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Orthodontic alignment of ankylosed teeth with aid of surgical luxation: Case series

Chong JA, Mah EC

J Orthod, 2023 Jul 04.
PMID: 37401621 DOI: 10.1177/14653125231185362

BACKGROUND: Identification of tooth ankylosis before comprehensive orthodontic treatment can be challenging. This case series illustrates different presentations of tooth ankylosis, the importance of early diagnosis, the use of surgical luxation to aid orthodontic alignment of ankylosed teeth and its sequelae.
CASE PRESENTATION: All three cases were adolescents: a 14-year-old girl with a highly placed upper left lateral incisor and history of general anaesthesia; a 14-year-old boy with an impacted upper right first premolar and history of dental trauma; and a 13-year-old girl with an infraoccluded upper left central incisor with history of replantation due to avulsion. Iatrogenic malocclusion developed from attempts to align ankylosed teeth. Subsequently, surgical luxation was performed, and the ankylosed teeth were successfully aligned. However, it was associated with pulp calcification, root resorption and recurrence of ankylosis.
CONCLUSION: Surgical luxation and orthodontic alignment of ankylosed teeth can be considered a useful short-term solution to delay the need of surgical removal and teeth replacement.
Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia

Chong JA, Chew JK, Ravindranath S, Pau A

J Dent Educ, 2014 Feb;78(2):206-12.
PMID: 24489028

This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.
The Heritability of Palatal Rugae Morphology Among Siblings*, †

Chong JA, Syed Mohamed AMF, Marizan Nor M, Pau A

J Forensic Sci, 2020 Nov;65(6):2000-2007.
PMID: 32692413 DOI: 10.1111/1556-4029.14507

Although there is clinical applicability of the palatal rugae as an identification tool in forensic odontology, controversy exists whether the palatal rugae patterns are stable or variable. The greater the genetic component, the higher the probability that palatal rugae patterns are stable. The aim of this study was to compare the palatal rugae morphology between full siblings and the proportion of variability due to genetic component. This cross-sectional study was conducted on digital models of 162 siblings aged 15-30 years old. The palatal rugae patterns were assessed with Thomas and Kotze (1983) classification using Geomagic Studio software (3D Systems, Rock Hill, SC). The palatal rugae morphology between siblings showed significantly similar characteristics for total number of left rugae (p = 0.001), left primary rugae (p = 0.017), secondary rugae for right (p = 0.024) and left sides (p = 0.001), right straight rugae (p = 0.010), and right convergent rugae (p = 0.005) accounting for at least 6.25%-12.8% of the variability due to heredity. Despite the similarities found, the palatal rugae patterns showed significant differences between siblings of at least 46.9% (p = 0.001). Zero heritability was found in 9 of the 14 rugae patterns. Meanwhile, total number of rugae, primary, backward, and convergent rugae showed moderate heritability (h2 > 0.3) and total number of secondary rugae showed high heritability (h2 > 0.6). In conclusion, despite the individuality characteristics, an appreciable hereditary component is observed with significant similarities found between sibling pairs and the palatal rugae patterns were both environmentally and genetically influenced.
Morphological patterns of the palatal rugae: A review

Chong JA, Mohamed AMFS, Pau A

J Oral Biosci, 2020 09;62(3):249-259.
PMID: 32619633 DOI: 10.1016/j.job.2020.06.003

BACKGROUND: Palatal rugae are asymmetric ridges of connective tissue located behind the incisive papilla over the anterior hard palate. They serve as stable superimposition landmarks to assess tooth movement in orthodontics and as identification aids in forensic odontology. However, the stability of palatal rugae remains controversial. This review aimed to describe the genetic, growth, and environmental factors that may influence the palatal rugae patterns. A broad search of PubMed and ScienceDirect databases was conducted. A total of 193 articles were identified, of which 73 met the selection criteria. Data were extracted into a table that presented the details of the study, sample description, and changes in the palatal rugae patterns.
HIGHLIGHT: There were conflicting results regarding sexual dimorphism and population characterization of the palatal rugae patterns. All rugae showed positional changes, increased lengths, and lower numbers, but no significant shape changes with growth. The lengths, numbers, and positions of the rugae were affected by orthodontic treatment, especially their lateral points, but their individual characteristics did not change.
CONCLUSION: The diversity in rugae patterns and their potential for sex discrimination among different populations showed differing results due to individual variations and the complex influence of genetic, growth, and environmental factors on their morphology.