Fractures of the mandible and their management are discussed in detail in textbooks and articles dealing with facial trauma. This paper presents the management and treatment of a case of a unilateral comminuted and complicated fracture of the mandible due to dog attack on a geriatric patient. The attack also severed the patient's right arm. Due to the severity of the trauma, an emergency surgery was performed on the mandible and arm.
A case of unicystic ameloblastoma which recurred after 15 years showing unusual histological features is reported. The prominent pseudo-glandular features present are described. This case highlights the importance of extensive histological examination for more characteristic features of ameloblastoma to reach a correct diagnosis.
Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.
Transposition of teeth is a rare and special type of ectopic eruption where two contiguous teeth are found occupying each other's respective normal positions. Nine patients with transposed maxillary teeth are reported. The literature on transpositions, especially on the theories regarding the aetiology, is reviewed.
The aim of this retrospective study is to report on the prevalence of post-extraction complications among patients attending the Oral Surgery outpatient clinic of the Faculty of Dentistry, University of Malaya over a 12-month period from January to December, 1992. The prevalence of post-extraction complications which required further treatment was only 3.4% (n = 100), out of a total of 2968 patients who had extraction of one or more permanent teeth. Analysis based on complete clinical reports (n = 79) showed that dry socket accounted for nine out of ten cases of post-extraction complications. However the aetiology was largely unknown. No obvious association with medical history could be made. Lower teeth were more likely to have complications. The most common teeth associated with dry socket were the molars (76%) and premolars (19%). The most common molars to be affected are the first, followed by the third and lastly the second molars. A brief review of current aetiological factors of dry socket was discussed.
Two hundred and twenty-nine children aged 12-15 years who were continuous residents of Penang island, in the north of Peninsular Malaysia were examined for caries and enamel defects. Caries prevalence was 82.2% with a DMFT score of 3.4 and DMFS score of 4.9; there were very few missing teeth and very little untreated caries in the population examined. Majority of DF (decayed/filled) lesions were pits and fissures with approximal and smooth surfaces relatively caries free. The prevalence of enamel defects was 76.4% with 19.1% of all teeth examined being affected. More posterior than anterior teeth were affected by enamel defects just as there were more maxillary than mandibular teeth affected by enamel defects. Diffuse patchy opacities were the most common defect diagnosed and this was found in 60.2% of the population examined. A bilateral distribution of diffuse patchy opacities was seen in 41.5% of the population examined. Tooth surfaces with enamel defects were no more susceptible to caries than defect-free surfaces.
A case of an incomplete tooth fracture followed by a complete fracture was presented. The difficulty of diagnosing this condition was discussed as well as the possible histological explanation of the symptoms experienced by the patient. It once again points out to practising dentists, that whilst deep pockets can give rise to severe periodontal pain, intense and excruciating pain should be investigated with the cracked tooth in mind.
An important relationship should exist between the periodontist and restorative dentist. Periodontics and restorative dentistry should not be divisible and all forms of restorations, from a simple filling to a complex precision-retained bridge, should be performed with the health and biology of the periodontium in mind. A very crucial concept which should be borne in the mind of every restorative dentist is the concept of biologic width.
Lack of awareness of signs and symptoms and risk factors of oral cancer can lead to late presentation of the disease that contributes to poor survival of patients who contract it. This study aims to determine the level of awareness regarding oral cancer in adult patients attending School of Dental Sciences, Universiti Sains Malaysia.
This study is aimed to evaluate the accuracy of Demirjian method in estimating the chronological age of male and female Kelantanese Malay children between 6 and 16 years of age and to establish a new dental age (DA) curve if the Demirjian method was not found to be accurate. About 905 panoramic radiographs of healthy Malay children between 6 and 16 years of age were collected from the radiographic unit in the Hospital Universiti Sains Malaysia (HUSM) and the orthodontic clinic in Hospital Kota Bharu (HKB). Children who had any disease affecting the dental development, or have agenesis in the lower arch and poor quality radiographic images were excluded. The results showed that Demirjian method overestimated the chronological age (CA) by 1.23 years for boys and 1.20 years for girls and it was less accurate for the Kelantanese Malay children. Thus new standard curve were produced and tested on external samples. Results showed that the mean difference between the chronological age and DA is about 0.17 years for boys and 0.11 years for girls. DA was more advanced in the Kelantanese Malay boys and girls as compared to French-Canadian children in all age groups. It is concluded that the Demirjian method tends to be less accurate in estimating the chronological age in Malay children. The new curve that was produced is more applicable to the Kelantanese Malay children.
A case of talon cusp in the primary maxillary left central incisor is reported. This dental anomaly was not associated with any other somatic or dental abnormality. Though pulpal extension into the cusp was detected radiographically, clinical examination after the cusp was ground failed to reveal any pulpal extension. The tooth was badly carious and was restored with a polycarbonate crown.
Early orthodontic interventions are often initiated in the developing dentition to promote favourable developmental changes and remove or suppress those that are unfavourable. Early interceptive orthodontics can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. It also improves self-esteem in the subjects and parental satisfaction. Early detection and appropriate referral of cases requiring interceptive orthodontics are important. However, lack of awareness among school children, parents and primary-care personnel (dental nurses and dental officers) may result in patients not being referred for timely interceptive intervention. This article presents a general view of the scope of interceptive orthodontics that can be carried out in early mixed dentition, i.e. when the permanent incisors and molars are erupting into the oral cavity.
Many studies have been reported on radiographic lesion sizes of periapical lesions. However no studies have been reported on prevalences of subjective radiographic features in these lesions except for the early assumption that a periapical cyst usually exhibit a radiopaque cortex. This study is conducted to evaluate the prevalences of several subjective radiographic features of periapical cysts and granulomas in the hope to identify features that maybe suggestive of either diagnosis. The results showed that a regular (circular or semi-circular) radiographic outline is likely to be a periapical cyst while an irregular radiographic outline is not indicative of either a cyst or a granuloma. The association between the regular/irregular radiographic outline and the type of periapical lesion was found to be statistically significant (p less than 0.001). The associations of two other radiographic features and the type of periapical lesion were found to be just statistically significant (p less than 0.01). These features are the symmetry/asymmetry of the radiolucency in relation to the apex and the funnel-shaped/angular-shaped extension of the radiolucency. The widely accepted criteria that the possession of a radiopaque cortex surrounding the radiolucency can discriminate between a periapical cyst and granuloma cannot be statistically supported in this study.
To obtain the profile of periodontal conditions in West Malaysian adults, five small scale surveys were carried out on selected occupational adult groups, 20-54 years old, between 1987 to 1990. Periodontal assessment was made using the CPITN index. In all, 779 subjects were examined. Results indicated that only 16% of the adults examined had healthy gingivae. Bleeding of the gingivae was limited to the younger (20-24 years) age group. Calculus is highly prevalent in at least 65.5% of all the subjects examined. Periodontal pockets were limited to mostly shallow pockets and the risk of developing pockets increased with increasing age. Both navy personnel and factory workers showed a higher number of healthy sextants across all ages as compared to the other three occupational groups; viz., rubber tappers, villagers and government workers. The rubber tappers were the only group with deep pockets, with the prevalence ranging between 8 to 25%. Implications of the findings to the Malaysian dental delivery system are discussed.
Early-onset periodontitis in children, teenagers and young adults is quite rare. This form of periodontitis progresses very rapidly and cause massive destruction to the periodontium. Various names have been given to this condition since it was first recognised in the 1920s. Through time the nomenclature changed from one to the other. Currently 3 forms of early-onset periodontitis are recognised--i.e. prepubertal periodontitis (PPP), localised juvenile periodontitis (LJP) and rapidly progressive periodontitis (RPP). The clinical features of juvenile periodontitis as it was first described together with that of the present 3 clinical entities mentioned above are presented. Concepts on the aetiology of the disease have also changed through time, and include degenerative process, bacterial infection, defects in the host defense system and heredity. Current thought is that there is an interplay of most of these factors in pathogenesis of the disease. Treatment modalities changed too. At the moment, comprehensive periodontal therapy with meticulous oral hygiene measures seem to be the treatment of choice. Concurrently, systemic tetracycline administration might have some added benefits.
Any foreign body in the paranasal sinuses can cause chronic complications. It is therefore important to remove these foreign bodies meticulously. Various approaches are available to accomplish this. This article is a case report of a patient who had gutta-percha as a foreign body in left maxillary sinus, after a gutta-percha point had been used to trace a sinus to confirm that it was an oroantral fistula. Traditional surgical approaches to the maxillary sinus require invasive techniques, such as radical antrostomy and the Caldwell-Luc approach. These may result in further complications and morbidity. The gutta-percha point in this case report was removed endoscopically in an otolaryngology clinic with local anaesthesia using a sublabial antroscopy. There is only one case reported in the dental literature regarding the endoscopically-assisted technique for removal of displaced gutta-percha using the sublabial antroscopy approach (Yura S, Ohga N, Ooi K, Izumiyama Y. Procedure of endoscopic removal of a gutta-percha point in maxillary sinus mucosa by ultrathin arthroscope.
Study site: ENT clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia