This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.
The controversy on malignant transformation of oral lichen planus has always intrigued researchers. We present a case of lichenoid lesion and squamous cell carcinoma of the tongue, occurring in a middle aged Indian lady. The diagnosis and timing of these lesions is discussed.
CWorhexidine gluconate, a dicationic bisbiguanide agent, contains anti-plaque properties. Most chlorhexidine gluconate mouth rinses presently available contain alcohol in varying concentrations. The role of alcohol in these mouth rinses is to act as a preservative and solvent although it may have deleterious effects on the oral epithelium on long term usage. Recently, an alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse (Oradex®) has become available in Malaysia. This clinical study is aimed at determining the effects of this alcohol-free product compared to a placebo. A group of 60 meticulously screened subjects were assigned into two groups of 30 each. The first group started using the test product for 2 weeks followed by a washout period of 4 weeks. After this duration, this group used the placebo for a further 2 weeks. The 2nd group underwent similar protocol as the 1st except that this group started with the placebo. Measurements consisting of the following scores were recorded at baseline and after 2 weeks for each group: Plaque, Gingivitis: Papillary Bleeding, Stain and Calculus. Full mouth prophylaxis was carried out for all subjects after measurements at baseline as well as after the 2-week period. They were told to rinse with 15 ml of the designated mouth rinse twice daily for thirty seconds each after tooth brushing. The results of this study indicated that there was significant improvement in the plaque, gingival and papilla bleeding scores compared to the placebo. Stain and calculus scores were significantly increased for the test product when compared to the placebo. In conclusion, this study showed that alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse is effective in reducing plaque and gingivitis but causes staining and calculus formation.
The purpose of this study is to assess the effectiveness of C02 laser in relieving symptoms associated with Oral lichen planus (aLP) and lichenoid lesions (aLL) and the event of healing. Six patients were selected for this study with 13 sites treated. Each lesion was ablated with C02 laser and the wound allowed to heal undisturbed. Prior to treatment, 4 patients had both unprovoked and provoked pain and 2 patients rated for provoked pain only. After laser ablation, five out of six patients treated recorded no pain / 0 pain score. One month post-laser, the treated area was almost the same colour as the surrounding normal mucosa and soft in texture in all but one patient in which there was some fibrosis and residual plaque-like patch. Weconclude that the use of C02 laser in the treatment of aLP and aLL shows positive results in relieving symptoms associated with these lesions.
Until today there are still a high percentage of oral microorganisms have not been identified due to inability to isolate using the cultural method. However, identification of uncultivable microorganisms associated with disease will permits clinicians for a more accurate diagnosis, treatment and preventive measures. Unculturable microorganisms are also involved in disease and may account for treatment failure since their susceptibility to antimicrobial agents would be unknown. Thus, the opportunity for a rational approach to the treatment of disease relies on the state of knowledge concerning its aetiology and pathogenesis. Recently developed molecular methods have made it possible to characterise mixed microflora in their entirety, including the substantial numbers of unculturable bacteria. The development of rapid molecular methods like PCR provides a reliable identification of unculturable microorganisms. This paper will review the current literature regarding the PCR techniques used to identify uncultivable oral microflora.
Mental nerve neuropathy is an important presenting complaint that may be encountered by dental surgeons in their daily practise. There are various pathological processes that could bring about this symptom, ranging. from simple dental cause to vague, life threatening diseases. We present three cases of mental paraesthesia of different aetiologies. A literature review on mental nerve neuropathy related to malignancies and infection is discussed. The importance of a thorough chair side history taking, clinical examination and relevant investigations are emphasised in a suggested clinical approach to obtaining the diagnosis of a numb chin.
The CO2 laser has been actively used clinically for soft tissue surgery. The advantages have been widely acknowledged. In implant related tissue surgery, the use .6f CO2 laser has been debated on whether the heat generated during the procedure would be detrimental to the bone thus losing the implants through disosseointegration. In this preliminary work, CO2 laser was used to perform a simulated gingivectomy of tissue surrounding plasma coated titanium implants. The purpose was to observe the pattern of heat generated at different levels of the implant body. The safe power range and standard precaution was also identified. The results suggested that power output between 6 Watt to 8 Watt in repeated pulsed mode with duration of 5 seconds is considered safe. With this mode the operator
Polishing of dental ceramics has become an increasingly important procedure in restorative dentistry as allceramic restorations, which require post-cementation occlusal adjustment, are gaining in popularity. There are numerous studies in both dental and ceramic literature on polishing of dental ceramics and the effects of polishing on their mechanical properties. However, lack of standardization in polishing parameters, precludes comparison among these studies. A clear understanding is lacking of the relative roles and interdependence of handpiece speed, abrasive characteristic, and polishing load. This paper will discuss the mechanism of polishing and review the literature on polishing and its effect on the mechanical properties of ceramic restorations.
The habit of chewing betel quid has been practised since ancient times. Although the world has gone through modernization, a significant proportion of people still practices this habit. Substantial evidence has shown that betel quid chewing is associated with the occurrence of oral cancer and precancerous lesions, which has a tremendous psychosocial impact on an individual's life. Thus it becomes significantly important to dentistry to look into this matter. Since betel quid chewing is one of the causes of oral cancer, effort in cha~ging this habit is essential. This article addresses this issue.
Objective: This study aimed to assess the awareness of periodontal disease and level of knowledge of the relationship between smoking and periodontal disease amongst subjects who were smokers verses non-smokers.
Methods: A questionnaire looking at knowledge of respondents regarding gum disease and knowledge and awareness about oral impacts of smoking on periodontal disease was developed and pretested in Dental Faculty University of Malaya. Basic Periodontal Examination (BPE) index was used to assess periodontal status.
Results: The questionnaire was answered by 130 subjects. Prevalence of smoking was 14.6%. A total of 58.6% non-smokers and 57.9% smokers knew about periodontal disease. However, only 26.1% non-smokers and 10.5% smokers knew that the cause for periodontal disease was plaque. More non-smokers than smokers knew that smoking affected periodontal health (80.2% and 68.4% respectively) (p>0.05) and tooth mobility was an effect of smoking on periodontal health (27.0% and 0%) (p<0.05). Regarding source of information on effect of smoking on periodontal health, 63.2% smokers and 63.1% non-smokers reported obtaining information through the mass media. However, only 31.6% smokers and 28.8% non-smokers were informed by their dentist.
Conclusion: The awareness of periodontal disease and knowledge of the relationship between smoking and periodontal disease was low in this selected population of smokers and non-smokers.
Keywords: Awareness, knowledge, periodontitis, smoking
Study site: Primary Care Unit, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
The aim of study was to evaluate the level of satisfaction of patients treated in the undergraduate Year 4 and Year 5 of University of Malaya. The subjects were patients treated in the Year 4 periodontology clinic (Polyclinic B) (n=38) and Year 5 periodontology clinic (Polyclinic C) (n=30). Data was gathered using a questionnaire which consisted of 4 components namely appointment facilities, infrastructure and basic facilities, behaviour of students dental clinician, and quality and efficiency of treatment provided. The results showed that for appointment facilities the level of satisfaction was almost 80%; for infrastructure and basic facilities the satisfaction was more than 85%; for behavior of students dental clinician the level of satisfaction was more than 90% and for quality and efficiency of treatment provided the level of satisfaction was more than 60%. When all the components were compared between patients treated in Polyclinic B to patients treated in Polyclinic C, there was no statistically significant difference (p>0.05). In conclusion, the level of satisfaction of patients treated in the undergraduate Year 4 and Year 5 periodontology clinic of University of Malaya is the same
Aim: Self-assessment based on benchmarked professional standards is an excellent tool to assist in improving the dental curriculum. Areas of strength and weaknesses can be identified. It can also act as a baseline standard when significant changes are introduced to the dental curriculum. The aims of this prospective cross-sectional study was to investigate self-assessed confidence of final year dental undergraduates in paediatric dentistry enrolled at University of Malaya in 2013. Methods: 65 undergraduates completed anonymised questionnaires which were formulated based on expected professional competencies in three domains namely clinical skills, patient management, and professional development and clinical governance. Visual analogue score (VAS) represented by a 10cm line with score ‘0’ no confidence at all and ‘10’ complete confidence was used to measure the level of confidence. Results: The overall analysis of self-assessed confidence was very positive with median VAS ≥ 5cm in; clinical skills, 7.66±1.31cm (range=2.41–9.97cm: n=62; 95.4%), patient management 7.73±1.27cm (range=5.09–9.95cm: n=64; 100.0%), and professional development and clinical governance, 8.13±1.21cm (range=5.22–10.00cm: n=64; 100.0%). High confidence was reported for routine dental care (fillings and preventive care) while lower confidence reported for basic life support (median VAS=5.65cm) and pulp therapy for immature permanent teeth (median VAS=5.95cm). Conclusions: The final year dental undergraduate students of the University of Malaya appear to have good overall self-assessed confidence in core areas in paediatric dentistry.
Objective: This study examined the influence of visual art therapy techniques in reducing anxiety level
among 4 to 6 years old paediatric dental patients.
Methods: Eleven subjects were selected among 4 to 6 years old paediatric dental patients. The initial
reaction towards dental procedure/treatment was evaluated using Frankl Behavior Rating Scale. The
anxiety level was assessed by using Malay-Modified Child Dental Anxiety Scale (MCDASf
) to measure
a child situational anxiety of pre- and post-treatment. Visual art making activities included free drawing,
clay moulding and collage technique. The participant reaction to dental treatment was assessed by using
Frankl Behavioural Rating Scale for two subsequent independent visits in two weeks interval. Median
and Ordinal Test ranked the variables score of behavioural reaction towards dental treatment and anxiety
level.
Results: Play-doh (PD) subjects could accept dental procedures more if compared to free drawing (FD)
and storytelling by collage (ST) subjects, which has lower post treatment-median scores in Visit 1 and
Visit 2, FD and ST subjects need more time to show positive attitude towards dental treatment.
Conclusion: These findings suggest dental anxiety level of children aged 4 to 6 years old reduced after
the art therapy and play-doh(clay-moulding technique) is the art making activity of choice among 4 to 6
years old paediatric dental patients.
This clinical audit is aimed to provide an insight into the performance of dental technicians in rendering
fixed prosthodontics services at Faculty of Dentistry, University of Malaya. A retrospective audit was
carried out between 1st of November 2014 and 31st January 2015 using data derived from records and
monthly returns of the technicians, which are kept at the ceramic laboratory. Retrospective data on
cases of diagnostic wax-ups, full metal crowns, metal ceramic crowns, all ceramic crowns and bridges
that were sent to ceramic laboratory for fabrication from 1st of September 2013 to 31st of August 2014
was systematically extracted from the record and tabulated categorically in SPSS version 22.0. The
turnaround time in workings day for diagnostic wax-ups and the prostheses was calculated by deducting
exit date from entry date. Subsequently, the turnaround time and the complexity of cases were categorized
accordingly. The association of turnaround time and the complexity of the cases was analysed using
Fisher Exact test with p value < 0.05. Within this time frame, a total of 102 cases of diagnostic waxups,
36 cases of crown and 18 cases of bridges were fabricated. 57.8% of diagnostic wax-ups were
completed within 3 days. 100% of 1 unit crown were completed within 7 days and 94.4% of bridges were
completed within 14 days. There was a significant association of turnaround time and the complexity of
the cases for diagnostic wax-ups and crowns with p value
In recent years, three-dimensional (3D) in vitro cell culture models have earned great attention, especially in the field of human cancer disease modelling research as they provide a promising alternative towards the conventional two-dimensional (2D) monolayer culture of cells with improved tissue organization. In 2D cell culture systems, the complexity of cells on a planar surface does not accurately reflects the in vivo cellular microenvironment. Cells propagated in 3D cell culture model, on the other hand, exhibit physiologically relevant cell-to-cell interactions and cell-to-extracellular matrix (ECM) interactions, important in maintaining a normal homeostasis and specificity of tissues. This review gives an overview on 2D models and their limitations, followed by 3D cell culture models, their advantages, drawbacks and challenges in present perspectives. The review also highlights the dissimilarities of 2D and 3D models and the applicability of 3D models in current cancer research
Prescription of flexible denture (FD) is non preference by the clinician in Ministry of Health Malaysia and it was not included in the curriculum of public university. However, among private dental practitioner (PDP) this treatment modality is highly favourable. Therefore, this study was conducted to assess the level of knowledge and perception on the flexible dentures by the PDP. The level of perception and knowledge on FD was analysed using validated questionnaire. 42 PDP had participated. An independent t-test was employed to determine the statistical difference between genders. One Way ANOVA was used to evaluate the statistical difference between their years of experience in private sector on knowledge and perception of flexible denture. There was no significant different in knowledge between female and male (p=0.892) and years of experience (p=0.617). Perceptions of flexible denture, was not significantly influence by genders (p=0.068) but by year of experiences between group A and B (p=0.039), and between group B and group C (p=0.039). P value was set at 0.05. In conclusion, there is a correlation between perceptions of flexible denture and years of experience of private dental practitioner.
This study aimed to evaluate the coronal microleakage of different thickness of different restorative materials (glass ionomer cement (GIC, GC Gold Label 2), composite restoration (SDR, Dentsply Sirona) and (Filtek Z350 XT, 3M ESPE)) used as final restoration in endodontically treated teeth. 72 sound maxillary incisors were used. Following instrumentation, all canals were obturated with gutta-percha (Dentsply Maillefer) and Roth sealer (Roth International Ltd). After 2mm of gutta-percha removal below cemento-enamel junction, the crown was cut until length of 6mm from the gutta-percha to the incisal edge was achieved. The teeth were divided into four experimental groups (n=18) and access restorations were placed in different thickness combinations. Group 1 (G1): 2mm SDR + 4mm Filtek; Group 2 (G2): 4mm SDR + 2mm Filtek; Group 3 (G3): 2mm GIC + 2mm SDR + 2mm Filtek; Group 4 G4): 6mm SDR. All samples were thermocycled (500 thermal cycles between 5o and 55o C and dwell time of 30s), coated with nail varnish leaving 1mm margin around the filling material, immersed in 2% Rhodamine B solution and sectioned longitudinally. The dye penetration was observed under a stereomicroscope (Olympus SZX7) with 1.25x magnification. The data were analysed using Kolmogorov-Smirnov test, ANOVA test and post-hoc Tukey’s HSD test. There was significant difference of microleakage among all groups. G1 showed least microleakage but with no significant difference between G1 and G3 (p=0.513) and G1 and G4 (p=0.477). G2 showed significant microleakage compared to G1, G3 and G4 (p
The information of biomechanical properties is crucial in the study of biological tissue and its clinical relevance. 3mm x 3mm free gingival human tissues was taken using disposable punch biopsy (Accu sharp blade, India) and stored in 0°C Freezer. The sample was sectioned to a thickness of 10μm using high profile microtome blade (Leica 818, Germany) and cryostat (Leica CM1850UV, United Kingdom). The sample was analysed using Atomic Force Microscope (Nanowizard® 3, JPK Instruments, Germany) at room atmosphere. The collagen fibrils of the free gingival tissues appeared to be stacked in basket weave like structure. The mean value of free gingival collagen fibrils width and the length of D-band were 106.71±11.18nm and 65.82 ± 3.04nm respectively. The Young’s modulus of collagen fibrils for human free gingival tissue at overlap region was 212.88 ± 242.58 MPa, whereas at the gap region was 207.00 ± 230.71 MPa. Within the limitation of the study, the collagen fibrils appeared to be stacked in basket weavelike structure. The length and width of the collagen fibril were similar to the values investigated using other techniques. There was significant linear relationship between Young’s modulus of overlap and gap regions.
The objectives of this study is to evaluate the suitability of full cup test (FCT), numeric pain rating scale (NPRS), and visual analogue scale (VAS) to assess pain after surgical removal of lower third molar and to identify which of these three pain scales is the easiest to use. A total of 50 patients, age between 18 to 30 years who underwent minor oral surgery for removal of impacted third molar were sampled in Faculty of Dentistry, University of Malaya. The patients were provided with forms containing three pain scales and they were required to mark each pain scales – FCT, NPRS and VAS daily for three consecutive post-operative days. The forms were collected a week later when patients came back for review. The validity between NPRS with VAS, FCT with NPRS and FCT with VAS were tested using Spearman rank correlation coefficient. Results showed that the correlation coefficient values for each pair were very high and significant. The findings when comparing Day 1, Day 2 and Day 3 and the combination for those three days showed no significant differences. No evidences indicated that the findings for Day 1 were more superior in comparison with other days. In conclusion, FCT was as valid as NPRS and VAS. The pain scale which was claimed to be the easiest to use by patients was NPRS, followed by FCT and VAS. However, further studies are needed to investigate the reliability and sensitivity of FCT.
The aim of this study was to assess the viability of coating collagen to Hydroxyapatite (HA) coated commercially pure Titanium (cpTi) samples. Five samples of cpTi were immersed in a simulated body fluid (Tas-SBF) after stages of gritting, sandblasting and acid etching. One sample was taken out after 3, 5 and 7 days of immersion in Tas-SBF respectively. The 7 days Tas-SBF coated sample was coated with collagen by physical adsorption method. Analysis was performed to study the surface roughness, morphology and elemental analysis of the coated surfaces.The equipment used wereAlicona, Scanning Electron Microscope (SEM), Energy-dispersive X-ray Spectroscopy (EDS) and Fourier Transform Infrared Spectroscopy (FTIR). Process of sand blasting and acid etching were able to produce desired morphology and surface roughness. The average surface roughness, Sa of sand blasted cpTi surface and acid etched cpTi were 2.17 ± 0.75 µm and 2.12 ± 0.15 µm respectively. Immersion in Tas-SBF produced a crystalline coating and morphology that were similar to bone-like apatite. Roughness value of cpTi after being immersed in SBF for 7 days was 2.23 ± 0.31 µm and the Ca/P ratio was 7.076. Collagen coated samples had the highest Sa value which was 3.91 ± 0.31 µm and the Ca/P ratio was 1.190. This study showed that it is possible to achieve apatite and collagen coating on a modified cpTi surface using physical adsorption method.