Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for
aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite
resin restorations have become an integral part of contemporary restorative dentistry and can be called “star
of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the
tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations.
Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of
treatment, patient’s expectations and duration of treatment should be taken into consideration. This article
presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with
satisfactory outcome that mimic the natural dentition.
Oral cancer is the sixth most common malignancy in the world. Despite recent advances in cancer diagnoses and therapies, the five-year survival rate of oral cancer patients has remained at a dismal 50% in the last few decades. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits namely betel quid chewing, smoking and alcohol consumption. This paper provides a brief overview on the various aetiological agents and risk factors implicated in the development of oral cancer.
This cross-sectional study was carried out to identify A. actinomycetemcomitans and P. intermedia in the subgingival plaque of three ethnic groups (Malays, Chinese and Indians) in a selected group of adult Malaysians with advanced Chronic Periodontitis and to correlate these findings with their periodontal status. Thirty periodontally diseased adults were age, gender and ethnically matched with 30 healthy individuals. Clinical parameters were assessed for all. Subgingival plaque samples were collected for identification of A. actinomycetemcomitans and P. intermedia using polymerase chain reaction. Prevalence for P. intermedia (83.3%) was high and A. actinomycetemcomitans
(6.7%) low in the total subject population. P. intermedia and A. actinomycetemcomitans were more
prevalent in diseased (86.7%, 10% respectively) than in healthy (80%, 3.33% respectively) subjects. A. actinomycetemcomitans was detected in 15% Indians, 5% Malays but none of the Chinese subjects whereas P. intermedia was detected in 90% Malays, 85% Indians and 75% Chinese subjects. No significant association between presence of A. actinomycetemcomitans
and P. intermedia with race and periodontal disease status was found. Only A. actinomycetemcomitans had a significant association with clinical attachment level (CAL) (p < 0.05). In conclusion, in this small subject group, none of the pathogens were associated with race and periodontal disease status and only A. actinomycetemcomitans had a significant association with CAL.
Objective: An in vitro assessment of MG-63 human osteosarcoma cells' alkaline phosphatase (ALP) activity when in contact with calcium hydroxide powder (CH), paste (CHP) and grey mineral trioxide aggregate (MTA). Methods: MG-63 cells were seeded to the three selected materials for durations of 0.25, 0.5, 1, 24, 48 and 72 hours. BCIP-NBT assay was used and ALP activity quantified using ELISA reader at 410 nm. Results: The overall analysis for ALP activity indicated significant interaction between test materials and control (maintenance medium). Subsequently, the test materials were paired and analysed for initial (0.25, 0.5, 1 hour) and delayed response (24, 48 and 72 hours). During the initial response, CH exhibited an increased ALP activity compared to MTA. This interaction was not dependant on duration. The delayed response exhibited elevated ALP activity with CHP when compared to MTA and CH. The interaction of CHP was dependant on duration. Conclusion: All three materials exhibited increased ALP activity.
Surgery done around gingival margin may eventually result in loss of attachment and recession of the gingiva. Root hypersensitivity is another possible complication when coupled with overzealous tooth brushing by the patients. This paper presents an alternative method to remove a lesion located at the lateral cervical third of a root. Its advantage is that the gingival margin is kept intact.
The standard procedure for alveolar cleft closure in cleft lip and palate patients is by alveolar bone grafting (ABG) where the residual opening of oronasal fistula in the palate is also closed simultaneously. Occasionally there is a situation of soft tissue inadequacy and attempt to close the fistula at the same procedure as ABG may compromise the result of the bone graft itself. An unforeseen leakage at the closure may cause graft infection leading to failure. This article reports on a technique where alveolar bone grafting was done without closure of residual palatal fistula to provide adequate soft tissue coverage for the grafted bone. This may reduce the risk of leakage at the oral mucosal coverage of the graft . The residual palatal fistula will be closed at later stage by muco-palatal flap or tongue flap. We reported on a case of a failed ABG which was reconstructed using this technique. Various other techniques to ensure success of ABG were also discussed. Conclusion: The alveolar bone grafting without closure of oro-nasal fistula reduced the risk of failure of ABG in a wide alveolar cleft.
Odontogenic carcinomas of the jaws are subclassified into malignant ameloblastoma, ameloblastic carcinoma and primary intraosseous carcinoma arising from within the bone. These may arise from residual islands of epithelium derived from dental lamina or epithelial lining of dental cysts. Ameloblastic carcinoma is extremely rare. An aggressive case of ameloblastic carcinoma occumng in a 59-year-old Malay man is presented. Wide excision of the primary lesion with radical neck dissection was carried out. He developed lung metastasis 4 months post-operatively. Despite chemotherapy upon discovery of lung metastasis, he expired 7 months following the initial diagnosis.
The prevalence of tooth loss amongst the elderly is generally very high. Hence mastication and subsequently nutrition is greatly affected leading to the impairment of their general health. Therefore denture construction is an important aspect in the rehabilitation of the oral and general health in most elderlies. However, poorly constructed dentures and lack of maintenance coupled with various other health and healthrelated problems of the elderly, for instance poor general health especially with immunocompromised states, multiple medication intake, xerostomia, reduced mobility, economic status, mental state and ignorance may all lead to discomfort and denture associated lesions in these elderly patients. No regional studies or data on denture-related lesions in the general population have been reported. Previous epidemiological studies of adults in Malaysia (1,2) and other local studies have not investigated lesions of the oral tissues associated with geriatric denture wearers although studies in developed countries, where prevalence of denture usage is high, have noted that denture-related lesions to be the most common group of oral mucosal lesions in the elderly (3-7). As has been reported in most developing countries, the proportion of elderly in Malaysia is also increasing. It has also been noted that the mean number of teeth present decreases as age increases; in those between 15 to 19 years, all 28 teeth are present, 35 to 44 years-old have 23 teeth whereas those above 65 years retain only 12 teeth. Edentulousness increases from 0% to 7.3% to 56.6% in these age groups respectively (2). It is anticipated that with the increasing population of the elderly in Malaysia and the improving economy, the proportion of denture wearers in the population will increase. In view of the lack of investigations in Malaysia focusing exclusively on this group of lesions, it is therefore the aim of this pilot investigation to highlight the prevalence of denture- related lesions in a representative population of the elderly living in the community, both in the urban and rural areas. It may also form a basis against which future studies can be compared.
Chlorhexidine gluconate and hexitidine have been used in many oral health care products as antiplaque and antigingivitis agents. Based on the clinical observations and the plaque and gingivitis scores, chlorhexidine gluconate has been reported to be a better agent. In this study, the anti-adherence properties of chlorhexidine gluconate and hexitidine on individual bacteria strains isolated from a 3-hour plaque (Streptococcus sanguis, Streptococcus mitis 1 and Actinomyces sp.) and on a whole 6-hour plaque culture were determined and compared. The study showed that chlorhexidine gluconate inhibited almost 100 % the adherence of the individual bacteria strains and 87.7 % the adherence of a whole 6-hour plaque culture to the saliva-coated glass surface. Hexitidine appeared to be more selective in its effect. It was shown to inhibit the adherence of S. sanguis and Actinomyces sp. to saliva-coated glass surface by 86.5 % and 51.4 % respectively. Its effect on the S. mitis 1 strains is comparable to that of a whole 6-hour plaque culture where inhibition to adherence were less than 4 % for both.
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
To date there is no standard protocol on evaluation of the masticatory performance in complete denture wearer even though many methods had been described in the literature for measurement of the masticatory performance of the complete denture wearers. The masticatory performances were measured either subjectively or objectively, but no positive correlation was found between subjective and objective measurement. Therefore, there is a need to standardize the objective measurement, as subjective measurements rely on patients’ perceptions, which is not reliable. Intra individual and inter individual variations that exist support the need to standardize the method of measurement.
The objectives of the study were to determine the normal dental arch width of Malays, their correlation with
the facial framework and the ideal size of orthodontic impression trays that fit the dental arch. Eighteen adult
Malays with normal Class I occlusion were evaluated. Arch width was measured on each subject’s dental
cast. Direct anthropometric measurements were taken for 8 facial landmarks. Orthodontic impression trays
were tried on each subject’s dental cast to determine the best fitting tray. Correlations analysis was made
between the arch widths and the best fitting impression trays used and also with various craniofacial
anthropometric measurements. The eight measurements from the craniofacial region were compared
with the maxillary and mandibular intercanine, interpremolar and intermolar widths. In the maxillary arch,
there were significant correlation between the face width and the interpremolar and intermolar widths
respectively, while in the mandibular arch, significant correlations were noted between the mandible depth
and the interpremolar and intermolar widths respectively. The most common fitting impression tray was size
6 for the upper jaw and size 5 for the lower jaw. There was a significant correlation between the maxillary
intercanine width and the size of the impression trays. The significant correlation between upper and lower
interpremolar and intermolar widths and the anthropometric measurements of this Malay population may
assist in predicting arch expansion to achieve Class 1 occlusion during orthodontic or maxillofacial surgical
treatment. The significant correlation between the upper intercanine width and the size of impression tray
can be a useful parameter when determining the size of impression tray.
Aneurysmal bone cyst is a rare non-epithelialized pseudocyst of the jaws. Jaffe and Lichtenstein in 1942 were the first to recognize aneurysmal bone cyst as a distinct clinical and pathological entity while Bernier and Bhaskar in 1958 were the first to describe the presence of this lesion in the jaws. A case of aneursymal bone cyst in the maxilla is presented and the literature reviewed.
Solanum ferox L. is a plant species which belongs to the Solanaceae family and the genus Solanum. The Solanum genus was found to exhibit anticariogenic activity and was traditionally used to treat oral diseases. However, there is no scientific study done specifically for Solanum ferox L. Hence the aim of the study is to determine the anticariogenic properties of flesh and leaf of ethanolic extract of Solanum ferox L. Alkaloids, flavonoids and tannins were detected in the leaf ethanolic extract via preliminary phytochemical screening. The presence of these phytochemicals may contribute to the anticariogenic activity. Treatment with different concentrations of flesh and leaf of ethanolic extract were used against Streptococcus pyogenes and Staphylococcus aureus via the method of agar well diffusion to indicate zones of inhibition. The antibiofilm activity of the flesh and leaf ethanolic extracts was tested. The flesh and leaf ethanolic extracts possess antimicrobial activity dose-dependently and positive antibiofilm activity against respective pathogens. The flesh ethanolic extract has stronger anticariogenic activity compared to leaf ethanolic extract against respective pathogens. Streptococcus pyogenes exhibited higher susceptibility as compared to Staphylococcus aureus. In conclusion, it has been shown that the ethanolic extract of Solanum ferox L. exhibit anticariogenic properties against Streptococus pyogenes and Staphylococcus aureus.
This study aim to evaluate antimicrobial efficacy of sodium hypochlorite (NaOCl) and ozonated water against Enterococci faecalis biofilm. The bacterial biofilm was exposed to 2.62%, 1.31% NaOCl and 0.1 ppm ozonated water over a range of time periods. The presence of viable cells was determined by enumeration of colony forming units (CFU). All experiments were repeated four times (n=4). The effectiveness of the agents was compared using nonparametric Kruskal- Wallis test. The result revealed that 2.62% of NaOCl can completely kill E. faecalis biofilm in 15 minutes whereas 1.31 % NaOCl required a longer time to produce such effect. 0.1 ppm ozonated, however, did not exhibit any antimicrobial effect within the period of time tested. From this study, it can be concluded that 0.1 ppm ozonated water was not comparable with 2.62% and 1.31% NaOCl in antimicrobial efficacy against E. faecalis biofilm.
The aim of this study is to evaluate the treatment outcome using fixed and removable appliances, in the Faculty of Dentistry, University of Malaya (U.M.). The study models of 25 fixed and 30 upper removable appliance cases, with complete written records were examined before and after orthodontic treatment using the PAR (Peer Assessment Rating) Index. All the data were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows. Eighty five percent of the cases selected as sample were either 'improved' or 'greatly improved'. Among the 10 cases which were 'greatly improved', all had high pre-treatment PAR points (> 35 PAR points). Conversely, all the eight cases classified as 'worse or no different' were with low pretreatment PAR scores « 20 PAR points). The mean treatment duration in this study was 23. I months, ranging from 2 months to 78 months. The results of this study showed that the standard of treatment in this Faculty were fairly acceptable.
This cross sectional study investigated the clinical and radiographic status of crowned teeth with and without root canal treatment. The study used secondary data from records of patients who received crown treatment at the Faculty of Dentistry, University of Malaya before 2015 and walk-in patients attending the primary care clinic between July - December 2016. The inclusion criterion was crown fitted for more than 12 months. Once identified, the patients were assessed for clinical and radiographic status. Data were entered into and analysed using SPSS Version 20 software. A total of 66 crowns [35 root canal treated (RCT) and 31 non-root canal treated (n-RCT)] were identified. Chi-square test was carried out to determine the health of crowned teeth and for its longevity in the oral cavity. There were 43 crowns (46.5% RCT; 53.5% n-RCT) with plaque accumulation, 15 (66.7% RCT; 33.3% n-RCT) with gingival swelling/recession, 17 (46.5% RCT; 53.5% n-RCT) with widening of the periodontal ligament, 13 (53.8% RCT; 46.2% n-RCT) with bone loss and 5 (60% RCT; 40% n-RCT) crowns with periapical lesion. There was no statistically significant difference except for poorer alveolar bone condition for crowns that have been in the mouth for >10 years. Based on the study, no significant adverse pulpal involvement between crown with RCT and crown without RCT was observed.
Patient satisfaction can be used as one of the indicator for measuring quality of dental care provided. The
objective of this study was to assess patient experiences with dental service provided by undergraduate
dental students in Faculty of Dentistry, University of Malaya. A cross sectional study was done by
distributing a self-answered questionnaire to patients treated by undergraduate dental students. Patient
level of satisfaction was assessed by using five point Likert-like scale (strongly disagree, disagree, neutral,
agree and strongly agree), with a list of items divided into three domains, consist of interpersonal skills,
dental treatment and services. The response rate was 71.3%. The mean satisfaction scores were 83.09%,
78.62 and 74.16 for interpersonal skills, dental treatment and services domains respectively and the overall
mean satisfaction score was highly satisfactory (78.62%). The percentage of satisfied patients was 82.4%,
66.2% and 55.4% for interpersonal skills, dental treatment and services domains respectively. There
was significant association between satisfaction score with age (p-value=
The role of smoking as a contributory factor in the progression of the periodontal disease process has long been suspected and recently a large number of studies have been published in the dental literature regarding this possible role. Much of the literature has also indicated that smokers affected with periodontitis respond less favorably to periodontal treatment be it non-surgical, surgical and regenerative. This paper will review the current literature regarding the effects of smoking on various aspects of the periodontal disease process and present an explanation for the possible association between smoking and the progression of periodontitis.