Displaying publications 1 - 20 of 56 in total

  1. Sushma R, Sathe TT, Farias A, Sanyal PK, Kiran S
    Ann Afr Med, 2017 Jan-Mar;16(1):6-12.
    PMID: 28300045 DOI: 10.4103/aam.aam_43_16
    BACKGROUND: Candida albicans is one of the microorganisms which harbor the oral cavity, especially in elderly. However, the incidence of existence of this increases in patients using removable dental prosthesis. There is therefore a need to test the anticandidal efficacy of these cost-effective, easily available products to be used as routine denture cleansers.
    AIM AND OBJECTIVES: (1) To evaluate antifungal properties of triphala churna on the heat cure denture base material. (2) To evaluate the antifungal effect of chlorhexidine gluconate on the heat cure denture base material. (3) To compare the antifungal effect of triphala churna and chlorhexidine gluconate with a control. (4) To evaluate which among triphala churna and chlorhexidine gluconate has a better antifungal property on the heat cure denture base material.
    MATERIALS AND METHODS: Study population consisted of sixty dentures wearers from those attending the Outpatient Department of Prosthodontics of the School of Dentistry, Krishna Institute of Medical Sciences Deemed University, Karad. Swabs were collected from the dentures before and after the use of triphala and chlorhexidine. The swabs were cultured on Sabouraud dextrose agar and the total Candida counts were determined.
    CONCLUSION: Triphala as an antifungal is shown to have more efficacy than the conventional chlorhexidine mouthwash. Résumé Arrière-plan: Candida albicans est l'un des micro-organismes qui abritent la cavité buccale surtout chez les personnes âgées. Cependant, l'incidence de l'existence de cette augmentation chez les patients utilisant des prothèses dentaires amovibles. Il est donc nécessaire de tester l'efficacité anticancédique de ces produits rentables et faciles à utiliser pour être utilisés comme nettoyants de routine pour prothèses dentaires. Buts et Objectifs: (1) Évaluer les propriétés antifongiques de Triphala churna sur le matériau de base de la prothèse thermo-durcissable. (2) Évaluer l'effet antifongique du gluconate de chlorhexidine sur le matériau de base de la prothèse thermo-durcissable. (3) Comparer l'effet antifongique de Triphala churna et du gluconate de chlorhexidine avec un témoin. (4) Évaluer lequel parmi Triphala churna et le gluconate de chlorhexidine a une meilleure propriété antifongique sur le matériel de base de la prothèse de durcissement à chaud. Matériaux et Méthode: La population de l'étude était constituée de soixante porteurs de prothèses dentaires de ceux qui fréquentaient le Département de Prosthodontie de l'École des Sciences Dentaires de l'Institut Krishna des Sciences Médicales de l'Université de Karad. Des prélèvements ont été effectués sur les prothèses avant et après l'utilisation de Triphala et de chlorhexidine. On a cultivé les écouvillons sur de l'agar Sabouraud dextrose et on a déterminé le nombre total de candida.
    CONCLUSION: Triphala comme un anti fongique est démontré pour avoir plus d'efficacité que le lavage de la bouche classique chlorhexidine.
    Matched MeSH terms: Dental Clinics
  2. Jaafar, N., Jallaludin, R.L., Razak, I.A., Esa, R.
    Ann Dent, 1995;2(1):2462-2060.
    The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.
    Matched MeSH terms: Dental Clinics
  3. Asma, M., Ho, S.L., Yong, J.S., Nor, N.A.M., Yusof, Z.Y.M.
    Ann Dent, 2013;20(2):9-14.
    In response to the introduction of an integrated dental education program at University of Malaya (UM) in 2011, a study was conducted to develop a caries risk assessment model (CRA) for use in non-surgical caries management for Year 3 and 4 students of the new integrated program. Methods: The CRA model was based on risk indicators used by dental students in the Preventive Dental Clinic (PDC). Patients aged 15 years and above who attended the PDC for the first time in year 2009 and 2010 were used as study sample. Four hundred and fourteen patient names were identified from the student PDC logbook. Of the 414, 359 dental records had complete data and included in the analysis. Data were analysed using SPSS version 17.0. Chi-square test was used for group comparison and associated factors for coronal caries were analysed using Multiple Logistic Regression (MLR). Results: The final model showed that adults, brushing teeth once daily, and not having dental prosthesis/appliance were 3.31 (CI=1.64-6.69), 2.53 (CI=1.19-5.40), and 2.25 (CI=1.25-4.10) more likely to develop coronal caries, respectively, than adolescents, brushing teeth at least twice a day, and having dental prosthesis/appliance. Conclusions: The results indicate that age group, toothbrushing frequency and dental prosthesis status are significant indicators for coronal caries among patients. Outcomes of the study contributed towards bridging the gap between cariology
    and preventive modules in the new integrated dental program.
    Matched MeSH terms: Dental Clinics
  4. Lee, A.T., Lai, L.W., Goh, Y.C., Chan, S.W., Siar, C.H.
    Ann Dent, 2017;24(1):10-18.
    Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters. Materials and methods: In this retrospective crosssectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya were examined for the presence of AR-related OMC. The study period was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
    Matched MeSH terms: Dental Clinics
  5. Wan Nurazreena WH, Rashidah B., Mohd Zambri M.M., Maria J.G.
    Ann Dent, 2018;25(1):0-0.
    To determine the number of cases that are at risk of poor stability in terms of arch width changes following fixed appliances treatment at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. In a retrospective audit, 101 pre- and post-treatment lower study casts were selected from cases completed in the year 2015 at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. Samples were measured using a universal caliper by a single calibrated operator. Samples was categorised as extraction or non-extraction types. Arch width changes was determined using paired T-test. The recommended limit was 0mm for inter-canine width, 2 mm for inter-first premolar width and 3mm for inter-second premolar and inter-molar width. Differences were considered “within limits”, if the changes were within the recommended limit ±0.25mm (for possible marginal measurement error) and “expanded”, if above the range for within limits. 42.6% were non-extraction while 57.4% were extraction cases. In the non-extraction group, 52.2% cases had expanded inter-canine widths, followed by inter-first and second premolars (27.9%) and interfirst molar (20.9%) widths. Arch width changes for the inter-first and second premolars and inter-molars widths were statistically significantly different (p
    Matched MeSH terms: Dental Clinics
  6. Ahmad Azlina, Berahim Zurairah, Sidek Mohamad Ros, Mokhtar Khairani Idah, Samsudin Abdul Rani
    Mitochondrial DNA (mtDNA) is a hereditary material located in mitochondria and is normally maternally inherited. Mutational analysis performed on mtDNA proved that the mutations are closely related with a number of genetic illnesses, besides being exploitable for forensic identification. Those findings imply the importance of mtDNA in the scientific field. MtDNA can be found in abundance in tooth dentin where it is kept protected by the enamel, the hardest outer part of the tooth. In this study, two techniques of mtDNA extraction were compared to determine the efficacy between the two techniques. Teeth used for the study was collected from Dental Clinic, Hospital Universiti Sains Malaysia. After the removal of tooth from the tooth socket of the patient, the tooth was kept at -20C until use. Later, pulp tissue and enamel was excised using dental bur and only the root dentin was utilized for the isolation of mtDNA by crushing it mechanically into powdered form. MtDNA was extracted using the two published methods, Pfeifer and Budowle and then subjected to spectrophotometry DNA quantification and purity, Polymerase chain reaction (PCR) amplification of hypervariable-two region of mtDNA, followed by DNA sequencing to analyze the reliability of the extraction techniques. In conclusion, both techniques proved to be efficient and capable for the extraction of mtDNA from tooth dentin.
    Matched MeSH terms: Dental Clinics
  7. Norisa Othman, Haslina Taib, Norehan Mokhtar
    The objectives of this study were to determine the normal mean value of the root-crown (R/C ratios) in Malay patients and their variations by gender and dental arch from orthopantomogram radiographs (OPGs). Two thousand nine hundred and twenty teeth with fully developed roots were measured from 112 OPGs. Subjects with history of maxillofacial trauma or orthodontic therapy were excluded. The mean age of the subjects was 19.1 (SD 2.08) years old for males while females 18.9 (SD 2.19) years old in the range from 15 to 22 years old. The intra-examiner reproducibility of the assessment method was good (Intraclass correlation coefficient 0.81). Results of this study showed that there was no significant difference between R/C ratios of males and females groups. However, the ratios of the antagonist teeth for both males and females were significantly greater in the mandible than in the maxilla (p
    Matched MeSH terms: Dental Clinics
  8. Ismail, N.M., Ismail, A.R., Wan Nor Syuhada, W.A.R.
    Root canal treatment (RCT) requires high level of technical skills of the dentist. Its outcome is an important part of evidence-based practice and become the basis of treatment planning and prognostic considerations. Adequate removal of micro-organisms and prevention of recolonization of residual micro-organisms through the placement of root filling with satisfactory coronal seal ensures success. This retrospective record review study aimed to investigate the practices of RCT in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic, Kota Bharu, Kelantan. It involved 333 randomly selected patient records at the HUSM Record Unit. Data was obtained by careful analyses of daily treatment progress sheets and analyzed using SPSS version 12.0. A total of 2996 RCT cases were seen and 59.8% of patients were females. The age range of patients varied from 14 to 64 years. The maxillary anterior teeth were most commonly treated (52.6%). Most operators (99.1%) used step-back technique and 97.6% used files to prepare root canals. The most commonly used material for obturation and sealing was gutta-percha and epoxy resin-based sealer (AH26). About 82.9% used calcium hydroxide as intra-canal medication. About 25.5% of cases had no periapical pathology, 65.8% with pre-existing periapical radiolucencies healed in 1-3 months whereas 2.1% of cases with periapical pathology eventually healed after a year. About 6.9% cases failed after retreatment. The number of radiographs taken was two to four pieces. RCT is a useful intervention to maintain longevity of teeth. Decision making and current updates of methods and materials are essential among practitioners as well as administrators to ensure success.
    Matched MeSH terms: Dental Clinics
  9. Rashid, A.K., Anwar, N., Azizah, A.M., Narayan, K.A.
    A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
    Matched MeSH terms: Dental Clinics
  10. Siti Norsuryani Shamsuddin, Azelinda Ahmad, Haslina Taib, Wan Majdiah Wan Mohamad
    Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
    Matched MeSH terms: Dental Clinics
  11. Linn, Lynn Ko Wei, Nor Fatiyah Che M. Nasir, Norsila Abdul Wahab
    Prevalence of dysphagia is one of the important epidemiological data which will contribute to the proper planning and support the setting up of a swallowing rehabilitation clinic at this hospital. The present study aimed to determine the prevalence of dysphagia in patients with head and neck cancer (HNC) at Hospital Universiti Sains Malaysia (Hospital USM) from 2001-2010. In this institutional retrospective study, a total of 66 records were obtained comprising of 86.4% Malay patients, 9.1% Chinese, 1.5% Indians, and 3% other ethnic groups. These data were taken from the database of HNC patients seen at the dental clinic, Hospital USM between 2001 and 2010. Difficulty swallowing, frequent coughing during meal, choking, diet modification, and non-oral nutritional support were identified as signs and symptoms associated with dysphagia. Results showed that 59.1% of patients have had dysphagia before, during, or after the treatment of HNC. Data from the present study would be instrumental in increasing awareness among clinicians involved in patient care and it may help in planning the outline of management of dysphagia. Furthermore, it is anticipated to have implications for further research in swallowing and dysphagia.
    Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Dental Clinics
  12. Athirah Ab Rahman, Adam Husein, Hany Mohamed Aly Ahmed, Dasmawati Mohamad, Wan Zaripah Wan Bakar, Manal Farea, et al.
    Light intensity output is one of the determinants for adequate curing of visible light-cured materials. The aim of this survey was to evaluate the light intensity outputs (LIOs) of light curing units (LCUs) in dental clinics of Hospital Universiti Sains Malaysia (HUSM) and School of Dental Sciences, Universiti Sains Malaysia (USM). The respective LIOs of all functioning Quartz Tungsten Halogen (QTH) and Light Emitting Diode (LED) LCUs were tested using two light radiometers. For cordless LED LCUs, the testing procedure was done in situ and after being fully charged. Statistical analysis using Kruskal Wallis and Wilcoxon signed ranks tests were performed to compare the LIOs between groups and between the LIOs of in situ and post-charged cordless LED LCUs, respectively. The level of significance was set at 0.05 (p
    Matched MeSH terms: Dental Clinics
  13. Oo, Mon Mon Tin, Naing, Lin, Mani, Shani Ann, Abdul Rashid Ismail
    Dental caries is an important community dental health problem with limited studies in the mixed dentition stage. The aim of this study was to determine the caries prevalence and treatment needs among 7- 9 year old school children in Kelantan which is situated in North East Malaysia. A retrospective dental record review of fully documented dental records belonging to primary school children attending a paediatric dental clinic was conducted. Dental caries was recorded using dmft index and DMFT index for deciduous teeth and permanent teeth respectively. Three hundred and nineteen dental records of 175 (54.9%) boys’ and 144 (45.1%) girls’ were selected and subjected to a ‘dental record study’. The prevalence of dental caries was 93% (95% CI : 89,97) in primary dentition and 50.5% (95% CI : 42.2, 58.8) in permanent teeth. Mean dmft and DMFT was 6.2(SD 3.39) and 1.04(SD 1.34) respectively. Regarding treatment needs in the primary dentition, 35.4% of teeth needed one surface filling, 34.7% needed extraction, 24.5% needed two or more surfaces filling and 5.6% needed pulp care. In the permanent dentition, 54.7% required sealants and 21.9% required one surface restoration. The caries prevalence and treatment needs were high among this study population in the mixed dentition stage, particularly showing the early involvement of newly erupted permanent teeth. It appears that high caries prevalence in the primary dentition is a risk factor for caries in newly erupted permanent teeth. Oral health promotions programmes are required in the mixed dentition stage and may reduce the risk of caries in permanent dentition.
    Matched MeSH terms: Dental Clinics
  14. Keat, John Hon Chong, Ahmad Dzulfikar Samsudin, Mei, Siang Ma
    Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still
    remains as the most common dental surgical procedure that is performed on outpatient basis. In the present
    study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia
    by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples
    underwent standard operating procedures and medication. Post operative complications in terms of pain,
    swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery.
    The result of this study showed that there is no significant difference between the three irrigating solution used in
    surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of
    research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical
    removal of impacted lower wisdom tooth.
    Matched MeSH terms: Dental Clinics
  15. Wong, Soo Yee, Roselinda Ab. Rahman, Haslina Taib
    The purpose of this study was to evaluate the periodontal status distal to the adjacent second molar following the extraction of a partially or fully impacted mandibular third molar at Klinik Pergigian Pakar Hospital Universiti Sains Malaysia (KPPHUSM) from April of 2008 until June of 2008.This was a prospective study which involved the clinical and radiological study of patients. In this study, convenience sampling method had been used. The sample size was 22 patients aged 18-32 years old with inclusion criteria. The outcomes measured in this study were periodontal pocket depth (PPD), clinical attachment level (CAL) and alveolar bone height (ABH). Subjects were examined at distal surface (disto-buccal, mid-distal and disto-lingual) of second molar for PPD and CAL before and 3 months after the impacted adjacent lower third molar extraction. OPG was taken each before and after the third molar removal. These data were analyzed using SPSS version 16 and Wilcoxon-signed-ranks test was used to compare the PPD, CAL and ABH pre and post operatively. All the results were not significant with p >0.05. For PPD, median = 3mm pre and post extraction. CAL median= 2mm pre and post operatively and ABH median of 3.10mm (before) and 2.8mm (after) the third molar removal. From our study, we concluded that there were no significant changes of PPD, CAL and ABH at distal side of second molar after 3 months of the adjacent impacted lower third molar removal.
    Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Dental Clinics
  16. Khairiyah AM, Razak IA, Raja-Latifah RJ, Tan BS, Norain AT, Noor-Aliyah I, et al.
    Asia Pac J Public Health, 2009 Apr;21(2):184-95.
    PMID: 19190002 DOI: 10.1177/1010539509331788
    The objective of this study is to share cost analysis methodology and to obtain cost estimates for posterior restorations in public sector dental clinics. Two urban and 2 rural dental clinics in Selangor state were selected. Only cases of 1 posterior restoration per visit by dental officers were included over 6 months. One capsulated amalgam type, 1 capsulated tooth-colored, and 1 non-capsulated tooth-colored material were selected. A clinical pathway form was formulated to collect data per patient. Annual capital and recurrent expenditures were collected per clinic. The mean cost of an amalgam restoration was RM 30.96 (sdRM 7.86); and tooth-colored restorations ranged from RM 33.00 (sdRM 8.43) to RM 41.10 (sdRM 10.61). Wherein 1 USD = RM 2.8. Restoration costs were 35% to 55% higher in clinics in rural areas than in urban areas. The findings demonstrate economy of scale for clinic operation and restoration costs with higher patient load. Costs per restoration were higher in rural than in urban dental clinics. More studies are recommended to address the dearth of dental costs data in Malaysia.
    Matched MeSH terms: Dental Clinics/economics*
  17. Chu GT, Latifah RJ
    Asia Pac J Public Health, 2001;13(2):79-84.
    PMID: 12597503 DOI: 10.1177/101053950101300204
    This study investigated the sociodemographic profiles of patients attending public and private dental clinics and the types of treatment received. Patients (n=454) were interviewed using a structured questionnaire at two public and four private clinics in Sibu District, Sarawak. Generally, Chinese (74.7%), females (60.0%) and urban dwellers (83.7%) were more likely to visit the dentist. Both clinics had more females and more Chinese but private clinics had a lower percentage of female attendees (53.1% versus 67.0%) but a higher percentage of Chinese (85.0% versus 64.5%). Private attendees were younger (mean age of 31.0 years compared to 41.0 years) and from higher income households (median value of MR 2,000 versus MR 900) than public attendees. Treatments were mostly curative and a third of the visits were associated with painful conditions. Age (p=0.006), gender (p=0.003), ethnicity (p<0.001) and household income (p<0.001) were associated with the type of clinic visited. Choice of clinic was not related to having painful conditions (p=0.970). To ensure a more affordable and equitable distribution of oral healthcare, health planners need to identify disparities in the utilization of services and differences between public and private attendees.
    Matched MeSH terms: Dental Clinics/utilization*
  18. Golding KM
    Aust Dent J, 1971 Dec;16(6):389-93.
    PMID: 5291233
    Matched MeSH terms: Dental Clinics
  19. Mohamed Rohani M, Calache H, Borromeo GL
    Aust Dent J, 2017 Jun;62(2):173-179.
    PMID: 27670933 DOI: 10.1111/adj.12465
    BACKGROUND: Special Needs Dentistry (SND) has been recognized as a dental specialty in Australia since 2003 but there have been no studies addressing the profile of patients for specialist care. The purpose of this study is to identify, via referrals received, the profile of patients and quality of referrals at the largest public SND unit in Victoria, Australia.
    METHODS: All referrals received over a 6-month period (1 January-30 June 2013) by the integrated SND unit (ISNU) were reviewed prior to allocation to the outpatient clinic (OP), domiciliary (DOM) or general anaesthetic (GA) services.
    RESULTS: Six-hundred and eighty-eight referrals were received with the majority for the OP clinic (68.3%), followed by DOM (22.4%) and GA services (9.3%) (χ2  = 360.2, P 
    Matched MeSH terms: Dental Clinics
  20. Mohd-Dom T, Ayob R, Mohd-Nur A, Abdul-Manaf MR, Ishak N, Abdul-Muttalib K, et al.
    BMC Oral Health, 2014;14:56.
    PMID: 24884465 DOI: 10.1186/1472-6831-14-56
    The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components.
    Matched MeSH terms: Dental Clinics/economics*; Dental Clinics/manpower; Dental Clinics/organization & administration
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