Khon Kaen University Dental Journal

Clinical Application of Botulinum Toxin Type A in the Management of Masseter Muscle Hypertrophy: A Narrative Review

2025-11-04T10:48:15+07:00

Objective: To explore the clinical application of botulinum toxin type A (BTXA) in the treatment of masseter muscle hypertrophy (MMH), with emphasis on its mechanism of action, administration techniques, therapeutic outcomes, and potential adverse effects.

Materials and Methods: A narrative review was conducted by searching databases including ThaiJo, PubMed, Scopus, and Web of Science using keywords such as “botulinum toxin” “masseter muscle hypertrophy” “mechanism of action” “side effects” and “treatment outcomes” Studies published in English or Thai were included, while case reports and studies lacking sufficient data were excluded.

Results: BTXA has been shown to effectively reduce masseter muscle volume, enhance facial aesthetics, and alleviate symptoms associated with temporomandibular disorders (TMD). Despite its temporary effects requiring repeated injections, BTXA remains a minimally invasive, well-tolerated treatment with a low complication rate.

Conclusion: BTXA is a safe and effective non-surgical option for managing MMH. Optimizing injection protocols and understanding the pharmacodynamics of BTXA are essential for achieving favorable therapeutic outcomes and minimizing adverse effects.

Intentional Replantation for Treating Maxillary Sinusitis and Periodontally Compromised Tooth: A Report of 2 Cases

2025-07-29T10:29:31+07:00

Objective: The purpose of this article is to demonstrate the successful outcome of intentional replantation treatment in two patients. Intentional replantation is a treatment of choice for treating periapical lesions in teeth that have previously undergone unsuccessful conventional endodontic therapy, especially when endodontic microsurgery is contraindicated.

Case Presentation: The first case revealed a successful intentional replantation for treating left maxillary sinusitis caused by the infection of the left maxillary first molar. A 1-year follow-up showed complete resolution of the left maxillary sinus and complete periapical bone formation at the palatal root. The second case described intentional replantation of a periodontally compromised tooth, and the 9-month follow-up clinically showed a decrease in probing depth along with new peri-radicular bone formation.

Conclusion: Intentional replantation can be used as an alternative treatment for maxillary sinusitis due to odontogenic origin and can be performed in teeth with concomitant periodontitis presenting a periodontal pocket depth of no more than 6 mm at a single site, with favorable treatment outcomes.

Clinical Manifestations and Dental Management in a Pediatric Patient with Chromosome 22q11.2 Deletion Syndrome: A Case Report

2025-09-09T16:56:20+07:00

Objective: This report aims to describe the orofacial and dental manifestations, along with the comprehensive dental management, in a child diagnosed with 22q11.2 DS.

Case Presentation: A 4-year-old girl presented with multiple congenital anomalies, including complex cyanotic congenital heart disease, dysmorphic craniofacial features, bilateral complete cleft lip and palate, and anovestibular fistula. The patient also exhibited hypotonia, feeding and swallowing difficulties, hearing loss, hypernasal speech, and global developmental delay. The patient had previously undergone several major surgical interventions as part of her multidisciplinary management. Clinical and radiographic examinations revealed multiple extensively carious teeth consistent with severe early childhood caries, along with malformation and agenesis of several developing permanent teeth. Owing to the patient’s limited ability to cooperate, significant medical comorbidities, and extensive dental treatment needs, comprehensive oral rehabilitation under general anesthesia was provided. The procedure was completed successfully; however, the patient experienced a prolonged postoperative recovery. Following treatment, she was scheduled for regular dental and medical follow-up visits to ensure ongoing preventive care, monitoring, and long-term management.

Conclusion: Patients with 22q11.2 DS commonly have multiple underlying medical conditions and are at increased risk for orofacial anomalies and oral diseases. Dental care should begin early and be maintained throughout the patient's life. Successful management requires a collaborative, multidisciplinary approach involving specialized medical and dental professionals, supported by informed and engaged caregivers, to achieve optimal oral health and improve overall quality of life for these patients.

Comparison of Final Shade Outcomes of High-Translucent Monolithic Zirconia Crowns on Anodized and Non-Anodized Titanium Abutment Backgrounds

2025-12-02T13:28:36+07:00

Objectives: To evaluate the effects of two different abutment backgrounds: non-anodized and gold-colored anodized titanium abutments, and the application of opaque coloring liquids on the color outcomes of high-translucent monolithic zirconia crowns.

Materials and Methods: Forty crown-abutment samples were fabricated using CAD-CAM technology and divided into four groups (n=10 per group): non-anodized titanium (TI) and gold-colored anodized titanium (G) abutments, each combined with zirconia crowns either with opaque liners (OP) or without opaque liners (NO). Color measurements were performed using a spectrophotometer (SpectroShade™ Micro II) to determine the CIELab values of the specimens. The CIEDE2000 formula was applied to calculate color differences (ΔE₀₀) between each specimen and the zirconia crown on a PMMA abutment (control). The ΔE₀₀ values were further compared against the 50:50% acceptability thresholds for dentists (ΔE₀₀<2.41) and patients (ΔE₀₀<2.83). The ΔE₀₀ data were analyzed using one-way ANOVA followed by Tukey’s post hoc test, with statistical significance set at p<0.05.

Results: Crowns with opaque liners (G+OP and TI+OP) showed significantly lower ΔE₀₀ values, achieving patients’ acceptable thresholds (ΔE₀₀<2.83), compared to crowns without liners (G+NO and TI+NO) (p<0.05). No significant differences were found between the G+OP and TI+OP groups or between the G+NO and TI+NO groups.

Conclusions: The study concludes that applying opaque coloring liquids effectively masked the grayish color of titanium abutments and improved esthetic outcomes, while gold anodization alone provided limited color improvement. Clinicians are encouraged to incorporate opaque liners for optimal color outcomes in implant-supported zirconia restorations. Further research is recommended to explore long-term performance and alternative techniques.

Effect of Restoration Method on Fracture Resistance of Endodontically Treated Teeth with Radicular Cracks

2026-01-15T10:58:56+07:00

Objective: To compare the fracture resistance of radicular cracks obturated with gutta-percha and restored by using dual-cured resin composite or a fiber-reinforced composite post placed 2 mm apical to the cracks.

Materials and Methods: 30 Bovine teeth were decoronated to obtain a standardized root length of 12 mm. Longitudinal cracks were simulated using a hammer and chisel, and only roots presenting a single crack line measuring 4-5 mm on the external surface were selected. Root canals were prepared and obturated with gutta-percha. The specimens were divided into three groups. Group 1, obturated with gutta-percha without additional restoration; Group 2, restored with dual-cured resin composite placed 2 mm apical to the cracks and Group 3, restored with a fiber-reinforced composite post placed 2 mm apical to the cracks. Fracture resistance testing was performed using a Universal Testing Machine. A compressive force was applied centrally over the canal opening until fracture occurred. The maximum force (newton) and fracture patterns were recorded.

Results: The highest mean compressive force was observed in the fiber-reinforced composite post group (717.753±72.44 N), followed by the dual-cured resin composite group (680.308±51.69 N). The gutta-percha group demonstrated the lowest value (207.165±37.28 N). One-way ANOVA and Tukey’s HSD test revealed statistically significant differences between the gutta-percha group and the other two groups (p<0.05). However, no significant difference was found between the dual-cured resin composite group and the fiber-reinforced composite post group (p>0.05).

Conclusion: Restoration of radicular cracks by using dual-cured resin composite and fiber-reinforced composite post significantly improved fracture resistance compared with gutta-percha. However, no significant differences were found between these two restoration methods.

Caries Experiences and Predictive Factors of Dental Caries in the Working Age Group in Phon Thong, Roi-et Province

2025-12-22T15:04:37+07:00

Objective: To explore caries experiences and evaluate the predictive factors of dental caries in the working age group.

Materials and Methods: This cross-sectional analytical study was carried out in a working age group of 250 people aged between 18-59 years in Phon Thong District, Roi Et Province. Data were collected between July and October 2023. The questionnaires and oral health records were used for data collection. The content validity represented by IOC was between 0.67-1. The reliability of the questionnaire ranged from 0.82–0.92. Data were analyzed using descriptive statistics, Chi-square test, Fisher’s exact test, Pearson correlation coefficient and multiple linear regression with stepwise method.

Results: The study showed that 68.8% were female. The average age was 46.58 years (SD=10.53). Data from oral health examination revealed that most participants had dental caries (80%). The caries experience score (given as DMFT score) was 9.2 teeth/person. When analyzing the predictive factors of dental caries, the finding indicated that age (β=0.17, p=0.006), oral health literacy (β=-0.18, p=0.007) and oral health behaviors (β=-0.19, p=0.006) statistically predicted 17% of the number of dental caries in the working- age group (R²=0.17, p<0.001).

Conclusion: Factors predicting dental caries in working-age population included age, oral health literacy and oral health behaviors. These results can be used as basic information to prevent dental caries by enhancing oral health literacy and promoting oral health behaviors.

Chemical Composition, Degree of Conversion and Flexural Properties of a Three-Dimensional Printed Denture Base Resin

2026-03-18T16:33:30+07:00

Objective: This study aimed to evaluate the chemical composition, degree of conversion (DC), and flexural properties of a commercially available 3D printing denture base resin, and to compare them with a conventional heat-cured denture base resin.

Materials and Methods: A 3D-printed denture base resin (NextDent Denture 3D+, NDD) and a conventional heat-polymerized resin (ProBase® Hot, PBH) were investigated. The chemical compositions of the unpolymerized NDD resin were characterized using Fourier-transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (¹H-NMR), and high-performance liquid chromatography/mass spectrometry (HPLC/MS). The DC of both materials was measured via FTIR analysis. Flexural strength, modulus, and yield stress were determined using a three-point bending test per ISO 20795-1:2013 guidelines.

Results: HPLC/MS analysis revealed that NDD primarily consists of Bis-EMA monomers with 3–7 ethylene oxide units. The PBH resin demonstrated a significantly higher DC (97.59±1.14%) than NDD (69.81±4.90%) (p<0.001). Flexural strength and modulus of PBH (99.40±6.56 MPa; 2812.20±54.44 MPa) were also significantly higher than NDD (88.58±8.50 MPa; 2625.40±368.42 MPa) (p<0.001). Despite the differences, both materials met ISO flexural property standards.

Conclusion: The 3D printing resin primarily contains Bis-EMA with varied chain extender lengths and exhibits lower DC and flexural properties compared to the heat-cured resin. Optimization of printing and post-curing parameters is necessary to improve polymerization and mechanical performance of 3D-printed denture bases.

Marketing Mix Factors Affecting Dental Service Utilization: A Cross-sectional Study at Thammasat University Student Dental Clinic

2026-02-18T08:47:43+07:00

Objective: This study aimed to investigate the marketing mix factors influencing the utilization of dental services at the student dental clinic of Thammasat University, and to compare these factors according to patients’ personal characteristics, including gender, age, occupation, educational level, income, and payment method.

Materials and Methods: A descriptive cross-sectional study was conducted using an online questionnaire administered to 394 patients who received services at the student dental clinic between February and April 2025. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Inferential statistics were performed using the Mann-Whitney U test and Kruskal–Wallis test to examine differences among groups.

Results: The three most influential marketing mix factors affecting the utilization of dental services were physical evidence, people, and products, respectively. The least influential factor was promotion. Significant differences in perceptions of marketing mix factors were found among patients with different ages, occupations, educational levels, incomes, and payment methods.

Conclusion: Marketing mix factors significantly influence the utilization of dental services at the student dental clinic. Patients’ perceptions of these factors are associated with their personal characteristics. These findings provide important input for improving service quality and developing effective marketing strategies to better meet patients’ needs at student dental clinics.