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Accuracy of single and parallax film and digital periapical radiographs in diagnosing apical periodontitis - a cadaver study

Kanagasingam S, Hussaini HM, Soo I, Baharin S, Ashar A, Patel S

Int Endod J, 2017 May;50(5):427-436.
PMID: 27063356 DOI: 10.1111/iej.12651

AIM: To compare the accuracy of film and digital periapical radiography (PR) in detecting apical periodontitis (AP) using histopathological findings as a reference standard.
METHODOLOGY: Jaw sections containing 67 teeth (86 roots) were collected from nine fresh, unclaimed bodies that were due for cremation. Imaging was carried out to detect AP lesions using film and digital PR with a centred view (FP and DP groups); film and digital PR combining central with 10˚ mesially and distally angled (parallax) views (FPS and DPS groups). All specimens underwent histopathological examination to confirm the diagnosis of AP. Sensitivity, specificity and predictive values of PR were analysed using rater mean (n = 5). Receiver operating characteristics (ROC) analysis was carried out.
RESULTS: Sensitivity was 0.16, 0.37, 0.27 and 0.38 for FP, FPS, DP and DPS, respectively. Both FP and FPS had specificity and positive predictive values of 1.0, whilst DP and DPS had specificity and positive predictive values of 0.99. Negative predictive value was 0.36, 0.43, 0.39 and 0.44 for FP, FPS, DP and DPS, respectively. Area under the curve (AUC) for the various imaging methods was 0.562 (FP), 0.629 (DP), 0.685 (FPS), 0.6880 (DPS).
CONCLUSIONS: The diagnostic accuracy of single digital periapical radiography was significantly better than single film periapical radiography. The inclusion of two additional horizontal (parallax) angulated periapical radiograph images (mesial and distal horizontal angulations) significantly improved detection of apical periodontitis.
Fulltext Revisiting the association between candidal infection and carcinoma, particularly oral squamous cell carcinoma

Mohd Bakri M, Mohd Hussaini H, Rachel Holmes A, David Cannon R, Mary Rich A

J Oral Microbiol, 2010 Dec 21;2.
PMID: 21523221 DOI: 10.3402/jom.v2i0.5780

BACKGROUND: Tobacco and alcohol are risk factors associated with cancer of the upper aerodigestive tract, but increasingly the role of infection and chronic inflammation is recognized as being significant in cancer development. Bacteria, particularly Helicobacter pylori, and viruses such as members of the human papilloma virus family and hepatitis B and C are strongly implicated as etiological factors in certain cancers. There is less evidence for an association between fungi and cancer, although it has been recognized for many years that white patches on the oral mucosa, which are infected with Candida, have a greater likelihood of undergoing malignant transformation than those that are not infected.
OBJECTIVE: This article reviews the association between the development of oral squamous cell carcinoma in potentially malignant oral lesions with chronic candidal infection and describes mechanisms that may be involved in Candida-associated malignant transformation.
Maxillofacial trauma with emphasis on soft-tissue injuries in Malaysia

Hussaini HM, Rahman NA, Rahman RA, Nor GM, Ai Idrus SM, Ramli R

Int J Oral Maxillofac Surg, 2007 Sep;36(9):797-801.
PMID: 17630250

Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.
Oral cancer screening in private dental practices in a developing country: opportunities and challenges

Saleh A, Kong YH, Haron N, Aripin SF, Vadiveloo M, Hussaini H, et al.

Community Dent Oral Epidemiol, 2017 04;45(2):112-119.
PMID: 27805279 DOI: 10.1111/cdoe.12266

OBJECTIVES: Private dental practitioners constitute approximately 40% of all registered dentists in Malaysia, and this group affords an avenue for prevention and early detection of oral cancer. However, such activities are still limited. This study investigated the feasibility of incorporating opportunistic screening of oral cancer in the private dental setting.
METHODS: Dentists were recruited through two main dental associations in Malaysia and attended a 1-day training session on recognizing abnormalities within the oral cavity. Following the training, the dentists conducted screening and provided risk habits cessation advice at their respective clinics for 6 months. The impact of the program was evaluated by determining the number of patients who were screened and/or provided with risk habits cessation advice.
RESULTS: Twenty-six dentists took part in the program and conducted opportunistic screening on a total of 2603 individuals. On average, they screened about 23.0% of their patients and 5.1% were given risk habits cessation advice. Notably, dentists who had lower patient load were more likely to conduct opportunistic screening.
CONCLUSIONS: While the participating private dentists state that they have a role in performing opportunistic screening and providing risk habits cessation advice, these activities are still not a priority area in the private clinics, strongly suggesting that strategies to motivate dentists in this setting are urgently needed.
Fulltext In vitro study of white spot lesion: Maxilla and mandibular teeth

Mohamed AM, Wong KH, Lee WJ, Marizan Nor M, Mohd Hussaini H, Rosli TI

Saudi Dent J, 2018 Apr;30(2):142-150.
PMID: 29628737 DOI: 10.1016/j.sdentj.2017.12.001

Aim: The aim of the study was to evaluate the effect of resin infiltration on colour changes and surface roughness of artificial white spot lesions (WSLs) on maxillary and mandibular premolar.
Materials and methods: Sixty (60) extracted sound Maxilla (Mx) and Mandibular (Mn) premolars were randomly divided into 2 groups (test and control). Artificial WSLs were produced on buccal surface of teeth and were immersed in artificial saliva for 8 weeks. Colour components (L∗, a∗, b∗) and surface roughness (Sa∗) were assessed on 40 teeth using colour difference meter RD-100 and Alicona® Infinite Focus profilometer respectively. The measurements were done at baseline (T1), directly after artificial WSLs (T2), after 24 hours immersed in saliva and application of resin (T3) and immersion in artificial saliva for 1 (T4), 2 (T5), 4 (T6), 6 (T7) and 8 (T8) weeks. SEM images analysis were carried out on 20 teeth in four time points.
Results: The values of L∗ (lightness), b∗ (yellow/blue) and Sa∗ (surface roughness) are gradually reduced to the baseline value. Whereas, the value of a∗ gradually increased with distinct treatment time to achieve the baseline value. The higher value of L∗ and Sa∗, the whiter the lesion suggesting higher degree of enamel demineralization and surface roughness. Lower L∗ values suggest a masking colour effect.
Conclusion: The material produced favorable esthetics on colour and the surface roughness of teeth at distinct treatment times. It is recommended to be used to improve WSL post orthodontic treatment.
Transcriptional profiling of oral squamous cell carcinoma using formalin-fixed paraffin-embedded samples

Saleh A, Zain RB, Hussaini H, Ng F, Tanavde V, Hamid S, et al.

Oral Oncol, 2010 May;46(5):379-86.
PMID: 20371203 DOI: 10.1016/j.oraloncology.2010.02.022

Despite the advances in cancer treatment, the 5-year survival rate for oral cancer has not changed significantly for the past 40 years and still remains among the worst of all anatomic sites. Gene expression microarrays have been used successfully in the identification of genetic alterations in cancer development, however, these have hitherto been limited by the need for specimens with good quality intact RNA. Here, we demonstrated the use of formalin-fixed paraffin-embedded tissues in microarray experiments to identify genes differentially expressed between cancerous and normal oral tissues. Forty-three tissue samples were macrodissected and gene expression analyses were conducted using the Illumina DASL assay. We report RNA yield of 2.4 and 0.8 microg/mm(3) from tumour and normal tissues, respectively and this correlated directly with the tissue volume used for RNA extraction. Using unsupervised hierarchical clustering, distinct gene expression profiles for tumour and normal samples could be generated, and differentially expressed genes could be identified. The majority of these genes were involved in regulation of apoptosis and cell cycle, metastasis and cell adhesion including BCL2A1, BIRC5, MMP1, MMP9 and ITGB4. Representative genes were further validated in independent samples suggesting that these genes may be directly associated with oral cancer development. The ability to conduct microarrays on formalin-fixed paraffin-embedded specimens represents a significant advancement that could open up avenues for finding genes that could be used as prognostication and predictive tools for cancer.