This clinical case report describes an aspect of restorative management of worn teeth. It illustrates the use of diagnostic overlay removable partial denture or DORPD, which has the same function as occlusal splint but with advantages of providing immediate aesthetic improvement and function.
Congenitally missing teeth creates significant challenges to the clinicians in both diagnosis and management. The need for interdisciplinary involvement is essential for optimum dental care. The purpose of this clinical report is to describe an interdisciplinary management of a 15-year-old adolescent presented with non-syndromic oligodontia. The principle of management is presented with special emphasis on prosthodontic aspects. Various restorative treatment modalities specified for oligodontia patients are outlined.
Certain beverages e.g. coffee, tea, soft drinks, fruit juices, alcoholic beverages, may affect the physical properties of composite resins. Objectives: The objectives of this study were to: (1) evaluate the effect of different beverages and chilli sauce on the wear resistance of composite resins, (2) evaluate effect of the duration of immersion in the beverages and chilli sauce on the wear resistance of composite resins.
Materials and methods: Disc specimens were fabricated using two different types of composite resins: (i) Filtek Z350 (3M ESPE, USA, nano-filled composite, 40 specimens) and (ii) Solare P (GC Dental Products Corp, Japan, microhybrid composite, 40 specimens). After polymerization, all the specimens were polished using Enhance Polishing System (Dentsply International Inc.,USA). The specimens were air-dried before weighing using Sartorius BP 221S weighing balance (Sartorius AG, Goettingen, Germany). Ten specimens from each type of composite were immersed in distilled water (control group), Coca cola®, orange juice (Peel Fresh®) and chilli sauce (Maggi®) respectively. The duration of immersion was 6 hours and 1 week. A reciprocal compression-sliding system was used to evaluate the wear resistance of the specimens. The specimens were moved back and forth with a loaded counter-body (235g) against sand paper (P1000, 3M ESPE, USA) in running water. The weight of the specimens were measured after 6 hours of immersion and 20,000 wear cycles and also at 1 week of immersion with further 20,000 wear cycles. The wear resistances were tabulated as percentage of weight loss from the specimens. Results were statistically analyzed using one way ANOVA and post-hoc Tukey’s test (p= 0.05).
Results: The results showed that Solare P has significantly lower wear resistance compared to Filtek Z350. There was no significant difference in wear resistance for Filtek Z350 when immersed in chili sauce, Coca-cola® and orange juice in comparison with control group for 6 hours and 1 week. Similar findings were observed for Solare P.
Conclusion: Within the limitations of this study, it was concluded that Solare P has poorer wear resistance than Filtek Z350. The soaking medium investigated and duration of immersion have no influence on the wear resistance of Solare P and Filtek Z350.
Collaborative learning: a peer group teaching in oral hygiene instructions activity
Introduction: The objectives of this survey were to investigate whether an oral health education activity through collaborative learning and peer group teaching by students would give a positive impact and to evaluate its effectiveness, sufficiency and relevancy of the activity content.
Methods: Three third year dental students in each group were assigned to demonstrate to their group mates the myriad of oral hygiene device for plaque removal and how they are used. Fifteen students were appointed each as a ‘toothbrushing specialist’, ‘flossing specialist’ and interdental toothbrush specialist’ respectively. The others acted as participants in the group. The students then teach each other in the group on how to use these oral hygiene measures. A self-administered questionnaire assessing the activity outcome was given to fifty-two third year dental students who attended the demonstration. The data were entered in the computer using the SPSS version 12.0 for analysis.
Results: Overall response rate was 100%. Slightly more than half of the students felt confident to teach their patients effective toothbrushing and flossing and able to indicate the usage of interdental toothbrush. Most of the students preferred a small group teaching rather than a larger one. The result shows that student’s knowledge, attitudes and practices on effective oral hygiene has gained.
Conclusion: Collaborative learning in the clinical environment appears to give positive impact on the dental student’s ability to impart oral health education to their patients.
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”.
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.
The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
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 prevalence of periodontal abscesses in emergency dental clinics was found to be between 8%-14%. The purpose of this study was to study the clinical features of periodontal abscesses seen in a specialist periodontal unit. There were 14 patients with equal distribution of gender. The mean age was 39.6 years. Twelve upper teeth (86%) were found to be involved as compared to two lower teeth (14%). There were more posterior teeth involved, a total of nine teeth (64%) as compared to five anterior teeth (36%). The mean pocket depth associated with the abscesses was found to be 7.4mm. There were ten buccal sites (71%) as compared to four palatal sites (29%). Average temperature of patients was 36.9° C. Only one patient was found to have cervical lympadenopathy (7%). The teeth involved were found to be mostly mobile with mobility of grade I to III (71%).
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.
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.
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 (
Gingival overgrowth is a well-recognized unwanted effect associated with three major drugs / drug groups - phenytoin, cyclosporine and the calcium channel blockers. Cyclosporine is the first-choice immunosuppressant for preventing allograft rejection in patients who have received organ or bone marrow transplants. This report aims to highlight a case in which the patient on cyclosporine therapy had also contracted Hepatitis C virus infection.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
Objectives: To evaluate the marginal microleakage of Class II cavities restored with various types of composite resins.
Materials and Methods: Standard Class II slot cavities were prepared at the proximal surfaces of 40 intact premolars which were divided into 4 groups. Four types of composite resins (Esthet-X-Denstply, USA, FiltekTMZ350- 3M ESPE, USA, Beautifil- Shofu, Japan and Solare P-GC, Japan) were used to restore the slot cavities. All the specimens were thermocycled and immersed in 0.5% basic fuschin dye for 24 hours. The specimens were then sectioned in mesio-distal direction. The marginal microleakage at the occlusal and cervical margin was scored using the ISO microleakage scoring system. Data was entered using SPSS Version 12.0 and analyzed using STATA software programme.
Results and discussion: All composite resins exhibited worse microleakage at the cervical margin compared to occlusal margin. Esthet-X showed significantly better microleakage score at the occlusal margin compared to Beautifil and Solare P. FiltekTMZ350 and Beautifil showed mainly microleakage into enamel only at the occlusal margin. Solare P demostrated better resistance against microleakage at the cervical margin compared to other composite resin tested. Esthet-X, Filtek Z350 and Beautiful is not significantly different from each other in terms of microleakage at the cervical margin.
Conclusion: This study showed that none of the materials used in this study is able to eliminate microleakage. Composite resin restorations exhibited worse micorleakage at cervical margin in comparison to occlusal margin.
The aim of the present study was to assess the current approaches and philosophies pertaining to direct restorations, bleaching and root canal treatment amongst general dental practitioners (GDPs) in the Klang Valley, Malaysia. A questionnaire, together with a stamped addressed envelope and an explanatory letter, was sent to 200 GDPs in the Klang Valley in April-July 2005. The GDPs were selected at random. A total of 153 (76.5%) of the GDPs responded to the survey. 46.4% of the respondents stated that the use of amalgam was decreasing whereas 79.7% stated an increase in the use of composite resins. Clinical indication (85.6%) and patients’ demand for aesthetics (73.9%) appeared to be the main factors influencing the choice of restorative materials. Fractured restorations was the main reason for the replacement of amalgam restorations (77.1%) whilst secondary caries was the main reason for the replacement of composite resin restorations (73.9%). Almost two thirds of the GDPs surveyed provided chair side bleaching while 75.8% of the GDPs would supervise home bleaching. Sodium hypochlorite was the most common endodontic irrigant used amongst the GDPs surveyed and cold lateral compaction was the most commonly used obturation technique.
Objectives: The objectives of the study were to assess: i) the staining susceptibility of composite resins, ii) the ability of whitening toothpastes in removing stains from composite resins.
Materials and Methods: Thirty specimens from each composite resins: Filtek Z350 (3M ESPE), Filtek Z250 (3M ESPE) and Beautifil (Shofu Inc.) were fabricated. After polishing, specimens were immersed in coffee for 3 days. Specimens were then brushed twice a day for 2 weeks using Colgate Total (Colgate-Palmolive, control group), Colgate Advanced Whitening (Colgate- Palmolive, test group) and Darlie All Shiny White (Hawley & Hazel Chemical Co., test group). Colour changes (?E*) were measured using Spectrophotometer at baseline, after coffee immersion and after brushing. Results were statistically analyzed using one way ANOVA and Tukey’s test.
Results: There was significant difference in terms of colour changes for Filtek Z350, Filtek Z250 and Beautifil after coffee immersion (P0.05).
Conclusions: Filtek Z350 was able to resist staining by coffee better than Filtek Z250 and Beautifil. The whitening toothpastes did not offer added advantage in terms of ability to remove stains compared to ordinary toothpaste.
Introduction: Nowadays, there is a worldwide trend for universities to utilize the benefits of e-learning as a mechanism to facilitate improvements in teaching and learning. Purpose: The aim of this study is to evaluate the effectiveness of using e-learning in the teaching of fixed prosthodontic course i.e. FPeL.
Materials and Methods: This was a retrospective analysis of questionnaire data, collected from fourth and fifth year dental undergraduates at the Faculty of Dentistry, National University of Malaysia (Universiti Kebangsaan Malaysia, UKM). For fixed prosthodontics (FP), all students had received a series of traditional classroom lectures, seminars, video demonstration, preclinical and Fixed Prosthodontics e-Learning or FPeL in semester 1 and 2 during their 4th year. The questionnaire of 4 sections was administered after the students completed fixed prosthodontics course.
Results: Questionnaires were returned by 136 students (80.9% response rate). Unfortunately, the response rate dropped 12.4% when only 115 students accessed and used the FPeL (68.5%). Majority of FPeL users felt PFeL was beneficial to their learning in the fixed prosthodontic course. PFeL users recommended printable version with detailed explanations, illustrated with more photos and with addition of references.
Conclusions: PFeL assisted users in the learning process of fixed prosthodontics.
The assessment of pulp vitality is a crucial diagnostic procedure in the practice of endodontics. Dentists should establish their treatment decisions based on good sound information and in the best interests of the patients. Therefore, a definite diagnosis must be established with comprehensive investigation and records before any treatment is carried out1. Since the dental pulp is enclosed in an opaque tooth, the assessment of tooth vitality is undertaken indirectly by: looking for clinical or radiological evidence of pulp necrosis or apical periodontitis; investigating nerve conduction; or examining the blood flow. (Copied from article).
Deviations from normal occlusion are known as malocclusion. Orthodontics treatment usually is the choice of management of irregularities and abnormalities of their relation to the surrounding structures i.e malocclusions. Patient or parent commonly seeks orthodontic treatment for aesthetic reasons rather than functional problems such as temporomandibular joint dysfunction. With greater demand for orthodontic treatment due to greater awareness of the people towards dental health, good orthodontic treatment outcome would be expected. Good orthodontic treatment outcome usually related to good clinical management of the patients. (Copied from article).