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.
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.
To assess the oral health behaviour and preventive dental care experiences of patients with special health
care needs (SHCN) who attended the Special Care Dental (SCD) Clinic at University of Malaya. Data
were collected from 31 patients using a self-administered questionnaire which consisted of questions
pertaining to their oral health behaviours and experiences on receiving preventive dental care (PDC).
For patients who were unable to answer due to existing health conditions, parents or primary caregivers
were approached as proxy. Descriptive analysis was conducted and reported based on percentages to
identify the oral health behaviour and PDC of the individuals. Majority brushed their teeth at least once a
day (84%), used fluoridated toothpaste (87%) and oral hygiene aids (58%). However, almost half of them
(48%) required assistance from parents or caregivers during tooth brushing and consumed sugary snacks
in between meals (58%). About 80% had received PDC where the type of care received was mainly oral
hygiene advice (77%). Slightly more than 80% preferred the one-to-one demonstration method during
PDC. Most gave positive evaluation on their PDC experience especially on items pertaining to the dentist’s
attitude. Whilst most of the SHCN patients in this study had positive perception on the PDC that they
received and practised good brushing behaviour, their dietary habits need to be improved. Thus, regular
preventive dental visit amongst SHCN patients is important for appropriate and comprehensive dental care
in maintaining oral health.
The study aimed to compare mechanical properties and surface characteristics of initial and working
aesthetic archwires with their conventional counterparts. High Aesthetic Sentalloy (full rhodium coating
nickel-titanium; Dentsply GAC) represented the initial aesthetic archwires; and FLI TRU-CHROME
(labial PTFE-coated stainless steel; RMO) as the working aesthetic archwires; together with their
conventional counterparts were analysed. A three point bending test was conducted using a universal
testing machine (AGS-X SERIES, Shimadzu, Japan) to determine the load-deflection characteristics of
archwires. Surface hardness was evaluated by Vickers microhardness test (HMV-FA, Shimadzu, Japan).
A 3D Optical Surface Texture Analyzer (ALICONA, InfiniteFocus Real3D, Belgium) and a Field Emission
Scanning Electron Microscope (FESEM, FEI Quanta 250, USA) were used for surface evaluation.
Results showed that load-deflection characteristics of High Aesthetic Sentalloy archwires did not differ
from its control, whereas FLI TRU-CHROME archwires exhibited higher loading and unloading forces
than its counterpart. No statistically significant difference in surface hardness was found between FLI
TRU-CHROME and its control archwires. The coating surfaces of both aesthetic archwires were rougher
than the non-coated conventional archwires, with similar roughness between non-coated surface of FLI
TRU-CHROME archwires and its counterpart. FLI TRU-CHROME archwires showed a distinct coating
thickness but coating layer is undefined in High Aesthetic Sentalloy archwires. In conclusion, the aesthetic
rhodium coated nickel titanium archwire has similar mechanical properties as control nickel titanium
archwire without being adversely affected by the addition of the coating layer. The aesthetic coated PTFE
stainless steel archwire has higher load response which could be an advantage as rigid wire in working
stage of orthodontic treatment. Based on their performance, their use could be recommended in cases
where aesthetic aspect is crucial and where the friction aspect is not critical as their surface roughness
values increased.
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.
The aim of the study was to assess the association between past fluoride exposures from ingested toothpaste and current fluorosis manifestations in 10- 11 year old index subjects. Fluorosis was assessed with the Dean’s Index in 1343 10-11 year old index subjects. Two hundred index subjects who had younger 4-5 year old siblings were sub sampled and fluoride exposures from ingested toothpaste in their younger siblings (proxy subjects) were determined. The values for the fluoride ingested per brushing of the proxy subjects were utilised together with past frequency of toothbrushing of index subjects to extrapolate on the past exposure of index subjects. The mean extrapolated past fluoride exposure from ingestion of toothpaste was highly variable; 671.7 ug ± 739.3 ug (sem= 56.9). It was higher in the subjects with fluorosis (697.3 ug) than in those without fluorosis (646.89 ug) but differences were not of statistical significance. This approach of extrapolation has not been reported elsewhere and need to be validated. The implications of the present methodology to estimate past fluoride exposure is discussed.
The aim of the study was to determine the characteristics and pattern of the betel/tobacco quid chewing habit in the estate Indian community. The study was conducted in 6 randomly selected estates. It involved oral mucosal examination and an interview to solicit personal data as well as history and details of oral habits. Of a total of 618 subjects studied, 19.3 % (n= 119; 89 females and 30 males) were betel !tobacco quid chewers. The youngest age of onset of betel quid chewing is 10 years. The mean frequency of chewing quid is 4.3 times/day and the mean duration of chewing is 8.1 minutes. Initiation to the habit occur at a young age and a major role is played by family and friends in initiation to the habit. Practises of adding tobacco and lime appear to have adverse effects and are associated with higher occurrences of precancer lesions in this study (p
Diagnosis by histopathology remams as one of the most important investigative methods used to establish a definitive diagnosis of a lesion or disease state. The provision of oral tissue diagnostic services is therefore an essential function of an Oral Pathology unit. A review of the English language literature disclosed that much of the documented information on the patterns of oral diagnostic services were from the United States, Canada and the United Kingdom. This paper provides an overview of such surveys carried out in these countries.
Endoseous Implant insertion for the replacement of missing teeth is the state of the art at present times. An understanding of the biology of the perimplant tissues is imperative for the overall success in the dental rehabilitation of a patient with fixture supported prosthesis. The dental implant tissue interface comprises bone, both cortical and cancellous bone; supracrestal connective tissue and the epithelial attachment. A comprehensive review of the response of bone during the postoperative or healing phase, the loading or remodelling phase and during the steady phase is described.
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.
The purpose of the present study was to determine the periodontal profile, toothbrushing habits and oral hygiene status of patients referred to a teaching institution for periodontal treatment, based on patients' treatment records. A total of 207 consecutive patients diagnosed with periodontitis who had been interviewed and clinically examined over a period of approximately one year were included in this study. The assessments of plaque levels, bleeding on probing (BOP) scores, probing pocket depth (PPD) and degree of bone loss from radiographs were made. The average age of this study group was 45 ± 12.8 years old with an age range of 20 to 76 years. The subjects comprised of 40% Malays, 34% Chinese and 26% Indians. The male to female ratio was almost 1.5: 1. These patients presented with high plaque and BOP scores. These findings do not concur with the high frequency of toothbrushing reported (86.5 % of subjects brushing twice or more times per day). This may reflect on the ineffectiveness of brushing as evident from their high plaque scores. Periodontal pockets were detected in 69 % of the teeth in these patients with an average of 17 teeth per patient being involved. Probing pocket depths of >6mm was found on the average in 3 teeth per patient. Alveolar bone loss as assessed from radiographs was detected in 52 % of the teeth in this study group of which 12 teeth per patient on the average exhibited this. Advanced bone loss involving about 2/3 and more of the root length was detected on the average on 1 tooth per patient. Early onset periodontitis accounted for about 5% of the total cases seen. About 21 % of subjects suffered from advanced adult periodontitis. Hence about a-quarter of the patients referred already had marked periodontal destruction.
In this study we aimed to determine the adverse effects and pain outcome following carbamazepine
pharmacotherapy to manage patients with classical trigeminal neuralgia. The study was carried out on
patients diagnosed with classical trigeminal neuralgia at the Faculty of Dentistry, University of Malaya.
Medical records of patients diagnosed with trigeminal neuralgia over a period of 11 years from April, 2003
to April, 2014 were reviewed. A total of 49 patients who fulfilled the inclusion criteria were included in
the study. Demographic details, clinical features and blood test reports of the patients were recorded
from the patient’s clinical files. Subjects included in the study were administered the Faces Pain Rating
Scale (FPS) and Numeric Pain Rating scale (NRS) to measure the pain outcome retrospectively. Analysis
and interpretation of results was carried out using SPSS. Hepatic adverse effects were more commonly
seen in our patients (n=39) followed by haematological (n=27), renal (n=23) and non-specific adverse
effects (n=22). However, there was no significant association between the observed side effects and
carbamazepine pharmacotherapy. Analysis of our data using Pearson Chi Square test, showed no
significant correlation between gender, ethnicity and age of the patients with adverse effects. 9 out of
the 49 subjects included in the study were administered the FOS and the NRS. Pain perception after
treatment was significantly decreased (p-0.007) in comparison to pain perception before commencement
of therapy with carbamazepine in the selected group of patients. Even though pain perception decreased
in the selected patients, the data is insufficient to state the efficacy of the treatment as none of the patients
reported a complete relief from their pain. The results of our study showed that there were no significant
haematological, hepatic, renal, and non-specific adverse effects associated with the use of carbamazepine.
The efficacy of this drug in the treatment of trigeminal neuralgia was proven to be satisfactory. It may be
concluded that carbamazepine could be considered as the drug of choice in the treatment of trigeminal
neuralgia.
Side effects such as abrasion of the dental hard tissue have been frequently observed following the extensive use of mechanical cleansing. As promising antiseptics like chlorhexidine produces extrinsic dental staining on long term usage, there has been increasing interest and research generated towards chemically based stain removing agents. This invitro studyexamined whether some commercial oral hygiene products could inhibit chlorhexidine derived stain independent of any mechanical cleansing action. Perspex blocks were soaked in triplicate in chlorhexidine solution for 2 minutesand stain inhibition by these products was determined by further soaking the blocks in productl water slurries for 2 minutes and finally in tea solution for I hourly periods. The optical density (OD) of each specimen was determined at each hourly interval by spectrophotometry at 395 nm and the mean values obtained. At the end of the study, most of the products inhibited stain compared to water control and there was a variation in the stain inhibitingefficacyof the products. It is thus concluded that oral hygiene products like dentifricesand mouthrinses can inhibit chlorhexidine derived extrinsic dental stain to a variable degree through a chemical action by contained ingredients.
Purpose of the study: The objective of this study was to investigate the flexural strengths of five commercially available tooth-coloured restorative materials – Alpha-Dent (composite resin, Dental Technologies Inc.), Solare Anterior (composite resin, GC), F2000 (polyacid-modified composite resin, 3M), Beautifil (giomer, Shofu) and Fuji II LC (resin- modified glass ionomer cement, GC] using the ISO 4049 specifications. Materials and Method: Ten specimens of (25±0.2)mm x (2±0.1)mm x (2±0.1)mm from each material were prepared at 22-23ºC using a customized metal mould. After light polymerization, the specimens were stored in distilled water at 37ºC for 24 hours. The specimens were subsequently blotted dry, measured and subjected to flexural testing using an Instron Universal Testing Machine with a crosshead speed of 0.5mm/min. The flexural strengths were calculated from the maximum load exerted on the specimens. Data were analysed using one way ANOVA and scheffe’s post-hoc multiple comparison tests at a significance level of 0.05.Results: The results showed that the mean flexural strengths of Beautifil, Solare Anterior and Alpha-Dent were above 80 MPa and those of F2000 and Fuji II LC were below 80 MPa. The results of one-way ANOVA and Scheffe’s post-host tests demonstrated that Beautifil had significantly higher mean flexural strength compared to Fuji II LC, F2000 and Alpha-Dent (P
Purpose of the study: The objective of this study was to investigate the existence of the golden proportion between the width of the maxillary anterior teeth of undergraduate dental students at University of Malaya. Materials and method: Standardised photographs of 100 dental students’ smiles displaying only the lips and the teeth were captured. The images were transferred to a personal computer and the width of the maxillary anterior teeth was measured using an Image
Analyzer (Leiqa QWin). Calculations were made according to the Theory of Golden Proportion. The
data were statistically analysed using paired student T-test (α
A study was undertaken to identify the oral health status and treatment needs of 403 drug abusers enrolled in a drug rehabilitation center in Perak, Malaysia. The prevalence of dental caries was 97.0%. Calculus was present in 82.1% of the dentate individuals, but only 14.6% had pockets greater than 3mm. The mean DMFT observed was 11.7, with missing teeth (MT=9.6) constituting the major component. Denture needs were high (67.2%), but only 11.4% of individuals had prostheses.
The epithelial cystic linings and adjacent connective tissues of 61 cases of odontogenic cysts (radicular cysts[RC], dentigerous cysts[DC] and odontogenic keratocysts[OKC]) and unicystic ameloblastomas(UA) were described and compared histopathologically. The type of epithelium in relation to the presence of rete processes and the distribution of chronic inflammatory cells were analyzed statistically. Significant associations between the presence of rete processes in the non-keratinized epithelial linings and inflammation in the subjacent connective tissues of RC and DC were found in this study. There was also a statistically significant association between the presence of rete Processes and nonkeratinized epithelial linings in OKC. The results also showed that in inflamed OKC, the cystic lining epithelium exhibited hyperplasia indistinguishable from lining epithelium of RC and DC. This study further showed that ameloblastomatous-like epithelial cystic linings were present in inflammed odontogenic cysts. All except for one case of unicystic ameloblastomas in this study showed ameloblastomatous epithelial cystic linings. It is recommended that the lining epithelium of RC and DC be examined carefully in order to rule out OKC. Similarly, ameloblastomatous-like lining epithelium arising from chronic inflammation in RC and DC should be differentiated from true ameloblastomatous cystic lining. Such careful examinations are diagnostically important in view of the similarities of epithelial cystic linings of inflamed OKC with DC and RC aggressive behavior ofOKC and UA.
Proliferating Cell Nuclear Antigen (PCNA) is one of the several markers of cellular proliferation. Epithelial proliferations play a significant role in the behaviour of odontogenic lesions. The objective of this study was to describe and compare the distribution of PCNA expression within the epithelial linings of odontogenic cysts. A total of 49 cases of odontogenic cysts consisting of 18 radicular cysts, 16 dentigerous cysts, 15 odontogenic keratocysts (OKCs) was studied. All tissues were processed routinely prior to embedding in paraffin. PCNA immunohistochemical staining was performed on 4 !-tm thick deparaffinized sections mounted on sialinized slides using the peroxidase antiperoxidase method. The distributions of PCNA expression in the cysts linings were noted and comparison was made qualitatively and quantitatively. PCNA labelling index was used for the quantitative assessment. The results showed that PCNA staining was distributed in the basal and supra basal cells for radicular cysts, dentigerous cysts, and OKCs. PCNA labelling index was highest in OKC (22.33±4.07). The high PCNA labelling index in OKC is indicative of high proliferative activity thus supporting previous reports of OKC as the most aggressive type of odontogenic cysts.
Simulated canals in clear resin blocks have been widely used in pre-clinical endodontic teaching. The artificial canal provides direct visualisation of procedures in root canal treatment. Stanuardised simulated root canals have been produced in the Faculty of Dentistry, University of Malaya for dental education and research. The canals are easy and inexpensive to construct. An outline of the method of construction of resin simulated canals is presented in this paper.
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.