∫®ÿ≈π‘‡«» ‚¥¬

„π·ºàπ§√“∫®ÿ≈‘π∑√’¬åπ—Èπ πÕ°®“°®–ª√–°Õ∫‰ª¥â«¬‡™◊ÈÕ

·∫§∑’‡√’¬·≈â« ¬—ßª√–°Õ∫¥â«¬ “√®”æ«°‚æ≈’·´§-

§“‰√¥å (polysaccharide) ∑’Ë‡™◊ÈÕ·∫§∑’‡√’¬ √â“ß¢÷Èπ‡æ◊ËÕ„™â

„π°“√¬÷¥‡°“– ‡™àπ ‡°≈◊Õ‡À≈Á°∑’Ë‰¡à≈–≈“¬ (insoluble

iron salts) ·§≈‡´’¬¡ (calcium) ·≈–øÕ ‡øμ (phos-

phate) ‚¥¬„πªï §. ». 1976 Reid ·≈–§≥–19 »÷°…“

Õß§åª√–°Õ∫¢Õß√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫

‡Àß◊Õ°æ∫«à“ª√–°Õ∫¥â«¬‡°≈◊Õ‡øÕ√‘§ (ferric salt) ®”æ«°

‡øÕ√‘§´—≈‰ø¥å (ferric sulfide) ∑’Ë √â“ß¢÷Èπ®“°ªØ‘°‘√‘¬“

√–À«à“ß‰Œ‚¥√‡®π —≈‰ø¥å (hydrogen sulfide) ∑’Ëº≈‘μ

‚¥¬‡™◊ÈÕ·∫§∑’‡√’¬ ‚¥¬¡’ “√μ—Èßμâπ‰¥â·°à∏“μÿ‡À≈Á°„ππÈ”≈“¬

À√◊Õ„π¢Õß‡À≈«„π¢Õ∫‡Àß◊Õ° (gingival crevice) ÷Ëß

Õ“®‡ªìπ§”μÕ∫¢Õß¢âÕ ß —¬∑’Ë«à“ ∑”‰¡∂÷ßæ∫√Õ¬§√“∫

’¥”¡“°∑’Ë∫√‘‡«≥¥â“π≈‘Èπ¢ÕßøíπÀπâ“≈à“ß ‚¥¬‡¡◊ËÕ¡’°“√

√â“ß√Õ¬§√“∫¢÷Èπ·≈â«π—Èπ®– àß‡ √‘¡„Àâ·§≈‡´’¬¡·≈–

øÕ ‡øμ – ¡¡“°¢÷Èπμ√ß∫√‘‡«≥π—ÈπÊ ∑”„Àâ°“√≈–≈“¬

¢Õßº‘«‡§≈◊Õ∫øíπ (enamel dissolution) ≈¥≈ß §«“¡

“¡“√∂„π°“√∑”„Àâ‡ªìπ°≈“ß (buffering capacity)

‡æ‘Ë¡¢÷Èπ ´÷ËßÕ“®®–‡ªìπ§”μÕ∫¢Õß¢âÕ ß —¬∑’Ë«à“∑”‰¡„π

°≈ÿà¡Õ“ “ ¡—§√∑’Ë¡’√Õ¬§√“∫ ’¥”¡’§à“‡©≈’Ë¬Õ—μ√“°“√‡°‘¥

øíπºÿπâÕ¬°«à“ μàÕ¡“¡’°“√»÷°…“∂÷ßÕß§åª√–°Õ∫∑“ß‡§¡’

(chemical composition)18, 19 ¢ÕßπÈ”≈“¬„π‡¥Á°Õ“¬ÿ

√–À«à“ß 4 ∂÷ß 16 ªï∑’Ë¡’·≈–‰¡à¡’√Õ¬§√“∫ ’¥” æ∫«à“„π

πÈ”≈“¬¢Õß‡¥Á°∑’Ë¡’√Õ¬§√“∫ ’¥”¡’ª√‘¡“≥·§≈‡ ’¬¡

øÕ ‡øμ ∑Õß·¥ß (copper) ‚´‡¥’¬¡ (sodium) ·≈–

‚ª√μ’π Ÿß°«à“ ·μà¡’ª√‘¡“≥°≈Ÿ‚§ πâÕ¬°«à“‡¥Á°∑’Ë‰¡à¡’√Õ¬

§√“∫ ’¥” ·≈–„π‡¥Á°∑’ËπÈ”≈“¬¡’Õß§åª√–°Õ∫∑“ß‡§¡’

‡À≈à“π—Èπ¡’Õ—μ√“°“√‡°‘¥øíπºÿπâÕ¬≈ß¥—ßπ—Èπ®÷ß¡’ ¡¡μ‘∞“π

∑’Ë«à“√Õ¬§√“∫ ’¥”π’ÈÕ“®®–¡’§«“¡ —¡æ—π∏å°—∫‡™◊ÈÕ·∫§-

∑’‡√’¬ „π™àÕßª“°∑’Ë‰¡à —¡æ—π∏åÀ√◊Õ¡’§«“¡ —¡æ—π∏å°—∫

¿“«–™àÕßª“°∑’Ë¡’ ÿ¢¿“æ¥’ ‰¡à¡’øíπºÿ

∫∑∫“∑¢Õß‡™◊ÈÕ·∫§∑’‡√’¬„π™àÕßª“°μàÕ°“√‡°‘¥√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°

®“°°“√√«∫√«¡ß“π«‘®—¬·≈–√“¬ß“π≈à“ ÿ¥ (sys-

tematic literature review)20 æ∫«à“ ‡™◊ÈÕ°≈ÿà¡¡‘«·∑π å

‡μ√Áª‚μ§Õ§‰§¬—ß§ß¡’∫∑∫“∑„π°“√°àÕ„Àâ‡°‘¥‚√§øíπºÿ

Õ¬à“ß‰√°Áμ“¡ „π°≈ÿà¡μ—«Õ¬à“ß∑’Ë¡’øíπºÿπ—Èπ‰¡à®”‡ªìπ∑’Ë®–

μâÕß¡’‡™◊ÈÕ°≈ÿà¡π’È„π√–¥—∫ Ÿß‡ ¡Õ‰ª ‚¥¬‡©æ“–„π‰∫‚Õøî≈¡å

∑’Ë‰¥â¡“®“°∫√‘‡«≥√Õ¬‚√§øíπºÿ√–¬–‡√‘Ë¡μâπ∑’Ë¬—ß‰¡à‡ªìπ√Ÿ

(non-cavitated stages of lesion formation) ´÷Ëß®“°

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554


185

∑ƒ…Æ’°“√‡°‘¥·ºàπ§√“∫®ÿ≈‘π∑√’¬å„πªí®®ÿ∫—π ‰¥â·°à ∑ƒ…Æ’

√–∫∫π‘‡«» (ecological plaque hypothesis) ∑’Ë°≈à“««à“

√Õ¬‚√§øíπºÿ®–‡°‘¥¢÷Èπ°ÁμàÕ‡¡◊ËÕ ¿“«–¢Õß√–∫∫π—Èπ‡ ’¬

¡¥ÿ≈ πÕ°®“°π’È∑’Ë ”§—≠§◊Õ √Õ¬‚√§øíπºÿπ—ÈπÕ“®®–‰¡à‰¥â

‡°‘¥®“°‡™◊ÈÕ°≈ÿà¡¡‘«·∑π å ‡μ√Áª‚μ§Õ§‰§ ‡æ’¬ß°≈ÿà¡‡¥’¬«

·μà‡™◊ÈÕ∑’Ë‰¡à„™à°≈ÿà¡¡‘«·∑π å∑’Ë “¡“√∂º≈‘μ·≈–∑π°√¥‰¥â¥’

(non-mutans acidogenic and aciduric bacteria)

‡™àπ‡™◊ÈÕ·Õ§μ‘‚π‰¡´‘ 13, 20 ∑’Ë¡’§«“¡ —¡æ—π∏å„°≈â™‘¥

°—∫°“√‡°‘¥øíπºÿ„π√–¬–‡√‘Ë¡·√° (initiation of caries)

‚¥¬‡©æ“–√Õ¬‚√§ ’¢“« √Õ¬‚√§ºÿ∫√‘‡«≥√“°øíπ (root

surface caries) °ÁÕ“®®–¡’∫∑∫“∑∑’Ë ”§—≠ „π°√–∫«π

°“√‡°‘¥‚√§øíπºÿ°Á‡ªìπ‰ª‰¥â Ÿß ‡æ√“–«à“¡—π¡’§ÿ≥ ¡∫—μ‘

¥—ß∑’Ë‰¥â°≈à“«¡“·≈â« ∑”„Àâπ—°«‘®—¬∫“ß°≈ÿà¡ —ππ‘…∞“π«à“

‡™◊ÈÕ·Õ§μ‘‚π‰¡´‘ Õ“®‡ªìπ‡™◊ÈÕ ”§—≠„π°“√‡°‘¥‚√§øíπºÿ

(key player) Õ¬à“ß‰√°Áμ“¡ „π∫“ß°“√»÷°…“√“¬ß“π«à“

“¡“√∂æ∫‡™◊ÈÕπ’È∫πº‘«øíπ∑’Ë¬—ß‰¡àºÿ (sound crown surface)

¢Õß§π ÀπŸ·Œ¡ ‡μÕ√å (hamster) ·≈–ÀπŸ∑’Ëª≈Õ¥‡™◊ÈÕ

(gnotobiotic rat) ‚¥¬μ√«®‡™◊ÈÕ¥â«¬«‘∏’∑“ß™’«‚¡‡≈°ÿ≈

(molecular technique) ·μàπ—°«‘®—¬Õ’°°≈ÿà¡‡ πÕ¢âÕ

¡¡ÿμ‘∞“π∑’Ë«à“ æ∫‡™◊ÈÕ·Õ§μ‘‚π‰¡ ‘ „π√–¥—∫ Ÿß°≈—∫æ∫

‡™◊ÈÕ°≈ÿà¡ ‡μ√Áª‚μ§Õ§‰§„π√–¥—∫μË”·≈–¡’§«“¡ —¡æ—π∏å

°—∫°“√‡°‘¥‚√§øíπºÿ∑’ËμË”≈ß ´÷Ëß„Àâº≈‰ª„π∑“ß‡¥’¬«°—π°—∫

√“¬ß“π∑’Ë«à“ √Õ¬§√“∫ ’¥”¡’§«“¡ —¡æ—π∏å°—∫Õ—μ√“°“√

‡°‘¥‚√§øíπºÿ∑’ËμË” ®“°¢âÕ ¡¡ÿμ‘∞“π∑—Èß 2 π—Èπ ¡¡ÿμ‘∞“π

Õ—π∑’Ë 2 πà“®–¡’§«“¡‡ªìπ‰ª‰¥â Ÿß°«à“ Õ¬à“ß‰√°Áμ“¡

¢âÕ ß —¬Õ’°¢âÕÀπ÷Ëß∑’Ë«à“ ∑”‰¡®÷ß “¡“√∂æ∫√Õ¬§√“∫ ’¥”

‰¥â·§à„π∫“ß§π‡∑à“π—Èπ ∑—ÈßÊ∑’Ë‡™◊ÈÕ‡À≈à“π’È°Á “¡“√∂æ∫‰¥â

„π°≈ÿà¡μ—«Õ¬à“ß°≈ÿà¡„À≠à ´÷ËßÕ“®‡π◊ËÕß¡“®“°∑’Ë«à“„π·μà

≈–§πÕ“®¡’Õß§åª√–°Õ∫¢Õß‡™◊ÈÕ®ÿ≈™’æ„π·ºàπ§√“∫

®ÿ≈‘π∑√’¬å·≈–°√–∫«π°“√‡º“º≈“≠μà“ßÊ ∑’Ëμà“ß°—π ∂÷ß

·¡â«à“®–„Àâº≈≈—æ∑å∑“ß§≈‘π‘°∑’Ë‡À¡◊ÕπÀ√◊Õμà“ß°—π (¡’øíπºÿ

À√◊Õª√“»®“°øíπºÿ) ‡ªìπ∑’Ë·πàπÕπ«à“‡™◊ÈÕ∑’Ë‡¥àπ∑’Ë —¡æ—π∏å

°—∫°“√‡°‘¥‚√§øíπºÿπ—Èππà“®–‡À¡◊Õπ°—π ·μàÕß§åª√–°Õ∫

À√◊Õ‡™◊ÈÕ∑’Ë‰¡à‡¥àπ·≈–Õß§åª√–°Õ∫¢Õß·√à∏“μÿμà“ßÊ„π

πÈ”≈“¬·≈–¢Õß‡À≈«®“°‡Àß◊Õ°πà“®–·μ°μà“ß°—π21

‚¥¬ √ÿª ‡™◊ÈÕ·∫§∑’‡√’¬∑’Ë‡°’Ë¬«¢âÕß°—∫√Õ¬§√“∫ ’¥”

‰¥â·°à ‡™◊ÈÕ„π°≈ÿà¡·Õ§μ‘‚π‰¡´‘ (Actinomyces) ·Õ§-

°√‘‡°μ‘·∫§‡μÕ√å (Aggregatibactor) À√◊Õ·Õ§μ‘‚π∫“´‘≈≈—

·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§¡’·∑π å (Actinobacillus actino-

mycetemcomitans) æÕ√å‰ø‚√‚¡·π ®‘π®‘«“≈‘ (Pro-

phyromonas gingivalis) æ√’‚«‡∑≈≈“ ‡¡≈“‚π®‘π‘§“

(Prevotella melanogenica) ·≈–æ√’‚«‡∑≈≈“ Õ‘π‡μÕ√å-

¡‘‡¥’¬ (Prevotella intermedia)13, 20 ‚¥¬ à«π„À≠à‡ªìπ

‡™◊ÈÕ·∫§∑’‡√’¬°√—¡≈∫ (gram-negative) ·μà°àÕπ∂Ÿ°

‡√’¬°√«¡Ê«à“·∫§∑’‡√’¬°≈ÿà¡‚§√‚¡®‘π‘§ (chromogenic) ∑’Ë

¡—°æ∫„πºŸâªÉ«¬∑’Ë‡ªìπ‚√§‡Àß◊Õ°·≈–‚√§ª√‘∑—πμå 22 ‚¥¬

Õß§åª√–°Õ∫¢Õß·ºàπ§√“∫®ÿ≈‘π∑√’¬å„μâ‡Àß◊Õ° (subgingival

plaque) ∑’Ë¬÷¥‡°“–∫√‘‡«≥º‘«øíπ·≈–‡π◊ÈÕ‡¬◊ËÕ„π°√–‡ªÜ“

ª√‘∑—πμå (periodontal pocket) „πºŸâªÉ«¬‡À≈à“π’È®–¡’

°“√‡ª≈’Ë¬π·ª≈ß ‚¥¬¡’‡™◊ÈÕ·∫§∑’‡√’¬°√—¡≈∫∑’Ë‰¡àæ÷Ëßæ“

ÕÕ°´‘‡®π ‡™àπ ‡™◊ÈÕæÕ√å‰ø‚√‚¡·π ·≈–æ√’‚«‡∑≈≈“‡æ‘Ë¡¢÷Èπ

‡¡◊ËÕ‡∑’¬∫°—∫§π∑’Ë‰¡à¡’‚√§‡Àß◊Õ°·≈–‚√§ª√‘∑—πμå ”À√—∫

°“√»÷°…“„π‡¥Á°π—Èπ Wojcicki ·≈–§≥–23 √“¬ß“π«à“

‰¡àæ∫§«“¡·μ°μà“ß¢Õß§«“¡™ÿ°¢Õß‡™◊ÈÕæÕ√å‰ø‚√‚¡·π

·≈–æ√’‚«‡∑≈≈“„π‡¥Á°«—¬°àÕπ‡¢â“ Ÿà«—¬√ÿàπ (prepuberscent)

√–¬–«—¬√ÿàπ (circumpuberscent) ·≈–√–¬–À≈—ß«—¬√ÿàπ

(postpubertal) ‚¥¬ √ÿª«à“ §«“¡™ÿ°¢Õß‡™◊ÈÕ·∫§∑’‡√’¬

Õßμ—«π’È ‰¡à Õ¥§≈âÕß°—∫°“√‡æ‘Ë¡¢÷Èπ¢ÕßŒÕ√å‚¡π‡¡◊ËÕ«—¬

‡ª≈’Ë¬π·ª≈ß ¥—ßπ—Èπ®÷ß‰¡àπà“∑’Ë®–¡’§«“¡‡°’Ë¬«¢âÕß°—∫‚√§

‡Àß◊Õ°Õ—°‡ ∫À√◊Õ‚√§ª√‘∑—πμå‡™àπ‡¥’¬«°—∫∑’Ëæ∫„πºŸâ„À≠à

‡Àμÿº≈∑’Ë ”§—≠Õ’°Õ¬à“ßÀπ÷Ëß§◊Õ„π‡¥Á°π—Èπ ¿“«–°“√‡°‘¥

‚√§‡Àß◊Õ°Õ—°‡ ∫¢÷Èπ°—∫°“√‡ª≈’Ë¬π·ª≈ß¢Õß√–¥—∫ŒÕ√å‚¡π

¡“°°«à“®“°ª√‘¡“≥·ºàπ§√“∫®ÿ≈‘π∑√’¬å ´÷Ëß‰¡à‰¥â¡’§«“¡

—¡æ—π∏å∑’Ë‡ªìπ·π«μ√ß‡À¡◊Õπ„πºŸâ„À≠à (‡™àπ ¬‘Ëß¡’®”π«π

·ºàπ§√“∫®ÿ≈‘π∑√’¬å¡“°°Á∑”„Àâ‡°‘¥Õ“°“√Õ—°‡ ∫¡“°

¬‘Ëß¢÷Èπ) Õ¬à“ß‰√°Áμ“¡ ª√‘¡“≥·ºàπ§√“∫®ÿ≈‘π∑√’¬å‡ªìπÀπ÷Ëß

„πªí®®—¬‡ √‘¡∑’Ë∑”„ÀâÕ“°“√Õ—°‡ ∫¢Õß‡Àß◊Õ°·¬à≈ß μàÕ¡“

Watson ·≈–§≥–24 √“¬ß“π«à“æ∫‡™◊ÈÕæÕ√å‰ø‚√‚¡·π

®‘π®‘«“≈‘ ·≈–∑√’‚ªπ’Ë¡“ ‡¥πμ‘‚§≈à“ (Treponema den-

ticola) „π·ºàπ§√“∫®ÿ≈‘π∑√’¬å¡“°∂÷ß√âÕ¬≈– 86 „π‡¥Á°

∑’Ë¡’ ÿ¢¿“æ·¢Áß·√ß ‰¡à¡’‚√§ª√–®”μ—«·≈–‰¡à‰¥â∫√‘‚¿§∏“μÿ

‡À≈Á°À√◊Õ«‘μ“¡‘π‡ √‘¡„¥Ê ·μàμàÕ¡“ Morinushi ·≈–

§≥–25 √“¬ß“π«à“æ∫‡™◊ÈÕæÕ√å‰ø‚√‚¡·π ®‘π®‘«“≈‘

¡“°°«à“√âÕ¬≈– 60 „π‡¥Á°Õ“¬ÿ‡©≈’Ë¬ 12 ªï ·≈– √âÕ¬≈– 75

¢Õß‡¥Á°∑’Ëæ∫‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈— ·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§

¡’·∑π å¡’Õ“°“√‡Àß◊Õ°Õ—°‡ ∫·μà‰¡à‰¥â√“¬ß“π«à“‡Àß◊Õ°


186

« ∑—πμ ¡À‘¥≈ ªï∑’Ë 31 ‡≈à¡∑’Ë 3, 2554

Õ—°‡ ∫√–¬–„¥·≈–æ∫‡™◊ÈÕ„πª√‘¡“≥‡∑à“‰√

„π√–¬– 10 ªï∑’Ëºà“π¡“ °“√»÷°…“‡™◊ÈÕ®ÿ≈‘π∑√’¬å

‚¥¬„™â‡∑§π‘°∑“ß™’«‚¡‡≈°ÿ≈À“‡™◊ÈÕ·∫§∑’‡√’¬‚¥¬∑’Ë‰¡àμâÕß

‡æ“–‡™◊ÈÕ„πÀâÕßªØ‘∫—μ‘°“√ ´÷ËßÀπ÷Ëß„π‡∑§π‘°‡À≈à“π—Èπ

‰¥â·°à ‡∑§π‘°ªØ‘°‘√‘¬“≈Ÿ°‚´à (polymerase chain reaction,

PCR) ÷Ëß‡ªìπ‡∑§π‘°∑’Ë‡™◊ËÕ∂◊Õ‰¥â·≈–„Àâº≈·¡àπ¬” Okuda

·≈–§≥–26 „™â«‘∏’π’Èμ√«®À“‡™◊ÈÕ·≈–√“¬ß“π«à“‰¡àæ∫‡™◊ÈÕ

·Õ§μ‘‚π∫“´‘≈≈— ·Õ§μ‘‚π‰¡ ‘‡μÁ¡‚§¡’·∑π å·≈–æÕ√å

‰ø‚√‚¡·π ®‘π®‘«“≈‘ „π‡¥Á°∑’Ë‰¡à¡’øíπºÿ ‡™àπ‡¥’¬«°—∫

°“√»÷°…“¢Õß Saba ·≈–§≥–13 ∑’Ë√“¬ß“π«à“‡™◊ÈÕæÕ√å-

‰ø‚√‚¡·π ®‘π®‘«“≈‘ ·≈–æ√’‚«‡∑≈≈“ ‡¡≈“‚π®‘π‘§“π—Èπ

‰¡àπà“®–‡°’Ë¬«¢âÕß„π°√–∫«π°“√°“√‡°‘¥√Õ¬§√“∫ ’¥”

Õ¬à“ß‰√°Áμ“¡ Saba ·≈–§≥– √ÿª«à“‡™◊ÈÕ·Õ§μ‘‚π‰¡ ‘

Õ“®®–‡°’Ë¬«¢âÕß°—∫°√–∫«π°“√ √â“ß‡¡Á¥ ’ (pigmentation

process) „π√Õ¬§√“∫ ’¥” ‡æ√“–«à“„π¬’π®”‡æ“– (spe-

cific gene) ¢Õß‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈— ·Õ§μ‘‚π‰¡´‘‡μÁ¡

‚§¡’·∑π å¡’°“√º≈‘μ∏“μÿ‡À≈Á° (high iron production)

¡“°°«à“·∫§∑’‡√’¬μ—«Õ◊ËπÊ27 Õ¬à“ß‰√°Áμ“¡πà“®–μâÕß¡’

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·≈–æÕ√å‰ø‚√‚¡·π ®‘π®‘«“≈‘ ‚¥¬∑”°“√μ√«®‡ªìπ

√–¬–Ê æ∫«à“À≈—ß®“° 1 ∂÷ß 3 ªï æ∫«à“§«“¡™ÿ°¢Õß‡™◊ÈÕ

Õßμ—«π’È‰¡à‡ª≈’Ë¬π·ª≈ß ·μà§«“¡™ÿ°¢Õß‡™◊ÈÕ Õßμ—«π’È‰¡à

§ß∑’Ë ‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫√–À«à“ß√–¬–μà“ßÊ ‰¥â·°à√–¬–°àÕπ

«—¬√ÿàπ √–¬–‡¢â“ Ÿà«—¬√ÿàπ·≈–√–¬–«—¬√ÿàπ ·μà®–§ß∑’Ë¡“°¢÷Èπ

„π√–¬–«—¬√ÿàπμÕπª≈“¬ Tanaka ·≈–§≥–√“¬ß“π„πªï

§.». 200829 «à“§«“¡™ÿ°‡™◊ÈÕæ√’‚«‡∑≈≈“ ‡¡≈“‚π®‘π‘§“

æ√’‚«‡∑≈≈“ Õ‘π‡μÕ√å¡‘‡¥’¬·≈–æ√’‚«‡∑≈≈“ ‰π°√’‡´π π—Èπ

‰¡à·μ°μà“ß°—π„π√–À«à“ß°≈ÿà¡‡¥Á°∑’Ë¡’øíπºÿ·≈–‰¡à¡’øíπºÿ

‚¥¬§«“¡™ÿ°¢Õß‡™◊ÈÕ∑—Èß 3 μ—«π’È‰¡à —¡æ—π∏å°—∫Õ“¬ÿ¢Õß

‡¥Á° ·μà„π™à«ßÕ“¬ÿ√–À«à“ß 3 ∂÷ß 6 ªï æ∫«à“¡’§«“¡™ÿ°¢Õß

‡™◊ÈÕ 3 μ—«π’È Ÿß ÿ¥ ®–‡ÀÁπ‰¥â«à“§«“¡™ÿ°¢Õß‡™◊ÈÕ∑’Ë°≈à“«¡“

π—Èπ¡’§«“¡À≈“°À≈“¬¡“° Õ’°∑—Èß¬—ß·μ°μà“ß°—π‰ª„π

·μà≈–‡∑§π‘°∑’Ë„™â„π°“√μ√«®À“ ”À√—∫‡∑§π‘°∑’Ë„™â°—π

‡ªìπÕ¬à“ß¡“°Õ’°‡∑§π‘°Àπ÷Ëß ‰¥â·°à ‡∑§π‘°ªØ‘°‘√‘¬“≈Ÿ°‚ à

·∫∫‡√’¬≈∑“¡ (real-time quantitative PCR) ‚¥¬‡∑§π‘°

π’È “¡“√∂μ√«®À“‡™◊ÈÕ∑’Ë π„®‡ªìπ™à«ß√–¬–‡«≈“„π·μà≈–

√Õ∫¢ÕßªØ‘°‘√‘¬“≈Ÿ°‚ à·∑π∑’Ë®–μ√«®‡¡◊ËÕ ‘Èπ ÿ¥√Õ∫∑—ÈßÀ¡¥

∂◊Õ«à“¡’§«“¡®”‡æ“– Ÿß°«à“ªØ‘°‘√‘¬“≈Ÿ°‚´à·∫∫∏√√¡¥“

®“°√“¬ß“πμà“ßÊæ∫«à“ §«“¡™ÿ°¢Õß‡™◊ÈÕ‡À≈à“π’È‡¡◊ËÕ„™â

‡∑§π‘°·∫∫‡√’¬≈∑“¡°≈—∫æ∫πâÕ¬°«à“‡¡◊ËÕ‡∑’¬∫°—∫°“√

μ√«®¥â«¬«‘∏’ªØ‘°‘√‘¬“≈Ÿ°‚´à·∫∫∏√√¡¥“ ‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫

§«“¡‰«„π°“√μ√«® (sensitivity) √–À«à“ß 3 «‘∏’ (ªØ‘°‘√‘¬“

≈Ÿ°‚´à·∫∫∏√√¡¥“ªØ‘°‘√‘¬“≈Ÿ°‚´à·∫∫‡√’¬≈∑“¡·≈–«‘∏’

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∏√√¡¥“¡’§«“¡‰« Ÿß ÿ¥ √Õß≈ß¡“‰¥â·°à ªØ‘°‘√‘¬“≈Ÿ°‚ à

·∫∫‡√’¬≈∑“¡·≈–«‘∏’‡æ“–‡™◊ÈÕ„πÀâÕßªØ‘∫—μ‘°“√ μ“¡

≈”¥—∫30 ¬—ß§ßμâÕß¡’°“√»÷°…“°—πμàÕ‰ª Umeda ·≈–

§≥–31 À“§«“¡‡ ’Ë¬ß„π°“√μ‘¥‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈—

·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§¡’·∑π å æÕ√å‰ø‚√‚¡·π ®‘π®‘«“≈‘

∑√’‚ªπ’¡à“ øÕ√å‰´‡∑’¬ æ√’‚«‡∑≈≈“ Õ‘π‡μÕ√å¡‘‡¥’¬

æ√’‚«‡∑≈≈“ ‰π°√’‡´π·≈–∑√’‚ªπ’¡à“ ‡¥πμ‘‚§≈à“®“°

·ºàπ§√“∫®ÿ≈‘π∑√’¬å„μâ‡Àß◊Õ°·≈–πÈ”≈“¬ À√◊Õ®“°∑—Èß Õß

∫√‘‡«≥„π°≈ÿà¡μ—«Õ¬à“ßÀ≈“¬‡™◊ÈÕ “¬‰¥â·°à ·Õø√‘°—π

Õ‡¡√‘°—π (African-Americans) ‡Õ‡™’Ë¬πÕ‡¡√‘°—π (Asian-

Americans) Œ‘ ·ªπ‘° (Hispanics) ·≈–§Õ‡§‡™’Ë¬π

(Caucasians) „π‡¡◊Õß≈Õ ·Õß‡®Õ≈‘ ª√–‡∑» À√—∞

Õ‡¡√‘°“ æ∫«à“§«“¡≈÷°¢Õß°√–‡ªÜ“ª√‘∑—πμå (periodontal

probing depth) ¡’§«“¡ —¡æ—π∏å∑“ß∫«°°—∫°“√æ∫‡™◊ÈÕ∑—Èß

6 ™π‘¥π’È ‡™◊ÈÕ “¬∑’Ë¡’§«“¡‡ ’Ë¬ßμàÕ°“√æ∫‡™◊ÈÕæÕ√å‰ø-

‚√‚¡·π ®‘π®‘«“≈‘ „ππÈ”≈“¬·≈–‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈—

·Õ§μ‘‚π‰¡ ‘‡μÁ¡‚§¡’·∑π å„π°√–‡ªÜ“ª√‘∑—πμå®“°¡“°‰ª

πâÕ¬ ‰¥â·°à Œ‘ ·ªπ‘° ‡Õ‡™’Ë¬πÕ‡¡√‘°—π·≈–·Õø√‘°—π

Õ‡¡√‘°—π μ“¡≈”¥—∫ à«πÕ“¬ÿπ—Èπ‰¡à —¡æ—π∏å°—∫Õ—μ√“°“√æ∫

‡™◊ÈÕ ∑’Ëπà“ π„®¡“°Ê §◊Õ‡™◊ÈÕ‡À≈à“π’È‰¡à‰¥â∂à“¬∑Õ¥·∫∫

‡¥’¬«°—∫‡™◊ÈÕ∑’Ë‡°’Ë¬«¢âÕß°—∫‚√§øíπºÿÕ¬à“ß ‡μ√Áª‚μ§Õ°-

§— ¡‘«·∑π å ·¡â«à“®–Õ¬Ÿà„π§√Õ∫§√—«‡¥’¬«°—π·≈– “¡“√∂

μ√«®æ∫‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈— ·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§¡’·∑π

„π ¡“™‘°∫“ß§π„π√–¥—∫∑’Ë Ÿß°Áμ“¡ ‚¥¬‡™◊ÈÕ·Õ§μ‘‚π-

∫“´‘≈≈— ·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§¡’·∑π¡’°“√ àßºà“π∑“ß

·π«πÕπ (horizontal transmission) √âÕ¬≈–14 ∂÷ß 60

·≈– ¡’°“√ àßºà“π„π·π«¥‘Ëß √âÕ¬≈– 30 ∂÷ß 60 ”À√—∫

‡™◊ÈÕæÕ√å‰ø‚√‚¡·π ®‘π®‘«“≈‘ π—Èπ‰¡àæ∫°“√∂à“¬∑Õ¥¿“¬

„π§√Õ∫§√—«·≈–‰¡àæ∫°“√ àßºà“π„π·π«πÕπ Õ¬à“ß‰√°Á

μ“¡§π„π§√Õ∫§√—«‡¥’¬«°—π®–¡’‰∫‚Õ‰∑ªá (biotype)

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187

·≈– ’‚√‰∑ªá (serotype) ‡¥’¬«°—π ·μà‰¡à∑√“∫«à“‡°‘¥°“√

àßºà“π‰¥âÕ¬à“ß‰√

·¡â¬—ß‰¡à “¡“√∂ √ÿª‰¥â Õ¬à“ß·πàπÕπ«à“√Õ¬§√“∫

’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫‡Àß◊Õ°π—Èπ‡°‘¥®“° “‡Àμÿ„¥

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„π°“√‡°‘¥‚√§„π™àÕßª“° ‰¡à«à“®–‡ªìπ‚√§øíπºÿÀ√◊Õ‚√§

ª√‘∑—πμå °Áμ“¡ ®—¥‡ªìπ‚√§∑’Ë¡’ “‡ÀμÿÀ≈“°À≈“¬

(multifactorial disease) ·μà°Áπà“®–¡’§«“¡‡ªìπ‰ª‰¥â Ÿß

∑’Ë‡™◊ÈÕ·Õ§μ‘‚π∫“´‘≈≈— ·Õ§μ‘‚π‰¡´‘‡μÁ¡‚§¡’·∑π å

®–‡°’Ë¬«¢âÕß°—∫°“√‡°‘¥√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ

¢Õ∫‡Àß◊Õ° ‚¥¬‰¡à®”‡ªìπ∑’ËºŸâªÉ«¬‡¥Á°®–μâÕß¡’‚√§‡Àß◊Õ°

Õ—°‡ ∫À√◊Õ‚√§ª√‘∑—πμå ”À√—∫‡™◊ÈÕæÕ√å‰ø‚√‚¡·π ®‘π®‘

«“≈‘ ®—¥‡ªìπ‡™◊ÈÕ∑’Ëæ∫‰¥â‡ªìπ§√—Èß§√“« (transient bacteria)

„π·ºàπ§√“∫®ÿ≈‘π∑√’¬å„π‡¥Á°™à«ßÕ“¬ÿ∑’Ë¡’øíπ™ÿ¥º ¡∂÷ß

√–¬–øíπ·∑â “¡“√∂æ∫√Õ¬§√“∫π’È‰¥â‚¥¬‰¡à —¡æ—π∏å°—∫

Õ“¬ÿ ‡æ√“–«à“‡™◊ÈÕ·∫§∑’‡√’¬ “¡“√∂‡ª≈’Ë¬π·ª≈ß‰¥â∂â“

¿“«–·«¥≈âÕ¡‡ª≈’Ë¬π‰ª Ÿà¿“«–∑’Ë‡À¡“–„π°“√‡®√‘≠

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∑’Ë§«∫§ÿ¡°“√º≈‘μ‡¡Á¥ ’„Àâ‰¡à∑”ß“ππ—Èπ¬—ß§ß¡’°“√«‘®—¬

»÷°…“°—πμàÕ‰ª ·μà‡ªìπ∑’Ëπà“ —ß‡°μ«à“ °“√ √â“ß√Õ¬§√“∫

∑’Ëμ‘¥·πàπ∫πæ◊Èπº‘«∑’Ë·¢Áß (solid surfaces) ‡™àπ º‘«·°â«

æ≈“ μ‘°·≈–‰Œ¥√Õ° ’Ë·ÕÁ∫ª“‰∑ (hydroxyapatite)

¥Ÿ‡À¡◊Õπ®–‡ªìπ‡Õ°≈—°…≥å‡©æ“–∫ÿ§§≈‡æ√“–∂÷ß·¡â«à“

®–¡“®“°§√Õ∫§√—«‡¥’¬«°—π ∫√‘‚¿§Õ“À“√·∫∫‡¥’¬«°—π

·μà°Á “¡“√∂æ∫√Õ¬§√“∫ ’¥”‰¥â„π∫“ß§π‡∑à“π—Èπ

”À√—∫ “‡ÀμÿÕ◊ËπÊ ∑’Ë°≈à“«∂÷ß¡“·≈â« Õ“® àß‡ √‘¡

„Àâ¡’ “√μ—Èßμâπ ‰¥â·°à ∏“μÿ‡À≈Á°∑’Ë¡“°¢÷Èπ ÷Ëß àßº≈„Àâ

“¡“√∂‡°‘¥°“√ √â“ß√Õ¬§√“∫ ’¥”∑’Ë¡“°¢÷Èπ‰¥â ‡æ√“–

©–π—Èπ¬—ß‰¡à¡’°“√ªÑÕß°—π‰¥â®√‘ßÊ °Á§ß‡ªìπ‡™àπ°√≥’‡¥’¬«

°—∫°“√‡°‘¥øíπºÿ ‘Ëß∑’Ë∑”‰¥â¥’∑’Ë ÿ¥°Á§◊Õ≈¥ªí®®—¬√à«¡

(predisposing factors) ∑’Ë‡√“ “¡“√∂§«∫§ÿ¡‰¥â ´÷ËßÕ“®

∑”„Àâ¡’°“√‡°‘¥¢÷Èπ„À¡à „πÕ—μ√“∑’Ë™â“≈ß‰¥â

∫∑∫“∑·≈–«‘∏’°“√√—°…“¢Õß∑—πμ·æ∑¬å∑—πμ·æ∑¬å§«√·π–π”°ÿ¡“√·æ∑¬å‡°’Ë¬«°—∫√Õ¬

§√“∫∫πøíπ ª√–‡¿∑√Õ¬§√“∫øíπÕ¬à“ß§√à“«Ê ·≈–°“√

àßμàÕºŸâªÉ«¬ ‡π◊ËÕß®“°°ÿ¡“√·æ∑¬åÕ“®‡ªìπ§π·√°∑’Ë®–‡ÀÁπ

√Õ¬§√“∫ ’¥”∫πøíπ πÕ°®“°π’È∑—πμ·æ∑¬å§«√„Àâ§«“¡√Ÿâ

ºŸâª°§√Õß‡°’Ë¬«°—∫ “‡Àμÿ·≈–°“√√—°…“ ·≈–∑’Ë ”§—≠∑’Ë ÿ¥

§◊Õ„Àâ§”·π–π”¥â“π ÿ¢Õπ“¡—¬ Õ“À“√ ‡™àπ Õ“À“√∑’Ë¡’

‚ª√μ’π Ÿß®–‡æ‘Ë¡§«“¡®ÿ¢Õß∫—ø‡øÕ√å„ππÈ”≈“¬ „π∑“ßμ√ß

°—π¢â“¡ Õ“À“√∑’Ë¡’§“√å‚∫‰Œ‡¥√μ Ÿß®–≈¥§«“¡®ÿ¢Õß

∫—ø‡øÕ√å„ππÈ”≈“¬≈ß À√◊ÕÀ≈’°‡≈’Ë¬ß°“√„™â§≈Õ√å‡Œ°´‘¥’π

‚¥¬‡©æ“–Õ¬à“ß¬‘Ëß‰¡à§«√„™â´È”„π√–¬–‡«≈“„°≈âÊ°—πÀ√◊Õ

„™âμàÕ°—π‡ªìπ‡«≈“π“π ·≈–°“√π—¥À¡“¬°≈—∫¡“‡æ◊ËÕ¢—¥

§√“∫π’ÈÕÕ° §«√ —ß‡°μ·≈–§Õ¬√–«—ß‡ ¡Õ„πºŸâªÉ«¬∑’Ë„™â

πÈ”¬“∫â«πª“°‚¥¬‡©æ“–§≈Õ√å‡Œ°´‘¥’π ”À√—∫°“√

·ª√ßøíππ—Èπ °“√·ª√ß«—π≈– 2 §√—Èß¥â«¬¬“ ’øíπ∏√√¡¥“

®–™à«¬ªÑÕß°—π·§à√Õ¬§√“∫øíπ·∫∫¿“¬πÕ°‡∑à“π—Èπ ‚¥¬

¬“ ’øíπ à«π„À≠à¡’ƒ∑∏‘ÏÕàÕπ ”À√—∫¬“ ’øíπ∫“ß™π‘¥∑’Ë¡’

“√øÕ° ’ À√◊Õºß¢—¥Õ“®®– “¡“√∂¢®—¥§√“∫ÕÕ°∫“ß

à«π‰¥â·μà‰¡à·π–π”„Àâ„™â∫àÕ¬Ê ‡æ√“–«à“Õ“®∑”„Àâøíπ ÷°

‰¥â ‡¡◊ËÕ¡’Õ“°“√‡≈◊Õ¥ÕÕ°∫√‘‡«≥‡Àß◊Õ°Õ¬à“ª≈àÕ¬∑‘Èß‰«â

‡æ√“–«à“∏“μÿ‡À≈Á°„π‡´≈≈å‡¡Á¥‡≈◊Õ¥·¥ß°Á‡ªìπμ—«‡ √‘¡

°àÕ„Àâ‡°‘¥°“√μ‘¥ ’∫πøíπ‰¥â Õ¬à“ª≈àÕ¬„Àâ¡’πÈ”≈“¬·Àâß

(xerostomia) ®“° “‡Àμÿμà“ßÊ ‡™àπ π‘Ë«¢ÕßμàÕ¡πÈ”≈“¬

∑’Ëμ‘¥‡™◊ÈÕ‡æ√“–∑”„ÀâπÈ”≈“¬‰À≈πâÕ¬≈ß ‚√§§“ß∑Ÿ¡·≈–

‚√§ÀŸ§Õ®¡Ÿ°Õ◊Ëπ Ê °“√„™â¬“∫“ß™π‘¥ (antihypertensives

antihistamines) °“√√—°…“¥â«¬√—ß ’∂“«√

«‘∏’°“√√—°…“∑”§«“¡ –Õ“¥‚¥¬‡§√◊ËÕß¢Ÿ¥À‘ππÈ”≈“¬Õ—≈μ√“‚´π‘°

À≈—ß®“°π—Èπ¢—¥øíπ¥â«¬À—«¬“ß·≈–ºß¢—¥‚¥¬ÕÕ°·√ß°¥

‡≈Á°πâÕ¬ §«√¡“æ∫∑—πμ·æ∑¬å∑ÿ° 2 ‡¥◊Õπ‡æ√“–«à“√Õ¬

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‡æ√“–Õ“®∑”∫πº‘«‡§≈◊Õ∫øíπ¡’√Õ¬¢’¥¢à«π‰¥â

‚¥¬ √ÿª√Õ¬§√“∫ ’¥”∫πøíπ∫√‘‡«≥‡Àπ◊Õ¢Õ∫

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°“√»÷°…“∑’Ëæ∫§«“¡ —¡æ—π∏å°—∫Õ—μ√“°“√‡°‘¥‚√§øíπºÿ

∑’ËπâÕ¬≈ßπ—Èπ Õ“®‡π◊ËÕß¡“®“°À≈“¬ “‡Àμÿ ·μà “‡Àμÿ

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188

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Õ“®π”‰ª Ÿà°“√√—°…“·∫∫∑¥·∑π (replacement of oral

pathogens) „π≈—°…≥–∑’Ë‡À¡◊Õπ°—∫‚ª√‰∫‚Õμ‘° å·∫§∑’‡√’¬

„π°“√√—°…“‚√§øíπºÿ (probiotic approach in caries

prophylaxis)32

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ª√– ‘∑∏‘¿“æ„π°“√μâ“π‡™◊ÈÕ·∫§∑’‡√’¬¢Õß‚ª√æÕ≈‘ μàÕ‡™◊ÈÕ‡ÕÁπ‡∑Õ‚√§Õ°§— øï§—≈≈‘ ·≈–‡™◊ÈÕæÕ√åøî‚√‚¡·π

®‘π®‘«“≈‘ 131

°“√®”·π°‡æ»§π‰∑¬¥â«¬¥—™π’øíπ‡¢’È¬« 141

¡∫—μ‘∑“ß°“¬¿“æ¢Õßª≈“ ‡μÕ√åÀ‘π∑’Ë®”Àπà“¬„πª√–‡∑»‰∑¬ 151

ø≈ŸÕÕ‰√¥å‡®≈·≈–ø≈ŸÕÕ‰√¥å«“√åπ‘™ 161

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B 192

Subject Index: Volume 31, 2011

Trend of tooth width of Bangkok residents 1

Potential sex identification of canine width in a group of Thais 15

Self perception and social influence on facial profile of the patients seeking for orthodontic treatment at

Orthodontic Clinic, Faculty of Dentistry, Mahidol University 25

The clinical comparison of sealant retention between resin-based fissure sealant with adhesive and glass

ionomer sealant on partially erupted second permanent molars 37

Effectiveness and safety of slim mixed cut ends bristle toothbrushes 47

The treatment of condylar fractured by applying closed reduction: A case report 57

Effect of noble metal primers on the microtensile bond strength of resin cements to zirconia 65

Effect of denture cleanser containing longan-extract granules on color stability, surface roughness and hardness

of a polymeric denture base material 73

Using cone-beam computerized tomography before initiation intentional endodontic treatment 81

Apoptotic induction of Boesenbergia pandurata extract on oral squamous carcinoma cells 89

Factors influencing oral health care products consuming behavior of patients in dental clinic (Special clinic)

at Faculty of Dentistry Mahidol University 101

The influences of parental anxiety on level of dental fear/anxiety in a group of Thai children 111

Cephalometric assessment in anterior open bite patients treated woth and without mini-implant anchorages 121

Antimicrebial Efficacy of Propolis against Enterococcus faeclis and Porphyromonas gingivalis 131

Sexual dimorphism in Thais using canine index 141

Physical properties of dental stones available in Thailand 151

Fluoride gel and Fluoride varnish 161

Black stains in children: An update 175

B 193

°π°«√√≥ æ—≤π‰æ√ ≥±å 47

°¡≈“ «ÿ≤‘ “√«—≤π“ 65

°Õß°“≠®πå æ√ Ÿß àß 47

°—≈¬“ »ÿæÿ∑∏¡ß§≈ 151

¢®√‡°’¬√μ‘ ‡®π∫¥‘π∑√å 89

‡¢Á¡∑Õß ¡‘μ√°Ÿ≈ 111, 175

®‘πμπ“ “√–∫√√®ß 131

®ÿ±“√—μπå ‡™’Ë¬««“π‘™ 25

®ÿÃ“≈—°…≥å °…μ√ ÿ«√√≥ 47

™π—≠∏√ ∑Õß ≈ÿ°«ß»å 89

™≈“∏‘ª ™¡æŸπÿ™ ≥ Õ¬ÿ∏¬“ 111

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™‘μ«≈’ ≈’μ√–°Ÿ≈«√√≥“ 81

≥—∞°“πμå ‰μ√μ“ππ∑å 111

≥—∞«√√∏πå æ’√∑—μ‡«™°ÿ≈ 101

¥πÿ™‘…≥å æπ¡¬ß§å 81

∑«’æß»å Õ“√¬–æ‘»‘…∞ 15, 89, 141

∑‘æπ“∂ «‘™≠“≥√—μπå 161

∏π‘¬“ À¡«¥‡™’¬ß§– 131

ππ∑‘π’ μ—Èß‡®√‘≠¥’ 47

π≈‘π’ Õÿ¥¡™—¬ °ÿ≈ 73

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π‘μ¬“ ‡æÁß√—°…å 25

π‘æ‘∞ ÿ¿“®“√ÿæ—π∏å 141

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ªï¬å‡¡∏ ∫ÿ≠¡’¢“« 1

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æß»∏√ æŸà∑Õß§” 121

æ®¡“π »√’π«√—μπå 151

æ√æ®πå ‡øóòÕß∏“√∑‘æ¬å 1

æ’√»ÿ…¡å √Õ¥Õπ—πμå 101

‡æÁ≠ª√–¿“ ™‘«™√—μπå 121

¡“≈’ Õ√ÿ≥“°Ÿ√ 111

¬ÿ«¥’ Õ—»«π—π∑å 111

√«‘π—π∑å ¡—Ëß§ß 89

√–«’«√√≥ Õ“√¬– —πμ‘¿“æ 81

¥√√™π’ºŸâ·μàß: ªï∑’Ë 31, æ.». 2554

≈’√«√√≥ ∫Ÿ√≥®√√¬“°ÿ≈ 111

«‘¿“¥“ ‡≈‘»ƒ∑∏‘Ï 1

«π‘¥“ »√’‰æ‚√®πå∏‘°Ÿ≈ 15, 89, 141

«√“π—π∑å ∫—«®’∫ 73

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»»‘¿“ ∏’√¥‘≈° 25

¡™—¬ ¡‚πæ—≤π°ÿ≈ 1

¡™“¬ Õÿ√æ’æ≈ 65

ÿæ—≤™—¬ ∫ÿ≠ª√–∂—¡¿å 25,121

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ÿ√—μπå ¡ß§≈™—¬Õ√—≠≠“ 47

ÿ«√√≥’ ≈—¿π–æ√≈“¿ 121

À¬“¥æ‘√ÿ≥ ®‘√«—≤π°ÿ≈ 89

Õ—§√‘π ¿“πÿ ∂‘μ¬å 141

Õ“√’√—μπå º≈‘μππ∑å‡°’¬√μ‘ 47

Õ‘∑∏‘°√ ·´à≈âÕ 1

B 194

Akkarin Panusatid 141

Areerat Phalitnonkiat 47

Busayarat Santiwong 37

Chalatip Chompunud Na Ayudthaya 111

Chanunthorn Thongsagulwong 89

Chatcharee Suchatlampong 151

Chitvaree Leetrakulwanna 81

Danuchit Banomyong 81

Ittigon Law 1

Jintana Sarabunchong 131

Julalux Kasetsuwan 47

Jutharat Chiewvanich 25

Kajohnkiart Janebodin 89

Kallaya Suputtamongkol 151

Kamala Wootthisarnwatthana 65

Kanokwan Pattanapraison 47

Kemthong Mitrakul 111, 175

Kongkarn Pornsoongsong 37

Leerawan Buranajanyakul 111

Malee Arunakul 111

Naiwinit Somsuktaweekoon 141

Nalinee Udomchaisakul 73

Nattakan Traitanon 111

Nipit Supajarupan 141

Nittaya Pengrux 25

Nontinee Tangchareondee 47

Nuttawat Peeratatavetkul 101

Pemet Boonmegaew 1

Penprapa Chiewcharat 121

Pirasut Rodanant 101

Pongstit Bundit 141

Pongstorn Putongkam 121

Pornpoj Fuangtharnthip 1

Potchaman Sinavarat 151

Raweewan Arayasantiparb 81

Rawinun Munkong 89

Author Index: Volume 31, 2011

Sasipa Thiradilok 25

Somchai Manopatanakul 1

Somchai Urapepon 65

Supatchai Boonprathum 25, 121

Surachai Kertsurasakda 57

Surat Mongkilnchai-aranya 47

Suwannee Luppanapornlarp 121

Tawepong Arayapisit 15, 89, 141

Thaniya Muadcheingka 131

Tippanart Vichayanrat 161

Wanida Sripaifohthikoon 15, 89, 141

Waranun Buajeeb 73

Widchaya Kanchanavasita 73

Wikul Visalseth 47

Wipada Lertrid 1

Yardpiroon Jirawattanakul 89

Yuwadee Asvanund 111

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1. ‡æ◊ËÕ‡º¬·æ√à§«“¡√Ÿâ∑’Ë‰¥â®“°°“√«‘®—¬À√◊Õ»÷°…“§âπ§«â“∑“ß«‘™“°“√¥â“π∑—πμ·æ∑¬»“ μ√å ·≈– “¢“«‘™“«‘∑¬“»“ μ√å°“√·æ∑¬å∑’Ë‡°’Ë¬«¢âÕß2. ‡æ◊ËÕ àß‡ √‘¡ π—∫ πÿπß“π«‘®—¬ ·≈–°“√§âπ§«â“∑’Ë¡’§ÿ≥§à“‡æ◊ËÕ§«“¡°â“«Àπâ“∑“ß«‘™“°“√3. ‡æ◊ËÕ‡ªìπ ◊ËÕ —¡æ—π∏å∑“ß«‘™“°“√√–À«à“ß∑—πμ·æ∑¬å ·≈–ºŸâÕ◊Ëπ„π “¢“«‘™“∑’Ë‡°’Ë¬«¢âÕß„Àâ°â“«∑—π°“√‡ª≈’Ë¬π·ª≈ß§«“¡√Ÿâ∑’Ë¡’°“√æ—≤π“μ≈Õ¥‡«≈“4. ‡æ◊ËÕ‡º¬·æ√à‡°’¬√μ‘§ÿ≥¢Õß ∂“∫—π«‘∑¬“ “√π’È‰¥â√—∫∑ÿπÕÿ¥Àπÿπ®“°§≥–∑—πμ·æ∑¬»“ μ√å ¡À“«‘∑¬“≈—¬¡À‘¥≈

§”·π–π” ”À√—∫ºŸâπ‘æπ∏å∫∑§«“¡°“√ àß∫∑§«“¡‡æ◊ËÕμ’æ‘¡æå∑’Ë

∫√√≥“∏‘°“√«‘∑¬“ “√∑—πμ·æ∑¬»“ μ√å¡À‘¥≈ Àπà«¬ àß‡ √‘¡æ—≤π“∑“ß«‘™“°“√ μ÷° 4 ™—Èπ 9

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√Ÿª·∫∫∫∑§«“¡1. ∫∑«‘∑¬“°“√ (Original article) ‰¥â·°à √“¬ß“πº≈ß“π«‘®—¬„À¡à À√◊Õ√“¬ß“π°“√ ”√«®∑“ß√–∫“¥«‘∑¬“ ∑’Ë¡’ª√–‚¬™πåμàÕ«‘™“™’æ

∑—πμ·æ∑¬å´÷Ëß‰¡à‡§¬μ’æ‘¡æå„π«‘∑¬“ “√„¥ Ê ¡“°àÕπ2. ∫∑§«“¡ª√‘∑—»πå (Review article) ‰¥â·°à ∫∑§«“¡∑’Ë√«∫√«¡§«“¡√Ÿâ®“°μ”√“ Àπ—ß ◊Õ À√◊Õ«‘∑¬“ “√„À¡à À√◊Õ®“°º≈ß“π·≈–

ª√– ∫°“√≥å¢ÕßºŸâπ‘æπ∏å¡“‡√’¬∫‡√’¬ß¢÷Èπ ‚¥¬¡’°“√«‘‡§√“–Àå «‘®“√≥å ‡ª√’¬∫‡∑’¬∫ ‡æ◊ËÕ„Àâ‡°‘¥§«“¡≈÷°´÷ÈßÀ√◊Õ‡°‘¥§«“¡°√–®à“ß„π‡√◊ËÕßπ—Èπ¡“°¬‘Ëß¢÷Èπ3. √“¬ß“πºŸâªÉ«¬ (Care report) ‰¥â·°à √“¬ß“π°√≥’»÷°…“¢ÕßºŸâªÉ«¬´÷Ëß§√Õ∫§≈ÿ¡∂÷ß≈—°…≥–Õ“°“√‡∑§π‘§°“√«‘π‘®©—¬‚√§ √«¡∑—Èß°“√

μ‘¥μ“¡ª√–‡¡‘πº≈°“√√—°…“4. ª°‘≥°– (Miscellany) ‰¥â·°à ∫∑§«“¡∑—Ë«‰ª ¢âÕ§‘¥‡ÀÁπ‡ πÕ·π– ‡ªìπ√“¬ß“π —Èπ Ê ∑“ß«‘™“°“√∑’Ë‡°’Ë¬«°—∫∑—πμ·æ∑¬å À√◊Õ∫∑§«“¡

∑∫∑«π§«“¡√Ÿâ ‡√◊ËÕß·ª≈ ¬àÕ§«“¡®“°«‘∑¬“ “√μà“ßª√–‡∑»°“√‡μ√’¬¡∫∑§«“¡

(‡√‘Ë¡„™âμ—Èß·μà ªï∑’Ë 30 ©∫—∫∑’Ë 1 æ.». 2553 ‡ªìπμâπ‰ª)1. μâπ©∫—∫ àßμâπ©∫—∫ 1 ™ÿ¥ ”‡π“ 4 ™ÿ¥ ‰¡àμâÕß‡¬Á∫°√–¥“… „™â§≈‘ªÀπ’∫¡“‡ªìπ™ÿ¥ Ê ”À√—∫¿“æª√–°Õ∫·≈–μ“√“ß àß®”π«π 3 ™ÿ¥

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2. ¿“…“ „™â¿“…“‰∑¬À√◊Õ¿“…“Õ—ß°ƒ…°Á‰¥â À“°‡ªìπ∫∑§«“¡¿“…“‰∑¬„Àâ„™âμ—« –°¥μ“¡æ®π“πÿ°√¡©∫—∫√“™∫—≥±‘μ¬ ∂“π (©∫—∫≈à“ ÿ¥ªï æ.». 2542) À“°‡ªìπ∫∑§«“¡¿“…“Õ—ß°ƒ…μâÕßºà“π°“√μ√«® Õ∫®“°‡®â“¢Õß¿“…“π—Èπ Ê °àÕπ‡æ◊ËÕ§«“¡∂Ÿ°μâÕß°àÕπ àßμ’æ‘¡æå °“√„™âμ—«‡≈¢„π∫∑§«“¡ „Àâ„™â‡≈¢Õ“√∫‘°‡∑à“π—Èπ

3. Àπà«¬¡“μ√∞“π°“√«—¥ (unit of measurement) ‰¥â·°à Àπà«¬¢Õß§«“¡¬“« §«“¡ Ÿß πÈ”Àπ—° ª√‘¡“μ√ ‡ªìπμâπ §«√„™â√–∫∫‡¡μ√‘° (metric units) Õÿ≥À¿Ÿ¡‘§«√„™â‡ªìπÕß»“‡´≈‡ ’¬ §«“¡¥—π§«√„™â‡ªìπ¡‘≈≈‘‡¡μ√ª√Õ∑ (¡¡.ª√Õ∑) °“√«—¥∑“ß‚≈À‘μ (hematologic) ·≈–∑“ß‡§¡’§≈‘π‘°(clinical chemistry) §«√„™âÀπà«¬‡ªìπ√–∫∫‡¡μ√‘° Àπà«¬°“√«—¥Õ◊Ëπ Ê §«√„™â·∫∫¡“μ√∞“π “°≈π‘¬¡ §”¬àÕ·≈– —≠≈—°…≥å„™â‡©æ“–§”¬àÕ¡“μ√∞“π (stan-dard abbreviation) ‰¡à§«√„™â§”¬àÕ„π™◊ËÕ‡√◊ËÕß·≈–∫∑§—¥¬àÕ ‡™àπ «‘π“∑’ (sec.) π“∑’ (min.) §”‡μÁ¡¢Õß§”¬àÕ§«√Õâ“ß‰«âμàÕ∑â“¬§”¬àÕ§√—Èß·√°„π‡π◊ÈÕ‡√◊ËÕß ¬°‡«âπ‡ªìπÀπà«¬¡“μ√∞“π„π°“√«—¥ °“√√–∫ÿ´’Ëøíπ Õ“®„™â°“√‡√’¬°™◊ËÕÕ¬à“ß‡¥’¬« ‡™àπ øíπ‡¢’È¬«∫π´â“¬ (À√◊Õ upper left canine „π∫∑§«“¡¿“…“Õ—ß°ƒ…) À√◊Õ„™â —≠≈—°…≥åμ“¡√–∫∫ FDI two-digit notation ·≈–¡’™◊ËÕ„π«ß‡≈Á∫μàÕ∑â“¬‡©æ“–§√—Èß·√°∑’Ë°≈à“«∂÷ß ‡™àπ øíπ ’Ë 31 (øíπμ—¥´’Ë°≈“ß≈à“ß´â“¬)

4. ¿“æª√–°Õ∫ (Figure) ™◊ËÕ·≈–§”∫√√¬“¬„Àâæ‘¡æå„μâ¿“æ ·≈–μ“¡∑’ËÕâ“ß∂÷ß„π∫∑§«“¡‡ªìπ¿“…“Õ—ß°ƒ…‡∑à“π—Èπ‚¥¬‡√’¬ßμ“¡≈”¥—∫¿“æ·≈–„™âμ—«‡≈¢Õ“√∫‘° æ‘¡æå„π°√–¥“…·¬°·ºàπμà“ßÀ“°®“°‡π◊ÈÕ‡√◊ËÕß¢Õß∫∑§«“¡ —≠≈—°…≥å ≈Ÿ°»√ μ—«Õ—°…√„π¿“æ§«√‡ÀÁπ‰¥â™—¥‡®π ‡«âπ∑’Ë«à“ß„π‡π◊ÈÕ‡√◊ËÕßæ√âÕ¡∑—Èß‡¢’¬π·®âß‰«â„π°√Õ∫ ¥—ßμ—«Õ¬à“ß

¿“æ∂à“¬ „™â‰¥â∑—Èß¿“æ ’À√◊Õ¢“«¥” „π°√≥’‡ªìπ¿“æ∂à“¬„ÀâÕ—¥¥â«¬°√–¥“…¡—π¢π“¥ 8.9X14 ´¡. (‚ª °“√å¥) ·≈–¿“æ∂à“¬μâÕß™—¥‡®π§«√∫Õ°™◊ËÕ‡√◊ËÕß ™◊ËÕºŸâ‡¢’¬π À¡“¬‡≈¢μ“¡≈”¥—∫¢Õß¿“æ·≈–∑”‡§√◊ËÕßÀ¡“¬· ¥ß¢Õ∫∫π¢Õß¿“æ·≈–„ à´Õß·¬°μà“ßÀ“° °√≥’‡ªìπ¿“æ·∫∫¥‘®‘∑μÕ≈(digital) §«√¡’·øÑ¡¢âÕ¡Ÿ≈·¬°μà“ßÀ“°‰¡à§«√ Õ¥·∑√°„π‡π◊ÈÕ‡√◊ËÕß ‚¥¬„™â√Ÿª·∫∫„¥°Á‰¥â ‡™àπ (gps, fpg) μâÕß “¡“√∂‡ªî¥‰¥â¥â«¬‚ª√·°√¡®—¥°“√¿“æ(adobe photoshop) ·≈–§«√∫—π∑÷°¿“æ≈ß„π·ºàπ∫—π∑÷° (diskette) À√◊Õ ´’¥’√Õ¡ (CD ROM) ¥â«¬§«“¡≈–‡Õ’¬¥¢Õß¿“æ‰¡àπâÕ¬°«à“ 300 ¥’æ’‰Õ (dpi)°√≥’¿“æ≈“¬‡ âπ °√“ø À√◊Õ·ºπ¿Ÿ¡‘ „Àâ‡¢’¬πÀ√◊Õæ‘¡æå≈ß∫π°√–¥“…¡—π §«√„™âÀ¡÷° ’¥” ·≈–μâÕß¡’§”∫√√¬“¬·°πμ—Èß (ordinate) ·≈–·°ππÕπ (abscissa)

5. ¿“æ√—ß ’ „Àâ∂à“¬√Ÿª®“°øî≈å¡‡Õ°´‡√¬åμâπ©∫—∫‡ ’¬°àÕπ ·≈â«π”‰ªÕ—¥‡ªìπ¿“æ¢“«-¥” ‰¡à§«√Õ—¥¿“æ®“°øî≈å¡‡Õ°´‡√¬å ‡æ√“–®–‰¥â¿“æ∑’Ëº‘¥®“°§«“¡‡ªìπ®√‘ß ·≈–‰¡à§«√π”¿“æ√—ß ’‰ª°√“¥¿“æ (scan) ‡æ◊ËÕ·ª≈ß‡ªìπ¿“æª√–°Õ∫√Ÿª·∫∫¥‘®‘μÕ≈

6. μ“√“ß (Table)1. μâÕß∑”μ“√“ß·¬°μà“ßÀ“°®“°‡π◊ÈÕ‡√◊ËÕß ‚¥¬æ‘¡æåÀπâ“≈– 1 μ“√“ß ‡«âπ∑’Ë«à“ß„π‡π◊ÈÕ‡√◊ËÕßæ√âÕ¡∑—Èß‡¢’¬π·®âß‰«â„π°√Õ∫ §”Õ∏‘∫“¬¿“æ„™â

¿“…“Õ—ß°ƒ…2. μâÕß¡’™◊ËÕ (Title) ∑’Ë —Èπ ◊ËÕ‡π◊ÈÕÀ“¢Õßμ“√“ß ¡’‡≈¢°”°—∫μ“¡≈”¥—∫∑’ËÕâ“ß∂÷ß„π∫∑§«“¡ „Àâæ‘¡æå‡Àπ◊Õμ“√“ß §”∫√√¬“¬μ“√“ß„Àâæ‘¡æå

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3. ‡™‘ßÕ√√∂ (Footnote) „μâμ“√“ß ∫√√¬“¬§”¬àÕ —≠≈—°…≥å À√◊Õ‡§√◊ËÕßÀ¡“¬∑’Ëª√“°Ø„πμ“√“ß μ≈Õ¥®π§à“∑¥ Õ∫∑“ß ∂‘μ‘ (∂â“¡’) Õ¬à“ß§√∫∂â«π ‡™‘ßÕ√√∂‰¡à§«√„™â‡≈¢°”°—∫‡æ√“–Õ“® —∫ π°—∫‡≈¢°”°—∫¢Õß‡Õ° “√Õâ“ßÕ‘ß „Àâ„™â‡ªìπ —≠≈—°…≥å μ—«Õ¬à“ß ‡™àπ *, +, #, ** ‡ªìπμâπ

4. ‰¡àμâÕß¡’‡ âπ¥‘Ëß·≈–‡ âπ¢«“ß„πμ“√“ß ‰¡àμâÕß¡’°√Õ∫μ“√“ß°“√„™â¿“æª√–°Õ∫∑’Ë¡“®“°·À≈àßÕ◊Ëπ μâÕß¡’Àπ—ß ◊Õ§”¬‘π¬Õ¡®“°‡®â“¢Õß¿“æÀ√◊ÕºŸâ∂◊Õ≈‘¢ ‘∑∏‘Ï¿“æ ·≈–‡¢’¬π°”°—∫‰«â

√Ÿª·∫∫¢Õß°“√‡μ√’¬¡∫∑«‘∑¬“°“√ à«π∑’ËÀπ÷Ëß ∫∑§«“¡«‘∑¬“°“√§«√ª√–°Õ∫¥â«¬À—«¢âÕμà“ß Ê ¥—ßμàÕ‰ªπ’È1. ™◊ËÕ‡√◊ËÕß (Title) §«“¡¬“« ‰¡à‡°‘π 100 μ—«Õ—°…√ §«√¡’≈—°…≥–‡ªìπ¢âÕ§«“¡°√–™—∫ ◊ËÕ§«“¡À¡“¬¢Õß‡√◊ËÕßÕ¬à“ß™—¥‡®π2. ™◊ËÕºŸâπ‘æπ∏å (Author) ™◊ËÕ·≈–π“¡ °ÿ≈‡∑à“π—Èπ ∂â“¡’ºŸâ‡¢’¬πÀ≈“¬§π„Àâ‡√’¬ß≈”¥—∫§«“¡ ”§—≠μàÕ‡√◊ËÕß√“¬≈–‡Õ’¬¥‡°’Ë¬«°—∫ºŸâ‡¢’¬π ‡™àπ

«ÿ≤‘°“√»÷°…“ μ”·Àπàß∑“ß«‘™“°“√ ∂“∫—π∑’Ë∑”ß“π À√◊Õ∑’ËÕ¬Ÿà∑’Ëμ‘¥μàÕ‰¥â –¥«°3. ºŸâπ‘æπ∏å´÷Ëß√—∫º‘¥™Õ∫μ‘¥μàÕ‡°’Ë¬«°—∫∫∑§«“¡ (Correspondence author) ¡’™◊ËÕºŸâπ‘æπ∏å‡æ’¬ß§π‡¥’¬« π“¡ °ÿ≈ μ”·Àπàß∑“ß

«‘™“°“√ ∂“π∑’Ë∑”ß“π À¡“¬‡≈¢‚∑√»—æ∑å∑’Ë∑”ß“π À¡“¬‡≈¢‚∑√»—æ∑å¡◊Õ∂◊Õ ‚∑√ “√ √«¡∑—ÈßÕ’‡¡≈å (E-mail) ∑’Ë “¡“√∂μ‘¥μàÕ‰¥â –¥«°·≈–√«¥‡√Á«4. ·À≈àß‡ß‘π∑ÿπ (Research grant) „Àâ∫Õ°√“¬≈–‡Õ’¬¥ ·À≈àß∑ÿπ π—∫ πÿπ°“√»÷°…“ ‡√’¬ßμ“¡≈”¥—∫¥—ßπ’È ™◊ËÕ∑ÿπ ™◊ËÕ ∂“∫—π∑’Ë„Àâ∑ÿπ

ªï∑’Ë‰¥â√—∫∑ÿπ À¡“¬‡≈¢¢Õß∑ÿπ«‘®—¬ (∂â“¡’) à«π∑’Ë Õß ¡’√“¬≈–‡Õ’¬¥¥—ßπ’È1. ∫∑§—¥¬àÕ (Abstract) ¡’§«“¡¬“«‰¡à‡°‘π 250 §” ª√–°Õ∫¥â«¬À—«¢âÕ¥—ßπ’È

- «—μ∂ÿª√– ß§å (Objective) ®ÿ¥¡ÿàßÀ¡“¬¢Õß°“√»÷°…“√«¡∑—ÈßÕâ“ß∂÷ß ¡¡μ‘∞“π¢Õß°“√»÷°…“- «— ¥ÿÕÿª°√≥å·≈–«‘∏’°“√»÷°…“ (Materials and methods) «— ¥ÿÕÿª°√≥åÀ√◊ÕºŸâªÉ«¬∑’Ëπ”¡“»÷°…“ ®”π«π ™π‘¥ ª√–‡¿∑ «‘∏’°“√»÷°…“

À√◊Õ«‘∏’°“√∑¥≈Õß ·≈– ∂‘μ‘∑’Ëπ”¡“„™â- º≈°“√»÷°…“ (Results) º≈∑’Ë‰¥â®“°°“√»÷°…“∑¥≈Õß ·≈–°“√«‘‡§√“–Àå∑“ß ∂‘μ‘- ∫∑ √ÿª (Conclusion) º≈°“√»÷°…“∑’Ë ”§—≠∑’Ë‰¥â®“°°“√∑¥≈Õß- √À— §” (Key words) 3-6 §” „Àâ‡√’¬ß§” ”§—≠μ“¡Õ—°…√·≈–∂â“‡ªìπ¿“…“Õ—ß°ƒ…§—Ëπ¥â«¬‡§√◊ËÕßÀ¡“¬®ÿ≈¿“§ (,)- °“√‡μ√’¬¡∫∑§«“¡ª√‘∑—»πå „π°“√‡¢’¬π∫∑§—¥¬àÕ§«√¡’À—«¢âÕ¥—ßπ’È

- «—μ∂ÿª√– ß§å (Objective) ®ÿ¥¡ÿàßÀ¡“¬¢Õß°“√»÷°…“√«¡∑—ÈßÕâ“ß∂÷ß ¡¡μ‘∞“π¢Õß°“√»÷°…“- √À— §” (Key words) 3-6 §”„Àâ‡√’¬ß§” ”§—≠μ“¡Õ—°…√·≈–§—Ëπ¥â«¬‡§√◊ËÕßÀ¡“¬®ÿ≈¿“§ (,)

à«π∑’Ë “¡ ‡π◊ÈÕ‡√◊ËÕßæ‘¡æå‡ªìπ¿“…“‰∑¬À√◊ÕÕ—ß°ƒ…°Á‰¥âÀ—«¢âÕ¢Õß‡π◊ÈÕ‡√◊ËÕßæ‘¡æå„Àâ™‘¥À—«·∂«´â“¬¡◊Õ ÿ¥ ·μà≈–À—«¢âÕ„Àâ¢÷Èπ°√–¥“…·ºàπ„À¡à ´÷Ëß∫∑«‘∑¬“°“√ ·≈–∫∑§«“¡ª√‘∑—»πå®–„™âÀ—«¢âÕ‡À¡◊Õπ°—π∑ÿ°ª√–°“√ ‚¥¬

‡√’¬ß≈”¥—∫À—«¢âÕ¢Õß‡π◊ÈÕ‡√◊ËÕß¥—ßπ’È1. ∫∑π” (Introduction) ‡ªìπ à«π°≈à“«π”‚¥¬Õ“»—¬°“√μ√«®‡Õ° “√ ¢âÕ¡Ÿ≈®“°√“¬ß“π«‘®—¬ §«“¡√Ÿâ ·≈–À≈—°∞“πμà“ß Ê ®“°Àπ—ß ◊ÕÀ√◊Õ

«‘∑¬“ “√∑’Ë‡°’Ë¬«¢âÕß°—∫‡√◊ËÕß∑’Ë»÷°…“ ·≈–°≈à“«∂÷ß‡Àμÿº≈À√◊Õ§«“¡ ”§—≠¢Õßªí≠À“„π°“√»÷°…“ ¡¡μ‘∞“π¢Õß°“√»÷°…“ μ≈Õ¥®π«—μ∂ÿª√– ß§å¢Õß°“√»÷°…“„Àâ™—¥‡®π ¢Õ∫‡¢μ ·≈–«‘∏’°“√¥”‡π‘π°“√«‘®—¬ §«√¡’°“√°≈à“«Õâ“ß∂÷ß∫∑§«“¡À√◊Õ‡Õ° “√∑’Ë‡°’Ë¬«¢âÕß°—∫‡√◊ËÕß∑’Ë°”≈—ß∑”°“√«‘®—¬ ‡æ◊ËÕ· ¥ß§«“¡ —¡æ—π∏å¢Õßß“π∑’Ë‡ πÕ„π∫∑§«“¡π’È°—∫§«“¡√Ÿâ‡¥‘¡‡∑à“∑’Ë∑√“∫°—πÕ¬Ÿà ‡ªìπ à«π¢Õß∫∑§«“¡∑’Ë∫Õ°‡Àμÿº≈ π”‰ª Ÿà°“√»÷°…“ ·μà‰¡àμâÕßμ√«®‡Õ° “√ (Litera-ture Review) ∑’Ë‰¡à‡°’Ë¬«°—∫®ÿ¥¡ÿàßÀ¡“¬¢Õß°“√»÷°…“ §«√‡ªìπ à«π∑’ËÕ∏‘∫“¬„ÀâºŸâÕà“π√Ÿâ«à“®–μÕ∫§”∂“¡Õ–‰√ „Àâ√«¡«—μ∂ÿª√– ß§å¢Õß°“√»÷°…“‡ªìπ√âÕ¬·°â«„π à«π∑â“¬¢Õß∫∑π” ·μà‰¡àμâÕß‡¢’¬πº≈°“√»÷°…“·≈– √ÿª

2. «— ¥ÿÕÿª°√≥å·≈–«‘∏’°“√»÷°…“ (Materials and methods) °≈à“«∂÷ß√“¬≈–‡Õ’¬¥¢Õß«— ¥ÿÕÿª°√≥å ™◊ËÕ‡§¡’¿—≥±å ·À≈àß∑’Ë¡“ ≈—°…≥–‡©æ“–À√◊Õ√“¬≈–‡Õ’¬¥¢ÕßÕÿª°√≥å‡§√◊ËÕß¡◊Õ‡§√◊ËÕß„™âμà“ß Ê ¢—ÈπμÕπ¢Õß°“√∑¥≈Õß ¡“μ√°“√∑’Ë„™â»÷°…“ «‘∏’°“√‡°Á∫¢âÕ¡Ÿ≈ «‘∏’°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ ·≈– ∂‘μ‘∑’Ëπ”¡“„™â«‘‡§√“–Àå¢âÕ¡Ÿ≈

3. º≈°“√»÷°…“ (Results) · ¥ßº≈∑’Ë‰¥â®“°°“√»÷°…“∑¥≈Õß·≈–«‘‡§√“–Àåº≈ §«√®”·π°ÕÕ°‡ªìπÀ¡«¥À¡Ÿà·≈– —¡æ—π∏å°—∫«—μ∂ÿª√– ß§å¢Õß°“√»÷°…“ §«√„™â¿“æª√–°Õ∫ μ“√“ß °√“ø À√◊Õ·ºπ¿Ÿ¡‘·ª≈§«“¡À¡“¬¢Õßº≈∑’Ë§âπæ∫À√◊Õ«‘‡§√“–Àå Õ¬à“ß„¥Õ¬à“ßÀπ÷Ëß √ÿª‡ª√’¬∫‡∑’¬∫°—∫ ¡¡ÿμ‘∞“π∑’Ë«“ß‰«â μ“¡«‘∏’∑“ß ∂‘μ‘∑’Ë«‘‡§√“–Àå

4. ∫∑«‘®“√≥å (Discussion) «‘®“√≥å‰¥âμ—Èß·μà«—μ∂ÿª√– ß§å ¡¡ÿμ‘∞“π¢Õß°“√«‘®—¬ º≈∑’Ë‰¥â®“°°“√»÷°…“‡À¡◊ÕπÀ√◊Õ·μ°μà“ß‰ª®“°º≈ß“π∑’Ë¡’ºŸâ√“¬ß“π‰«â°àÕπÀ√◊Õ‰¡à Õ¬à“ß‰√ ‡æ√“–‡Àμÿ„¥®÷ß‡ªìπ‡™àππ—Èπ ‡æ◊ËÕ„Àâ¡’§«“¡‡¢â“„®À√◊Õ‡°‘¥§«“¡√Ÿâ„À¡à∑’Ë‡°’Ë¬«¢âÕß°—∫ß“π«‘®—¬π—Èπ √«¡∑—Èß¢âÕ¥’ ¢âÕ‡ ’¬¢Õß«— ¥ÿÕÿª°√≥å·≈–«‘∏’°“√ ‡ πÕ·π–§«“¡§‘¥‡ÀÁπ„À¡à Ê ªí≠À“μà“ß Ê ∑’Ë‰¥â®“°°“√»÷°…“∑¥≈Õß§√—Èßπ’È

5. ∫∑ √ÿª (Conclusion) º≈‚¥¬¬àÕ¢Õß°“√»÷°…“ º≈∑’Ë‰¥âμ√ß°—∫«—μ∂ÿª√– ß§å°“√«‘®—¬À√◊Õ‰¡à6. °‘μμ‘°√√¡ª√–°“» (Acknowledgements) °≈à“«¢Õ∫§ÿ≥μàÕÕß§å°√ Àπà«¬ß“π À√◊Õ∫ÿ§§≈∑’Ë„Àâ§«“¡™à«¬‡À≈◊Õ√à«¡¡◊Õ„π°“√«‘®—¬7. ‡Õ° “√Õâ“ßÕ‘ß (References) „ àμ—«‡≈¢Õ“√∫‘°À≈—ß¢âÕ§«“¡À√◊ÕÀ≈—ß™◊ËÕ∫ÿ§§≈‡®â“¢Õß¢âÕ§«“¡∑’ËÕâ“ß∂÷ß „ÀâÕâ“ßÕ‘ß¥â«¬μ—«‡≈¢∑’Ë‡ªìπμ—«¬°

(superscript) À≈—ß¢âÕ§«“¡ ´÷Ëß‡√’¬ßÀ¡“¬‡≈¢ 1, 3, 6 À√◊ÕÀ¡“¬‡≈¢ 1-3 ™‘¥´â“¬‡ ¡Õ·≈–‰¡àμâÕß„ à«ß‡≈Á∫ ‡√’¬ßμ“¡≈”¥—∫°àÕπÀ≈—ß∑’Ë°≈à“«∂÷ß„π∫∑§«“¡∂â“μâÕß°“√Õâ“ßÕ‘ß´È”„Àâ„™âÀ¡“¬‡≈¢‡¥‘¡

°“√‡¢’¬π‡Õ° “√Õâ“ßÕ‘ß „™â°“√Õâ“ßÕ‘ßμ“¡√–∫∫·«π§Ÿ‡«Õ√å (Vancouver system) ™◊ËÕ«“√ “√„Àâ„™â™◊ËÕ¬àÕμ“¡√Ÿª·∫∫°“√‡¢’¬πÕâ“ßÕ‘ß„π Pubmed(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) „π°√≥’∑’Ë™◊ËÕ¬àÕ«“√ “√‰¡àª√“°Ø„π PubMed „Àâ„™â™◊ËÕ¬àÕ«“√ “√μ“¡ Index Medicus ‚¥¬¡’μ—«Õ¬à“ß¥—ßπ’È

7.1 °“√Õâ“ßÕ‘ß«“√ “√∂â“ºŸâπ‘æπ∏å‰¡à‡°‘π 6 §π „Àâ„ à™◊ËÕ∑ÿ°§π∂â“¡“°°«à“ 6 §π„Àâ„ à 6 §π·√°μ“¡¥â«¬ çet al.é ∂â“‡ªìπ¿“…“Õ—ß°ƒ… À√◊Õ ç·≈–§≥–é ∂â“‡ªìπ

¿“…“‰∑¬7.1.1 «“√ “√¿“…“Õ—ß°ƒ… ™◊ËÕºŸâπ‘æπ∏å. ™◊ËÕ∫∑§«“¡. ™◊ËÕ«“√ “√ ªï∑’Ëæ‘¡æå; ªï∑’Ë: Àπâ“∑’ËÕâ“ßÕ‘ß. μ—«Õ¬à“ß (¢÷Èπμâπ¥â«¬π“¡ °ÿ≈ μ“¡¥â«¬

Õ—°…√μ—«·√°¢Õß™◊ËÕμâπ·≈–™◊ËÕ°≈“ß à«πªï∑’Ëæ‘¡æå‡ªìπªï§√‘ μå»—°√“™)μ—«Õ¬à“ß Harnirattisai C, Inokoshi S, Shimada Y, Hosada H. Interfacial morphology of an adhesive composite resin and etched

caries-affected dentin. Oper Dent 1992; 17: 222-8.

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7.1.2 «“√ “√¿“…“‰∑¬ ™◊ËÕºŸâπ‘æπ∏å. ™◊ËÕ∫∑§«“¡. ™◊ËÕ«“√ “√ ªï∑’Ëæ‘¡æå; ªï∑’Ë: Àπâ“∑’ËÕâ“ßÕ‘ß. μ—«Õ¬à“ß (™◊ËÕºŸâπ‘æπ∏å„Àâ„™â™◊ËÕ‡μÁ¡∑—Èß™◊ËÕμ—«·≈–π“¡ °ÿ≈ ·≈–ªï∑’Ëæ‘¡æå‡ªìπªïæÿ∑∏»—°√“™)

μ—«Õ¬à“ß ∏’√≈—°…≥å ÿ∑∏‡ ∂’¬√, ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈, ≥—∞æß»å ‘√‘π∑«—≤πå, «’√–»—°¥‘Ï ‰æ√—™‡«∑¬å, ª√–¿“°√ ®”πßª√– “∑æ√. ª√– ‘∑∏‘¿“æ¢Õß¬“™“Õ“√åμ‘‡§π·≈–¬“™“≈‘‚¥‡§π„π°“√ºà“μ—¥øíπ°√“¡§ÿ¥≈à“ß ’Ë∑’Ë “¡. « ∑—πμ ¡À‘¥≈ 2548; 25: 59-66.

7.1.3 ºŸâπ‘æπ∏å∑’Ë‡ªìπÕß§å°√ ™◊ËÕÕß§å°√. ™◊ËÕ∫∑§«“¡. ™◊ËÕ«“√ “√ ªï∑’Ëæ‘¡æå; ªï∑’Ë: Àπâ“∑’ËÕâ“ßÕ‘ß.μ—«Õ¬à“ß §≥–ºŸâ‡™’Ë¬«™“≠®“° ¡“§¡Õÿ√‡«™·Ààßª√–‡∑»‰∑¬. ‡°≥±å°“√«‘π‘®©—¬·≈–·π«∑“ß°“√ª√–‡¡‘π°“√ Ÿ≠‡ ’¬ ¡√√∂¿“æ¢Õß

‚√§√–∫∫°“√À“¬„®‡π◊ËÕß®“°°“√ª√–°Õ∫Õ“™’æ. ·æ∑¬ ¿“ “√ 2538; 24: 190-204.Council on Dental Materials and Devices. New American Dental Association Specification No. 27 for direct filling resins. J Am Dent Assoc

1977; 94: 1191-4.7.2 °“√Õâ“ßÕ‘ßÀπ—ß ◊Õ

7.2.1 ºŸâπ‘æπ∏å∑’Ë‡ªìπºŸâ‡¢’¬π ™◊ËÕºŸâπ‘æπ∏å. ™◊ËÕÀπ—ß ◊Õ §√—Èß∑’Ëæ‘¡æå. ‡¡◊Õß∑’Ëæ‘¡æå: ”π—°æ‘¡æå; ªï∑’Ëμ—«Õ¬à“ß ¡π— ‚√®πå«π“°“√, ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈. øíπ§ÿ¥ æ‘¡æå§√—Èß∑’Ë 1. °√ÿß‡∑æ¡À“π§√: ‚√ßæ‘¡æå ÿ∑∏‘- “√°“√æ‘¡æå; 2530: 14-15.Ringsven MK, Bond D. Gerotology and leadership skills for nurses. 2nd ed. Albany (NY): Delmar Publishers; 1996: 215-30.7.2.2 ºŸâπ‘æπ∏å∑’Ë‡ªìπÕß§å°√ ™◊ËÕÕß§å°√. ™◊ËÕÀπ—ß ◊Õ. ‡¡◊Õß∑’Ëæ‘¡æå: ”π—°æ‘¡æå; ªï∑’Ëæ‘¡æå.μ—«Õ¬à“ß Õß§å°√ºŸâ∫√‘À“√§≥–∑—πμ·æ∑¬»“ μ√å·Ààßª√–‡∑»‰∑¬. øíπ¥’¡’„™âμ≈Õ¥™’«‘μ. °√ÿß‡∑æ¡À“π§√: ‚√ßæ‘¡æå∫√‘…—∑™—μ‡μÕ√å

·Õπ¥åÕ‘ß§å; 2538.Virginia Law Foundation. The medical and legal implication of AIDS. Chalottevill: The Foundation; 1987.7.2.3 ºŸâπ‘æπ∏å∑’Ë‡ªìπºŸâ‡¢’¬π·≈–∫√√≥“∏‘°“√„πμ”√“ ™◊ËÕºŸâπ‘æπ∏å. ™◊ËÕ∫∑∑’ËÕâ“ßÕ‘ß. „π: ™◊ËÕ∫√√≥“∏‘°“√, (∂â“‡ªìπ¿“…“Õ—ß°ƒ…„™â in)

∫√√≥“∏‘°“√. ™◊ËÕÀπ—ß ◊Õ. §√—Èß∑’Ëæ‘¡æå. ‡¡◊Õß∑’Ëæ‘¡æå: ”π—°æ‘¡æå; ªï∑’Ëæ‘¡æå.Àπâ“∑’ËÕâ“ßÕ‘ß.μ—«Õ¬à“ß ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈. ¿“«–·∑√°´âÕπ‡©æ“–∑’Ë®“°°“√©’¥¬“™“‡©æ“–∑’Ë. „π: ÿ∑—» √—°ª√– ‘∑∏‘Ï-°Ÿ≈, ∫√√≥“∏‘°“√. μ”√“¬“™“

‡©æ“–∑’Ë@∑—πμ°√√¡. æ‘¡æå§√—Èß∑’ËÀπ÷Ëß. °√ÿß‡∑æ¡À“π§√: ‚√ßæ‘¡æå‡∑Á° å·Õπ¥å‡®Õ√åπ—≈æ—∫≈‘‡§™—Ëπ®”°—¥; 2548: 333-50.Yamada KM. Fibronectin and other cell interactive glycoproteins. In: Hay ED, editor. Cell biology of extracellular matrix. 2nd ed. New York:

Plenum Press; 1991: 111-46.7.2.4 ºŸâπ‘æπ∏åÀ≈“¬§π‚¥¬·¬°‡¢’¬π‡©æ“–∫∑·≈–¡’∫√√≥“∏‘°“√¢ÕßÀπ—ß ◊Õ ™◊ËÕºŸâπ‘æπ∏å. ™◊ËÕ∫∑∑’ËÕâ“ßÕ‘ß. „π: ™◊ËÕ∫√√≥“∏‘°“√,

(∂â“‡ªìπ¿“…“Õ—ß°ƒ…„™â In) ∫√√≥“∏‘°“√. ™◊ËÕÀπ—ß ◊Õ. §√—Èß∑’Ëæ‘¡æå. ‡¡◊Õß∑’Ëæ‘¡æå: ”π—°æ‘¡æå; ªï∑’Ëæ‘¡æå. Àπâ“∑’ËÕâ“ß∂÷ß.μ—«Õ¬à“ß ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈, ∏’√≈—°…≥å ÿ∑∏‡ ∂’¬√. °“¬«‘¿“§„π°“√©’¥¬“™“‡©æ“–∑’Ë. „π: ÿ∑—» √—°-ª√– ‘∑∏‘Ï°Ÿ≈, ∫√√≥“∏‘°“√.

μ”√“¬“™“‡©æ“–∑’Ë@∑—πμ°√√¡. æ‘¡æå§√—Èß∑’ËÀπ÷Ëß. °√ÿß‡∑æ¡À“π§√: ‚√ßæ‘¡æå‡∑Á° å-·Õπ¥å‡®Õ√åπ—≈æ—∫≈‘‡§™—Ëπ®”°—¥; 2548: 99-146.Philipps SJ, Whisnant JP. Hypertension and stroke. In:Largh JH, Brenner BM, editors. Hypertension:patophysiology, diagnosis, and

management. 2nd ed. New York:Raven Press; 1995: 465-78.°“√æ‘®“√≥“°≈—Ëπ°√Õß

∫∑§«“¡®–‰¥â√—∫°“√æ‘®“√≥“°≈—Ëπ°√Õß‚¥¬ºŸâ∑√ß§ÿ≥«ÿ≤‘„π “¢“«‘™“π—Èπ Ê Õ¬à“ßπâÕ¬ 2 ∑à“π ‚¥¬„™â‡«≈“ª√–¡“≥ 4 ∂÷ß 8 —ª¥“Àå ®“°π—Èπ®–·®âßº≈°“√æ‘®“√≥“„ÀâºŸâ‡¢’¬π∑√“∫

μâπ©∫—∫∑’Ë‰¥â√—∫°“√æ‘®“√≥“‡æ◊ËÕ®–μ’æ‘¡æå„π«‘∑¬“ “√ ∫√√≥“∏‘°“√®–®—¥ àß∫∑§«“¡„ÀâºŸâ√—∫º‘¥™Õ∫·°â‰¢ß“π„π°√≥’∑’ËºŸâ∑√ß§ÿ≥«ÿ≤‘‡ πÕ·π–„Àâ·°â‰¢„Àâ·°â‰¢À√◊Õ™’È·®ß‡æ‘Ë¡‡μ‘¡®π‡ªìπ∑’Ë‡√’¬∫√âÕ¬°àÕπ®÷ß®–μ’æ‘¡æå ·≈–μâÕß àß‡Õ° “√∑—ÈßÀ¡¥°≈—∫§◊π¡“μ“¡‡«≈“∑’Ë°”Àπ¥¡‘©–π—Èπ®–∂◊Õ«à“∑à“π‰¡àμâÕß°“√≈ßμ’æ‘¡æå

°√≥’∑’Ë∫∑§«“¡‰¥â√—∫°“√æ‘®“√≥“„Àâμ’æ‘¡æå ∫√√≥“∏‘°“√®–·®âß„ÀâºŸâπ‘æπ∏å àß∫∑§«“¡μâπ©∫—∫∑’Ë·°â‰¢§√—Èß ÿ¥∑â“¬ æ√âÕ¡·ºàπ´’¥’√Õ¡(CD ROM) ∑’Ë∫√√®ÿ‡π◊ÈÕÀ“·≈–¢âÕ¡Ÿ≈∑’Ë¡’Õ¬Ÿà„π∫∑§«“¡∑—ÈßÀ¡¥∑’Ë‰¥â·°â‰¢·≈â« ∑—Èßπ’ÈºŸâπ‘æπ∏åμâÕß¡’ ”‡π“‡°Á∫‰«â¥â«¬‡æ◊ËÕ°“√Õâ“ßÕ‘ß·≈–¬◊π¬—π„π¿“¬À≈—ß

°√≥’∑’ËÕ¬Ÿà„π¢—ÈπμÕπ°“√®—¥æ‘¡æå ∑“ß∫√√≥“∏‘°“√®– àßμâπ©∫—∫ (artwork) „ÀâºŸâ√—∫º‘¥™Õ∫μ√«®æ‘ Ÿ®πåÕ—°…√·≈–§«“¡∂Ÿ°μâÕß∑“ß«‘™“°“√(À“°ºŸâ√—∫º‘¥™Õ∫‰¡à àß§◊πμ“¡‡«≈“∑’Ë°”Àπ¥ ®–∂◊Õ«à“∑à“π‰¡àμâÕß°“√≈ßμ’æ‘¡æå)

”À√—∫∫∑§«“¡∑’Ë‰¡à‰¥â√—∫°“√μ’æ‘¡æå®–¡’°“√·®âßº≈æ√âÕ¡§◊πμâπ©∫—∫∫∑§«“¡π—Èπ·°àºŸâπ‘æπ∏å ∑“ß°Õß∫√√≥“∏‘°“√¢Õ ß«π ‘∑∏‘Ï∑’Ë®–‰¡àæ‘®“√≥“∫∑§«“¡´÷Ëß¡’°“√‡μ√’¬¡∫∑§«“¡‰¡à∂Ÿ°μâÕß ·≈–‰¡à·°â‰¢μ“¡ºŸâ∑√ß§ÿ≥«ÿ≤‘

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Mahidol Dental Journal

Information for Authors

Objectives of the Journal

1. To disseminate knowledge gained from academic research in dentistry and other related medical sciences;2. To promote valued research for academic advancement;3. To create an academic network and to build relationships among dentists and others in related fields in order to keep up with constantly

developing knowledge;4. To enhance the reputation of the Faculty of Dentistry and Mahidol University Dentistry Alumni Association.

Mahidol Dental Journal is financially supported by the Faculty of Dentistry, Mahidol University.

Submission of Manuscripts

Manuscripts for publication should be addressed to

The Editor, Mahidol Dental JournalAcademic Promotion and Development Unit, Bld. 4, Fl. 9Faculty of Dentistry, Mahidol University6 Yothi Road, Ratchathewi DistrictBangkok 10400

Tel. 0-2660-7769 Fax. 0-2660-7767Email: [email protected]

Manuscript Types

Mahidol Dental Journal publishes several types of articles. These include the following:

1. Original articles are articles including new research reports, survey reports in epidemiology, relevant case reports, and reports concerningnew dental materials and technical procedures. These articles should be useful to the profession of dentists and must be previously unpublished.

2. Review Articles are articles that derive knowledge from new textbooks and journals or from the author’s own work and experience. Theyshould be composed in an analytical, critical, and comparative style for the advancement of knowledge.

3. Miscellany encompasses the following:3.1 Special reports are short academic reports pertinent to dentists. These may be analyses; discussions; summaries of other useful academic

papers; articles reviewing aspects of the body of knowledge; summarized translations from international journals; commentaries; reviews; papers introducingmedical appliances or interesting books and textbooks; or reports of both national and international conferences.

3.2 Current concepts are concepts or knowledge in any certain areas that are useful. They can be translated or composed from other journalsrecognized for their high standard.

3.3 Ask the expert are responses to readers’ academic or clinical problems by experts in a particular field. Interesting questions and answersfrom conferences may also be published for the benefit of those who have not attended the conferences.

3.4 Letters to the editor are questions or academic comments valuable to readers and the profession.3.5 Research summaries or book reviews that are noteworthy.

Preparation of Manuscripts(effective from Volume 27 Number 1 2007)

1. Manuscripts must not be folded. One original and four copies of the manuscript as well as three copies of illustrations and tables must besubmitted along with a submission form for consideration for publication via a registered mail to protect against loss. Each copy of the manuscript shouldbe clipped, not stapled. The manuscript should be 10-20 pages including illustrations and tables of no more than 10 pages. The manuscript must bedouble-spaced on one-sided portrait A4 paper with an equal margin of 2.5 centimeters at all sides and paginated with the number on the top right corner.The manuscript file must be operated on Microsoft Word with the Cordia New 16 font.

2. The Thai spelling must conform to the Dictionary of the Royal Academy (1999 edition). English technical terms must be translated into Thaiwith the original words provided in parentheses only the first time they appear. Words that have been coined by the Royal Academy must be used. Wordsthat have not been coined must be transliterated in accordance with the criteria for transliteration set by the Royal Academy with the original wordsparenthesized for their first time use. (See www.royin.go.th for more information.) Only Arabic notation can be used in the manuscript.

3. Units of length, weight, volume, etc. should be given in metric measures. A measurement of temperatures must be in Celsius. Pressure mustbe in mercury millimeter. A hematologic measurement and a measurement of clinical chemistry should also be in metric unit. Other measurementsshould follow the universal standard. Only standard abbreviations and symbols must be employed. No abbreviations should appear in the title orabstract. When an abbreviation is used, its full form should be provided after its first use in the text, with an exception of units of measurement. Formanuscripts written in English, a tooth may be identified either by its name such as upper left canine or with FDI two-digit notations followed by its namein parenthesis the first time it is mentioned, for instance, Tooth #31 (lower left central incisor).

Manuscript Format and Structure

Part One must contain the following headings written in Thai and sequentially ordered.

1. Title: The title should be written in as much Thai as possible, be concise, and convey the main objective of the study. It must contain noabbreviations and should not exceed 100 letters in length.

2. Name of the author: Only first name and last name should be given. If there are many authors, their names should be organized accordingto their contributions to the research with the most important one listed first.

3. Degree of education: A maximum of two highest degrees should be provided after the author’s name in their official abbreviated forms. Ifthe author has graduated from a university outside Thailand, the degree must be given in the language of the country from which he or she has obtainedthe degree.

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4. Address: All authors should provide the detailed address of their organization. If they are not affiliated with any institution, their clinicaddress must be given.

5. Corresponding author: One author must be designated as the corresponding author. The last name, position, professional affiliation, officephone, cell phone, fax, and e-mail address must be provided for the corresponding author for fast and convenient contact.

6. Research grant: If the study is financially supported, specify grant citing in a sequence name of the grant, organization awarding the grant,year the grant is awarded, and grant number (if any).

7. Received: Write the date appearing in the editor’s acknowledgement upon the receipt of the manuscript.8. Accepted: Write the date appearing in the editor’s letter confirming the manuscript will be published.9. Abstract: The abstract is a summary of the whole paper. However, no conclusion should be drawn from the discussion. Neither must there

be any references, illustrations and tables. A tooth must be identified by its name rather than symbols. No English terminologies can be used. Insteadthey may be either translated or transliterated into Thai. No originals are needed.

The following are to be included in the abstract:Objectives along with the hypotheses of the study must be given.Materials and Methods provide information on materials or patients employed in the study, number, type, method of the study or experiment,

and statistics utilized in the study.Results present findings of the study including experimental study and statistical study (in case there is an analysis).Conclusion.10. Key words: 3-6 key words from the abstract are to be provided in alphabetical order and separated from one another with commas (,).

Part Two presents the information from Part One written in English.

1. Title: The first letter of each word in the English title must be capitalized while the rest, except for proper names, are written in lower caseletters.

2. Name of the author: Use the author’s first name followed by last name only.3. Degree of education: Use universal abbreviated forms of degrees.4. Address: Provide an address of every author. Add the country “Thailand” after area code.5. Corresponding author: Give name and address of the corresponding author for later contact regarding the manuscript.6. Research grant: Cite source of funding.7. Received: Write the date appearing in the editor’s acknowledgement upon the receipt of the manuscript.8. Accepted: Write the date appearing in the editor’s letter confirming the manuscript will be published.9. Abstract: The abstract should not exceed 250 words and include objectives, materials and methods, results and conclusion.10. Key words: There should be 3-6 key words whose meanings match the Thai key words and arranged in alphabetical order.

Part Three can be written in Thai or in English.

Headings of Part Three must not be indented. Use a new page for each heading. The headings are ordered sequentially as follows:

1. IntroductionThis first section introduces the whole paper by reviewing literature presenting knowledge and evidence from research as well as books or

journals related to the study. In addition, the introduction provides rationale or significance, hypotheses, objectives, scope and methods of the study withreferences to other articles to relate the present study to the known prior knowledge. In other words, it should address reasons leading to the study andinform readers what questions the study is trying to answer. Thus, the introduction should review only pertinent literature and leave out those outside thescope and objectives of the study. Neither should it report results and conclusion of the study.

2. Materials and MethodsUnder this second heading, two subheadings are to be included.

2.1 MaterialsThe material section imparts on details of the materials employed in the study citing chemical names, sources, characteristics or specifications

of materials, and experimental samples of animals and patients. Experimentation involving human and animal subjects requires the presentation ofrelevant details, for instance, whether the samples are patients or normal persons, animal and plant types, number of samples as well as other specificcharacteristics such as gender, age, weight, and so on.

Research involving experimental procedure on humans and animals must be conducted in full accordance with ethical principles. In this case,the author must be able to identify that the research has been conducted as such and supply evidence that it has been approved by the organization’sethical board.

2.2 MethodsThe method section explains experimental methodology, observations or techniques for securing data, experimental procedures, measures of

study, data collection, data analyses, and statistics utilized in the analysis of data. The explanation should be adequately detailed so as to allow forrepeated experimentation.

3. ResultsThis part presents findings obtained from experiments and analyses categorized into sections based on objectives of the study. Straightforward

findings without too many numbers can be descriptively presented. Complicated findings with numerous numbers and variables should be presentedusing illustrations, tables, graphs, or charts with the interpretation of the findings in comparison with the suggested hypotheses. (Be careful not toreiterate the results given in the illustrations or tables in the text.)

4. DiscussionDiscussion can be drawn from objectives, hypotheses, and findings of the study. It can be discussed whether the present study reveals findings

similar to or different from those previously presented, how they are alike or differ, and reasons for such similarities and differences in order for readersto understand and obtain novel knowledge created by the study. The author may discuss advantages and disadvantages of materials and methodsemployed in the study. New ideas or problems from the study can also be put forward. The author should discuss unexpected findings candidly andoffers recommendations on how those findings can be of any use.

5. ConclusionThe conclusion part encompasses the following: a summary of the findings of the study, a statement to show whether the findings correspond

with the hypotheses, a conclusion drawn from the discussion, and suggestions for further use of the results as well as further study.

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6. AcknowledgementsThis one-paragraph section is where the author acknowledges organizations and persons who have made substantive contributions to the study.

(It should be remarked, however, that citing in the acknowledgements too many organizations and persons can undermine the article as readers mayassume that most of the study has been carried out with assistance from others.)

7. ReferencesReferences include the list of documents the author has cited in the text. References are indicated by superscript Arabic numbers right after the

cited names or statements and should be numbered consecutively (for example, 1,3,6 or 1-3. They should be neither indented nor parenthesized. The samenumbers must be used for repeated references. Using abstracts as references and unpublished data must be avoided.

All references in the list should be numbered consecutively as they appear in the text, following the Vancouver system. Abbreviated names ofjournals must follow the reference style in the PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi). If a journal name does not appear in the PubMed,then the Index Medicus should be applied.

7.1 Journal references

Names of all authors must be included if there are no more than six authors. If there are more than six authors, only the first six names are

included followed by ‘et al.’ in English and ‘·≈–§≥–’ in Thai.

7.1.1 English JournalsReferences of English journals should contain the following: name of author. title of article. title of journal followed by year of

publication;volume:page numbers. (As for the author’s name, last name precedes first initials of first and middle names. Christian calendar is used forpublication year.) Below is an example:

Harnirattisai C, Inokoshi S, Shimada Y, Hosada H. Interfacial morphology of an adhesive composite resin and etched caries-affected dentin.Oper Dent 1992;17:222-8.

7.1.2 Thai JournalsReferences of Thai journals must have the following: name of author. title of article. title of journal followed by year of publication;volume:Page

numbers. (Both first and last names are written in full forms. Buddhist calendar is used for publication year.) An example is given below:

∏’√≈—°…≥å ÿ∑∏‡ ∂’¬√, ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈, ≥—∞æß»å ‘√‘π∑«—≤πå, «’√–»—°¥‘Ï ‰æ√—™‡«∑¬å, ª√–¿“°√ ®”πßª√– “∑æ√. ª√– ‘∑∏‘¿“æ¢Õß¬“™“Õ“√åμ‘‡§π·≈–¬“™“≈‘‚¥‡§π„π°“√ºà“μ—¥øíπ°√“¡§ÿ¥≈à“ß´’Ë∑’Ë “¡. « ∑—πμ ¡À‘¥≈ 2548;25:59-66.

7.1.3 Organizational authorsJournal references with organizational authors should have the following: name of organization. title of article. title of journal followed by year

of publication;volume:page numbers., e.g.,

§≥–ºŸâ‡™’Ë¬«™“≠®“° ¡“§¡Õÿ√‡«™·Ààßª√–‡∑»‰∑¬. ‡°≥±å°“√«‘π‘®©—¬·≈–·π«∑“ß°“√ª√–‡¡‘π°“√ Ÿ≠‡ ’¬ ¡√√∂¿“æ¢Õß‚√§√–∫∫°“√À“¬„®‡π◊ËÕß®“°°“√ª√–°Õ∫Õ“™’æ. ·æ∑¬ ¿“ “√ 2538;24:190-204.

Council on Dental Materials and Devices. New American Dental Association Specification No. 27 for direct filling resins. J Am Dent Assoc1977;94:1191-4.

7.2 Book references

7.2.1 Book references with individual authorsBook references with individual authors must be written as follows: name of author. title of book followed by edition. city of publication:publisher;

year of publication:page numbers., e.g.,

¡π— ‚√®πå«√“°“√, ÿ∑—» √—°ª√– ‘∑∏å°Ÿ≈. øíπ§ÿ¥ æ‘¡æå§√—Èß∑’ËÀπ÷Ëß. °√ÿß‡∑æ¡À“π§√:‚√ßæ‘¡æå ÿ∑∏‘ “√°“√æ‘¡æå;2530:14-15.Ringsven MK, Bond D. Gerotology and leadership skills for nurses 2nd ed. Albany (NY):Delmar Publishers;1996:215-30.

7.2.2 Book references with organizational authorsBook references with organizational authors should be written as follows: name of organization. title of book. city of publication:publisher; year

of publication., e.g.,

Õß§å°√ºŸâ∫√‘À“√§≥–∑—πμ·æ∑¬»“ μ√å·Ààßª√–‡∑»‰∑¬. øíπ¥’¡’„™âμ≈Õ¥™’«‘μ. °√ÿß‡∑æ¡À“π§√:‚√ßæ‘¡æå∫√‘…—∑™—μ‡μÕ√å·Õπ¥åÕ‘ß§å;2538.Virginia Law Foundation. The medical and legal implication of AIDS. Chalottevill:The Foundation;1987.

7.2.3 Book or textbook references with authors and editorsReferences of books with authors and editors must contain the following: name of author. title of cited chapter. In:name of editors, (use the word

„π in Thai) editor. title of book. edition. city of publication: publisher;year of publication.page numbers.,e.g.,

ÿ∑—» √—°ª√– ‘∑∏å°Ÿ≈. ¿“«–·∑√°´âÕπ‡©æ“–∑’Ë®“°°“√©’¥¬“™“‡©æ“–∑’Ë. „π: ÿ∑—» √—°ª√– ‘∑∏å°Ÿ≈, ∫√√≥“∏‘°“√. μ”√“¬“™“‡©æ“–∑’Ë@∑—πμ°√√¡. æ‘¡æå§√—Èß∑’ËÀπ÷Ëß. °√ÿß‡∑æ¡À“π§√:‚√ßæ‘¡æå‡∑Á°´å·Õπ¥å‡®Õ√åπ—≈æ—∫≈‘‡§™—Ëπ®”°—¥;2548:333-50.

Yamada KM. Fibronectin and other cell interactive glycoproteins. In: Hay ED, editor. Cell biology of extracellular matrix. 2nd ed. New York:PlenumPress;1991:111-46.

7.2.4 Book references with editors and several authors writing separate chaptersThe following are needed for references of books with editors and several authors writing separate chapters: name of author. title of cited

chapter. In:name of editors, (use the word „π in Thai) editor. title of book. edition. city of publication: publisher;year of publication.page numbers.,e.g.,

ÿ∑—» √—°ª√– ‘∑∏å°Ÿ≈, ∏’√≈—°…≥å ÿ∑∏‡ ∂’¬√. °“¬«‘¿“§„π°“√©’¥¬“‡©æ“–∑’Ë. „π: ÿ∑—» √—°ª√– ‘∑∏‘Ï°Ÿ≈, ∫√√≥“∏‘°“√. μ”√“¬“™“‡©æ“–∑’Ë@∑—πμ°√√¡. æ‘¡æå§√—Èß∑’ËÀπ÷Ëß. °√ÿß‡∑æ¡À“π§√:‚√ßæ‘¡æå‡∑Á°´å·Õπ¥å‡®Õ√åπ—≈æ—∫≈‘‡§™—Ëπ®”°—¥;2548:99-146.

B 13

Philipps SJ, Whisnant JP. Hypertension and stroke. In:Largh JH, Brenner BM, editors. Hypertension:pathophysiology, diagnosis, and management.2nd ed. New York:Raven Press;1995:465-78.

7.3 Dissertation referencesDissertation references should be written as follows: name of author. title of dissertation (type of degree). department,faculty. city:university;year

of degree conferring.,e.g.,

™ÿμ‘¡“ «à“ß. º≈¢Õß¬“ ’øíπø≈ŸÕÕ‰√¥å∑’Ëº ¡‰´≈‘∑Õ≈μàÕª√‘¡“≥‡™◊ÈÕ¡‘«·∑π å ‡μ√Áæ‚μ§Õ°‰´·≈–·≈§‚μ·∫´‘‰≈ (ª√–°“»π’∫—μ√∫—≥±‘μ). ∑—πμ°√√¡ ”À√—∫‡¥Á°, ¡À“«‘∑¬“≈—¬¡À‘¥≈. °√ÿß‡∑æ¡À“π§√:¡À“«‘∑¬“≈—¬¡À‘¥≈;2547-2548.

Rassameemasmaung S. Effects of porphyromonas gingivalis on human gingival fibroblasts (Doctor of Philosophy). Oral biology, MahidolUniversity. Bangkok:Mahidol University;2002.

7.4 Conference paper references

7.4.1 Conference documentsReferences of conference documents are written as follows: name of author. title of document. title of conference. year month date;venue;year

of publication.,e.g.,

Royce JC. Finches of Du page County. Page read at 2nd Annual conference on bird-watching. 1986 May 24-26;Midland University, Illinois:FlatPrairie;1986.

7.4.2 Reports published in seriesThe following must be included for references of reports published in series: name of author. title. country of publication. publisher;year of

publication.,e.g.,

°Õß∑—πμ “∏“√≥ ÿ¢, °√¡Õπ“¡—¬, °√–∑√«ß “∏“√≥ ÿ¢. √“¬ß“πº≈°“√ ”√«® ¿“«–∑—πμ ÿ¢¿“æ·Ààß™“μ‘§√—Èß∑’Ë 5 æ.». 2543-2544. ª√–‡∑»‰∑¬.°√ÿß‡∑æ¡À“π§√. ‚√ßæ‘¡æå∫√‘…—∑ “¡‡®√‘≠æ“≥‘™¬å (°√ÿß‡∑æ) ®”°—¥;2545.

Fluoride and human health. WHO Monograph;1970. Series no. 59.

7.4.3 Proceedings

References of proceedings should contain the following: name of author. itle. In:ame of editors, (use the word „π in Thai) editors. title ofproceedings;year month date of conference; venue. city of publication:publisher;year of publication:page numbers.,e.g.,

Hotz PR. Dental plaque control and caries. In:Lang PN, Attstrom R, Loe H, editors. Proceedings of European Workshop on Mechanical PlaqueControl;1998 May 9-12;Berne, Switzerland. Chicago:Quintessence publication; 1998:35-49.

7.5 Newspaper article referencesNewspaper article references contain the following: name of author. title of article. title of newspaper followed by date month year of

publication;section:page numbers (column number).,e.g.,

‡æ≈‘ß¡√°μ. À¡Õ. Àπ—ß ◊Õæ‘¡æå‰∑¬√—∞ «—π∑’Ë 30 ‘ßÀ“§¡ 2539;23. (§Õ≈—¡πå 5)Rensberger B, Specter B. CFCs may be destroyed by natural process. The Washington Post 1989 Aug 7;Sect. A:2(col.5).

7.6 Electronic referencesElectronic references are of two groups:

7.6.1 Online references from homepages and websitesOnline references must be written as follows: name of author. title of article. title of journal (media type) followed by year of publication (date

month year of retrieval); volume (number): (illustration). source.,e.g.,

Morse SS. Factors in the emergence of infections disease. Emerg Infect Dis (serial online) 1995 Jan-Mar (cited 1996 Jun 5);1(1):(24 screens).Available from:URL:http://www/cdc.gov/ncidod/EID/eid.htm.

7.6.2 Other electronic references including CD-ROM, diskettes, other computer databases

An example of other electronic references is given below:

CDI,clinical dematology illustrated (monograph on CD-ROM). Reeves JRT, Maibach H. CMEA Multimedia Group, producers. 2nd ed. Version2.0 San Diego:CMEA;1995.

7.7 Audio-visual aid referencesAudio-visual aid references should be written as follow: title of article (videocassette). city of manufacturing: manufacturer;year of

manufacturing.,e.g.,

HIV+/AIDS: the facts and the future (videocassette). St. Louis (MO):Mosby-year Book;1995.

Illustrations

1. All illustrations must be concisely titled in English and numbered in order of appearance in the text using Arabic notation. They can bedrawings, photographs, diagrams or graphs.

2. Titles and legends must be typed underneath the illustrations which are submitted on separate pages. Color names, dying techniques, andmagnification rates may be provided after legends or designated as bars within the illustrations. Symbols, arrows, or letters within the illustrations mustbe clearly identified.

3. A box must be left in the text to indicate the area where each illustration will be put and marked within the illustration “Illustration 1”, e.g.,

B 14

Illustration 1

4. Both color and black & white photographs can be used. As for color photographs, high-quality glossy prints of 8.9×14 cm. (postcard) arerequired. The title, number and author’s name should be indicated on the back of each photograph lightly in pencil so as not to leave any unwanted markon the front. Also indicate the top edge of each photograph. All illustrations should not be adhered to anything and must be placed in a separate envelop.Digital photographs should not be embedded in the text. Instead they should be separately filed. High resolution photographs of no less than 300 dpi mustbe saved on a diskette or a CD-ROM. They can be in any format that can be opened using Adobe Photoshop (tiff, gps, fpg, etc.). To avoid blur and fuzz,polaroids should not be used.

5. Radiographs should not be printed directly from the x-rays as the prints may be different from their originals. Black & white prints should beobtained from copies of the original x-rays. Scans of radiographs should not be used either.

6. Line drawings, graphs or charts must be drawn or printed with explanatory ordinate and abscissa in black & white on glossy paper.7. Prints from slides are required.8. If all or parts of previously published illustrations are used, permissions must be obtained from the copyright holder concerned and the

permissions must be indicated.

Tables1. Each table should be typed on a separate page. A box must be left in the text to indicate the area where each table will be put and marked

within table “Table 1”.2. Tables should be numbered consecutively and should have a concise explanatory title in English written over each table. Tables should be

kept to the minimum essential for proper presentation of the results.3. Each table must be typed with the footnote explaining abbreviations, symbols, or statistical values (if any) appearing on the table. Table

footnotes should not be numbered using Arabic numerals as they may be mixed up with the references. To avoid such confusions, symbols such as *, +,#, ** may be used instead.

4. Tables should contain no vertical lines, horizontal lines, and borderlines.

Review ProcessIt is imperative that authors prepare manuscripts in accordance with the format guidelines of the Journal. The manuscripts must be checked and

proofread for accuracy before being submitted to the editor.Manuscripts will be reviewed by at least two experts in the field. Review process generally takes two to eight weeks. The Journal then informs

the corresponding author of the result of the review process.Manuscripts with potential for publication will be sent to the authors for revision. When all revisions and changes are made according to the

referees’ comments, revised manuscripts must be submitted to the editor within a set period. Otherwise, the Journal will assume the author no longerwants to publish his or her manuscript.

The Editor will notify the author when the manuscript is accepted for publication. The final version of revised manuscript must be saved ondiskette or CD-ROM and submitted along with the diskette or CD-ROM. The author must keep a copy of the manuscript for later reference or confirmation.

During the printing process, the Editor will send the artwork of the manuscript to the corresponding author once for proofreading and checkingfor academic accuracy. (If the author does not return the proofread manuscript within a set period, the Journal will assume the author no longerwants to publish his or her manuscript.) The Editor will not send the manuscript to the author for proofreading again but more proofreading will becarried out by the editorial board to enable faster printing process.

Authors will be informed of review results and manuscripts unaccepted for publication will be returned to the authors. The Journal reserves theright not to consider manuscripts that have not been prepared in accordance with the Journal’s guidelines.

CopyrightTo conform to the copyright law, all authors are required to assign and transfer the copyright on their articles and original manuscripts to

Mahidol Dental Journal. Authors must also attest that the manuscript is previously unpublished and that the manuscript is submitted to the Journal onlyand is not currently under consideration elsewhere and the research reported will not be submitted for publication elsewhere no matter in what languagesthe manuscript is prepared. Manuscripts under multiple publication policy are exempt from the said practice.

Articles published in Mahidol Dental Journal are the copyright of the Journal. No part of the articles may be copied, modified, reproduced orutilized in any form for any purposes without permission from the Journal.

The contents and opinions presented in the articles published in Mahidol Dental Journal belong specifically to the author, not necessarily sharedby the Journal’s editorial board.

Permission and WaiversPermission of the copyright holders must be obtained in writing for the direct use of illustrations or tables previously published and under

copyright (except for reference use). Written permission must be submitted to the Editor before the manuscript can be published.Quotations must be written in quotation marks and references must be identified for each quotation. Permission of author is required for

quotations exceeding 5 lines.Waivers must be obtained in writing for photographs showing potentially identifiable persons and waivers must be presented to the Editors.

ReprintsAuthors will be given 20 copies of reprints and 1 copy of the Journal. If additional reprints and journal or reprints with color illustrations are

desired, they must be ordered when the final revised version of the article is submitted to the Editor. An extra amount will be charged for additionalreprints, journals, and color illustrations based on the price fixed by the publishing house.

Readers’ CommentsReaders’ comments on articles or other matters are welcome. These should be sent to the Editor via mail, fax or e-mail at the address given

above.

Advertising and SubscriptionContact the Editor at the above address for advertising, order and subscription.

Subscription RatesMahidol Dental Journal is published as one volume of three issues annually (January-April, May-August, and September-December). Subscription

rates for one issue are: 150 Baht for domestic order and 400 Baht for international order (including shipping and handling).

Subscription and Membership PaymentPlease mail an order form with money order payable to “Ms. Sirilux Promvisut” to the Editor at the address provided above.

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Original article

Cephalometric assessment in anterior open bite patients

treated with and without mini-implant anchorages

Penprapa Chiewcharat Suwannee Luppanapornlarp

Supatchai Boonpratham Pongstorn Putongkam

Antimicrobial Efficacy of Propolis against Enterococcus faecalis

and Porphyromonas gingivalis

Jintana Sarabunchong Thaniya Muadcheingka

Sexual dimorphism in Thais using canine index

Tawepong Arayapisit Wanida Sripairojthikoon

Akkarin Panusatid Naiwinit Somsuktaweekoon

Pongstit Bundit Nipit Supajarupan

Physical properties of dental stones available in Thailand

Potchaman Sinavarat Kallaya Suputtamongkol

Chatcharee Suchatlampong

Review article

Fluoride Gel and Fluoride Varnish


Black Stains in Children: An update

Kemthong Mitrakul

Contents

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Cephalometric assessment in anterior open bite patients ...

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