A case of a large dentigerous cyst associated with canine tooth in the maxillary antrum is presented. This case is of interest because of its extensiveness and the presence of an ectopic tooth in the roof of the maxillary sinus. Theoretical aspects of canine impaction and cyst formation are reviewed. The management of a jaw cyst, in particular, the still popular Caldwell-Luc procedure is discussed.
The main objective of a root end filling material is to provide an apical seal that prevents the movement of bacteria and the diffusion of bacterial products from the root canal system into periapical tissues. The aim of this study was to compare the microleakage of three root end filling materials Mineral trioxide aggregate (MTA), Glass ionomer cement (GIC) and Silver GIC (Miracle Mix) using dye penetration technique under stereomicroscope. Forty-five extracted human maxillary central incisors were instrumented and obturated with gutta percha using lateral compaction technique. Following this, the teeth were stored in saline. After one week, teeth were apically resected at an angle of 90ï° to the long axis of the root and root end cavities were prepared. The teeth were divided into three groups of fifteen specimens each and were filled with Group I -MTA, Group II - GIC and Group III - Miracle Mix. The samples were coated with varnish and after drying, they were immersed in 1% methylene blue dye for 72 hours. The teeth were then rinsed, sectioned longitudinally and observed under stereomicroscope. The depth of dye penetration was measured in millimeters. Microleakage was found to be significantly less in MTA (0.83 mm) when compared to GIC (1.32 mm) (p < 0.001) and with Miracle Mix (1.39 mm) (p < 0.001) No significant difference was found when microleakage in Miracle Mix was compared to that of GIC (p = 0.752). Thus we concluded that MTA is a better material as root end filling material to prevent microleakage, in comparison to GIC and Miracle Mix.
Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.
The aim of this study was to isolate stem cells from dental pulp of primary molars and incisors to be used as possible source for tissue engineering. Human primary molars and incisors were collected from subjects aged 4-7 year-old under standardized procedures. Within 24 hours, the tooth was cut at the cemento-enamel junction using hard tissue material cutter. The dental pulp tissue was extracted, digested and then cultured in Alpha Modified Eagles's Medium (α-MEM) supplemented with 20% FCS, 100 mM L-ascorbic acid 2-phosphate, 200 mM L-glutamine and 5000 units/ml Penicillin/Streptomycin. The cells were observed daily under the microscope until confluence. Children's tooth pulp- derived progenitor cells were found positive for stem cell markers CD105 and CD166, which are consistent with the finding for mesenchymal stem cells (MSCs) from bone marrow.
Root canal treatment (RCT) requires high level of technical skills of the dentist. Its outcome is an important part of evidence-based practice and become the basis of treatment planning and prognostic considerations. Adequate removal of micro-organisms and prevention of recolonization of residual micro-organisms through the placement of root filling with satisfactory coronal seal ensures success. This retrospective record review study aimed to investigate the practices of RCT in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic, Kota Bharu, Kelantan. It involved 333 randomly selected patient records at the HUSM Record Unit. Data was obtained by careful analyses of daily treatment progress sheets and analyzed using SPSS version 12.0. A total of 2996 RCT cases were seen and 59.8% of patients were females. The age range of patients varied from 14 to 64 years. The maxillary anterior teeth were most commonly treated (52.6%). Most operators (99.1%) used step-back technique and 97.6% used files to prepare root canals. The most commonly used material for obturation and sealing was gutta-percha and epoxy resin-based sealer (AH26). About 82.9% used calcium hydroxide as intra-canal medication. About 25.5% of cases had no periapical pathology, 65.8% with pre-existing periapical radiolucencies healed in 1-3 months whereas 2.1% of cases with periapical pathology eventually healed after a year. About 6.9% cases failed after retreatment. The number of radiographs taken was two to four pieces. RCT is a useful intervention to maintain longevity of teeth. Decision making and current updates of methods and materials are essential among practitioners as well as administrators to ensure success.
This study aims to determine the prevalence of denture wearing among elderly and to compare the oral health related quality of life (OHRQoL) between elderly with dentures and those without dentures. This cross sectional study involved 506 randomly selected edentulous elderly in the district of Badang, Kota Bharu, Kelantan. Consented participants were interviewed in the Kelantanese dialect at their homes by a single trained interviewer using the short version Oral Health Impact Profile [S-OHIP(M)] which had been translated into the Malay language, tested and validated for use in Malaysian population. Denture wearing and self rated denture status was noted. The prevalence of denture wearing was 46.2% (95% CI=41.83, 50.70). There was a significant difference in sex, smoking status, self perceived treatment need and self perceived satisfaction between denture wearers and non denture wearers. Denture wearers reported better overall OHRQoL compared to non denture wearers (p
MeSH terms: Aged; Cross-Sectional Studies; Dentures; Humans; Language; Mouth, Edentulous; Oral Health; Personal Satisfaction; Quality of Life; Surveys and Questionnaires; Self Concept; Smoking; Prevalence
This is a cross sectional study to determine the attitudes and practices in smoking cessation counselling among dentists in Kelantan and to identify the barriers that prevent them from doing so. Self-administered questionnaires were distributed to 152 dentists practising in Kelantan. A total of 84 (55.2%) questionnaires were completed and returned. Although majority of the dentists (98.8%) agreed that they have a role in smoking cessation counselling, only few of them (17.9%) were actually involved in a considerable extent. The main barriers cited were lack of training and time in their practice. In conclusion, dentists in Kelantan believed that they have a role in smoking cessation counselling but their involvement was rather limited.
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
Dentin morphology and the lesion found in dental caries have been studied for many years. It was first observed under optical microscopy, and later using electron microscopy. Confocal laser scanning microscopy (CLSM) applied with several fluorescent dyes such as alizarin red to see normal dentinal tubules. However, as far as authors aware, the CLSM studies of dentinal tubules in human caries using alizarin red is rare. The aim of this study is to examine histopathological and morphological changes in dentinal tubules of dentin caries stained with alizarin red using CLSM. Fifteen extracted carious teeth (premolar or molar) was collected and fixed in neutral formalin solution buffered with phosphate buffer, rinsed and stored in calcium free phosphate buffer saline (PBS) at 4°C. The specimens were dehydrated and embedded in resin. Longitudinal or cross sections were cut and polished and then stained with alizarin red S (100 μg/ml) in 0.5 M HCl solution for 24-48 hour at 37°C. After dehydration specimens were mounted on glass slide and examined under CLSM using epi-flourescent mode or transmission light mode with wave length of 512 nm. The images of dentinal tubules were taken serially and optimum images of three-dimensional structures were reconstructed using software of CLSM. Histopathological changes of dentinal tubules in human caries showed area of demineralized dentin, translucent zone, and normal area. The dentinal tubules were thin and had numerous branches. In conclusion, confocal microscopy revealed Study shows that confocal microscopy revealed histopathological changes in dentinal tubules affected by carious lesions.
This article reviews the concept of Combination Syndrome and presents a clinical case of a patient with a modern variation to this clinical scenario': The clinical procedures involved in the provision of a maxillary complete denture against a mandibular implant-supported complete fixed prosthesis is described with some suggestions on how to optimise the treatment outcome for the patient.
Direct composite veneers can be used to mask tooth discolorations and/or to correct unaesthetic tooth forms and/or positions. However, these type of restorations are often regarded as one of the most challenging in aesthetic dentistry presumably due to the extent of natural tooth structure that must be recreated. This paper discusses easy application techniques and tips for Ceram.X Duo™, a nano ceramic composite restorative material. Its natural shading system allows the restoration of tooth with both dentine and enamel shade and transforms it into a final direct veneer restoration that mimics a natural tooth.
Arrested root development of permanent te~th can occur due to local factors such as infection and trauma or general factors such as radiation and odontodysplasia. This case report presents a 11 tooth with arrested root development requiring endodontic treatment. Following obturation with MTA, a minor surgical procedure was performed to remove periapical pathologic tissue. The tooth had remained asymptomatic at the 6-month review and the case will be followed-up for at least 2 years to ensure complete healing.
The aims of this study were to determine the prevalence and factors that influenced smoking behaviours among male adolescents in Kuantan, Pahang. A cross-sectional study was conducted among the form four male students in Kuantan District. Three hundred and twenty three students were randomly selected from eight secondary schools. A self-administered questionnaire was distributed to all the respondents. Almost half of the sample was smokers (45.8%) and half of them were Malays (53.1%). Students whose parents had lower level of occupation were more likely to smoke (58.8%). Among smokers, 34.5% of them smoked since primary school and a majority (91.7%) smoked 10 or less cigarettes per day. Half of them (53.4%) reported that they bought loose cigarettes and most of them used their school pocket money to purchase the cigarettes (81.7%). From the multivariate analysis, it was found that Non-Science Stream classes (OR=3.92, 95% CI= 2.10, 7.32), peers' smoking (OR=6.07, 95% CI= 2.32, 15.92), and attitude towards smoking (OR= 21.93, 95% CI= 9.71,49.51) were significantly associated with smoking habit. The prevalence of smoking among male adolescents was considerably high'in this population. It is recommended that antismoking activities in school be carried out regularly and should involve an active participation from the adolescents themselves since peers have great influence on smoking habits.
Teaching is a complex activity which consists not only of giving instructions but also promotion of learning. Different students have different preference for learning styles. Dental educators must therefore attempt to mix and match their methods of teaching to accommodate students with differing learning styles to provide an opportunity to maximize their learning. This paper aims to share the writer's experience and students' perceptions towards a different mode of teaching/learning method. The Jigsaw Classroom method was employed on University of Malaya's third-year dental students during their Water Fluoridation lecture. At the end of the session, students were asked to reflect upon the learning experience and to inscribe their feelings. Initially, students showed their resentment towards the new learning style but their resistance changed once they got into a group and started to learn from each other. In the reflective essay, most students expressed that learning through teaching and discussing as required in the Jigsaw method enhanced their understanding of the topic and they claimed that they were able to retain the information better. In this study, the Jigsaw method proved that learning in the lecture hall can be fun, educational and enriching.
Aim: To manufacture a clinical simulation apparatus for the undergraduates' endodontic radiography teaching Objectives: • To provide a model for teaching of parallax method using Kelly's forcep • To provide a model for undergraduates to practice radiographic localization employing parallax method. • To allow students to practice taking radiographs in a way that simulates the clinical situations with a good diagnostic quality Methods: Impressions of a dentate arch (maxillary and mandibullary) were used to form a stone cast. A section of the cast, in the area where the natural teeth were to be placed, is sectioned and removed. Three maxillary extracted teeth (canine, first and second premolar) were selected and mounted with acrylic resin at the sectioned area. The resin was cured in a light box. The arches were mounted in a phantom head with a placement of rubber cheek. The first premolar was isolated with rubber dam. The intraoral holder (Kelly's forcep) was attached to a robotic arm. The students were taught the correct angulations of the x-ray cone for the paralleling technique and parallax method using Kelly's forcep during root canal treatment. Results: All students managed to complete the exercise and were considered competent when they produced acceptable quality of radiographs. Conclusion: The model described was improvised from a model that has been used during the past 2 years for undergraduates' endodontic courses. It has been well accepted as it simulates the clinical situation more closely than was possible previously.
Objective: this study was carried out to evaluate the relationship between smoking and periodontal status in a selected Malaysian population. The sample for this cross-sectional study involved 39 subjects who were smokers. Each subject was required to answer the guided questionnaire followed by clinical examination. The questionnaires had 11 questions and were set in English and Bahasa Melayu. Basically, the questionnaire consisted of 3 sections: socio-demographic data, smoking status and subject's knowledge on periodontal health. The clinical parameters used in this study were: Community Periodontal Index, Visible Plaque score, Gingival Bleeding Index and Calculus Surface Index. Results showed that out of 39 subjects, 28 subjects (71.8%) were current smokers, followed by 6 subjects (15.4%) and 5 subjects (12.8%) who were former and who never smoked respectively. From the 216 sextants examined, 42 sextants (19.4%) were healthy gingival, 127 sextants (58.8%) suffered from gingivitis and 47 (21.8%) sextants suffered from periodontitis. There were positive relationships between smoking and periodontal status.
Besides other indications, the spring cantilever bridge can solve the difficult clinical problem of providing diastema on either side of a pontic. Unlike the conventional bridges, it has a somewhat controversial design in that the anterior pontic is connected to its retainer on a posterior abutment by a relatively long flexible palatal bar. This paper presents a case report of a spring bridge which fractured due to metal fatigue after 30 years of continued service. Other studies reported a mean life span of 8-10 years for conventional bridges. The advantages of the spring cantilever bridge are also discussed.
The objective of this retrospective study was to investigate what percentage of the dental students in the University of Malaya has a tooth size discrepancy. The sample comprised 40 good quality pre-treatment study models with fully erupted and complete permanent dentitions from first molar to first molar, which were selected from the dental students of the University of Malaya. The mesiodistal diameter tooth sizes were randomly measured manually from first molar to first molar using digital calliper (Mitutoyu) accurate to 0.01 mm, and the Bolton analyses for anterior and overall ratios were calculated by scientific calculator. Reproducibility analysis for intra- and interexaminer calibrations was assessed by measuring 10 study models twice, a week apart. A paired sample t-test and the correlation coefficient were used to evaluate the systematic and random errors of the measurements using Statistical Package for Social Sciences (SPSS) version 12.0. The reproducibility of the intra and inter-examiners for the sum of upper and lower mesiodistal tooth size were high (average mean difference = 0.62, r = 0.82). This study found 47.5% of the samples had anterior, and about 10% had overall· tooth width ratios greater than 2 standard deviations from Bolton's mean. Large percentage of the dental students of the University of Malaya has tooth size discrepancies outside of Bolton 2 standard deviations. It would seem prudent to routinely perform the tooth size analysis and include the findings into orthodontic treatment planning.
MeSH terms: Calibration; Molar; Retrospective Studies; Social Sciences; Students, Dental; Tooth; Tooth Eruption; Reproducibility of Results; Dentition, Permanent
The purpose of this study was to investigate the light intensity of selected light curing units with varying distance and angulation of the light curing tip and lightmeter. Materials and method: Four types of light units; Spectrum 800 (Dentsply), Coltulux 3 (Coltene), Elipar FreeLight 2 (3M Espe) and Starlight Pro (Mectron) were evaluated for light intensity at various distances between the light curing tip and the radiometer Cure Rite Denstply (0,1,3,5,10 and 15 mm). The light curing units were tested at right angles to the aperture of the light meter and at the angles of 45°, 60° to it at a standardized 5 mm distance. Results: The highest light intensity was obtained when the tip of light curing unit was in contact with the lightmeter aperture. The light intensity decreased significantly when the light tip was placed 5mm, 10mm and 15mm away from the lightmeter aperture. However, no significant differences (p> .05) were detected between Omm, Imm and 3mm. There was a decrease in light intensity when light~·tip was angulated at 45° and 60° except for Coltolux 3. Conclusions: The intensity of the curing light was affected by the distance between the light curing tip and the lightmeter. However, the decrease in light intensity of the light curing unit was found not to obey the inverse square law for the distances 0 to 15 mm. The study found that there was no significant difference between 45° and 60° angulation between the light curing tip and the lightmeter. However, the decrease in light intensity was significant when compared to the light tip placed perpendicular (90°) to the aperture of the light meter.
Dental fear is a hindrance to the effective provision of oral health care and causes patients to delay, or even avoid necessary care altogether. The aim of this study was to determine the prevalence and level of dental fear, to identify specific fear provoking stimuli and also to explore the avoidance behaviour among the respondents. A cross-sectional study was conducted on a sample of 407 antenatal mothers utilizing the Kleinknecht's Dental Fear Survey Questionnaire. The overall prevalence of dental fear was 94.1% of which 67.6% of the subjects reported low fear levels, 26.5% were moderately fearful while none were highly fearful. Only 5.9% of the subjects reported no fear. The drill and anaesthetic needle were identified as the most fear provoking objects. Subjects with moderate fear were about 6.4 times (OR=6.39; 95%CI 3.81-10.75) more likely to avoid making appointments and 6 times (OR=6.05; 95% CI 3.20-11.50) more likely to cancel appointments compared to subjects with lower levels of fear. This. study indicates that dental fear is a common problem among antenatal mothers contributing to poor dental attendance.