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.
To explore the phenomenon of tongue piercing in Klang Valley. Semi-structured in-depth interviews were
conducted with piercers and those who had their tongue pierced (“piercees”) in Klang Valley. Five piercers
and eight piercees were interviewed. Piercees had their tongue pierced at age 16-25 years. Three main
reasons for tongue piercing were to enhance appearance, express their individuality, and out of curiosity.
They reported that they experienced various immediate and late complications. However, most were aware
of and expected the complications. The majority of piercers reported adequate infection control procedures
and enquired about the client’s health prior to piercing. Although some clients reported problems, such
reports were rare. Tongue piercing is an invasive procedure with some risks, but precautions such as
proper infection control procedures minimize the likelihood of encountering serious problems. The reasons
for tongue piercing varied between individuals. Although the majority of the interviewed piercers reported
cross-infection control, their knowledge of the medical risks associated with tongue piercing varied widely.
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 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.
This study aims to determine which age assessment data using the third molar development values
(local or international) is suitable for estimating the age of Malays or Chinese in Malaysia. A sample of 60
panoramic images of Malays and Chinese aged between 13.58 to 21.25 years were selected. Different
assessment surveys which included the studies by Yusof et al. (2015), Wilson (2005), Johan et al. (2012),
Mincer et al. (1993), AlQahtani et al. (2010) and Gunst et al. (2003) were employed to estimate the age
from the developing third molar on the panoramic images studied. The estimated ages were compared
to the chronological age of the selected Malaysians. All the datas were then recorded on Microsoft Excel
sheet. The two observers were then subjected to the Intraclass Correlation Coeffecient (ICC) inter-observer
reliability test.The highest number of correspondence (65%) between the chronological and estimated age
(within one year) was for the survey conducted by Wilson. With regards to ethnicities, 70% of Chinese
matched the mean estimated age by Wilson while Malays showed a high correspondence for the study
by Mincer et al. (63.3%). Furthermore the ICC reliability test showed strong agreement between the two
observers. There were similarities between the Malay and Chinese population in the correspondence of
the estimated age to the chronological age employing the different dental estimation surveys; in addition
the study by Wilson and Mincer et al. yielded best matching for these Malaysians.
This study aimed to determine the incidence, aetiology, types of injury, management and the outcomes of
the treatment of maxillofacial trauma among paediatric patients treated in Faculty of Dentistry, University of
Malaya. A retrospective study (2005-2015) was carried out which involved retrieving past records (manual/
electronic form) of paediatric patients (under 16 years old) who presented with maxillofacial trauma. Data
collected was organized using descriptive statistics with SPSS version 12.0.1. The total number of patients
was 120 but only 93 had complete records. The ratio of boys to girls was 2:1. The main cause of injury
was falling (54%) followed by motor-vehicle accident (MVA) (42%), assault (3%), and sport (1%). The total
count of soft tissue injury only was about 41% while 59% presented with maxillofacial fracture. Midface
were the most common fracture occurred followed by mandibular fractures. Both fractures were mostly
managed by open reduction and internal fixation (ORIF) using non-resorbable plates except for condylar
fractures which were mostly managed conservatively. In conclusion, the incidence of maxillofacial trauma
in children increased within the time frame of this study. The most common aetiology was fall. Hard tissue
injury accounting for most of the cases whereby midface was the most common site involved. ORIF was the
treatment of choice for most of the fracture cases except for condylar fractures (conservative management).
All patients had achieved reasonable outcomes postoperatively in terms of form and functions.
Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters. Materials and methods: In this retrospective crosssectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya were examined for the presence of AR-related OMC. The study period was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
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
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 objectives of this study were to compare the microhardness, flexural strength and compressive
strength of a new bulk-fill composite (SonicFill™) to a conventional nanohybrid composite (Herculite
Precis) and an established bulk-fill composite (Tetric N Ceram). In addition, the depth of cure of the
two bulk-fill resin composites was also investigated. The materials were prepared and tested for the
mechanical properties following ISO 4049:2009. Microhardness and depth of cure were measured using
Vickers hardness tester. Compressive and flexural strength were tested using a universal testing machine.
To determine the depth of cure, microhardness of the bulk-fill composites were measured as a function
of selected depth of materials at 0.5 mm, 2.0 mm and 4.0 mm. Data were analyzed by either one-way
ANOVA or Friedman test. Analysis demonstrated that SonicFill™ gave the highest microhardness value
(101.8 + 4.6 VHN) compared to the other two groups. There were no significant differences among all
groups in flexural and compressive strength. The depth of cure decreased as the thickness of both bulkfill
composites increased. In conclusion, SonicFill™ showed favorable mechanical properties compared
to other composites tested. In both bulk-filled groups, microhardness value decreased as the thickness
of the composite increased. The polymerization of the bulk-filled composites was effective only at 2 mm
or less.
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
The purpose of this study was to assess the association of bottle feeding and oral hygiene practices with the
severity of caries among 3 to 5-year-old children with Early Childhood Caries (ECC). This cross-sectional
study was carried out on pediatric dental patients with ECC attending a public university hospital. The
parents or guardians were interviewed for the bottle-feeding pattern and oral hygiene practices followed
by a clinical dental examination of their children with ECC. Data analysis was done using Chi squared test.
Out of 32 children, 69% had severe early childhood caries with mean dft of 8.88. In this study, 87.5% of
the subjects had a history of bottle feeding, with 53.1% still being bottle fed at the time of study. Current
bottle-feeding habit was found to be statistically significant with the severity of caries (p=0.021). Majority
(69 %) of the children were introduced to tooth brushing only after 1 year of age. About 40% of the children
consumed either pre-chewed rice and/or shared spoons or feeding utensils with their parents or siblings
but there was no significant association with the severity of caries (p=1.00). Because of its association with
ECC, prolonged bottle feeding is significantly associated with the severity of caries in our study population.
Besides, vertical and horizontal transmission of bacteria was also a risk factor for ECC, but it did not show
any significant association with severity of ECC.
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.
Sjörgren’s syndrome is an uncommon chronic autoimmune disorder that affects exocrine glands.
Sialolithiasis is an obstructive salivary gland disease which is also uncommon in the parotid salivary gland.
The existing literature has documented the occurrence of multiple calcifications within the parenchyma of
the parotid glands in patients with Sjörgren’s syndrome. This report describes the first case of right parotid
duct solitary sialolith formation in a 64 year old female patient with Sjörgren’s syndrome. Whether the
salivary stone encountered in this case represents an oral manifestation of Sjörgren’s syndrome or is just
a co-incidental finding was discussed.
This case involved periodontal supportive care after non-surgical management of localized, severe chronic
periodontitis (possibly with a history of aggressive periodontitis) and periodontal abscess. This included
maintaining the current periodontal health, and rehabilitation of patient’s oral function and aesthetic concern
using simple, economical and reversible direct restorations without further damaging the patient’s dentition
for example composite resin as splint. Besides that, to address the patient’s complaint of unsightly gaps in
between the teeth, an acrylic gingival prosthesis with denture tooth incorporated was constructed.
Oral lichen planus (OLP) which belongs to the spectrum of LP, is a commonly encountered
oral mucosal problem among patients seeking treatment in the Oral Medicine clinic. Its counterpart, oral
lichenoid reaction (OLR), which resembled OLP clinically and microscopically, is often encountered in
these patients as well. Although the various clinical forms of OLP/OLR are well-recognized, the disease
pattern in regards to lesion-active and lesion-free periods in these patients remains poorly characterized.
Thus the aim of this study was to determine the clinical and demographic profile of those patients with
active OLP/OLR lesions and compare them with those patients who are clinically lesion-free.
Materials and methods: The study subjects comprised 20 patients who attended the Oral Medicine
Clinic at the Faculty of Dentistry, University of Malaya for follow-up appointments/management. They
were interviewed according to a pre-designed questionnaire, and clinical examination was carried out. All
these were conducted under the supervision of Oral Medicine specialists. OLP was diagnosed according
to the internationally accepted criteria.
Results: The cohort consisted of predominantly female (n=14; 70%) and Chinese (n=9; 45%) patients,
with an overall age range of 26-79 years (median, 56 years). Fifteen (75%) patients presented with
active OLP/OLR lesions and the remaining 5 (25%) were lesion-free. The lesion-active group comprised
3 (15%) males and 12 (60%) females whereas the lesion-free had 3 (15%) males and 2 (10%) females.
Reticular LP was the most common type (n=21/35; 60%) and the gingiva was the most prevalent site
(n=21/46; 45.65%). Social habits, medical histories and medications were not significantly different
between lesion-active and lesion-free OLP patients.
Conclusions: Findings suggest that demographic parameters, lifestyle and systemic diseases do not
appear to influence the disease pattern and lesion severity in OLP.
Oral health literacy (OHL) is important in empowering people to improve their general and oral health. Carers’ OHL may be associated with their ability to deliver good oral healthcare to their children. The aim of this pilot study was to assess the OHL among carers of special needs children. This is a descriptive cross-sectional study of carers in four Community-Based Rehabilitation Centre. Data were collected through a structured face-to-face interview of 40 carers. Oral Health Literacy Malay Version (OHLI-M) was measured using text passages and prompts with a total of 57 items. These items were used to assess comprehension and numerical ability of carers based on domains namely, accessing dental care, understand appointment and following medication instructions. The results showed that majority of the participants had ‘marginal’ and ‘adequate’ OHL level of 32.5% and 52.5%, respectively. Only four (10%) participants had ‘inadequate’ OHL level. The ‘reading comprehension’ and ‘numeracy’ sections’ mean scores were 37.54 (95% CI 35.7-39.4) and 38.17 (95% CI 34.8-41.6). The total OHL mean score was 75.7 (95% CI 71.2-80.2). In conclusion, majority of the carers of special needs children in this sample had moderate OHL. Such information is important to develop more appropriate intervention programmes for carers to match their OHL.
This study aims to identify the relationship between dietary intakes of β-carotene with risk of oral cancer.
Methods: A hospital-based, case-control study was conducted on 306 Malaysians who seek treatment at participating centres/hospitals. Subjects selected from the Malaysian Oral Cancer Data and Tissue Banking System (MOCDTBS) consisted of 153 cases and 153 controls that were matched for gender, age (±5 years) and ethnicity. Food consumption was measured using Food Frequency Questionnaire (FFQ). NutrieMart Version 2.0.0 software was used to estimate daily nutrient of each subject from the FFQ. Logistic Regression analysis was conducted to compute the odds ratio (OR) for intakes of β-carotene and oral cancer risk.
Results: Intake of β-carotene was found to be not associated with risk of oral cancer (OR 0.83, 95%CI: 0.42-1.66, p>0.05).
Conclusion: No significant association was found between dietary intakes of β-carotene with oral cancer risk in this study population.