Perceived and normatic needs for dental treatment is increasing globally, as patients in various parts of the world demonstrate different patterns of oral diseases (1). Some regions showed an increasing demand for aesthetic dentistry (2), while some demonstrated a rise in procedures relating to tooth preservation and functional restoration (3). In spite of the variable market demands, it is evident that utilisation of oral health care services has improved worldwide, regardless of patients’ socioeconomic status and other personal or environmental circumstances (1). (Copied from article)
Platelet Rich Fibrin (PRF) is a natural autologous fibrin matrix and is an effective biomaterial product. The application of PRF in oral surgery is not limited to tissue regeneration, but it has been utilized in several minor and major oral surgical procedures. Numerous studies have proven that either alone or in combination with bone graft, PRF acts as bone and soft tissue regeneration and it is able to stimulate physiological wound healing. This case report will introduce the utilization of PRF combined with autogenous bone graft in restoring four walls dental socket defect due to post-surgical extraction complication and plan for implant placement in the future. It acts in the form of a resorbable membrane and stem cell connector to the bone. After 3 months post-surgery review, there was no signs of infection or tissue rejection and the harvested bone was still viable. The PRF is comparable to commercially available membrane in the market, where clinical results can be predicted and possibility of reduction in post-surgical complications is achieved. This is due to 1) its compatibility with bone graft materials notably autogenous type, 2) induced neovascularisation and 3) reduction in inflammatory reaction. Our team is confident that the result of PRF at the edentulous region for rehabilitation purposes is beneficial and cost-effective to our patients.
Aim: The Shortened Dental Arch (SDA) concept, proposed as a strategy to prevent prosthodontics overtreatment, is defined as a specific type of dentition with an intact anterior region and a reduction in the occluding pairs of posterior teeth. While this concept has been accepted worldwide, little is known about such a situation in Malaysia. This study was undertaken to determine the attitudes, awareness and opinion of dentists working at the Faculty of Dentistry, Universiti Teknologi MARA Malaysia (UiTM) towards the SDA concept. Methods and Methods: All dentists (n=71) working at the Faculty of Dentistry, UiTM were invited to participate in a paper-based questionnaire survey to assess their attitudes, awareness and perception towards the SDA concept. Results: The response rate was 59% (n=42). Overall, 85.7% of respondents were aware of the Kayser’s SDA concept. A majority of them (61.1%) learnt about it through undergraduate studies. Only some respondents reported patients’ dissatisfaction in chewing (29.4%), appearance (8.8%) and comfort (6.3%) following application of the concept. Most participants disagreed that missing molar teeth should be replaced in all patients (52.4%), and supported the application of SDA concept in clinical practice (88.1%). However, some would choose to replace missing molars for older patients in order to provide posterior support (90.5%), prevent anterior wear (52.4%) and improve masticatory function (83.3%). Conclusion: Respondents’ awareness and support for the SDA concept suggested its acceptance as a possible strategy in patient care.
It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.
Aim: To assess the prevalence and clinical features of aggressive periodontitis in newly referred patients to the Periodontal Clinic in Seremban.
Methodology: Sample size calculation was done using Epi Info software with minimum sample estimated at 279. 583 new patients who were referred to this clinic from year 2013 to July 2015 were examined clinically and radiographically. Patients were diagnosed using American Academy of Periodontology workshop 1999 definition.
Results: Thirty-one (5.3%) patients were identified as having aggressive periodontitis with 28 (90%) of these patients exhibiting generalized form of aggressive periodontitis. Mean age of these patients was 34.9 years. In terms of gender and ethnicity, 21 females and 18 Malays were diagnosed with Aggressive periodontitis. First molars had the highest amount of clinical attachment loss (CAL=5.4mm). The number of missing teeth at the first visit was at median 2 (Interquartile range=4). The number of prognostically hopeless teeth at first visit was at median 1 (Interquartile range=2). Canines were preserved in most of the patients.
Conclusion: Aggressive periodontitis was found in 5.3% of our samples. It was diagnosed at mean age of 34.9 years old.
People with hearing and/or speech impairments (HSI) reported having difficulty communicating with the dental team, indicating the need for the profession to develop an effective communication strategy when dealing with these patients. This paper discusses the development of a toolkit designed to guide delivery of oral hygiene instruction, oral health education and dental consultation for patients with HSI, and how its use had resulted in an improved oral health outcome in a patient with such disabilities.
In nowadays world, aesthetic dentistry has becoming a trend with the improvement of dental technology and materials. Composite resin becomes the material of choice as it offers good aesthetics, longevity and allow for minimally intervention approach. There are various ways of composite restorative techniques recommended to make out the best restorative outcome. Direct restorative technique promise acceptable cost, appointment time and color matching but it is a challenge for the clinician especially for extensive cavities. Indirect technique is good for extended cavity and providing less operator error, however, it requires multiple appointments, higher cost and laboratory involvement. Computer-aided design/ computer-aided manufacturing (CAD/CAM) technology might reduce the number of appointments, however, it will cause more financial burden to the patient and the clinician. Therefore, semi-direct technique was introduced, it combines the benefits of direct and indirect technique and this technique can be done without the use of any advanced technology and give out a good treatment outcome.
The aim of this literature review is to review the current care setting for conscious sedation for dentistry in the primary and secondary care sectors in the United Kingdom (UK) and to recommend a plan for setting up a service for the provision of conscious sedation in Malaysia based on the UK models. An electronic search using various databases and web-based search engines were conducted during the period from January to March 2016. Various combinations of keywords were used to help the literature search including dental care settings, conscious sedation, equipment for conscious sedation, referral pathway for sedation and training in sedation. The findings have shown that, although there are specific requirements for the facilities practising sedation, the majority of the requirements are common to all dental practices, such as health and safety, infection control, emergency drugs etc. The good integration between primary and secondary care in providing conscious sedation relies on the compliance with the referral pathway. It is recommended that the practice of conscious sedation in the dental setting in Malaysia begins at the Special Needs Dentistry (SND) Unit, Kajang Hospital because the unit has been partly equipped for conscious sedation and the specialist in charge has received appropriate training in Conscious Sedation for Dentistry at King’s College London Dental Institute. Ensuring safety, effectiveness and appropriateness of the sedation techniques used are the major aims when delivering care to fit individual needs. It is highly recommended to look into the country in which the service has been well established such as United Kingdom as a reference for future development of the conscious sedation service in Malaysia.
Collaborative teaching is an educational approach that seeks to involve participation of teachers and learners in achieving learning goals and outcomes in an interactive manner (1). Such approach has been effective in equipping students with knowledge and/or skills via high levels of learning, while allowing interpersonal development such as teamwork, time management, as well as communication and written competencies (2, 3). (Copied from article)
Delayed eruption of permanent upper incisors is a cause for concern to patients. It causes aesthetic, function and speech problems. This case report describes a technique of managing impacted dilacerated maxillary central incisors using removable appliances over one and a half year. It is a simple, operator- friendly and economical treatment option with favorable result.
Cosmetic surgery and aesthetic dentistry go hand in hand. As dentists, we are trained to analyze aesthetics from the features of the skeletal pattern and dental malocclusion, symmetry of the face, measurement of golden proportions and the features of the smile line. However, several facial ethnic features such as a ‘single eyelid’ may cause a person to be deemed as aesthetically challenged due to Western influence. This article reviews the prevalence of single and double eyelid in Asians and explains why some present with either one or double eyelids. The readers are also introduced to the term “Asian Blepharoplasty”.
Medical emergencies or unexpected events are situations that all dental practitioners are trained to face, yet none hope they become a reality. Although they occasionally happen, the prevalence is rather low. This special article will touch on three aspects: before, during and after an unexpected event happening in a general dental practice. Emphasis will be given on the ‘during and after’ phases, which includes the activation of basic life support when necessary, and the documentation that a dental practitioner needs to prepare in the event of adverse outcome despite of efforts made to prevent and manage it.
Aim: Orthodontic treatment duration is variable and associated with many factors Very few studies looks at operator changes influencing treatment duration and outcome. This study aims to evaluate the influence of operator changes on treatment time and quality.
Methodology: This is a 4-year cross-sectional retrospective study of preadjusted Edgewise two-arch appliance cases treated by single/ multiple operators and finished/debonded by the author. 60 singleoperator (Group 1) and 82 multiple-operator (Group 2) cases were selected and the Peer Assessment Rating (PAR) Index was used to measure treatment outcome.
Results: Group 1 (2.31 years, SD.86) had statistically significantly shorter treatment time than Group 2 (3.25 years, SD1.23). Mean % reduction in PAR scores was high (88.7%), although single operators (92%) showed a slightly higher (p=.04) reduction than multiple-operator cases (86.2%). Post-treatment PAR score was slightly higher in Group 2 (4.6, SD5.4) compared with Group 1 (2.6, SD2.9). There was no significant difference in post-treatment PAR scores with operator changes from within and outside the clinic although there was difference in treatment duration (p=.0001). Possible predictors of treatment duration included number of failed/changed appointments, extractions and pre-treatment PAR. Multiple linear regression model showed significant association of treatment time with failed/changed appointments (p=.0001) and number of operators (p=.0001) although this contributed to 57.5% of possible factors (r=.762) .
Conclusion: Change of operator contributes to increased treatment time by 11.3 months. Although standard of treatment was high in both groups there was slightly better outcomes in single operators. The reduction in PAR score can be predicted more accurately in single operators.
In 2013, the Malaysian Education Blueprint (Higher Education) was developed by the Ministry of Education to guide the transformation process of the education system in this country for the next decade, starting from 2015 (1). The blueprint highlighted core aspirations for Malaysian higher education, which includes rapid expansion of research output and quality (1). This effort is in line with the nation's aspiration to uplift the standard of service provision among healthcare professionals, whose practice should advance on the essence of high quality scientific evidence.(Copied from article)
Full mouth rehabilitation of the severely collapsed dentition is one of the most challenging procedures in restorative dentistry. The treatment aims are not only to restore function with sustainable restorations and to provide patients with an aesthetic smile, but also to conserve the remaining dentition and maintain the health of supporting structures. This case report describes the complete oral rehabilitation of a patient with severely broken down dentition and loss of posterior support. Loss of posterior support will not only result in breakdown of remaining dentition in the anterior region due to occlusal overload, it also adds years to the patient’s appearance. A complete treatment plan was outlined involving multidisciplinary team treatment included sessions of oral hygiene instructions and re-assessments, a diagnostic stage with provisional overlay denture at an increased occlusal vertical dimension (OVD), endodontic treatment and retreatment, crown lengthening as well as implant surgery. Final restoration involved both fixed and removable prostheses. Maintenance review was carried out periodically after completion of treatment for two years and good outcome was observed.
Introduction: Cone beam computed tomography (CBCT) has gained interest for improving diagnosis, treatment planning and facilitating better patient’s management in various dental fields. This study is part of the quality assurance programme in Dental Faculty, International Islamic University Malaysia (IIUM). This center offers dental radiography service not only for internal clinics but also act as a referral center for the eastern areas, Pahang, Malaysia. Aims: The aims of this study were; 1) to assess referral pattern for CBCT scans at the Dental Faculty, IIUM, Kuantan, and 2) to evaluate the completeness of the current referral form used by clinicians (for both internal and external referrals). Methods: An audit looking at both the external and internal referral CBCT forms of a four year period of examination (2010-2013) at the Radiology Unit, Dental Faculty, IIUM. Source of referrals, indications for CBCT and the referral forms were examined and analysed. Results: Total CBCT scans taken within the four-year period were 171, in which 96 were referred from internal sources whilst 75 were external referrals. External referrals were mainly from Paediatric Dentistry and Orthodontic clinics (59%), while other referrals were from implant clinic (20%), Paediatrics and Special Needs clinic (15%), Oral MaxilloFacial Surgery clinic (4%) and Periodontic clinic (1%) and Oral Medicine Oral Pathology (OMOP) clinics (1%). All forms from external sources are completely filled. In the Internal referral form, 41% of them came with no indication of why CBCT need to be taken. Out of 59% of cases with indications, 33% came from Paediatric Dentistry and Orthodontic department, followed by Oral Surgery department (10%). Implant treatment planning accounted for 7% of cases, Periodontics 4%, Temporo-Mandibular Joint assessment 2%, 1% for Conservative dentistry and Prosthodontic cases respectively and 1% cleft case. Further analysis of the internal referral forms revealed that only 14% of the forms were filled with complete patients’ details, 40% specified pregnancy status and 67% clearly stated patients’ medical status. Area of interest was not specified in 69% of cases and clinicians’ names were not stated in 94% of the cases. Majority of the forms were completed with clinicians’ signature (99%) and also radiographers’ details (97%). Conclusions: This study indicated that the majority of IIUM CBCT referrals were from internal sources. However, most of the referral forms were not completely filled. The internal form used, therefore, need to be improved and a much firmer referral framework should be in place.
Forensic odontology has been an interdisciplinary part of forensic science for many years. In Malaysia, this forensic discipline has been practiced for more than two decades however it is still considered a new discipline as there are a limited number of specialists. To date, there are less than ten practicing forensic odontologists in Malaysia. Many dentists do not have a clear perception of this field, thus forensic odontology rarely becomes a career of choice. The purpose of this article is to highlight the attributes of a competent forensic odontologist and encourage dentists towards this challenging career path.
This study was conducted on Royal Malaysian Navy submariners who were having training in France. It was designed to compare the oral health experiences and practices while under water and on land. Methods Eightysix Royal Malaysian Navy (RMN) submariners, who had undergone at least one cycle (288 hours) of under water training, were selected to participate in a self-administered questionnaire survey. Results Seven percent of the respondents reported oro-facial pain and discomfort; 9.3% reported bleeding gums and 12.8% experienced halitosis while under water. Of those experience oral problems, 82% reported disruption of their daily activities while under water. The study showed that 82.5% of them brush their teeth at least twice a day and 94.2% rinse after meals when there were under water. Meanwhile studies on land showed that 90.7% of them brush their teeth at least twice a day and 96.5% rinse after meals. Flossing was not practiced by most of the respondents. Conclusion It is concluded that brushing and rinsing are practiced regularly by submariners regardless whether they are on land or under water but flossing is not a common practice both on land and under water. Dental emergencies, such as toothache, TMJ pain and discomfort do occur during submarine operations and disrupt their daily activities. This might poses a threat to submarine operations.
Compliance to delivery of orthodontic appliances within specified times and factors which influenced compliance by dental technicians in Selangor was evaluated. This is a prospective 8-month study of 18 trainee/ trained technicians from 4 main government dental laboratories in Kajang, Klang, Tanjong Karang and Shah Alam. Delivery times specified by orthodontists were 1 day for plastic retainer, 3 days acrylic retainer, 5 days active plates (URA), 10 days functional appliances (FA), 10 days transpalatal arch (TPA) and 10 days for quadhelix. Punctual delivery was recorded as ‘compliant’. Compliance was compared between appliances, clinics, technicians, orthodontists and seniority of technicians. The sample comprised appliances from 365 patients; 38 (10.4%) Tanjong.Karang, 114 (31.2%) Kajang, 191 (52.3%) Klang and 22 (6.0%) Shah Alam. The majority of appliances were retainers (66.3%), followed by URA (13.4%), functionals (9.3%), TPA (9.0%) and quadhelix (1.9%). Mean compliance for all appliances in Selangor was 55%. Plastic retainers had highest compliance (77.8%), followed by acrylic retainers (59.9%), quadhelix (57.1%), FA (47.1%), TPA (45.5%) and URA (24.5%). Senior technicians (>3 years in service) were more compliant than juniors (
Evaluation of the mechanical behaviour of restoration dental materials is essential to understand their performance under different load conditions and to estimate their durability under clinical oral function. Restorative materials and dental tissues like other materials by having specific mechanical properties, such as static strength (i.e. compressive strength, tensile strength, flexural strength) and dynamic strength (i.e. fatigue strength). The selection of proper mechanical test type depends on the goals that the study claims to define. On such basis, the mechanical test can be chosen correctly. Laboratory studies should be designed as replications of the clinical oral circumstances to measure the mechanical and physical properties of a material and any arbitrary choices in the design of the study may result in large variations of data.