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.
Third molar surgery, a common dental procedure in Dental Faculty University Malaya, is known to
pose many possible complications, one of which is temporomandibular disorder (TMD); a chronic pain
concerning the joint apparatus, masticatory musculature and the associated muscle of head and neck
region. This research aims (i) to examine the signs and symptoms of TMD following third molar surgery
(ii) to study the surgical components of third molar surgery that contribute to the development of TMD
(iii) to compare incidence of TMD between operative and non-operative group six months after third
molar surgery. A descriptive longitudinal cohort study was conducted by recruiting twenty-two patients as
subjects of an operative group, and twenty patients as subjects of a non-operative group. The operative
group were examined at baseline, one week, one month, three months and six months after surgery. Each
patient underwent a series of Diagnostic Criteria of TMD DC/TMD examination and history questionnaire.
In the operative group, we found (i) increased incidence of trismus (92%), myofascial pain (69%) and
clicking (77%) of the patient group at one week review (ii) two new incidences of signs and symptoms of
TMD at final review (iii) no significant relationship between operator qualification to development of TMD
(iv) no association between degree of impaction to development of TMD (v) no relationship between
duration of procedures to development of TMD (vi) there is a significant difference in signs and symptoms
of TMD between operative group and control group (p
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
Background: In Malaysia, preschool teachers have long been utilised as oral health educators. However their level of oral health knowledge and effectiveness of the training they received are seldom investigated. This study aims to evaluate the of oral health education seminar (OHE) held for public preschool teachers (KEMAS) in terms of the improvement of their knowledge, practices and attitudes.
Methods: This was a one arm interventional study (before and after survey following OHE seminar intervention). All KEMAS preschool teachers (n=107) in Hulu Terengganu were invited to attend OHE seminar which consisted of 1 hour lecture and 40 minutes OHE demonstration. Pretest questionnaire was collected before the seminar started and post-test questionnaire was collected two weeks later. A self-administered questionnaire used in this study was adapted from “preschool teachers’ knowledge, practices and attitudes towards oral health”, National Oral Health Survey of Preschool Children, 2005. Data were analysed using descriptive and McNemar test, SPSS version 15.0.
Results: Of 107 subjects, only 61 teachers responded yielding to 57% response rate. All subjects were female with mean age of 46 years (SD: 6.03). Overall, there was an improvement of teachers’ oral health knowledge, practices and attitudes after the seminar. Several items seem to have be improved significantly after the seminar, for example knowledge item on factors causing periodontal disease (p=0.03). In terms of practice, all teachers reported they brushed teeth at least twice daily using fluoridated toothpaste and use of dental floss was increased significantly after the seminar (p<0.001). Majority of teachers have positive perceptions on their roles in oral health education.
Conclusion: Oral health education seminar appeared to be effective at influencing certain aspects of teachers’ oral health knowledge, practices and attitudes.
Keywords: attitudes, knowledge, oral health promotion, practice, preschool teachers
The study aimed to evaluate the quality of the hybrid
layer form by three different adhesive systems. Class V
cavities were prepared on the buccal surface of fourty
extracted human premolars. The prepared teeth were
randomly assigned into four groups according to the
adhesive system and application mode. The systems
were: Optibond S (OS, total-etch); Optibond Versa (OV,
two-bottles, self-etch); Single Bond Universal (SBU,
one-bottle, self-etch) and Single Bond Universal with
etchant (SBU + etchant). All cavities were restored with
composite (Filtek Z350XT). The samples were sectioned,
polished and pretreated to remove minerals, protein
and water prior to SEM evaluation. From the images,
thickness of the hybrid layers was measured. Present of
resin tags and adaptation failure were also recorded. The
data obtained were analyzed using ANOVA, Dunnett’s
T3, Kruskal-Wallis and Mann-Whitney tests. OS group
showed the highest average hybrid layer thickness (4.34
µm), followed by SBU + etchant (3.06 µm), OV (1.91 µm)
and SBU (0.95 µm). Both adhesive and cohesive failures
were observed in SBU group. Present of prominent resin
tags were seen in both OS and OV groups. In conclusion,
all the investigated adhesive systems were able to perform
distinguishable actions as shown in micro-morphological
alteration and hybrid layer thickness. Two-bottles, selfetch
adhesive (OV) was proven to produce negligible
adaptation failure compared to other adhesive systems in
the present study. Combined all-in-one adhesive (SBU)
was found to render a superior bonding performance in
total-etch mode comparing to self-etch mode.
In this study, the effect of beverages (Coke TM, Sprite™, Ribena™, Chrysanthemum tea and mineral water) on the demineralisation of the enamel surface was investigated. Demineralisation was determined by the rate of calcium released from the enamel surface on exposure to the beverages. Calcium was determined using the EDTA titration method. The pH of these beverages was measured using a pH meter and found to be in the acidic range (2.43 to 5.79) while mineral water which served as a control has a pH of 7.00. Ii was found that the rate of calcium released from Coke™(0.76 J..lg/min) showed a significant mean difference from Sprite™ (0.38 J..lg/min), Chrysanthemum tea (0.10 J..lg/min) and mineral water (0.00 J..lg/min)at p< .05, but was however not significantly different from Ribena™. Likewise, Chrysanthemum tea and mineral water also showed statistically no significant mean difference in the released of calcium during the study period. The results obtained in this study indicated that beverages with low pH may pose detrimental effect on the enamel surface which could have clinical implication, especially in people with salivary gland dysfunction or low salivary flow.
This study evaluated the effect of a Probiotic mouthrinse containing nisin, a bacteriocin extracted from Lactococcus lactis on dental plaque and gingivitis in young adult population. A group of 32 subjects were randomly assigned into two groups of 16 each. The first group started using the control mouthrinse (placebo) for 2 weeks followed by a washout period of 4 weeks. This group then used the test mouthrinse (Probiotic) for a further duration of 2 weeks. The second group followed a similar protocol as the first except that this group started with the test mouthrinse (Probiotic). Plaque Index (PI) and Gingival Index (GI) were recorded at baseline and after 2 weeks for each group. All subjects were given full mouth prophylaxis after each measurements. The results of this study showed that rinsing with Probiotic mouthrinse resulted in a statistically significant reduction of plaque accumulation and gingivitis compared to rinsing with placebo. The results indicated that Probiotic mouthrinse containing nisin had the potential of inhibiting plaque accumulation and was effective in reducing gingivitis.
This retrospective study aimed to determine the prevalence of temporomandibular disorder (TMD)
secondary to orthognathic surgery (OGS) in various types of dentofacial deformities, to access the
relationship of new onset of TMD in different types of OGS to pain-related TMD and intraarticular TMD,
and to evaluate the chronic facial pain, temporomandibular joint (TMJ) function, and masticatory efficiency
after OGS.
A total of 26 patients who were previously treated with OGS in University Malaya Medical Centre,
Kuala Lumpur from January 2005 to June 2015 agreed to participate. The subjects had either undergone
bilateral sagittal split ramus osteotomy (BSSRO) or bimaxillary osteotomy (BIMAX). All subjects were
assessed using Diagnostic Criteria for Temporomandibular Disorder (DC/TMD). Data collected from
patients’ records showed absence of TMD at presurgical stage. The present study showed 42.3% of 26
patients experienced TMD after OGS in various types of dentofacial deformities, 19.2 % of them presented
with post-operative facial pain, 30.8 % had limitation in mastication, 19.2 % experienced limitation in
mobility of the jaw, and 11.5% of them experienced limitation in verbal and emotional commences. In
conclusion, there was no association between prevalence of TMD secondary to OGS in either type
of dentofacial deformities or type of surgery involved. We also noted that the minority of the patients
suffered chronic facial pain and jaw function limitation after OGS.
The aim of this study was to determine the effectiveness of demineralized freeze-dried bone xenograft (DFDBBX) in minimizing post-surgical recession in moderate to advanced adult periodontitis in patients. Nine patients with a total of eighteen intrabony defects were matched for the tooth type, location of defects and periodontal pocket depth (5 to 7mm). Following an initial nonsurgical treatment, recession at defects indicated for surgery was measured pre-operatively. Surgical treatment was carried out by split mouth design, where the test sites were assigned DFDBBX and the control sites were subjected to debridement without the use of DFDBBX. Recessions were measured at 3 months, 6 months and 9 months post-operatively. The results showed no statistically significant difference in mean recession at 3, 6 and 9 months post-operatively compared to baseline for both test and control groups. Thus, DFDBBX was ineffective in minimizing recession on patients with moderate to severe periodontitis, as compared to surgical debridement alone.
This study evaluated the effectiveness of demineralized freeze-dried bone xenograft in reducing post-surgical pocket depth in moderate to advanced adult periodontitis in patients. Nine patients with a total of eighteen intrabony defects were selected for this study. The bony defects were matched for tooth type, location and pocket depth. Following an initial non-surgical treatment, only pockets of 5 to 7 mm deep were indicated for surgery. Periodontal pockets were measured pre-operatively and at 3, 6 and 9 months post-surgically. The study protocol included a split mouth design, where surgical treatment was carried out at both test and control sites. The test sites were assigned demineralized freeze-dried bone xenograft and the control sites were subjected to debridement alone without the use of demineralized freeze-dried bone xenograft. The results from this study showed a statistically significant difference in the mean pocket depth at 6 and 9 months post-operatively for both test and control groups, but there was no statistically significant difference at 3 months. In conclusion, demineralized freeze-dried bone xenograft was ineffective in reducing periodontal pocket depth in patients with moderate to severe periodontitis, as compared to surgical debridement alone.
Much interest has been generated in tooth-co loured inlays/onlays especially with patient's concern for esthetic appearance and the dentist's appreciation for additional strength of the restored tooth, together with bonding. Many types of tooth-coloured inlay/onlay restorations are available but none have undergone extensive and long term research. The different types of inlay/onlay restorations together with steps in their preparation are presented in this paper.
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
The population in Malaysia use various types of health and food supplements. These products are considered safe and are used without any concern for their toxicity. Among the products used as health supplements are products that contain lactic acid bacteria. This project studied the acute and subacute toxicity of a product containing minerals, herbs, vitamins and live lactic acid bacteria, on Sprague- Dawley rats. Acute toxicity was tested 24 hours after a single dose and subacute toxicity was studied 24 hours after 7 days of daily dosing. The parameters that were studied were alanine aminotransferase (AL T,SGPT), aspartate aminotransferase (AST, SGOT), serum urea, ratios of weight of kidney and liver weight to body weight and percentage changes in body weights. The contents of capsules of the product (6, 8 or lO capsules for acute studies and 6, 10 and 12 for subacute studies) were mixed with corn oil and fed orally to rats. Control rats were fed with corn oil alone. In the acute studies, the level of ALT in the rats treated with the contents of the capsule was lower than controls. There were no significant changes in the other parameters of the rats in the treatment groups as compared to controls. There were no significant differences in all the parameters between rats in the treatment groups as compared to controls in the subacute studies. Sprague-Dawley rats fed with high doses of the product did not show signs of toxicity in the parameters that were studied.
The impaction of dental prostheses in either the airway or esophagus is an under-recognized problem which may result in severe morbidity or even mortality. The radio-opacity and the size of fixed and removable dental prostheses in an animal carcass was investigated. Prostheses were placed one at a time in the oro-laryngopharynx or in tho trachea and the esophagus. Lateral radiographs were taken for each prosthesis in site. The radio-opacity and size of the prostheses on the radiograph was graded. Most of the prostheses investigated were radio-opaque though the removable prostheses were more likely to be radiolucent and differ in size. In a symptomatic patient with a missing dental prosthesis, a negative chest or abdominal radiograph does not exclude impaction, inhalation or ingestion. Further evaluation with endoscopy or even computed tomography may be essential to reduce the possibility of severe morbidity or even mortality.
The objective of the study was to attempt to verify the cause of self-reported oro-facial pain among 12-yearold children, objectively via a clinical examination. This is a descriptive, cross-sectional survey using a combination of self-reported questionnaire, face-to-face interview and clinical oral examination. The children were first asked to answer a self-filled questionnaire about their oro-facial pain experience in the past 4- weeks. In order to verify its cause, a clinical examination and an interview followed. Normative oral health status data was also collected. The sample was 1492 Malay schoolchildren with diverse socioeconomic background from the states of Johore, Kelantan and Sabah. The sample size for each state was calculated to give a sampling error of not more than 5 %. In each state, quota sampling was done to achieve a balanced distribution between gender and location. The data collected were normative status for caries, periodontal disease and traumatized teeth. Orofacial pain experience represented the subjective status for oral well-being. The cause of pain was confirmed through a clinical examination. The normative oral health status data implies a very low untreated disease and good oral health among the schoolchildren. However the subjective health status, as reflected by the prevalence of pain suggested that oro-facial pain and suffering was high (27.3%) with about 49% "of moderate and severe" intensity. The two main causes were caries and mouth ulcers. However in about onequarter of pain cases, diagnosis cannot be confirmed in the field survey setting. More than one-half of those with pain experienced disturbed sleep and study. It was concluded that overall oral health status and well-being can be better described if normative data is complemented with subjective data such as pain prevalence. The study shows that the majority (more than 75 %) of cases of subjective pain can be objectively verified in a field epidemiology survey setting. The reliability of the subjective data can be improved by a clinical examination as compared to unverified self-report. The study also confirms that the major source of oro-facial pain among the 12 year-olds were caries and mouth ulcers.
The aim of this research is to study how the physical changes in the maxillofacial trauma patients affect them psychologically in patients of different ages, sexes, races, socioeconomic backgrounds, types and severity of injury. The study was conducted by doing a questionnaire survey, which was divided into physical and psychological components. In the physical component, the questions were mainly related to the physical injuries to the patient, which could be visualized clinically and functionally. The psychological component consisted of analyzing the impact of the maxillofacial trauma to the psychological profile. Twenty patients of both sexes and ages, ranged from 15 to 62 years old were interviewed. The main cause of trauma was from motor vehicle accidents. This study appears to show that maxillofacial trauma may have a psychological impact on patients.
The objective of this study was to determine the effect chewing of two differently sized commercially available meswak might have on flow rate and pH of whole saliva. Twenty subjects participated in this study. They were distributed into two groups (A and B). Subjects in both groups A and B were asked to first chew on either a sized #1 or #2 cotton roll followed by the chewing of an equivalent sized piece of meswak (approximately 5 mm. and 10 mm. diameter) respectively. For subjects in group A, no differences in mean flow rate was seen after both the chewing regimes. In group B however, the increase in mean flow rate after the chewing of meswak compared to cotton roll was statistically significant at p < 0.05. Statistically significant lower values for pH were registered after the chewing of meswak compared to cotton roll in both groups A and B at p
The objective of this study was to determine the effect of chewing commercially available meswak may have on levels of calcium, chloride, phosphate and thiocyanate in stimulated whole saliva. A total of 20 subjects participated in the investigation. They were distributed into two groups. Those in group A (10 individuals) were asked to first chew on a cotton roll (sized #1) followed by the chewing of an equivalent sized 5mm piece of commercially available meswak. Subjects in group B (10 individuals) did the same but, chewed on cotton roll (sized #2) followed by the chewing of an equivalent sized 10mm piece of commercially available meswak. After following a specified chewing protocol, samples of stimulated whole saliva were collected into a graduated tube at the end of every chewing regime. Calcium, chloride, phosphate and thiocyanate analysis were carried out using colour titration and spectrophotometer. Results from this investigation indicated that commercially available meswak chewing sticks apart from containing high amounts of calcium and chloride may possibly release phosphate and thiocyanate into whole saliva. These findings suggest that the commercially available meswak used as chewing sticks may have the potential of releasing substances into saliva that could influence the state of oral health. Further studies have to be carried out to ascertain the therapeutic benefits of chewing commercially available meswak.
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.
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.