OBJECTIVES: Here, we provide an up-to-date review of the epidemiology, aetiology, diagnosis and clinical management of MIH.
MATERIALS AND METHODS: A review of the contemporary basic science and clinical literature, relating to MIH, was undertaken using information obtained (up to 10 April 2020) from the electronic databases PubMed, Scopus, Web of Science and the Cochrane Library.
RESULTS: There is a growing body of evidence relating to the aetiology, presentation and clinical management of MIH. Current knowledge appears to be focused on potential genetic aspects, as well as the development and validation of indices for the diagnosis and management of MIH. There has also been increasing recognition of the global and individual burden of this common condition.
CONCLUSIONS: Dental health professionals should regularly appraise the basic science and clinical MIH literature to ensure that they provide the best possible short- and long-term care for their young patients.
METHOD: This 2016 study located every dental practice in Malaysia (private and public) and mapped these practices against population, using Geographic Information Systems (GIS) tools. Population clusters within 5, 10 and 20 km of a dental clinic were identified, and clinic-to-population ratios were ascertained. Population data were obtained from the Population and Housing Census of Malaysia 2010. Population relative wealth was obtained from the 2014 Report on Household Income and Basic Amenities Survey for Malaysia. The physical address for each dental practice in Malaysia was gathered from the Official Portal of Ministry of Health Malaysia. All data for analysis were extracted from the integrated database in Quantum GIS (QGIS) into Microsoft Excel.
RESULT: The population of Malaysia (24.9 million) was distributed across 127 districts, with 119 (94%) having at least one dental clinic. Sixty-four districts had fewer than 10 dental clinics, and 11.3% of Malaysians did not reside in the catchment of 20 km from any dental clinic. The total dental clinic-to-population ratio was 1:9,000: for public dental clinics it was 1:38,000 and for private clinics it was 1:13,000.
CONCLUSION: Dental services were distributed relative to high population density, were unevenly distributed across Malaysia and the majority of people with the highest inaccessibility to a dental service resided in Malaysian Borneo.
METHODS: A cross-sectional study was conducted on third-, fourth- and final-year students of the dental and medical courses of MAHSA University, Malaysia. A total of 557 students participated in the survey. Oral cancer awareness, knowledge about risk factors, signs and symptoms of oral cancer, attitude and practices towards oral cancer were assessed using 43 questions. The questionnaire was pretested, and internal consistency, assessed using Cronbach's alpha, was acceptable (α > 0.7). The data were analysed using IBM SPSS version 21. The chi-square test was used to analyse the difference in oral cancer awareness between medical and dental students.
RESULTS: Among 557 participants, there were 351 (63%) medical students and 206 (37%) dental students. Based on the results obtained, dental students had a higher level of knowledge than medical students regarding oral cancer (P
METHOD: Stakeholders from key dental organisations/professions in Malaysia were purposively sampled and invited to participate in a semi-structured interview (n = 20) using a pre-tested topic guide. Interviews were recorded, transcribed verbatim and analysed using Framework Analysis.
RESULTS: Drivers for workforce were identified across four main domains: policy-politics; trends in demography; social and economic; and, technology-scientific development. The pace of change and possible interplay between drivers, most notably government policy, liberalisation of education and health services and challenges of workforce governance, followed by Malaysian demography and health trends. Implications for the future, including possible uncertainties, particularly in relation to specialisation and privatisation were identified, together in balancing and meeting public health needs/demands with professional career expectations.
CONCLUSION: Stakeholders' views on the high-level drivers for change broadly mirror those of high-income countries; however, specific challenges for Malaysia relate to rapid expansion of dental education and a young workforce with significant career aspirations, together with imbalances in the health care system. The impact of these drivers was perceived as leading to greatest uncertainty around specialisation and privatisation of the future workforce.
MATERIALS AND METHODS: The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant.
RESULTS: The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P
BACKGROUND: The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice.
METHODS: A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software.
RESULTS: The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients <60 years of age, without molar support, can attain acceptable chewing function and that SDA treatment does not lead to loss of occlusal vertical dimension (P < 0.05). A larger number of participants with ≤5 years of work experience than with >5 years of work experience perceived that the SDA concept enables simpler treatment planning (P < 0.05). Finally, a larger number of participants who graduated abroad than who graduated locally observed that patients without molar support had temporomandibular joint problems (P < 0.05).
CONCLUSION: Although Malaysian government dentists have good knowledge and perceptions of the SDA concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs.
METHODS: A total of 208 dentists from DSC nationwide completed an online questionnaire in June 2022. Demographic data and information on dentists' expanded roles were retrieved. Responses on dentists' satisfaction and perceived barriers were collected using a 5-point ordinal scale. Mann-Whitney U and Kruskal-Wallis tests were used to compare the mean rank differences for CS. Factors influencing CS were analysed using multiple logistic regression (MLR) (P < .05).
RESULTS: The mean age of the respondents was 32.68 ± 2.48 years. Almost half (49.0%) of the respondents were attached to a non-hospital-based clinic. The majority (72.0%) of them were permanently attached to the DSC. About half of the dentists (51.0%) strongly agreed that they received no financial incentives for their expanded role at the MOH DSC. Dentists attached at a non-hospital-based clinic (P = .046), working with more than 15 years of experience (P = .013), and having 12 to 18 months' duration of attachment (P = .014) were more satisfied. MLR analysis revealed that non-Malay respondents (odds ratio [OR], 1.54; P = .035) and those who applied for scholarships more than 3 times (OR, 1.85; P = .050) were more satisfied. In contrast, more than 19 months at the DSC decreased CS (OR, 0.44; P = .029).
CONCLUSIONS: Despite having a similar organisational structure, DSC dentists had different satisfaction levels. Dentists' ethnicity, duration of attachment, and frequency of applying for scholarships influenced their CS. Future career advancement plans in the MOH should consider these important influencing factors to ensure the delivery of quality health care from their personnel.
METHODS: Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement.
RESULTS: A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50.
CONCLUSIONS: Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.
METHODS: Waterpipe users, cigarette smokers, and never smokers were included. Demographic details were collected using a questionnaire. Characteristics of implants (dimensions, jaw location, depth of placement, insertion torque, and duration in function) were recorded. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD), and crestal bone loss (CBL) were recorded in all groups. Volume of PISF and levels of AGEs were determined using standard techniques. Sample-size estimation was done on data from a pilot investigation, and correlation between clinicoradiographic and immunoinflammatory parameters was assessed using logistic regression models. Probability values
METHODS: Three extracts of ginger (Zingiber officinale) rhizome prepared by maceration using the respective solvents and 6-shogoal were reconstituted in normal saline with 0.2% DMSO. Thirty C57BL/6 15-week-old mice were divided into 5 groups: Group 1, saline; Group 2, 70% methanol extract; Group 3, 80% ethanol extract; Group 4, 100% DMSO extract; and Group 5, 6-shogaol. The baseline pilocarpine-stimulated salivary flow rate was measured at the age of 15 weeks (15th week), and treatment solutions were administered by intraperitoneal injection from the 16th to 18th week. The stimulated salivary flow rate during treatment weeks was recorded for each group, and its difference with baseline was analysed using paired-sample t test. The change in salivary flow rate between the treatment groups and the control group was analysed using one-way analysis of variance.
RESULTS: Groups 2, 3, 4, and 5 showed a significant increase in salivary flow rate when compared to baseline (P < .05). The increase in salivary flow rate in all 4 treatment groups was significant when compared to the control group (P < .05). Group 4 produced the highest increase in salivary flow rate; however, the differences amongst the treatment groups did not reach statistical significance (P > .05).
CONCLUSIONS: All GR extracts (70% methanol, 80% ethanol, 100% DMSO) and 6-shogaol were equally effective in increasing the pilocarpine-stimulated salivary flow rate in C57BL/6 mice when administered systemically as a sustained dose for 3 weeks.
METHODS: An electronic search of articles published between January 1975 and November 2022 in PubMed, Web of Science, and EMBASE databases was performed. A total of 22 articles met the inclusion criteria and reported 27 cases of oral mucormycosis in total.
RESULTS: Fourteen patients had mandibular mucormycosis signs unrelated to COVID-19 infection, 6 had SARS-CoV-2-related mandibular mucormycosis, and 6 had manifestations in the tongue. All published case reports during the COVID-19 pandemic were from India. Patient ages ranged from 4 months old to 82 years, and most patients had important comorbidities, such as blood dyscrasias related to immune deficiency and uncontrolled type 2 diabetes mellitus. The signs and symptoms of mandibular and tongue mucormycosis varied from dental pain, loose teeth, and nonhealing sockets to dysphagia and paraesthesia of the lip. Some patients also reported trismus, draining sinus tract, and facial pain. The diagnosis of oral mucormycosis was based on a combination of clinical, radiographic, and histopathologic findings by demonstrating fungal hyphae in tissue specimens. In most cases, mucormycosis was managed with systemic amphotericin B, strict glycaemic control, and aggressive surgical debridement of infected tissue, minimising the progression of the fungal infection and thus improving the survival rate. In some cases, combined antifungal therapy, antibiotic therapy, and chlorhexidine mouthwashes were used successfully.
CONCLUSIONS: Recognition of the signs and symptoms by oral care providers is pertinent for the early diagnosis and treatment of tongue and mandibular mucormycosis, and providers should be aware of the possibility of this opportunistic fungal infection in patients with COVID-19. A multidisciplinary approach is recommended for the management of this lethal infection.
METHODS: Participants were invited from 3 day-care community centers. Intraoral photographs were captured and assessed by both GumAI (test) and a panel consisting of 2 calibrated periodontists and a dentist (benchmark). Mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and F1 score were calculated to determine GumAI's diagnostic performance in comparison to the benchmark. User acceptance with this tool was assessed using 2 Rasch Theory-based 5-point Likert-type questions.
RESULTS: 44 participants were recruited out of 80 invited older adults. GumAI demonstrated a sensitivity of 0.93 and specificity of 0.50 compared to the panel's assessments, with a PPV of 0.90 and NPV of 0.56. The accuracy and F1 scores were 0.85 and 0.91, respectively. All participants expressed high acceptance of the process.
CONCLUSION: GumAI demonstrates high sensitivity, PPV, accuracy, and F1 score compared to the panel's assessments but falls relatively short in specificity and NPV. Despite this, the tool was highly accepted by older adults, indicating its potential to enhance gingivitis detection and oral hygiene management in community settings. Further refinements are necessary to improve specificity and validate usability measures.
CLINICAL RELEVANCE: This study may pave the way for broader applications of mHealth systems in community settings, enabling greater health coverage and addressing oral health disparities.
METHODS: From inception until December 2023, a systematic search of published in-vitro studies from Scopus, PubMed, and the Cochrane Central Register of Controlled Studies was conducted. The protocol was registered in PROSPERO (CRD42024531416). NMA compared properties related to dimensional accuracy and surface properties between conventional and digital dentures. The ranking was performed using the surface area under the cumulative ranking guidelines.
RESULTS: A total of 6004 articles were initially identified, of which 342 duplicates were removed, and 5566 were excluded by screening the titles and abstracts. A total of 96 articles were assessed by full-text reading, and 43 were included in the quantitative synthesis. As per the NMA results, MIL demonstrated significantly higher trueness of fit when compared with conventional compression moulding (standardized mean differences [SMD] = -2.25 [95% CI: -4.09, -0.40]), P = .017 (
MATERIALS AND METHODS: An injectable silane-based antimicrobial aimed to modulate macrophage polarisation was manufactured. Experimental analysis included colorimetric cell migration assays on gingival fibroblasts, macrophage phagocytosis characterisation, immunofluorescence staining, triacylglycerol accumulation within macrophages by LCMS, cellular metabolic/proliferation assays, macrophage exposure quantification with morphology assessment using FE-SEM, Raman spectral analysis, RNA isolation for relative gene expression and animal study model to morphometrically and microscopically analyse partial thickness burn wound healing under QAS/K21.
RESULTS: M1 and M2 polarisation both appeared exaggerated under QAS/K21 treatment. The wounds treated with K21 had depicted accelerated healing as compared to control (P < .05) in dorsal skin of rabbits. Relative gene expression results demonstrate reduced cytokine and anti-inflammatory response under the influence of K21. While M1 expression, TG accumulation, and associated characterisations demonstrate the programmed inflammatory potential of K21.
CONCLUSION: the antimicrobial and reparative efficacy of K21 silane aids in programmed inflammation for enhanced tissue healing and repair.