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  1. Ismail N, Hamzah SH, Wan Mokhtar I
    Case Rep Dent, 2022;2022:5288515.
    PMID: 35070457 DOI: 10.1155/2022/5288515
    Cerebral palsy is a neurological and motor condition characterised by muscle balance and posture impairments. Bruxism and malocclusion were frequently observed in patients with cerebral palsy, in contrast to other oral anomalies. The report outlines how severe awake bruxism is managed in a 16-year-old Korean boy who has nonverbal spastic cerebral palsy and global developmental delay. The treatment protocol involved the fabrication of soft occlusal splints of three and four millimetres in thickness, followed by the placement of stainless-steel crowns on all first permanent molars whilst video recording and a bruxism diary was kept. Fixed restorations demonstrate increased endurance in withstanding bruxism force in persons who are dependent on their caretaker.
  2. Ismail N, Isa KAM, Wan Mokhtar I
    Children (Basel), 2022 Oct 05;9(10).
    PMID: 36291461 DOI: 10.3390/children9101526
    Passive immobilisation is regarded as able to potentially cause physical distress and intense anxiety manifestations. The study aims to investigate the physiological variations of children with special health care needs while using a Papoose board and a combination of basic behaviour guidance during dental treatment. This is a randomised crossover trial involving 90 children with special health care needs receiving standard dental care with two methods of behaviour guidance sequentially. Exposure A is a combination of tell-show-do, distraction, and positive reinforcement, while exposure B is passive immobilisation with a Papoose board. The subject child’s blood pressure, heart rate, and oxygen saturation level were measured at four different times during dental treatment. In total, 74 children’s physiological data were successfully collected with a mean age of 9.85 years (SD = 2.71). Further, 64.9% of the children were diagnosed with autism spectrum disorder, 12.2% with attention deficit hyperactivity disorder, 9.5% with intellectual disability, 8.1% with Down syndrome, 2.2% with global developmental delay, and 1.1% with dyslexia and cerebral palsy, respectively. The measurement of children’s blood pressure, heart rate, and oxygen saturation level with the application of a Papoose board or a combination of the basic behaviour guidance revealed no significant changes (p > 0.05). The use of a Papoose board is safe and has no discernible influence on the child’s physiological responses.
  3. Ismail N, Mohd Yusof MYP, Wan Mokhtar I
    J Clin Pediatr Dent, 2024 May;48(3):6-14.
    PMID: 38755976 DOI: 10.22514/jocpd.2024.053
    Exploring parental opinions regarding the use of passive immobilisation during dental treatment is critical when identifying behaviour guidance application priorities. Instead of being dismissed as an inappropriate and less favourable option, this article aims to systematically evaluate factors affecting parental acceptance toward the use of passive immobilisation as behaviour guidance among children during dental treatment in various populations and regions. This research follows Arksey and O'Malley framework and updated by Joanna Briggs Institute Framework for Scoping Reviews methodology to summarise 40 research papers from 1984 to 2022 in PubMed, Web of Science, Science Direct, EBSCO Host, Scopus, grey literature and Google search outlining the research trend of parental acceptance toward passive immobilisation as behaviour guidance. Factors influencing parental acceptance toward the use of passive immobilisation were classified into parental socio-economic and demographic characteristics, exposure method of the devices to the parents, type of dental procedures, and children's cooperation and cognitive level. In conclusion, the current explorative review of the parental perspective toward passive immobilisation proposed a recommendation and facilitate the dentist to consider this technique as an alternative option for behaviour guidance in paediatric dentistry.
  4. Wan Roselan WN, Bawawi SN, Baharuddin IH, Wan Mokhtar I
    Spec Care Dentist, 2023;43(4):409-415.
    PMID: 36087053 DOI: 10.1111/scd.12774
    AIM: The study evaluated parents' oral health care experiences and practices for their children with Down syndrome and its effect on the child's teeth and gingiva's condition METHOD: 75 parents of children with Down syndrome between 0 and 16 years of age responded to 18-item bilingual questionnaire concerning their child's oral health status RESULT: Most parents rated their child's teeth and gingiva health as good. There is no correlation found between experience score and practice score (r = -0.057), and no correlation between practice score on the child's both teeth (r = -0.001) and gingiva's condition (r = 0.031).

    CONCLUSION: The parental oral health care experience and practices for their children with Down syndrome are deemed sufficient. However, a tailor-made comprehensive oral health care for them is very advisable, thus eradicating the barriers and challenges.

  5. Ashraf M, Abdullah J, Ariff A, Biswal BM, Mokhtar I, Othman N
    Malays J Med Sci, 2003 Jan;10(1):95-9.
    PMID: 23365508
    Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.
  6. Mahmod M, Mohd Darul ND, Mokhtar I, Md Nor N, Md Anshar F, Maskon O
    Int J Infect Dis, 2009 Sep;13(5):e316-8.
    PMID: 19541521 DOI: 10.1016/j.ijid.2009.01.017
    While electrocardiogram (ECG) changes are common during viral dengue infection, atrial fibrillation (AF) is a very rare manifestation. It has previously been highlighted that cardiac complications during dengue infection are invariably transient and will spontaneously resolve following recovery from the illness. We present the case of a young patient with IgM- and IgG-positive dengue hemorrhagic fever complicated by AF. ECG revealed a structurally normal heart. The patient remained in AF despite resolution of the illness. Reversion to normal sinus rhythm was achieved after loading of oral amiodarone.
  7. Yusof MYPM, Rahman NLA, Asri AAA, Othman NI, Wan Mokhtar I
    Imaging Sci Dent, 2017 Dec;47(4):233-239.
    PMID: 29279822 DOI: 10.5624/isd.2017.47.4.233
    Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor.

    Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis.

    Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved.

    Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients.

  8. Mohd Yusof MYP, Wan Mokhtar I, Rajasekharan S, Overholser R, Martens L
    Forensic Sci Int, 2017 Nov;280:245.e1-245.e10.
    PMID: 28958768 DOI: 10.1016/j.forsciint.2017.08.032
    Through numerous validation and method comparison studies on different populations, the Willems method exhibited a superior accuracy. This article aims to systematically examine how accurate the application of Willems dental age method on children of different age groups and its performance based on various populations and regions. A strategic literature search of PubMed, MEDLINE, Web of Science, EMBASE and hand searching were used to identify the studies published up to September 2014 that estimated the dental age using the Willems method (modified Demirjian), with a populations, intervention, comparisons and outcomes (PICO) search strategy using MeSH keywords, focusing on the question: How much Willems method deviates from the chronological age in estimating age in children? Standardized mean differences were calculated for difference of dental age to chronological age by using random effects model. Subgroup analyses were performed to evaluate potential heterogeneity. Of 116 titles retrieved based on the standardized search strategy, only 19 articles fulfilled the inclusion criteria for quantitative analysis. The pooled estimates were separately kept as underestimation (n=7) and overestimation (n=12) of chronological age groups for both genders according to primary studies. On absolute values, females (underestimated by 0.13; 95% CI: 0.09-0.18 and overestimated by 0.27; 95% CI: 0.17-0.36) exhibited better accuracy than males (underestimated by 0.28; 95% CI: 0.14-0.42 and overestimated by 0.33; 95% CI: 0.22-0.44). For comparison purposes, the overall pooled estimate overestimated the age by 0.10 (95% CI: -0.06 to 0.26) and 0.09 (95% CI: -0.09 to 0.19) for males and females, respectively. There was no significant difference between the young and older child in subgroup analysis using omnibus test. The mean age between different regions exhibited no statistically significant. The use of Willems method is appropriate to estimate age in children considering its accuracy among different populations, investigators and age groups.
  9. Affandi TYIMS, Wan Mokhtar I, Mohd Yusof MYP, Ahmad MS
    J Int Soc Prev Community Dent, 2023;13(3):256-263.
    PMID: 37564173 DOI: 10.4103/jispcd.JISPCD_228_22
    AIMS AND OBJECTIVES: Special care dentistry (SCD) provides oral health care to disabled individuals in an environmental, cultural or social setting that supports their oral health. This study aimed to analyze the profiles of patients managed at an SCD clinic in a teaching hospital based on their sociodemographic background, medical condition or disability, dental diagnosis and treatment provided.

    MATERIALS AND METHODS: This retrospective audit study included patients seen from the clinic's inception in January 2017 until June 2022, retrieved from the faculty's record management system. The pattern of patients seen was arranged on an Excel sheet and analyzed using SPSS. Quantitative data were analyzed via descriptive analysis (frequency) and chi-square test (P < 0.05).

    RESULTS: A 220% surge in the number of patients treated between January 2017 and June 2022, from two to 91 years old, with more male patients seen. Most patients had an intellectual disability (49.7%), followed by medical compromised (16.4%) and genetic conditions or syndromes (12.0%). 43% of had caries, which is more prevalent in women, and 31.6% had periodontal disease, with the majority being between the ages of 21 and 40. Periodontal treatment accounted for most of the dental treatment (76.1%). Even though only a small percentage of endodontic therapy was performed (2.4%), a significant association was found between the treatment, gender and age group of patients seen in the clinic.

    CONCLUSION: Considering their health profile, oral diagnosis and therapy, this study demonstrated the varied sorts of patients encountered in an SCD specialist clinic. This useful information will be beneficial in the development of a comprehensive care dentistry center for this community.

  10. Mohd Suria TYI, Omar AF, Wan Mokhtar I, Rahman ANAA, Kamaruddin AA, Ahmad MS
    Spec Care Dentist, 2023;43(6):848-855.
    PMID: 37013967 DOI: 10.1111/scd.12857
    OBJECTIVES: This study aims to analyze the impact and students' perceptions of online peer-assisted learning (OPL), developed as an alternative and innovative approach to Special Care Dentistry (SCD) training during the COVID-19 pandemic. Online peer-assisted learning (OPL) is an alternative pedagogical approach that combines online education and peer-assisted teaching.

    METHODS: The OPL session was conducted by two postgraduate students in SCD (as teachers), to final year undergraduate dental students (as learners) (n = 90), supervised by two specialists in SCD-related areas (as supervisors). Vetted online pre- and post-intervention quizzes were conducted before and after the session, respectively, followed by an online validated feedback survey of the students' learning experiences. Meanwhile, a reflective session was conducted between the postgraduate students and supervisors to explore their perceptions of OPL. Quantitative data was analyzed via paired t-test (significance level, P 

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