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ว.ทันต.ขอนแกน, ปที่ 13 ฉบับที่ 2 ก.ค.-ธ.ค. 255392

Prevalence and distribution of dental anomalies in pretreatment orthodontic Thai patients

Abstract The aim of this study was to evaluate the prevalence and distribution of dental anomalies, includingother pathologic fi ndings in the pre-treatment records of Thai orthodontic patients at the Faculty of

Dentistry, Khon Kaen University. Two observers retrospectively examined 570 panoramic radio-

graphs, study models and pre-orthodontic records. Dental anomalies were recorded using panoramic

radiographs and study models. The prevalence and distribution of the anomalies were assessed and

reported as descriptive statistics. Patients were between 12 and 40 years of age(mean 19.38+4.23).

Persons between 16 and 20 years of age comprised the most common age group (51.1%) requiring

for orthodontic treatment. The patient types included: class I (25.3%), II (27.4%), III (13.2%) and

superclass I (34.0%). Crowding and spacing were found in 89.6% and 73.2% of patients, respectively.

It was found that 38.6% of patients had at least one dental anomaly: hypodontia being the most

common (26.1%), followed by microdontia (13.7%), root shape abnormality (3.4%), hyperdontia (2.7%),

transposition (1.6%), macrodontia (1.4%) and fusion 0.7%. In conclusion, the developmental dental

anomalies found in Thai orthodontic patients were comparable with other research.

Keywords: dental anomaly, panoramic radiograph, tooth abnormality, orthodontics

Suwadee Kositbowornchai* Chutimaporn Keinprasit** Nusara Poomat***

* Associate Professor, Department of Oral Diagnosis, Faculty of Dentistry Khon Kaen University** Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Khon Kaen University*** Assistant Professor, Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University

Correspondence author Associate Professor Suwadee Kositbowornchai Department of Oral Diagnosis, Faculty of Dentistry Khon Kaen University, Amphur Muang, KhonKaen, 40002 Tel: ++66-4320-405 ext. 11154 Fax: ++66-4320-862 E-mail: [email protected]

KDJ. Vol.13 No.2 July - Desember, 2010 93

INTRODUCTION

Dental anomalies, and their influence onmalocclusions,have long been a concern to the dental profession.Ben-Bassat and Brin1 found that multiple congenitally-missing teeth affected the skeletal pattern. Endo et al.2 reported the association of hypodontia and craniofacial morphology in Japanese orthodontic patients. Uslu et al.3 found no statisticallysignificant correlations between having a dental anomaly and the type of malocclusion, except having an impacted tooth or a short blunt root. An increased prevalence of an occlusal deep bite was reported in palatally-displaced maxillary canine subjects.4 Whether the prevalence of dental anomaly causes any orthodontic problem has not, however, been fully understood. The difference in the prevalence of dental anomalies in orthodontic patients reported over the past 10 years of publications was very high. Altug-Atac and Erdem5 reported 5.46% of the orthodontic patients in a group of 3,043 had at least 1 developmental dental anomaly, while Thongudompornand Freer6 investigated 111 orthodontic patients and found that 74.8% had at least 1 dental anomaly.

The possible cause of the variance in these reports might be due to race, sample selection and size,

type of dental anomalies and malocclusion. Indeed, most of the publications reported the prevalence of

hypodontia in orthodontic patients more than any other type of dental anomaly and no type of malocclusion was reported.7-9 These informational gaps limit our understanding of dental anomalies in persons with

orthodontic problems. Our purpose8, therefore, was to investigate the prevalence and distribution of dental anomalies in panoramic radiographs of Thai orthodontic patients and evaluate whether the result was comparable with

other studies among orthodontic groups published over the last decade.

MATERIALS AND METHODS

Pre-orthodontic study models and panoramic radiographs of 570 orthodontic patients were retrospectively evaluated. All of the patients had been seen at the Orthodontic Clinic, Faculty of Dentistry, Khon Kaen University, between 1999 and 2006. Detailed medical, dental and family histories were obtained for all subjects. The selection criteria follow: 1. No significant medical history, such as signifi cant trauma to the jaw bones. 2. No history of metabolic disorders or syndrome affecting bone metabolism and/or tooth formation. 3. No history of extraction or previous orthodontic treatment. 4. No cleft lip and/or palate, craniofacial anomalies and diagnosed syndromes. 5. Required good quality of study models with stable occlusion and good quality panoramic radiographs.

Demographic data Age, sex and type of malocclusion were recorded for each patient. Panoramic radiographs and study models were examined for dental anomalies and pathologic fi ndings, with agreement between an orthodontist and a radiologist. Descriptions of anomaliesused the criteria presented by Langland et al.10. The following dental anomalies were assessed: 1. Number abnormalities (hypodontia and hyperdontia); 2. Size abnormalities (macrodontia and

microdontia); 3. Shape abnormalities (fusion, gemination); 4. Location (transposition of tooth);

5. Other idings.Statistical analysis Descriptive analyses—using the Statistical Package for Social Science (SPSS 9.0)—was used

f


to calculate the prevalence and distribution within the dental anomaly data. Percentages and means were also calculated.

RESULTS The sample group comprised 124 males (21.8%) and 446 females (78.2%). Age rangedbetween 12 and 40 years (mean, 19.38+ 4.23);the average for the male and female groups was18.1 and 19.0, respectively. Most of those seekingorthodontic treatment were between 12 and 25 years of age (94.3%), with the largest group being between 16-20 years of age (51.1%). The patients were grouped into: class I (25.3%), II (27.4%), III (13.2%) and superclass I (34.0%). Crowding and spacing problems were found in 89.6% and 73.2% of patients, respectively. It was found that 38.6% of patients had at least one dental anomaly. The prevalence and distribution of dental anomalies follow:

Hypodontia

Of the 570 subjects, 149 (26.1%) had 350 missing teeth. The prevalence and distribution of hypodontia is presented in Table 1. The most commonmissing tooth was the third molar (68.9%), followedby the lateral incisor (15.1%) and the second premolar(8.6%). Except for the third molar, the other missing teeth occurred in mandible (17.4%) more often than in the maxilla (13.7%) and were distributed fairly evenly between the right and the left side. Among the hypodontia group, the percentage of patients with one, two, three, four or fi ve congenitally missing teeth were 11.4, 6.5, 3.3, 3.0 and 0.7 respectively. The prevalence of six or more congenitally missing teeth was 1.4 % The highest number of congenitally missing teeth was 14 but in only one subject (0.2% of the total number of subjects)

Hyperdontia refers to one or more extra teeth. Mesiodens is the extra tooth in the maxillary midline.

Our study reports extra teeth, either supernumerary teeth or mesiodens, separately. A total of 15 subjects (2.6%) presented; 12 with supernumerary teeth and 9 with mesiodens (Table 2). Six subjects presented 1 supernumerary tooth and three with 2 extra teeth.

Nine mesiodens were found in 6 subjects. Three

subjects had 2 cone-shaped mesiodens. The ratio of upper to lower and anterior to posterior supernumerary teeth was 2 to 1 and 3 to 1 respectively.

Regarding shape, the extra tooth shape resembledthe adjacent permanent tooth, such as the incisor (2 cases), a cone shape (2 cases) or a canine

(5 cases) at the anterior sextant and the premolar(1 case) or the molar shape (2 cases) at the posterior sextant.

R L R L R L R L R L R L R L R L80 60 0 1 0 1 7 3 4 4 1 1 11 13 1 1 188

(53.7%)52 49 1 2 0 2 10 10 0 2 0 1 16 13 2 2 162

(46.3%)350

(100.0%)

Number of tooth missing (% of missing tooth)

(M=molar, PM=premolar, C=canine, I= incisor, R=right, L=left)(1.1%)

1stM

(0.3%)

2nd PM

(40.0%)

(28.9%)

(68.9%) (15.1%)241

C 2nd I 1st I

(0.6%) (6.9%)

53 6

1st PM

Mandible

Total

(1.7%)3 30 10 3

(8.6%) (2.9%) (0.9%)

(0.6%)

(5.7%) (0.6%) (0.3%) (8.3%) (1.1%)

(2.9%) (2.3%)

Total

Arch

(0.6%)

(0.9%)

2ndM

(0.3%)

(0.9%)4

3rdM

Maxilla

Table 1 Prevalence and distribution of hypodontia


Macrodontia and microdontia – The occurrence of macrodontia was less common than microdontia. Eight subjects had macrodontia (1.4% of the total 570 cases), including 5 cases of 1 macrodontia, 2 cases of 2 macrodontia [#28 (the maxillary left third molar) & #48(the mandibulary right third molar) and #25 (the maxillary left second premolar) & #34 (the mandibulary left fi rst premolar)] and 1 case of 3 macrodontia [#15 (The maxillary right second premolar,#35 ( the mandibulary left second premolar & #45 the mandibulary right second premolar)]. Macrodontiadid not appear in the anterior sextant. The most common type of macrodontia presented at the third

molar (7 teeth), followed by the second premolar (4 teeth) and the fi rst premolar (1 tooth). There were 78 cases (13.7%, 120 teeth) of microdontia (Table 3). The most commonly affected teeth fairly equally represented the maxillary third molar (56 from the whole 120 teeth) and the maxillary lateral incisors (55). It is very common in the maxilla (96.7%) and very rare in the mandible (3.3%). The majority of patients presented one (40 cases) or two microdontias (35 cases). Two cases presented 3 microdontias and one case presented 4 microdontias.

Total

- maxilla 9subjects12 teeth

- mandible (1.6%)

Mesiodens 6subjects- maxilla 9 teeth

(1.1%)3(2cone shape)3(1cone shape)

(0.0%)(0.5%)(0.2%)

1 6 1

1

Patient's right sextant Anterior sextants Patient's left sextant

3 0

Supernumerary tooth

(0.2%) (1.1%) (0.2%)

Fusion – There were four cases (0.7%) of 7 fused teeth, one case of single fusion, three cases of double fusion. Except for one tooth of the maxillary second premolar, the remaining six teeth had fusion at the

mandible. Most fusion occurred among the lower

canine and lower premolar teeth. There was only one

case of fusion of a lower lateral incisor.

Gemination was not found in this study.

Table 2 Prevalence and distribution of supernumerary tooth and mesiodens (% of the subjects)

Table 3 Prevalence and distribution of hypodontia (% of microdontia)


Transposition – Of the 9 transposition cases (1.6%), fi ve were located between the lateral incisor and the adjacent canine, two between the canine and the fi rst premolar and two between the fi rst and second premolar.The abnormality occurred two times in the maxilla to the mandible (6/3). There was no transposition at all of the central incisor and molars.

Other fi ndings

Among the 570 records, other radiographic fi ndings were present (Table 4). Idiopathic osteosclerosis represented 10% of the fi ndings followed by bifi d root (1.8%), trifi d root (0.2%), three root of the fi rst mandibular molar (0.2%), and odontoma (0.7%). Idiopathic osteosclerosis occurred only in the mandible. Of the 14 bifi d roots, 13 showed at the

fi rst mandibular premolars and one at the second mandibular premolar. Six cases presented single bifi d root and four cases showed two bifi d roots. One trifi d of the fi rst mandibular premolars was found. Of the 4 odontoma cases, three were in the maxilla and one in the mandible. Hypercementosis was found in 7 cases (1.2%, 9 teeth); one at the canine and the fi rst molar and seven at the premolar teeth. No incisal tooth presented hypercementosis. Only one subject showed three hypercementosis (#15, #34, #35). Dental anomalies were ranked according to prevalence (Table 5). Missing teeth and microdontia occurred more often than extra teeth and macrodontia. Root abnormalities were more common than crown abnormalities.

Number (% of case) Location (number of tooth)Idiopathic osteosclerosis

(M=molar, PM=premolar, C=canine)

upper C,2nd PM(1,3)lower1st PM,2nd PM,1st M(3,1,1)

sextant 4,5,6lower 1st, 2nd PM(13,1)lower 1st PM(1)lower 1st M(1)quadrant1(3)quadrant3(1)

Hypercementosis

54 (10%)10 (1.8%)1 (0.2%)1 (0.2%)2 (0.4%)2 (0.4%)7 (1.2%)

Findings

Bifid rootTrifid rootThree rootsCompound odontomaComplex odontoma

Table 4. The other findings by general anatomic location

Table 5. Dental anomaly problems according to prevalence order


DISCUSSION

Although the prevalence and distribution of dental anomalies has been studied in various groups of orthodontic patients, the discrepancies in the variousresults have been attributed to racial differences, variable sampling techniques and different diagnostic criteria including the orthodontic problem selected.

Hypodontia

Hypodontia is a common dental anomaly found in orthodontic patients. Multiple missing teeth not only cause malocclusion but also make orthodontic treatmentdiffi cult due to poor occlusal support and stability. Some missing teeth have been reported in association with at least one other dental anomaly9,11,12 and may complicate orthodontic problems. The prevalence of hypodontia in orthodontic patients has been reported differently. Excluding the third molar, hypodontia ranges from 2.6% in Turkey5, to 5.5% in Mexico13, 6.3% in Brazil9, 8.5% in Japan7, 11.1% in Korea14, 14.7% in Hungary8, to 26.4% in Thais (this study). Altug-Atac and Erdem 5, Uslu et al.3 and our study found tooth agenesiswas the most prevalent dental anomaly among

orthodontic patients. The most common missing tooth in orthodontic

patients varies among the studied groups. Endo et al. 7

reported the most commonly affected tooth was in the mandibular second premolar. The maxillary lateral

incisor was the most frequent in many studies.3, 5, 9, 13 -15

In our study, the most commonly missing tooth, excluding the third molar, was the mandibular lateral

incisor (8.3%), followed by the maxillary lateral incisor (6.9%) and the mandibular second premolar (5.7%). There are reported differences in symmetrical

hypodontia: some have predominant symmetry7, 13

while in some unilateral dental agenesis is more common than bilateral agenesis.16

Hyperdontia

Hyperdontia is detected by chance either during intraoral examination or on radiographs. In case of malocclusion, the orthodontist plays a key role in the diagnosis and therapy through a comprehensive examination. The treatment decision is based on the individual case and may require interdisciplinary cooperation. The prevalence of supernumerary teeth is usually lower than that of tooth agenesis.17 The prevalence of supernumerary teeth in orthodontic patients ranges between 0.3%-1.37% 3,17,18, while our study documented 1.6%. The difference in race signifi cantly affects the frequency of hyperdontia.19

The most common site of supernumerary teeth is in the maxillary anterior region.3, 8

Mesiodens may cause delay or ectopic eruption of the permanent incisor or further alter occlusion and appearance. Early diagnosis is therefore needed for appropriate treatment, thereby reducing the invasiveness of surgery, orthodontic treatment and possible complications.20 Most of the studies reported mesiodens in terms of supernumerary teeth. The prevalence of mesiodens in orthodontic patients ranged between 0.3-1.8 %5, 6, which is not signifi cantly different from the general population

(0.15-1.9%).20 Our study found mesiodens in 1.1% of orthodontic patients. Size abnormalities (macrodontia and microdontia) Dental morphology is only one of several factors that may be involved in the etiology of dental crowding

or spacing. Macrodontia is very much less common than microdontia.5 Compared with other studies3, 5, 6,the percentage of macrodontia and microdontia in our

study was the highest (1.4% and13.7%, respec-tively). The most common microdontia was of the maxillary lateral incisor.5, 6 Maxillary and mandibular


fi rst and second molars were the only teeth not affected by macrodontia or microdontia (Table 3).

Shape abnormalities (fusion, gemination) Fusion requires management for esthetic reasons. Fusion and gemination in the general population are reportedly very low (0.19% and 0.22%, respectively)and extremely limited in orthodontic reports. Altug-Atac and Erdem5 reported the frequency of fusion and gemination was 0.23% and 0.07%, respectively. In our study, fusion occurred in only 0.7% and no gemination was found. In our study, fusion, macrodontia and gemination were not found in the maxillary fi rst premolar, the maxillary and mandibular fi rst and second molars, or the lower central incisor.

Location abnormalities (transposition) Teeth transposition is a rare eruption anomalythat involves the permanent dentition (incidence 0.3-0.4%).21,22 Transposition are more frequently seen in the maxilla23, as in our study, and affecting (in descending order) the canines and fi rst premolars,the canines and lateral incisors and the lateral and central incisors.23,24 Our study found the most frequently transposed teeth were the maxillary canine-lateral incisors. Transposition may occur with

other anomalies, such as aplasia, peg-shaped lateral incisor and deciduous teeth retention.21 Diagnosis could be made at the radiological level: the earlier the diagnosis, the less risks related to orthodontic treatment.

Other fi ndings Except for idiopathic osteosclerosis, the number

of root shape, odontoma and hypercementosis occurred at a very low rate in our study and was hardly seen in other reports. The correlation between dental anomalies and

orthodontic problems has not been widely studied. Chung et al.14 reported the association of a congenitallymissing third molar and skeletal class III malocclusion.Endo et al.2 evaluated the effect of hypodontia to craniofacial morphology. Whereas Bauer at al.25 found no statistically relevant correlation between the location of missing teeth and the craniofacial growth pattern. The difference in these results refl ects the need for further study on both the prevalence, type of dental anomaly, location of abnormalities and type of orthodontic problems, in order to better understand whether there is a correlation between dental anomaly and orthodontic problems.

CONCLUSION

Prevalence and distribution of some dental anomaliesin Thai orthodontic patients differed from other studies.Orthodontists should concern about the difference in dental anomalies in various group of patients. Careful diagnosis simplify treatment plan and reduce complications.

ACKNOWLEDGEMENTS

This study was supported by Faculty of Dentistry, Khon Kaen University, Thailand. Special thanks to

Mr. Bryan Roderick Hamman for assistance with the English-language presentation of the manuscript.

REFERENCES

1. Ben-Bassat Y, Brin I. Skeletodental patterns in patients with multiple congenitally missing teeth. Am J Orthod Dentofacial Orthop 2003;124:521-5.2. Endo T, Yoshino S, Ozoe R, Kojima K, Shimooka S. Association of advanced hypodontia and craniofacial morphology in Japanese orthodontic patients. Odontology 2004;92:48-53.3. Uslu O, Akcam O, Evirgen S, Cebeci L. Prevalence of dental anomalies in various malocclusions. Am J Orthod Dentofacial Orthop 2009;135:328-5.


4. Leifert S, Jonas I. Dental anomalies as a microsymptom of palatal canine displacement. J Orofac Orthop 2003;64:108-20.5. Altug-Atac AT, Erdem D. Prevalence and distribution of dental anomalies in orthodontic patients. Am J Orthod Dentofacial Orthop 2007;131:510-4.6. Thongudomporn U, Freer TJ. Prevalence of dental anomalies in orthodontic patients. Aust Dent J 1998; 43:395-8.7. Endo T, Ozoe R, Kubota M, Akiyama M, Shimooka S. A survey of hypodontia in Japanese orthodontic patients. Am J Orthod Dentofacial Orthop 2006; 129: 29-35.8. Gabris K, Fabian G, Kaan M, Rozsa N, Tarjan I. Prevalence of hypodontia and hyperdontia in paedodontic and orthodontic patients in BUdapest. Community Dental Health 2006;23:80-2.9. Gomes R, da Fonseca J, Paula L, Faber J, Acevedo A. Prevalence of hypodontia in orthodontic patients in Brasilia, Brazil. The Eur J Orthod 2010;32(3):302-6.10. Langland O, Langlais R, CR M. Principles and practice of panoramic radiology including intraoral radiographic interpretation. WB Saunder Company, Philadelphia, 1982.11. Becker A, Smith P, Behar R. The incidence of anomalous maxillary lateral incisors in relation to palatally-displaced cuspids. The Angle Orthodontist 1981;51:24-9.12. Garib D, Peck S, Gomes S. Increased occurence of dental anomalies associated with second-premolar agenesis. Angle Orthodontist 2009;79:436-41.13. Silva Meza R. Radiographic assessment of congenitally missing teeth in orthodontic patients. Int J Paediatr Dent 2003;13:112-6.14. Chung C, Han J, Kim K. The pattern and prevalence of hypodontia in Koreans. Oral Diseases 2008; 14: 620-625.15. Fekonja A. Hypodontia in orthodontically treated children. European Journal of Orthodontics 2005; 27: 457-

16. Polder B, Van’t Hof M, Van der Linden F, Kuijpers-Jagtman A. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol 2004;32:217-26.17. Legovic M, Ceranic I, Cehich A. Anomalies in the number of permanent teeth in orthodontic patients in 2 localities in Croatia. Schweizer Monatsschrift fur Zahnmedizin 1990;100:286-90.18. Alberti G, Mondani P, Parodi V. Eruption of supernumerary permanent teeth in a sample of urban primary school population in Genoa, Italy. Eur J Paediatr Dent 2006;7:89-92.19. Harris E, Clark L. An epidemiological study of hyperdontia in American blacks and whites. Angle Orthodontist 2008;78:460-5.20. Russell K, Folwarczna M. Mesiodens-diagnosis and management. J Can Dent Assoc 2003;69:362-6.21. Budai M, Ficzere I, Gabris K, Tarjan I. Frequency of transposition and its treatment at the Department of Pedodontics and Orthodontics of Semmelweis University in the last fi ve years. Fogorvosi szemle 2003;96:21-4.22. Yilmaz HH, Turkkahraman H, Sayin MO. Prevalence of tooth transpositions and associated dental anomalies in a Turkish population. Dentomaxillofac Radiol 2005;34:32-5.23. Ely N, Sherriff M, Cobourne M. Dental transposition as a disorder of genetic origin. Eur J Orthod 2006; 28:145-1.24. Sha ipura y , Kuf t inec M. Max i l la r y tooth transpositions:characteristic features and accompanying dental anomalies. Am J Orthod Dentofacial Orthop 2001;119:127-34.25. Bauer N, Heckmann K, Sand A, Lisson J. Craniofacial growth patterns in patients with congenitally missing permanent teeth. J Orofac Orthop 2009; 70:139-51.26. Baccetti T. A controlled study of associated dental anomalies. Angle Orthod 1998;68:267-74.


ความชุกและการกระจายของวิกลภาพแหงฟนในผูปวยชาวไทยกอนเขารับการรักษาทางทันตกรรมจัดฟน

บทคัดยอ บทความนี้มีวัตถุประสงคเพื่อประเมินความชุกและการกระจายของวิกลภาพแหงฟนรวมถึงพยาธิสภาพอื่นๆในภาพรังสีพานอรามิกกอนการจัดฟนของผูปวยที่เขารับการจัดฟนที่คณะทันตแพทยศาสตร

มหาวิทยาลัยขอนแกน โดยผูอานภาพรังสี 2 คน ศึกษาภาพรังสีพานอรามิกยอนหลัง จํานวน 570 ภาพ

แบบจําลองศึกษาและบันทึกประวัติผูปวย รายงานความชุกและการกระจายของวิกลภาพแหงฟนดวยสถิติ

เชิงพรรณนา ผลการศึกษาพบผูปวยอายุระหวาง 12 ถึง 40 ป (อายุเฉลี่ย 19.38+ 4.23 ป) โดยอายุที่เขารับ

การจัดฟนมากที่สุดอยูระหวาง 16-20 ป (รอยละ 51.1) ผูปวยประกอบดวย การสบฟนชนิด คลาสวัน

(รอยละ 25.3) คลาสทู (รอยละ 27.4) คลาสทรี (รอยละ 13.2) และ ซูเปอรคลาสวัน (รอยละ 34) พบฟนซอน

และฟนหางรอยละ 89.61 และ 73.2 ตามลาํดับ รอยละ38.6 ของผูปวยพบลักษณะวกิลภาพแหงฟนอยางนอย 1

อยาง โดยพบภาวะฟนนอยเกิน มากท่ีสดุ คอื รอยละ 26.1 ตามดวย สภาพฟนเลก็ รอยละ 13.7 ความผิดปกติ

ของรูปรางรากฟน (รอยละ 3.4) สภาพฟนมากเกิน (รอยละ 2.7) ฟนขึ้นผิดตําแหนง (รอยละ1.6) สภาพ

ฟนใหญ(รอยละ 1.4) และการรวมตัวของฟน(รอยละ 0.7) กลาวโดยสรุป วิกลภาพแหงฟนในผูปวยคนไทย

กอนเขารับการรักษาทางทันตกรรมจัดฟนมีปริมาณเทียบเคียงไดกับของผลงานวิจัยอื่นๆ

คําไขรหัส : วิกลภาพแหงฟน, ภาพรังสีพานอรามิก, ความผิดปกติของฟน, ทันตกรรมจัดฟน

สุวดี โฆษิตบวรชัย* ชุติมาพร เขียนประสิทธิ์** นุสรา ภูมาศ***

*รองศาสตราจารย ภาควิชาวินิจฉัยโรคชองปาก คณะทันตแพทยศาสตร มหาวิทยาลัยขอนแกน**ผูชวยศาสตราจารย ภาควิชาทันตกรรมจัดฟน คณะทันตแพทยศาสตร มหาวิทยาลัยขอนแกน***ผูชวยศาสตราจารย ภาควิชาทันตกรรมชุมชน คณะทันตแพทยศาสตร มหาวิทยาลัยขอนแกน

ผูรับผิดชอบบทความ

รองศาสตราจารย สุวดี โฆษิตบวรชัย ภาควิชาวินิจฉัยโรคชองปาก คณะทันตแพทยศาสตร มหาวิทยาลัยขอนแกน อ. เมือง จ. ขอนแกน 40002 โทรศัพท 0-4320-405 ตอ 11154 โทรสาร 0-4320-862 จดหมายอิเล็กทรอนิกส [email protected]

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