The purpose of this study was to determine the dimensional accuracy of the skull models produced by Rapid prototyping technology using stereolithography apparatus. Computed tomography images were captured from four dry normal adult human skulls. The resultant 2-D images were stored in Digital Imaging and Communications in Medicine (DICOM) format. The segmentation of the images was prepared in MIMICS software. The slice files were then exported to a stereolithography apparatus (SLA) to produce the replica of each skull. Eight linear measurements were repeatedly made between identified landmarks on each of the original skull and its replica model using an electronic digital calliper. Each of the linear measurements was repeated 5 times and the average was taken to determine the absolute difference and percent difference between the original skull and its replica model. The overall absolute difference between the four human adult skulls and its replica models was 0.23 mm with a standard deviation of 1.37 mm. The percent difference was 0.08% with a standard deviation of 1.25%. The degree of error established by this system seems affordable in clinical applications when these models are used in the field of dental surgery for surgical treatment planning.
The replacement of missing teeth with implant borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent developments in oral implantology involve the use of immediate implant placement technique that significantly reduces waiting time. This case report describes the management of an anterior missing tooth using immediate implant. The result was good, which further validate the use of this technique for suitable patient management.
Submasseteric abscess is unusual in the head and neck region. Patients with this condition may be misdiagnosed as a parotid abscess due to the similarities in their presentation. Awareness and due recognition should be given to this unusual problem.
Gingival overgrowth is frequently observed in patients taking certain drugs such as calcium channel blockers, anticonvulsants and immunosuppressant. This can have a significant effect on the quality of life as well as increasing the oral bacterial load by generating plaque retention sites. Amlodipine, a third generation calcium channel blockers has been shown to promote gingival overgrowth although in very limited cases reported. The management of gingival overgrowth seems to be directed at controlling gingival inflammation through a good oral hygiene regimen. However in severe cases, surgical excision is the most preferred method of treatment, followed by rigorous oral hygiene procedures. This case report describes the management of gingival overgrowth in a hypertensive patient taking amlodipine. Combination of surgical gingivectomy and CO2 laser treatment was used to remove the gingival overgrowth. CO2 laser surgery produced good hemostasis and less pain during the procedure and post operatively. This case report has also shown that periodontal treatment alone without a change in associated drug can yield satisfactory clinical response.
Lasers were introduced into the field of clinical dentistry with the hope of overcoming some of the drawbacks posed by the conventional methods of dental procedures. Since its first experiment for dental application in the 1960s, the use of laser has increased rapidly in the last couple of decades. At present, wide varieties of procedures are carried out using lasers. The aim of this review is to describe the application of lasers in dental hard tissue procedures. Lasers are found to be effective in cavity preparation, caries removal, restoration removal, etching, and treatment of dentinal sensitivity, caries prevention and bleaching. Based on development in adhesive dentistry and the propagation of minimum intervention principles, lasers may revolutionize cavity design and preparation.
A 48 years old Malay lady with a case of painless soft fluctuant swelling of left parotid gland is reported. The lesion was found to be a cystic lesion through the pre operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called “branchial cyst”. Through the literature reviews of parotid lymphoepitelial cyst the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre operative evaluation of the parotid swelling furthermore it is non-invasive, harmless, painless and relatively quick.
The purpose of this study was to evaluate hardness (indicator for polymerization) and thickness of two types of resin cement at coronal, middle and apical level of tooth root canal. Ten extracted maxillary incisors were instrumented and post space was prepared for cementation of titanium post. Samples were divided into two groups and each group was cemented either of the two types of resin cements; Panavia F [dual-cured (PF)] and Rely X Luting 2 [self-cured (RL)]. The teeth were longitudinally sectioned; hardness and thickness was measured using Vickers hardness tester and a microscope (Leica DMLM). SEM observations along the cement line at the 3 different root levels were performed. Statistical analysis was performed to test significance of differences in hardness and thickness of the two types of cement (t-test; p= 0.05) and at different levels of the same type (one-way ANOVA followed by multiple comparison; p= 0.05). Significant difference of hardness was found at the apical level between the two groups and between the coronal and apical level of PF (p0.05). Moreover, voids were more obvious within the dual-cured group of cement. Dual-cured resin cement was found to be less polymerized than self-cured type at apical level. Increased thicknesses of resin cements in comparison to post space size were observed in both groups. Use of metallic post with resin cements needs further evaluation.
The reconstruction of the upper eyelid with medial canthal involvement post extensive removal of malignant tumour remains a challenge. Proper eyelid reconstruction is necessary to reestablish anatomic integrity, restoration of its functions and to maintain the best cosmetic appearance. These case reports illustrate an alternative reconstructive technique for large upper eyelid full thickness defect with medial canthal involvement. Two cases of upper eyelid tumours involving medial canthal region underwent staged reconstruction by glabellar flap advancement and reconstruction of the posterior lamellar with autologous graft using buccal mucosa and ear cartilage. The posterior lamellar graft and flap survived without any complication except for mild eyelid margin notching in one of the two cases. The staged reconstruction with glabellar flap advancement provides adequate defect coverage, excellent blood supply, maintains eyebrow contour and function of the eyelid. The flap also perfectly matches the surrounding tissue with minimal donor site morbidity.
Osteomyelitis of the mandible, a serious complication of untreated odontogenic infection has been reported. This case report describes an interesting presentation of chronic suppurative osteomyelitis (CSO) of the mandible in a 13 years old anaemic male patient. Investigations revealed inversion of his permanent teeth leading to trans-cutaneous extra-oral eruption along with marked destruction of mandible on the affected side. The treatment included a pre surgical course of antibiotics followed by the removal of the retained second premolar tooth, surgical debridement of the affected bone, and resection of the cutaneous sinus tract. The post-operative healing was uneventful. A combination of antibiotic therapy and surgical debridement were effective in the treatment of chronic suppurative osteomyelitis.
Imaging is a keystone for the understanding and delivery of craniofacial health care and recent developments have led to many diverse technologies and approaches. This paper reviews new developments in three-dimensional imaging, as well as three-dimensional facial image acquisition. Visualization and convergence of the data from these technologies are also described for construction of patient-specific models.
The sample size calculation for a prevalence only needs a simple formula. However, there are a number of practical issues in selecting values for the parameters required in the formula. Several practical issues are addressed and appropriate recommendations are given. The paper also suggests the application of a software calculator that checks the normal approximation assumption and incorporates finite population correction in the sample size calculation.
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
Endodontically treated teeth are generally weaker than sound teeth. The study objective was to compare the fracture resistance of endodontically treated teeth restored with different restorative techniques. Fifty extracted human maxillary central incisors of similar size were divided into five groups of 10 teeth. Group 1 was left intact as the control group. Other groups (Groups 2, 3, 4 and 5) were all endodontically treated followed by restorations using different restorative techniques; light cured composite resin (CR), CR and crown, post and CR, and post-CR core and crown respectively. The specimens were loaded in a universal testing machine with a static force at a crosshead speed of 0.5mm/min at 135 ° to the long axis of the root until failure. The means and the standard deviations of the maximum load at failure for groups 1, 2, 3, 4 and 5 were 1259.11N (379.12N), 578.63N (196.70N), 667.13N (298.72N), 1247.65N (294.48N) and 623.60N (193.75N) respectively. The results of one-way ANOVA showed statistically significant differences existed among the groups tested (p
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 a major health problem affecting an estimated 90% of school children worldwide. This cross-sectional study aimed to evaluate oral health knowledge, attitude, and practices among secondary school students in Kuching, Sarawak. Data was collected using a pretested questionnaire on 209 randomly selected students from four schools. Results showed no significant differences between the gender and age groups in terms of knowledge level, but significant differences were observed between the schools. The students had positive attitude towards the dental services, but their dental visits were still low due to fear of dental needle and handpieces. Toothbrush and toothpaste were still the most commonly used oral hygiene aids. As compared to parents and friends, dentist was perceived to have more influence on oral hygiene practices among the students. Girls consumed more sweets, snacks and soft drinks than boys. However, girls spent longer time to brush their teeth and brush more frequently. Oral health education should be a life-long practice and incorporated into the school environment with the support of teachers and parents.
Oral cancer is one of the common cancer cases identified in the developing countries. Genetic mutation and overexpression of certain genes and proteins have been associated in the development of this cancer. Notch signalling pathway is normally involved in controlling the development process of vertebrates and invertebrates; however, deregulation of this pathway was found to be responsible in the formation of certain cancers including oral cancers. Activation of this pathway requires binding of the ligands to its receptors. Four NOTCH receptors (NOTCH 1, 2, 3 and 4) have been identified in mammals. Disruptions within these molecules might interfere with the normal functions of Notch signalling pathway. Hence, this study was conducted to detect mutations of NOTCH1 and NOTCH2 receptor genes which might be occurring in the oral cancer cases obtained from the local population. DNA extracted from fresh-frozen tissue biopsy of the tongue and buccal mucosa from 10 confirmed cases of oral cancer were subjected for polymerase chain reaction (PCR) amplification using the specific sets of primers. The PCR products were sent for sequencing before final results were analysed.
Due to time and cost limitation, only two out of four NOTCH receptor genes; NOTCH1 and NOTCH2, were used in this analysis. The results revealed absence of nucleotide changes for both NOTCH receptor genes amplified from these oral cancer samples. More samples and further analysis looking into other regions in these genes are required to conclude the involvement of NOTCH receptor genes mutation in causing oral cancer.
Lingual tonsil is a part of Waldeyer’s ring. It consists of lymphoid follicles and subject to proliferation and hypertrophy. Palatine tonsillitis, by far is the commonest cause of odynophagia originating from oropharyngeal region. Lingual tonsillitis is a rare occurrence. We reported a patient who presented with severe odynophagia after two months of palatine tonsillectomy. Examination revealed the lingual tonsils were inflamed and covered with exudates.
Epidemiological studies of occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the aetiology of malocclusion. The objective of this article was to give an overview on occlusion, malocclusion and the various methods on measuring the occlusion. Each index and method of the assessment described was based on the opinion of an individual or a group of individuals. It had been widely agreed that no particular index or method available that are truly inclusive of all occlusal criteria. Therefore, different indices or method had been developed according to different requirements and it may be necessary to use more than one index in order to gather information to suit the objective of the particular study.
This study was to investigate the association between functional dentition with inadequate calorie intake and underweight in elderly people living in “Pondok” in Kelantan. A cross-sectional study participated by 369 elderly people was carried out. A simple random sampling method was utilized for the selection of the subjects. Subjects were interviewed using a structured form to collect information about subjects’ demographic background and self-reported health status. The 24-hour recall method was used to provide information on the subject’s exact food intake during the previous 24 hours. Body mass index was calculated from subjects’ weight and height, followed by oral assessment. The “Nutrical Software” was used for nutrient calculation, followed by SPSS version 11.5 for data analysis. The response rate was 95.6%. Majority of the respondents were female (92.4%). The percentage of subjects who had inadequate calorie intake and underweight was 71.0% and 25.7% respectively. The percentage of edentulism was 81.0%. The proportion of elderly with compromised functional dentition was 48.2% and majority was edentate elderly without wearing any complete dentures or wearing defective dentures, 23.6% and 56.2% respectively, while 20.2% was dentate elderly. The odds of having inadequate calorie intake and getting underweight among elderly with a compromised functional dentition was 3.7 times and 42.0 times respectively, compared to elderly with a non-compromised functional dentition. There was a significant association between inadequate calorie intake and underweight with functional dentition among elderly living in “Pondok” in Kelantan.
Tooth wear is the loss of tooth tissue and structures not due to caries. It can occur in various forms either attrition, abrasion, erosion, noncaries cervical lesion (NCCL) or a combination of two or more forms. The objective of this study was to determine the patterns and associated aetiologies of tooth wear among adults in Kelantan, Malaysia. This crosssectional study involved 81 adults with tooth wear which was visually assessed using the Smith and Knight Tooth Wear Index (TWI). A questionnaire was used to seek putative aetiologies of the wear. Data were analyzed and the results were expressed as frequencies and percentages. Six thousand three hundred and eighty four tooth surfaces were examined in 1596 teeth. 17.4% surfaces had tooth wear; 80% scored 1, 18% scored 2 and 2% scored 3. Among the 81 cases of tooth wear, 29 (35.8%) had abrasion; 25 (30.9%) had attrition; 1(1.2%) had erosion while 26 (32.1%) had the combined type. Among those with abrasion, majority had the habit of eating freshwater clams (Corbicula fluminea) as local delicacy where most of the times people use their teeth to pry open the clam shells. Erosion was related to the pooling of carbonated drinks or beverages in the mouth before swallowing. In conclusion, most adults experienced abrasion and the most common possible associated aetiology is the way of eating clams.