Abscess of the periodontium is a localized purulent inflammation of the periodontal tissues1. It has been classified into three categories which are gingival abscess, periodontal abscess and pericoronal abscess. A periodontal abscess can be defined as a localized purulent infection affecting the tissues surrounding a periodontal pocket that can lead to the destruction of supporting structures4 including tortuous periodontal pockets, furcation involvement, and intrabony defects. The lesion may be acute or chronic abscess. A localized acute abscess may progress to a chronic abscess if the pus drains through a fistula into the outer gingival surface or into the periodontal pocket. (Copied from article).
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.
This study aims to determine the prevalence of hand-held ProTaper® files system among UKM final year dental undergraduates and to assess their perception in performing endodontic treatments.
Methods: 85 final year dental students from 2006/2007 academic session participated in the questionnaire survey. All students underwent didactic endodontic teaching of conventional stainless steel files throughout a 2-year course and a 2-day ProTaper® hand files seminar on canal preparation. Each student had a total of 6 months clinical period before the survey was distributed to the subjects and returned for data analysis.
Results: A 100% response rate was received. About 58.8% (n=50) used hand ProTaper routinely while 41.2% claimed themselves as non-users. Amongst the users, 52.5% were moderate users and about 33.6% were frequent users. Tooth type and size of canals were the selected criteria for file use. Majority of users used ProTaper® hand for posterior teeth and regarded it as user friendly. Although almost all users expressed concern of instrument fracture during use, very few did break. Procedural errors were not experienced by 51.3% users.
Conclusion: About 2/3rd majority of UKM undergraduate dental students use ProTaper® hand-held system as an alternative for canal preparation. Procedural errors were perceived to occur much less when using the NiTi files. The system can be initiated to novice users and can be taught as part of endodontic curricula.
Forensic odontological examination of a disputed bitemark can furnish the police and the prosecutor with useful evidence to either implicate or exonerate a person in relation to a crime, on the basis that each person’s bitemark is as distinctive as his or her dentition. The aims of this article are (a) to evaluate the extent of which bitemark evidence is reliable as a proof of identification of a biter for the purposes of criminal investigation and prosecution in Malaysia and (b) to make the necessary recommendations (if any) for the purpose of improving the reliability of such evidence. Where a questioned bitemark is not sufficiently detailed, any findings made from its examination shall be highly unreliable and prejudicial. On the other hand, where a bitemark is sufficiently detailed, then any findings made from its examination may be reliable, provided that the forensic odontologists and other practitioners in the criminal justice system are professionally trained to handle the said bitemark. Therefore, police officers must be given a basic training in the field of forensic odontology so that they will be able to appreciate the evidential value of bitemark and contribute to the development of bitemark cases in Malaysia. The relevant authorities governing the dental practice in Malaysia should standardize the methodology and terminology used in bitemark examination and in the reporting of its findings so that confusion and inconsistency among the forensic odontologists are kept absolutely low. Finally, forensic odontologists must be given specialized training in bitemark examination so that the probative value of their findings can be improved.
Actinobacillus actinomycetemcomitans is considered a major pathogen in periodontal disease. The aim of this study was to determine the prevalence of A. actinomycetemcomitans from 46 subjects aged 20-24 years old of who were all periodontally healthy Malays.
An audit of broken/lost removable appliances was carried out. This study aimed to measure the occurrence of broken/lost appliances over a period of 6 months. It also assessed whether there was any difference in the occurrence rate between patients who paid for treatment and those who received it free of charge. The results indicated that the total number of broken/lost removable appliances was 183, from a total of 472 appliances issued. For paying patients, 59 of 177 patients had at least one broken/lost appliance, giving an occurrence rate of 33.3%. For nonpaying patients, 60 of 112 patients had at least one broken/lost appliance, giving an occurrence rate of 53.6%.
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.
It is the aim of all clinicians to accomplish biological tooth movement, which implies the use of low, continuous force. Constant unrelented search for a better wire, which can deliver optimal orthodontic force, has led to the invention of a lot of orthodontic wires such as Stainless steel, Beta Titanium, Nickel Titanium and multi stranded wires. In this study, the loading and unloading properties of 0.016 inch, 0.016x0.022 inch and 0.017x0.025 inch dimensions of stainless steel, conventional NiTi, Super elastic NiTi, and TMA arch wires were determined by means of a modified three point bending test for two inter bracket widths of 5 mm and 6.5 mm for deflection of 1 to 3 mm. The applied forces dependence on cross-sectional size differs from the linear-elastic prediction in super elastic NiTi wires. The stainless steel wires had the highest force values on all the three dimensions and cross section. On loading and unloading, TMA wires had force values in-between stainless steel, conventional NiTi and super elastic NiTi. The conventional NiTi had much lower force values compared to stainless steel and TMA and were linearly progressing compared to Super elastic NiTi. On loading and unloading the super elastic NiTi had force values in the range of conventional NiTi and had constant forces on higher deflection. The studies showed that the force value was comparatively higher in 5 mm inter bracket width than the 6.5 mm inter bracket width for all the cross section and dimension of wires.
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.
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)
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).
Gingival overgrowth (gingival hyperplasia, gingival fibromatosis) can be caused by underlying factors such as taking certain medications or genetic in origin. The extent of the enlargement varies in different individuals and also within the same individuals. Aesthetics and effective plaque control is compromised and part of the objectives of treatment is to help in these aspects. (Copied from article).
There are evidences that chronic oral infections are associated with cardiovascular disease (CVD). Periodontal disease is a common, mixed oral infection affecting the supporting structures around the teeth. It was reported that 75% of the adult population has gingivitis and 20% to 30% exhibits the severe destructive form of periodontitis. Although more than 500 bacterial species inhabit the human oral cavity, only a few Gram negative bacteria such as Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola and Actinobacillus actinomycetamcomitans causes gingivitis and periodontitis. These periodontal pathogen occupy the subgingival space and organize as a bacterial biofilm. The bacterial biofilm will be in direct contact with host tissues along an ulcerated epithelial interface, called periodontal pocket. The break in the epithelial integrity directly exposes the host to bacteria and their products eg. lipopolysaccharide (LPS) endotoxin. (Copied from article).
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”.
The objective of this part of the study was to understand the current trend on readership of the Malaysian Dental Journal (MDJ) among Malaysian dentists. Their views on the contents and quality of the Malaysian Dental Journal were enquired. We also enquired the reasons they chose-to/chose-not-to read the MDJ. Of the 225 dentists surveyed, the number of MDJ readers was 101; with only 24.75% reading all issues published. The editorial section was rated as “useful” by 70.3% of readers, while 79.2%, 87.1%, 87.1% and 80.2% of readers rated the research article section, the review article section, the case reports section and book recommendation section similarly respectively. Feedback from readers indicated that they wanted more case reports, more review articles on “how to do it” and on medical problems in dentistry. More than half (55.45%) of the MDJ readers preferred to receive the journal in both hard and soft copies. For the non-readers, the most common reasons cited for not reading the MDJ was not being able to access to the journal, followed by not having time to read. Our finding suggested that the respondents preferred to learn from colleagues’ experience and to read article that can improve their clinical knowledge and skill.
The objective of this survey was to understand the current trend of readership of professional dental journals among Malaysian dentists. A total of 225 questionnaires were sent out to Malaysian dentists who attended various dental related conferences throughout Peninsular Malaysia from February 2006 to July 2006. Questionnaires comprised of questions relating to dentists’ socio-demographic status and a list of journal(s) read by them. Malaysian dentists’ view on the content and quality of a particular dental journal, i.e. the Malaysian Dental Journal (MDJ) was also enquired. The details of this finding are highlighted in Part II of this study. A total of 156 questionnaires were returned; the respondents were made up of 61 male and 91 female dentists. Almost 80% of the respondents aged between 20-49 year-old and most respondents (n= 132; 84.62%) only had a basic Bachelor of Dental Surgery or equivalent degree while another 19 (12.18%) had in addition, a post-graduate degree. Almost equal numbers of respondents were working in the Ministry of Health (MOH) or Armed Force (n=73; 46.8%) and private practice (n=74; 47.4%). Also, equal number of respondents (n=67; 42.95%) were found to be working as single-handed practitioner and in a partnership/assistant/working-with-other specialties type of practice Almost two-thirds (n=103; 66%) of the respondents read more than one professional journal, and a majority of them worked in the private sector. The percentage of readers reading more than one journal from the private practice (n=67, 60.0%) was close to twice of that from the MOH (n=36, 35.0%). No specific age-group pattern was present but the least number of subscribers were from those 60 year-old and above (n=3), whereby none of them subscribed to any professional dental journal/magazine. The highest percentage of subscribers were from those in the age group of 40-49 year-old, whereby 86.49% (n=32) of dentists in this age-group subscribed to at least one professional dental journal/magazine. Out of the list of journals/magazines provided, it was found that the MDJ has the most number of readers. The MDJ was most read by dentists in the private practice while the Annals of Dentistry of the University of Malaya was most read by dentists in the MOH. In conclusion, it was found that almost two-third of the respondents read more than one professional journal, with the MDJ receiving the most number of readers. More dentists in the private practice read professional dental journals than dentists in the MOH.
Introduction: Preclinical teaching using simulation is very beneficial in training dental graduates. The use of laboratory simulation for its undergraduate training during the preclinical years has been used in dental education. Purpose: The aim of this study was to evaluate student’s perception, self evaluation and satisfactory level in preparing duralay burn-out post and core in preclinical fixed prosthodontics sessions.
Materials and Methods: The participants comprised of 104 fourth year dental undergraduates in the Faculty of Dentistry Universiti Kebangsaan Malaysia. The students had undergone preclinical session for endodontics during the 3rd year and had already completed root canal treatment on single rooted tooth. The same tooth was used for preclinical post and core preparation. The gutta percha was partially removed and the root canal was prepared. They then proceeded with the preparation of duralay build-up/pattern based on the lecture, video demonstration and manual given. Once completed and satisfied with their work, students were asked to answer the questionnaires in the simulation manual.
Results: Student response rate was 88.46% (92/104). Majority of the students were satisfied with their canal preparation, with about 5mm gutta percha left apically, appropriately shaped canal with sufficient retention and resistance form. They also thought that the surface of the duralay was good with no voids. With regards to the coronal preparation, majority of them incorporated ferrule effect and prepared preliminary crown preparation. More than half of the students claimed the level of difficulty of this procedure was moderate. Furthermore, majority of them said that the lecture and the preclinical manual were sufficient and helpful. The help from the supervisors was also benefit in preparing duralay burnout post and core.
Conclusions: From this study, majority of fourth year dental students could perform appropriate canal preparation as well as duralay pattern post and core. Only one student did not feel competent and confident in doing canal preparation and duralay pattern post and core. Our teaching methods and aids were proven to help them in preparing these tasks.
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 general aim of this study was to examine the patients’ perception of dental extractions. The specific objectives were to understand the purpose of extractions from the patients’ point of view, to find out the relationship between age and type of teeth extracted and to compare the patients’ perceptions with clinical indications for dental extraction. The survey was done using self administered, structured questionnaires to collect information. From the survey we found that toothache (33%) and the presence of cavities (34%) were the main reasons for extraction from the patients’ point of view. Besides that, the number of patients requiring extractions decreased with age. The main clinical indication for tooth extraction was caries (73%) and of these, 29% of restorable teeth were extracted.