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.
The study aimed to evaluate the shear bond strength (SBS) and to analyse the failure mode at the resin-dentine interface of different dental adhesive systems. A total of 75 sound premolar teeth were selected and randomly assigned into five different adhesive groups (n=15): OptiBond Solo (OBS, total-etch), OptiBond Versa (OBV, two-bottles, self-etch), Adhe SE Ivoclar (ADHE, two-bottles, self-etch), G-Bond (GB, one-bottle, self-etch), and OptiBond All in One (OBO, one-bottle, self-etch). The occlusal surface of each tooth was flattened and composite resin cylinder (4x2 mm) was built up on the flat dentine surface using a custom made mould. The specimens were then subjected to 500 thermal cycles between 5 °C and 55 °C and dwell time of 20s. The SBS test was conducted using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed using one-way ANOVA and Dunnett T3 Test. Failure mode was determined as adhesive, cohesive or mixed mode using a stereomicroscope and the data were analyzed using Fisher's exact test. The total-etch (OBS) had significantly higher value of SBS than the two self-etch (ADHE and GB) adhesive systems. Within the self-etch systems, OBV showed significantly higher SBS value compared to ADHE and GB. There were no statistically significant differences between types of failure mode (p > 0.05) and adhesive group. It can be concluded that the different compositions in the self-etch adhesive materials may contribute to the different SBS value. The failure modes detected within all tested groups did not show clinically important differences.
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.
There is a wide variation in the morphology of third maxillary molar which can be difficult to be identified radiographically. We present a case of a 26 year-old Yemeni female patient presented with difficult extraction of her left maxillary third molar. The extracted tooth showed a rare variation of root morphology, having four roots with three roots curving palatally at the apices. This report emphasized the potential complex morphological variation of maxillary third molar which may lead to the difficulty of a routine straight forward procedure thus needing careful extraction maneuvering to prevent any complications.
The diagnosis of oral cancer have been variously reported as being due to delay by clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer on more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
In Malaysia the School Dental Service (SDS) provides comprehensive dental treatment with the aim of rendering the child dentally fit before leaving primary school at 12 years. Hence the purpose of this study was to investigate I) the prevalence and treatment needs of traumatised permanent incisors and 2) to assess their relationship to the degree of incisor overjet amongst 12-13 year-old schoolchildren. The sample comprised of 1519 schoolchildren attending 20 secondary government and government-aided schools in Klang district. There were 772 boys and 747 girls. The sampling procedure involved a multistage, clustered and stratified random sampling. The prevalence of traumatic injuries in permanent incisors was 2.6% which confirmed the results of a previous local study. Boys suffered more trauma than girls with a ratio of about 1.5:I. A majority (77.5% ) of the children had one tooth affected. The most commonly affected teeth were the upper central incisors (91.8%) followed by the lower central incisors (4.1%). A high percentage (57.5%) of children with traumatised anterior teeth had increased overjet (>3mm). Almost all cases (93.9%) required two or more surface fillings. However the majority of affected children (56%) were satisfied with their appearance. It is concluded that traumatic dental injuries should be incorporated as part of the treatment plan for the SDS and appropriately managed soon after occurrence or not later than 12 years after which they leave the SDS. Future epidemiological studies should also give due emphasis to the relative importance of traumatised teeth in children.
Human saliva contains a large number of proteins which can be separated using polyacrylamide gel electrophoresis (PAGE). In this study the protein profiles of whole saliva of diabetic and non-diabetic were compared. Considerable variations between individuals in the protein profiles were observed. The saliva from diabetic patients appeared to have more of proline-rich protein bands in the molecular weight region below 56 KOa. Further investigations using individual gland saliva should be carried out.
A pilot study was conducted on 135 sixteen-year-old students from three rural schools in Kelantan to establish the prevalence of orofacial pain and discomfort. About 44% reported to have experienced some oro-facial pain in the preceding four weeks. About 27% of those with pain, still experienced the pain at the time of clinical examination but only 8% have consulted professional help. Most of the pain encountered were only mild or moderate in nature. Only 7% and 10% respectively, reported that the pain affected their sleep and concentration to study. The main cause was toothache and sensitivity. The prevalence of discomfort was 22%, the most common causes being recurrent oral ulcers and bleeding gums. The impacts of orofacial pain was mainly manifested at the personal level, and very few affecting social functioning. However, untreated decay and missing teeth were very low (mean DT 0.47, mean MT 0.27), while filled teeth (mean Ff 2.9) was the main component of the DMFf (mean 3.66, sd ± 2.6). Severe periodontal disease and the prevalence of traumatised teeth was not a major public health problem. The high prevalence of pain merit further research. Therefore a larger study involving other age-groups in other states is planned.
The effect of filler content and storage conditions such as drying, storing in water and thermal cycling on linear dimensional changes were investigated and evaluated. The dimensional accuracy studies were performed using a specific designed mould and a coordinate measuring machine. The findings gave support to the view that tiller content is an important factor influencing the physical and mechanical properties of the composite inlay material. The higher tiller content gave less polymerization shrinkage. The greatest linear shrinkage recorded was 0.79 %. The average linear shrinkage (in air, water and thermal cycling) for 79 % filler Prisma AP.H was 0.33 %, for 65 % tiller Prisma AP.H was 0.35 % and for 50 % filler Prisma AP.H was 0.42 %. Generally, dimensional changes was greatest when stored dry. This was followed by materials which were thermal cycled. The least dimensional change recorded was when the materials were stored in water.
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.
The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
The canine teeth of the mature ferret have closed apices. They are easily accessible for operating purposes and are sufficiently large, allowing conventional cavity preparation techniques to be prepared using ordinary dental instruments. Handling of the ferret is relatively easy since it becomes quite tame after a period of time. The body weight in male is greater and the teeth larger than those of the female. The cost of purchase and maintenance of the ferret is also inexpensive. For all these reasons, the ferret male is animal of choice in dental experiments.
In recent years, dental evidence has played an important role in the positive identification of unknown deceased victims of catastrophies. To improve further dental identification techniques, there is an urgent need to adopt a national policy on denture marking as a compulsory procedure in the fabrication of dentures. The favoured scheme of marking which provides the most information for the identity of the denture wearer is proposed here.
The palatal root of the first permanent molar is the most commonly deflected root into the maxillary sinus during extraction. A rational approach to the surgical removal of a root from the antrum is important. Some surgeons prefer the alveolar approach while others prefer the Caldwell-Luc operation. A case is presented where the palatal root tip of the left upper first molar was removed from the maxillary sinus by the Caldwell-Luc approach with simultaneous closure of the oro-antral fistula resulting from dental extraction. A fibreoptic light probe was used. The advantages and disadvantages as well as how to avoid the common complications of this surgical technique are discussed. A good result was achieved with successful removal of the root and no loss of sensibility of the teeth and/or gum for this case.
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.
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 calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955. It accounts for less than 1% of all odontogenic lesions. A case of CEOT which presented together with cardiac abnomlalities is presented here and the literature of CEOT is reviewed.
Microleakage testing has been used to determine the possible clinical performance of a restorative material. Many microleakage testing materials have been developed and performed through the years. There has been no agreement as to which testing methodology would give the most accurate results. Attempts have been made to simulate the oral conditions and to give a more quantitative representation of micro leakage. The different micro leakage testing methodologies are presented in this paper.
The construction of an electrical pain stimulator was described.
The parameters of pulse width and frequency on the quality of
pain stimulation was determined. The best design and construction
of the electrode for the stimulator was produced.
Background: The high prevalence and impacts of orofacial pain (OFP) have caused major sufferings to individuals and society. The purpose of the study was to investigate the problems and impacts of OFP among a group of Malaysian aborigines. The objectives were to determine (i) the prevalence, aetiology, duration, severity, types and persistence of OFP during the past 3 months preceding the study; (ii) its associated impact on daily performance; and (iii) the measures taken for pain relief.
Methods: This is a cross sectional study carried out in Kuala Lipis, Pahang involving 6 villages of Orang Asli Bateq and Semai. Study sample was chosen using convenient sampling including adults aged 16 years and above. Participants were invited for an interview using structured questionnaire followed by clinical examination. Data analysis was carried out using SPSS ver12.
Results: Response rate was low at 20% (n = 140). Over one-quarter (26.4%) of the sample experienced OFP in the previous 3 months. Toothache was found to be the main aetiology (83.3%) followed by gingival pain (18.9%), temporomandibular joint (10.8%) and facial pain (8.1%). Mean duration of pain was 9.8 days for toothache, 162.4 days for gingival pain, 7.3 days for TMJ and 5.7 days for facial pain. Of those who had OFP, over half rated the pain as moderate (37.8%) and severe (29.7%) and most of the pain was ‘intermittent’ in nature (81.1%). Over half (62.2%) admitted the pain had disappeared during the interview. In terms of pain relief, 56.8% of the sample used traditional medicine. The pain had impacted on the chewing ability (70.3%, p=0.01), ability to sleep at night (73.0%, p<0.001), levels of anxiety (70.3%), ability to perform daily chores (33.3%) and social life (35.1%) of the Orang Asli sample.
Conclusion: This study suggests the prevalence of OFP was high among the Orang Asli sample, which imposed considerable physical and psychological impacts on daily life.
Key words: orofacial pain; impacts; quality of life; Malaysian aborigines