Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.
To assess their awareness and usage of mouthguard and occurrence of sports-related oral injuries in athletes who involve in various sports activities in Kota Bharu. A cross-sectional study was carried out among 180 athletes aged 12 to 27 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athletes' awareness of mouthguard use. The respondents consisted of 107 males (59.5%) and 73 females (40.5%) with a mean age of 16.7 years (SD 5.53). There were 60 (22.2%) athletes who had one or more types of sports-related oral injuries sustained. Laceration of lips, tongue and gums were the most frequent injuries (57.5%) while loosening of teeth and fracture of teeth sustained in 12.5% and 10.0% of athletes respectively. Malay traditional martial arts silat athletes, 17(68.0%) experienced the highest oral injuries among athletes. The prevalence of oral injuries was significantly different between ball sports, martial arts and other non-contact sports (p=0.002). Sixty-one athletes (33.9%) reported that they were aware of mouthguard; however none of the athletes used the mouthguards during their sports activities. Malay traditional martial arts silat was the most common susceptible to sustain oral injuries. None of the athletes were wearing mouthguard. Education on prevention of orofacial trauma should be given to the coaches and athletes. Wearing of mouthguard during sport activities should be compulsory during practice and competition events.
We present an algorithm to reduce the number of slices from 2D contour cross sections. The main aim of the algorithm is to filter less significant slices while preserving an acceptable level of output quality and keeping the computational cost to reconstruct surface(s) at a minimal level. This research is motivated mainly by two factors; first 2D cross sections data is often huge in size and high in precisions – the computational cost to reconstruct surface(s) from them is closely related to the size and complexity of this data. Second, we can trades visual fidelity with speed of computations if we can remove visually insignificant data from the original dataset which may contains redundant information. In our algorithm we use the number of contour points on a pair of slices to calculate the distance between them. Selection to retain/reject a slice is based on the value of distance compared against a threshold value. Optimal threshold value is derived to produce set of slices that collectively represent the feature of the dataset. We tested our algorithm over six different set of data, varying in complexities and sizes. The results show slice reduction rate depends on the complexity of the dataset, where highest reduction percentage is achieved for objects with lots of constant local variations. Our derived optimal thresholds seem to be able to produce the right set of slices with the potential of creating surface(s) that traded off the accuracy and speed requirements.
Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates
second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common
form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a
complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to
inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula
and discuss the clinical presentation and surgical management of such lesion.
Xeroderma pigmentosum-D (XPD) is one of the genes that play a role in the Nucleotide-Excision Repair (NER). Polymorphisms in XPD gene have been identified and reported to be associated with many types of cancer with two common single nucleotide polymorphisms (SNPs), namely, XPD312 and XPD751. The XPD312 polymorphism is at exon 10 codon 312 Asp to Asn (A→G) and the association of this polymorphism with oral cancer is very little known, especially, in Malaysia. The aim of this study was to screen for XPD312 gene polymorphisms in human oral cancer patients attending Hospital Universiti Sains Malaysia (HUSM), Malaysia. Blood samples were collected from 10 oral cancer and 10 normal healthy subjects with their consent. DNA was extracted using commercial DNA extraction kit and Polymerase Chain Reaction (PCR) was performed to amplify the XPD312 gene. The PCR products were digested using restriction enzyme, Sty I and analyzed on a 3% agarose gel for the detection of polymorphisms. This was followed by DNA sequencing to confirm the findings. In the current study, only homozygous wild type polymorphisms in the XPD312 gene was noticed in the oral cancer tissues as revealed by the restriction enzyme and DNA sequencing analyses.
Dental caries is the main oral health problem in hearing-impaired (HI) children and remains the most neglected need. The present study aimed to determine caries prevalence and treatment needs in HI children and the association with salivary parameters. A cross-sectional study was conducted on 63 HI children aged between 7-14 years who attended a special school for the deaf. Clinical oral examination was done and salivary parameters (resting flow rate and resting pH) were measured. Caries experience was charted using the index of decay-filled teeth (dft) and Decay-Missing-Filled Teeth (DMFT) for primary and permanent dentition respectively. Data were analysed using SPSS version 12.0. The mean age was 11.5 (SD 2.39) years and 53.8% were female. Dental caries prevalence was 88.0% (95% Cl: 73.0, 100.0) in primary dentition and 85.0% (95% Cl: 73.0, 96.0) in permanent dentition. The mean dft was 6.1 (SD 4.14) and the mean DMFT was 4.9 (SD 3.28). The mean resting flow rate was 0.14 (SD 0.08) ml/min while mean pH was 6.8 (SD 0.79). Both pit and fissure sealants and restorations were the highest (83.1%) treatment needs. Only 3.1% of the children did not require any treatment. There were no significant association between both salivary flow rate and salivary pH with caries experience in the primary (p=0.342, p=0.610 respectively) and permanent (p= 0.99, p=0.70 respectively) teeth. In conclusion, children with HI have high caries prevalence and unmet need for dental treatments. Salivary pH and resting flow rate of the children were not associated with their caries experience.
The objective of this study was to evaluate the effects of salivary testing in dental caries assessment. The role of saliva flow rate, pH, viscosity and buffering capacity in subjects with high caries (DMFT>5) (group 1) against subjects with low caries (DMFT=0) (control group) were evaluated. 40 subjects between the age of 18 and 40 years old were selected (20 subjects control group and 20 subjects group 1). By using a salivary testing kit (GC Asia Dental Pte Ltd, Japan), each subject underwent test such as hydration status of the oral mucosa, viscosity and pH of resting saliva, stimulated salivary flow rate and buffering capacity of stimulated saliva. The results showed that the flow rate, viscosity, pH and buffering capacity of saliva in subjects of group 1 (DMFT>5) was significantly lower (p
The objectives of this study were to determine the normal mean value of the root-crown (R/C ratios) in Malay patients and their variations by gender and dental arch from orthopantomogram radiographs (OPGs). Two thousand nine hundred and twenty teeth with fully developed roots were measured from 112 OPGs. Subjects with history of maxillofacial trauma or orthodontic therapy were excluded. The mean age of the subjects was 19.1 (SD 2.08) years old for males while females 18.9 (SD 2.19) years old in the range from 15 to 22 years old. The intra-examiner reproducibility of the assessment method was good (Intraclass correlation coefficient 0.81). Results of this study showed that there was no significant difference between R/C ratios of males and females groups. However, the ratios of the antagonist teeth for both males and females were significantly greater in the mandible than in the maxilla (p
Study site: Dental clinic, Hospital Universiti Sains Malaysia
Root canal treatment (RCT) requires high level of technical skills of the dentist. Its outcome is an important part of evidence-based practice and become the basis of treatment planning and prognostic considerations. Adequate removal of micro-organisms and prevention of recolonization of residual micro-organisms through the placement of root filling with satisfactory coronal seal ensures success. This retrospective record review study aimed to investigate the practices of RCT in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic, Kota Bharu, Kelantan. It involved 333 randomly selected patient records at the HUSM Record Unit. Data was obtained by careful analyses of daily treatment progress sheets and analyzed using SPSS version 12.0. A total of 2996 RCT cases were seen and 59.8% of patients were females. The age range of patients varied from 14 to 64 years. The maxillary anterior teeth were most commonly treated (52.6%). Most operators (99.1%) used step-back technique and 97.6% used files to prepare root canals. The most commonly used material for obturation and sealing was gutta-percha and epoxy resin-based sealer (AH26). About 82.9% used calcium hydroxide as intra-canal medication. About 25.5% of cases had no periapical pathology, 65.8% with pre-existing periapical radiolucencies healed in 1-3 months whereas 2.1% of cases with periapical pathology eventually healed after a year. About 6.9% cases failed after retreatment. The number of radiographs taken was two to four pieces. RCT is a useful intervention to maintain longevity of teeth. Decision making and current updates of methods and materials are essential among practitioners as well as administrators to ensure success.
A case of a large dentigerous cyst associated with canine tooth in the maxillary antrum is presented. This case is of interest because of its extensiveness and the presence of an ectopic tooth in the roof of the maxillary sinus. Theoretical aspects of canine impaction and cyst formation are reviewed. The management of a jaw cyst, in particular, the still popular Caldwell-Luc procedure is discussed.
Given that the germline mutations of BRCA1 and BRCA2 confer genetic susceptibility to cancer, the
genetic variations, polymorphisms or mutations are widely analyzed in Western countries. However, in Asian
population, the prevalence of BRCA1 and BRCA2 polymorphisms is very limited. In Asia, breast cancer occurs in
women early with an age of onset under 50 years. This review comprises the incidence of BRCA1 and BRCA2
polymorphisms in the Japanese, Korean and Malaysian population. Founder mutations of BRCA1 and BRCA2
were also compared to mark the genetic difference in these populations. The mutational analysis performed to
analyze the entire coding region of BRCA1 and BRCA2 include the next generation sequencing and full
sequencing of all exons and intron-exon junctions. From the diagnosis of triple negative breast cancer (TNBC)
patients, TNBC is associated with the lack of tailored therapies and the treatment option available for TNBC
patients is mainly chemotherapy. The poor prognosis of TNBC leads to determine the predictive biomarkers in
order to develop treatment efficacy. This review will address the current clinical therapies available to treat TNBC
patients.
Renal cancer is a rare occurrence in all adult malignancies, and renal cell carcinoma (RCC) is the most common type. Due to its aggressive behaviour and high tendency for metastasis, manifestation of RCC varies, often with non-urologic features or symptoms from metastatic sites. Metastatic RCC to the head and neck region is rare particularly to the tongue are extremely rare. We report an elderly lady who presented with recurrent tongue mass metastasis from RCC, a rare cancer with even rarer metastatic site.
One of the roles expected of dental personnel is to promote dental seeking behaviour to the public. It is to ensure that adults maintain an optimum number of teeth for overall health and quality of life by enabling them to eat, speak and socialise without pain, discomfort or embarrassment. The objective of this study was to determine the reasons for seeking dental care and the factors that influence this decision among adult patients. This was a retrospective study of clinical records among patients of 18 years old and above who attended Universiti Sains Islam Malaysia (USIM) Dental Polyclinic, an academic dental centre, for the first time from January 2015 to December 2016. Socio-demographic data on age, gender and occupation as well as the reason for the visit were retrieved from the clinical records. Analysis of data was conducted using SPSS software version 21.0 and the pvalue was set at p
Prolonged work with highly repetitious flexion and extension of the wrist and forceful grip task were shown to increase the risk of developing carpal tunnel syndrome (CTS) among dental personnel. The present study was carried out to determine the prevalence, risk factors and coping strategies of probable CTS among clinical dental support staff in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted and a set of questionnaire consisting of socio-demographic status, work-related and psychosocial risk factors and coping strategies was distributed. Ninety-five clinical dental support staff completed and returned the questionnaire with a response rate of 80.5%. The prevalence of probable CTS was 38.9%, with the highest prevalence was found among dental surgery assistants (40.5%) followed by dental technologists (29.7%). There was no significant association between work-related or psychosocial risk factors with probable CTS (p>0.05). Most of the respondents with symptoms of CTS chose religion as the coping mechanism; mean 7.11 (SD 1.13). Awareness training should be emphasized among clinical dental support staff on the prevention of CTS.
Study site: Hospital Universiti Sains Malaysia (HUSM)
Primary thyroid lymphoma is a relatively uncommon pathology of the thyroid gland that mainly occurs in elderly females. We describe a rare case of B-cell thyroid lymphoma in a young healthy male. It is an important diagnosis to be considered in patients presenting with a rapidly enlarging neck mass as its management is different from other differentiated thyroid carcinoma which require total thyroidectomy plus adjuvant radioactive iodine ablation. Our report emphasizes the need for clinical awareness leading to early detection, followed by early multidisciplinary management.
Primary intra-osseous squamous cell carcinoma (PIOSCC) is a rare tumour which occurs centrally
within the jaws. It is believed to arise from odontogenic epithelial remnants or from pre-existing odontogenic
cysts/tumours. A case of PIOSCC arising from an odontogenic cyst in a 57-year-old female is discussed.
Initial clinical and radiographic examination was suggestive of an odontogenic cyst / cystic tumour. The
lesion was enucleated and sent for diagnostic histopathology which revealed the presence of an invasive
carcinoma arising from the walls of the odontogenic cyst. The patient then underwent right mandibular
resection and reconstruction as well as right supra-omohyoid neck dissection. Long standing odontogenic
cysts have the potential to undergo malignant transformation though this may not always be the case.
Relying only on radiographic findings for the management of cyst-like lesions without obtaining
histopathological diagnosis is extremely ill-advised.
Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is relatively a rare tumour of head and
neck region. Without histopathological confirmation, it appears and behaved as like malignant epithelial tumor of
the head and neck region as will be illustrated in the present case. Cutaneous involvement of the tumor with
distant metastasis has made the prognosis unfavorable. This isolated case of head and neck PC-ALCL was
highlighted as it has a tendency to behave aggressively and early diagnosis and treatment is crucial to avoid poor
survival outcome.
Tooth wear is the non-carious loss of tooth tissue due to attrition, erosion and/or abrasion. The amount of wear that accelerates physiological tooth wear is referred as pathological tooth wear. This study aims to determine the prevalence and mean scores according to mouth quadrant of raw tooth wear (RTW) and pathological tooth wear (PTW) and investigate sex association with PTW among 16-year-old secondary school children in Kota Bharu, Kelantan. This cross-sectional study involves 688 participants randomly selected from eight government secondary schools. The Smith and Knight Tooth Wear Index (TWI) was used. Data were analyzed using a simplified Microsoft Excel program developed based on the index to quantify PTW. Bar graphs were plotted to highlight the mean scores according to mouth quadrant. About 44% of participants were male and 56% were female. The prevalence of RTW and PTW among subjects was 100% and 20.1% respectively. It was found that 32.8% of tooth surfaces were affected with RTW and 0.7% of study subjects already had exposed dentine. The most affected quadrant for RTW and PTW was the upper and lower incisal quadrant respectively. Males had 92% more odds of developing tooth wear compared to females. In conclusion, all subjects have some degree of wear. About one-fifth of the study subjects were affected by PTW. The patterns of wear were similar to those encountered in the Western societies. There was statistically significant association between sex and PTW.
Prevalence of dysphagia is one of the important epidemiological data which will contribute to the proper planning and support the setting up of a swallowing rehabilitation clinic at this hospital. The present study aimed to determine the prevalence of dysphagia in patients with head and neck cancer (HNC) at Hospital Universiti Sains Malaysia (Hospital USM) from 2001-2010. In this institutional retrospective study, a total of 66 records were obtained comprising of 86.4% Malay patients, 9.1% Chinese, 1.5% Indians, and 3% other ethnic groups. These data were taken from the database of HNC patients seen at the dental clinic, Hospital USM between 2001 and 2010. Difficulty swallowing, frequent coughing during meal, choking, diet modification, and non-oral nutritional support were identified as signs and symptoms associated with dysphagia. Results showed that 59.1% of patients have had dysphagia before, during, or after the treatment of HNC. Data from the present study would be instrumental in increasing awareness among clinicians involved in patient care and it may help in planning the outline of management of dysphagia. Furthermore, it is anticipated to have implications for further research in swallowing and dysphagia.
Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Several studies on job stress have been conducted among nurses, teachers, clerks, lecturers, laboratory technicians, petroleum and automotive workers and the calculated prevalences ranged from 20-35%; associated factors identified include high job demand, low job control and poor social support. Thus, the aim of the present study was to determine the prevalence and associated factors of stress in dental healthcare workers of an institution of higher learning in Kelantan. A cross-sectional study of the prevalence and associated factors of stress in 54 dental healthcare workers of an institution of higher learning in Kelantan [response rate of 63.5 percent] was conducted in March 2006. The Malay version of the validated Depression, Anxiety and Stress Scale and Karasek’s Job Content Questionnaire were used as research instruments in this study. Informed consents were obtained from all participants. The prevalence of stress was 22.2%. One (1.9%) staff member experienced severe stress whilst 20.4% experienced mild to moderate stress. After controlling for age, sex, marital status and duration of work, psychological job demand (adj. b 0.61, 95% CI 0.21, 1.00, p=0.003), toxic exposures (adj. b 1.41, 95% CI 0.47, 2.35, p=0.004) and overtime work (adj. b 5.67, 95% CI - 1.18, 10.16, p=0.015) were directly associated with reported stress in dental healthcare workers. High psychological job demand, increased toxic exposures at work and increased overtime work were significantly associated with stress in dental healthcare workers. These findings can be used to guide preventive measures to reduce stress in dental healthcare settings.