A case report of a 16 year old male oligodontia patient who presented with a Class I malocclusion on a skeletal I base. He had multiple missing teeth of upper lateral incisors and all premolars except for lower right first premolar. Treatment involved fixed appliance with the aid of mini-implants to mesialize posterior teeth in order to reduce the number of prosthodontic replacement of the remaining missing teeth planned for the future. The application of the mini-implants in the sequence of treatment is presented
Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.
Abscess of the periodontium is a localized purulent inflammation of the periodontal tissues1. It has been classified into three categories which are gingival abscess, periodontal abscess and pericoronal abscess. A periodontal abscess can be defined as a localized purulent infection affecting the tissues surrounding a periodontal pocket that can lead to the destruction of supporting structures4 including tortuous periodontal pockets, furcation involvement, and intrabony defects. The lesion may be acute or chronic abscess. A localized acute abscess may progress to a chronic abscess if the pus drains through a fistula into the outer gingival surface or into the periodontal pocket. (Copied from article).
Forensic odontological examination of a disputed bitemark can furnish the police and the prosecutor with useful evidence to either implicate or exonerate a person in relation to a crime, on the basis that each person’s bitemark is as distinctive as his or her dentition. The aims of this article are (a) to evaluate the extent of which bitemark evidence is reliable as a proof of identification of a biter for the purposes of criminal investigation and prosecution in Malaysia and (b) to make the necessary recommendations (if any) for the purpose of improving the reliability of such evidence. Where a questioned bitemark is not sufficiently detailed, any findings made from its examination shall be highly unreliable and prejudicial. On the other hand, where a bitemark is sufficiently detailed, then any findings made from its examination may be reliable, provided that the forensic odontologists and other practitioners in the criminal justice system are professionally trained to handle the said bitemark. Therefore, police officers must be given a basic training in the field of forensic odontology so that they will be able to appreciate the evidential value of bitemark and contribute to the development of bitemark cases in Malaysia. The relevant authorities governing the dental practice in Malaysia should standardize the methodology and terminology used in bitemark examination and in the reporting of its findings so that confusion and inconsistency among the forensic odontologists are kept absolutely low. Finally, forensic odontologists must be given specialized training in bitemark examination so that the probative value of their findings can be improved.
Introduction: Preclinical teaching using simulation is very beneficial in training dental graduates. The use of laboratory simulation for its undergraduate training during the preclinical years has been used in dental education. Purpose: The aim of this study was to evaluate student’s perception, self evaluation and satisfactory level in preparing duralay burn-out post and core in preclinical fixed prosthodontics sessions.
Materials and Methods: The participants comprised of 104 fourth year dental undergraduates in the Faculty of Dentistry Universiti Kebangsaan Malaysia. The students had undergone preclinical session for endodontics during the 3rd year and had already completed root canal treatment on single rooted tooth. The same tooth was used for preclinical post and core preparation. The gutta percha was partially removed and the root canal was prepared. They then proceeded with the preparation of duralay build-up/pattern based on the lecture, video demonstration and manual given. Once completed and satisfied with their work, students were asked to answer the questionnaires in the simulation manual.
Results: Student response rate was 88.46% (92/104). Majority of the students were satisfied with their canal preparation, with about 5mm gutta percha left apically, appropriately shaped canal with sufficient retention and resistance form. They also thought that the surface of the duralay was good with no voids. With regards to the coronal preparation, majority of them incorporated ferrule effect and prepared preliminary crown preparation. More than half of the students claimed the level of difficulty of this procedure was moderate. Furthermore, majority of them said that the lecture and the preclinical manual were sufficient and helpful. The help from the supervisors was also benefit in preparing duralay burnout post and core.
Conclusions: From this study, majority of fourth year dental students could perform appropriate canal preparation as well as duralay pattern post and core. Only one student did not feel competent and confident in doing canal preparation and duralay pattern post and core. Our teaching methods and aids were proven to help them in preparing these tasks.
The primary obligation and ultimate responsibility of a dental surgeon is not only to restore aesthetic and function, but also to relieve pain which originates from dental pathology or surgical procedures performed. Post operative dental pain is mainly of inflammatory origin. Common traditional oral analgesics, namely salicylates, paracetamol and non-steroidal anti-inflammatory drugs have been the drugs of choice, but are increasingly being superseded by newer designer analgesics, the cyclooxygenase-2 (COX-2) inhibitors. This article reviews the advantages and disadvantages of prescribing common traditional oral analgesics as well as exploring the potential use of COX-2 inhibitors as an alternative to these analgesics for the control of post operative pain in dentistry.
Oral granular cell tumour is a fairly rare lesion with a predilection for the tongue. Seven cases (6 females, 1 male) of oral granular cell tumour were seen during the 40 year period (1967-2006) in Stomatology Unit, Institute for Medical Research (IMR) in which 5 cases were located at the tongue. All the cases presented as a single swelling and excisional biopsies were carried out in all cases.
The assessment of pulp vitality is a crucial diagnostic procedure in the practice of endodontics. Dentists should establish their treatment decisions based on good sound information and in the best interests of the patients. Therefore, a definite diagnosis must be established with comprehensive investigation and records before any treatment is carried out1. Since the dental pulp is enclosed in an opaque tooth, the assessment of tooth vitality is undertaken indirectly by: looking for clinical or radiological evidence of pulp necrosis or apical periodontitis; investigating nerve conduction; or examining the blood flow. (Copied from article).
Certain beverages e.g. coffee, tea, soft drinks, fruit juices, alcoholic beverages, may affect the physical properties of composite resins. Objectives: The objectives of this study were to: (1) evaluate the effect of different beverages and chilli sauce on the wear resistance of composite resins, (2) evaluate effect of the duration of immersion in the beverages and chilli sauce on the wear resistance of composite resins.
Materials and methods: Disc specimens were fabricated using two different types of composite resins: (i) Filtek Z350 (3M ESPE, USA, nano-filled composite, 40 specimens) and (ii) Solare P (GC Dental Products Corp, Japan, microhybrid composite, 40 specimens). After polymerization, all the specimens were polished using Enhance Polishing System (Dentsply International Inc.,USA). The specimens were air-dried before weighing using Sartorius BP 221S weighing balance (Sartorius AG, Goettingen, Germany). Ten specimens from each type of composite were immersed in distilled water (control group), Coca cola®, orange juice (Peel Fresh®) and chilli sauce (Maggi®) respectively. The duration of immersion was 6 hours and 1 week. A reciprocal compression-sliding system was used to evaluate the wear resistance of the specimens. The specimens were moved back and forth with a loaded counter-body (235g) against sand paper (P1000, 3M ESPE, USA) in running water. The weight of the specimens were measured after 6 hours of immersion and 20,000 wear cycles and also at 1 week of immersion with further 20,000 wear cycles. The wear resistances were tabulated as percentage of weight loss from the specimens. Results were statistically analyzed using one way ANOVA and post-hoc Tukey’s test (p= 0.05).
Results: The results showed that Solare P has significantly lower wear resistance compared to Filtek Z350. There was no significant difference in wear resistance for Filtek Z350 when immersed in chili sauce, Coca-cola® and orange juice in comparison with control group for 6 hours and 1 week. Similar findings were observed for Solare P.
Conclusion: Within the limitations of this study, it was concluded that Solare P has poorer wear resistance than Filtek Z350. The soaking medium investigated and duration of immersion have no influence on the wear resistance of Solare P and Filtek Z350.
The general aim of this study was to examine the patients’ perception of dental extractions. The specific objectives were to understand the purpose of extractions from the patients’ point of view, to find out the relationship between age and type of teeth extracted and to compare the patients’ perceptions with clinical indications for dental extraction. The survey was done using self administered, structured questionnaires to collect information. From the survey we found that toothache (33%) and the presence of cavities (34%) were the main reasons for extraction from the patients’ point of view. Besides that, the number of patients requiring extractions decreased with age. The main clinical indication for tooth extraction was caries (73%) and of these, 29% of restorable teeth were extracted.
Cancer causes approximately 12% of all deaths throughout the world and is the third leading cause of death in developing countries. In Malaysia, Indians have the highest incidence of mouth cancer compared to other races, and females are more affected compared to males.
Objective: The main objective of this study was to analyze the cases of oral cancer treated in the dental department of Penang hospital, Malaysia and to determine the risk factors associated with oral cancer.
Methodology: We reviewed the medical reports of all the patients with oral cancer treated in the dental department of Penang General Hospital from 1994 to 2004.
Results: There were 46 cases of oral cancer treated by the dental department of Penang General Hospital during this time period. 22 were males and 24 females. The mean age of the patients was 61.2 years old. Indians comprised the majority of the cases (n=23; 50%) followed by Malays (n=12; 26.1%) and Chinese (n=11; 23.9%). Of these cases, 54.3% (n=25) had used quid, 39.1% (n=18) smoked cigarettes and 32.6% (n=15) consumed alcohol. Indians made up 76% (n=19) of all quid users (p=
Collaborative learning: a peer group teaching in oral hygiene instructions activity
Introduction: The objectives of this survey were to investigate whether an oral health education activity through collaborative learning and peer group teaching by students would give a positive impact and to evaluate its effectiveness, sufficiency and relevancy of the activity content.
Methods: Three third year dental students in each group were assigned to demonstrate to their group mates the myriad of oral hygiene device for plaque removal and how they are used. Fifteen students were appointed each as a ‘toothbrushing specialist’, ‘flossing specialist’ and interdental toothbrush specialist’ respectively. The others acted as participants in the group. The students then teach each other in the group on how to use these oral hygiene measures. A self-administered questionnaire assessing the activity outcome was given to fifty-two third year dental students who attended the demonstration. The data were entered in the computer using the SPSS version 12.0 for analysis.
Results: Overall response rate was 100%. Slightly more than half of the students felt confident to teach their patients effective toothbrushing and flossing and able to indicate the usage of interdental toothbrush. Most of the students preferred a small group teaching rather than a larger one. The result shows that student’s knowledge, attitudes and practices on effective oral hygiene has gained.
Conclusion: Collaborative learning in the clinical environment appears to give positive impact on the dental student’s ability to impart oral health education to their patients.
The aim of present study was to determine if the radiological features noticed on dental panoramic radiographs can ascertain the different variants of ameloblastomas. Methods: A total number of 177 cases of ameloblastoma diagnosed in 5 centers in Malaysia were reviewed. The clinical records of these cases were analyzed with respect to age, sex, ethnicity, diagnosis of the lesions, anatomic site, size, side, year of diagnosis, status of the lesion, and characteristics of the lesions. Detailed radiographic features such as septation, calcification, effect on adjacent structures, periosteal reactions, demarcation and cortication of the border of the lesions were recorded. Results: The unicystic, plexiform and acanthomatous ameloblastomas tend to have unilocular radiolucencies as opposed to the follicular ameloblastoma, which demonstrated commonly multilocular radiolucency with soap-bubble appearance. The well-demarcated borders with thin condensed sclerotic border of the lesions appeared to be more significant in unicystic ameloblastoms. Moderately and poorly demarcated lesions are commonly found in follicular and acanthomatous ameloblastomas. Multiplanar pattern of root resorptions, protrusion of roots into lesions and cortical expansions with intact visible margins are commonly seen in ameloblastomas. Conclusion: The various histopathological patterns are not closely related to any specific radiological appearances in the jaws and there seems to be no direct or obvious correlation between the histopathological patterns of the tumours and the radiological appearance of ameloblastomas.
The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
Tissue regeneration is a rapidly growing field providing a beacon of hope in the field of restorative and endodontics. Root canal treatment involves the removal of pulp tissue and replacement by an inorganic materials where as regenerative endodontics deals with replacement with healthy pulp to revitalize the teeth .Research in the field of tissue engineering and material science have lead to significant progress but still is plague with lots of drawbacks and failures, hence it is still not being adapted as routine clinical procedures .The purpose of this article is to review the advances made in regenerative endodontics and the future scopes.
The prevalence of periodontal abscesses in emergency dental clinics was found to be between 8%-14%. The purpose of this study was to study the clinical features of periodontal abscesses seen in a specialist periodontal unit. There were 14 patients with equal distribution of gender. The mean age was 39.6 years. Twelve upper teeth (86%) were found to be involved as compared to two lower teeth (14%). There were more posterior teeth involved, a total of nine teeth (64%) as compared to five anterior teeth (36%). The mean pocket depth associated with the abscesses was found to be 7.4mm. There were ten buccal sites (71%) as compared to four palatal sites (29%). Average temperature of patients was 36.9° C. Only one patient was found to have cervical lympadenopathy (7%). The teeth involved were found to be mostly mobile with mobility of grade I to III (71%).
Objectives: To assess pattern of toothpaste usage among young children under 6 years old.
Materials and methods: This was a cross-sectional descriptive study carried out at the Faculty of Dentistry, Universiti Kebangsaan Malaysia. Parents of children below 6 years old were involved. 200 questionnaires were distributed and 136 (68%) were returned for analysis. The questionnaire covered the following parameters: type, frequency, and quantity of toothpaste usage among children, level of parental knowledge of fluoride concentration in toothpaste and selection criteria of suitable toothpaste for their children.
Results: Majority of the respondents (83.1%) said they used children’s toothpaste to brush their child’s teeth and 62.5 % of them knew that the toothpaste used had fluoride in it. Slightly more than half of the respondents (53.7%) said they started brushing their child’s teeth one year after eruption of the first tooth. Almost an equal proportion of the respondents reported using toothpaste twice daily (50.7%) and only 44.1% of them supervised their children’s brushing. Respondents generally used more than a pea-sized toothpaste quantity (53.6%). Taste, fluoride concentration and brand of the toothpaste appeared to be the main criteria that influenced the selection of the toothpaste (55.9%). Income and educational levels of the respondents did not influence the type of toothpaste used.
Conclusion: These findings indicated that although parents were brushing their childrens’ teeth with children toothpaste, they were still unaware of the proper usage and importance of fluoridated toothpaste.
Introduction: Nowadays, there is a worldwide trend for universities to utilize the benefits of e-learning as a mechanism to facilitate improvements in teaching and learning. Purpose: The aim of this study is to evaluate the effectiveness of using e-learning in the teaching of fixed prosthodontic course i.e. FPeL.
Materials and Methods: This was a retrospective analysis of questionnaire data, collected from fourth and fifth year dental undergraduates at the Faculty of Dentistry, National University of Malaysia (Universiti Kebangsaan Malaysia, UKM). For fixed prosthodontics (FP), all students had received a series of traditional classroom lectures, seminars, video demonstration, preclinical and Fixed Prosthodontics e-Learning or FPeL in semester 1 and 2 during their 4th year. The questionnaire of 4 sections was administered after the students completed fixed prosthodontics course.
Results: Questionnaires were returned by 136 students (80.9% response rate). Unfortunately, the response rate dropped 12.4% when only 115 students accessed and used the FPeL (68.5%). Majority of FPeL users felt PFeL was beneficial to their learning in the fixed prosthodontic course. PFeL users recommended printable version with detailed explanations, illustrated with more photos and with addition of references.
Conclusions: PFeL assisted users in the learning process of fixed prosthodontics.
Introduction: The peer assessment rating (PAR) index was used to self-audit 4 years of completed pre-adjusted edgewise appliance cases treated by a single orthodontist in a government clinic. The objectives of this study were to evaluate orthodontic treatment standards and factors which may influence treatment outcomes and treatment time.
Methodology: Pre and post-treatment study models were scored using the PAR index by the author. 17 models were re-examined for intra-examiner reliability using intra-class correlation coefficient (ICC). ICC was excellent for pretreatment (0.96), post-treatment (0.98) and reduction in PAR (0.96) scores.
Results: There were 173 cases (51 males; 122 females) with mean age 17.6 (SD 5.75) years. Mean treatment time was 18.6 (SD 6.47) months with range between 5-40 months. There was no statistically significant difference between one-arch and two-arch cases and between routine and compromised cases. Treatment time in extraction cases (mean 19.5, SD 6.17) was significantly different (p=0.000) compared with non-extraction cases (mean 11.6, SD 4.10) although this accounted for 15% of the variation only (r=0.388). 76.3% cases were ‘greatly improved’, 22.0% ‘improved’ and 1.7% ‘worst/ no different’. Mean pretreatment, post-treatment and reduction in PAR score was 34.1(SD 9.68), 6.4 (SD 6.84) and 27.9 (SD 9.69) respectively. Mean percentage PAR score reduction was 82.0% (SD 1.96). Pretreatment (p=0.000), post-treatment (p=0.000) and reduction (p=0.489) in PAR scores was significantly different between routine and compromised cases. There was significant difference (p=0.000) between category of improvement and pretreatment scores but not with treatment time.
Conclusion: Severe malocclusions had larger reduction in PAR scores and required longer treatment time. Extraction cases took longer to complete and routine cases had better outcomes than compromised cases with severe skeletal discrepancy.
The cleft lip and palate patients often have constricted maxillary arch, congenitally missing teeth, impacted teeth, and many kinds of malocclusion problems. Secondary bone grafting in cleft lip and palate patients is performed preferably before the eruption of permanent canine in order to provide adequate periodontal support for eruption and preservation of the teeth adjacent to the cleft. Secondary grafting with iliac marrow consistently produces trabecular bone to unify the maxilla and provide odontogenic support. Presented here is a case of unilateral cleft lip and palate, which was treated by expansion by quad helix and straight wire appliance for correction of dental malocclusion. Also discussed in detail the entire range of treatment procedures the boy underwent from 14 years of age, especially the role of secondary bone grafting with iliac marrow to facilitate the eruption of permanent impacted canine.