Actinobacillus actinomycetemcomitans is considered a major pathogen in periodontal disease. The aim of this study was to determine the prevalence of A. actinomycetemcomitans from 46 subjects aged 20-24 years old of who were all periodontally healthy Malays.
Quality radiographs of diagnostic value are important in root canal treatment. The dentist who has knowledge and skills in the use of radiographs for diagnostic purposes has a professional responsibility to ensure that the radiographs are obtained with minimum risk of radiation dose to and for the benefit of the patient. This article reviews the effectiveness of radiography techniques required for successful root canal treatment with the patient’s interest in mind. Awareness of effectual radiographic techniques, their constraints and applicable techniques for improvements are discussed. It seeks to reduce potentially harmful ionising radiation dose to patients and optimise the use of X-rays to produce diagnostic radiographs during root canal treatment.
An audit of broken/lost removable appliances was carried out. This study aimed to measure the occurrence of broken/lost appliances over a period of 6 months. It also assessed whether there was any difference in the occurrence rate between patients who paid for treatment and those who received it free of charge. The results indicated that the total number of broken/lost removable appliances was 183, from a total of 472 appliances issued. For paying patients, 59 of 177 patients had at least one broken/lost appliance, giving an occurrence rate of 33.3%. For nonpaying patients, 60 of 112 patients had at least one broken/lost appliance, giving an occurrence rate of 53.6%.
This clinical case report describes an aspect of restorative management of worn teeth. It illustrates the use of diagnostic overlay removable partial denture or DORPD, which has the same function as occlusal splint but with advantages of providing immediate aesthetic improvement and function.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
Compliance to delivery of orthodontic appliances within specified times and factors which influenced compliance by dental technicians in Selangor was evaluated. This is a prospective 8-month study of 18 trainee/ trained technicians from 4 main government dental laboratories in Kajang, Klang, Tanjong Karang and Shah Alam. Delivery times specified by orthodontists were 1 day for plastic retainer, 3 days acrylic retainer, 5 days active plates (URA), 10 days functional appliances (FA), 10 days transpalatal arch (TPA) and 10 days for quadhelix. Punctual delivery was recorded as ‘compliant’. Compliance was compared between appliances, clinics, technicians, orthodontists and seniority of technicians. The sample comprised appliances from 365 patients; 38 (10.4%) Tanjong.Karang, 114 (31.2%) Kajang, 191 (52.3%) Klang and 22 (6.0%) Shah Alam. The majority of appliances were retainers (66.3%), followed by URA (13.4%), functionals (9.3%), TPA (9.0%) and quadhelix (1.9%). Mean compliance for all appliances in Selangor was 55%. Plastic retainers had highest compliance (77.8%), followed by acrylic retainers (59.9%), quadhelix (57.1%), FA (47.1%), TPA (45.5%) and URA (24.5%). Senior technicians (>3 years in service) were more compliant than juniors (
Evaluation of the mechanical behaviour of restoration dental materials is essential to understand their performance under different load conditions and to estimate their durability under clinical oral function. Restorative materials and dental tissues like other materials by having specific mechanical properties, such as static strength (i.e. compressive strength, tensile strength, flexural strength) and dynamic strength (i.e. fatigue strength). The selection of proper mechanical test type depends on the goals that the study claims to define. On such basis, the mechanical test can be chosen correctly. Laboratory studies should be designed as replications of the clinical oral circumstances to measure the mechanical and physical properties of a material and any arbitrary choices in the design of the study may result in large variations of data.
Objective: To audit the amount and complexity of case load and the waiting time for orthodontic treatment in Orthodontic Department of Universiti Kebangsaan Malaysia (UKM).
Materials and Methods: This study involved three waiting list records in Orthodontic department, UKM and 484 patients’ record were selected using Random Sampling technique. Demographic data of the patients were noted. Data on date of patient’s visit to ‘Klinik Rawatan Utama’ (KRU), Screening clinic and first orthodontic treatment (removable/fixed) clinics were also recorded. The severity of referred cases were graded using complexity scale (Russle et al, 1999).
Results: Patients were mostly female (76%) with age ranging from 10 to 52 years old. 75% of the referred cases were complex cases. From the year 2002-2007, 35% were referred for removable and 65% were referred for fixed clinic. In average, orthodontic screening waiting time was 6.9 ± 2.5 month. Patient would received removable and fixed appliance treatment after 4.4 ± 1.0 months and 14.5 ± 9.8 months respectively.
Conclusions: Most patients were referred to fixed waiting list. The waiting time from 2002 until 2007 for orthodontic treatment in UKM was longest for fixed followed by screening. The shortest waiting time was for the removable treatment.
Study site: Orthodontic Department of Universiti Kebangsaan Malaysia (UKM)
Congenitally missing teeth creates significant challenges to the clinicians in both diagnosis and management. The need for interdisciplinary involvement is essential for optimum dental care. The purpose of this clinical report is to describe an interdisciplinary management of a 15-year-old adolescent presented with non-syndromic oligodontia. The principle of management is presented with special emphasis on prosthodontic aspects. Various restorative treatment modalities specified for oligodontia patients are outlined.
It is the aim of all clinicians to accomplish biological tooth movement, which implies the use of low, continuous force. Constant unrelented search for a better wire, which can deliver optimal orthodontic force, has led to the invention of a lot of orthodontic wires such as Stainless steel, Beta Titanium, Nickel Titanium and multi stranded wires. In this study, the loading and unloading properties of 0.016 inch, 0.016x0.022 inch and 0.017x0.025 inch dimensions of stainless steel, conventional NiTi, Super elastic NiTi, and TMA arch wires were determined by means of a modified three point bending test for two inter bracket widths of 5 mm and 6.5 mm for deflection of 1 to 3 mm. The applied forces dependence on cross-sectional size differs from the linear-elastic prediction in super elastic NiTi wires. The stainless steel wires had the highest force values on all the three dimensions and cross section. On loading and unloading, TMA wires had force values in-between stainless steel, conventional NiTi and super elastic NiTi. The conventional NiTi had much lower force values compared to stainless steel and TMA and were linearly progressing compared to Super elastic NiTi. On loading and unloading the super elastic NiTi had force values in the range of conventional NiTi and had constant forces on higher deflection. The studies showed that the force value was comparatively higher in 5 mm inter bracket width than the 6.5 mm inter bracket width for all the cross section and dimension of wires.
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.
There are evidences that chronic oral infections are associated with cardiovascular disease (CVD). Periodontal disease is a common, mixed oral infection affecting the supporting structures around the teeth. It was reported that 75% of the adult population has gingivitis and 20% to 30% exhibits the severe destructive form of periodontitis. Although more than 500 bacterial species inhabit the human oral cavity, only a few Gram negative bacteria such as Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola and Actinobacillus actinomycetamcomitans causes gingivitis and periodontitis. These periodontal pathogen occupy the subgingival space and organize as a bacterial biofilm. The bacterial biofilm will be in direct contact with host tissues along an ulcerated epithelial interface, called periodontal pocket. The break in the epithelial integrity directly exposes the host to bacteria and their products eg. lipopolysaccharide (LPS) endotoxin. (Copied from article).
This case report presents a combined surgical – orthodontic approach to the management of an unerupted maxillary right permanent central incisor in a 13 year-old Chinese male. Radiographic investigations revealed that the tooth was severely dilacerated, most likely as a result of trauma sustained to the upper maxillary right deciduous central incisor at the age of 3 years. After securing adequate space for the unerupted tooth by fixed appliance therapy, surgical exposure of the crown was carried out under local anaesthesia and oral sedation.
A gold chain was bonded to the exposed crown of the tooth. Traction was then carried out and the tooth was successfully brought to its final and correct position in the arch after 36 months of active orthodontic treatment.
Gingival overgrowth is a well-recognized unwanted effect associated with three major drugs / drug groups - phenytoin, cyclosporine and the calcium channel blockers. Cyclosporine is the first-choice immunosuppressant for preventing allograft rejection in patients who have received organ or bone marrow transplants. This report aims to highlight a case in which the patient on cyclosporine therapy had also contracted Hepatitis C virus infection.
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.