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 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.
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.
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.
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.
Aim: To assess the prevalence and clinical features of aggressive periodontitis in newly referred patients to the Periodontal Clinic in Seremban.
Methodology: Sample size calculation was done using Epi Info software with minimum sample estimated at 279. 583 new patients who were referred to this clinic from year 2013 to July 2015 were examined clinically and radiographically. Patients were diagnosed using American Academy of Periodontology workshop 1999 definition.
Results: Thirty-one (5.3%) patients were identified as having aggressive periodontitis with 28 (90%) of these patients exhibiting generalized form of aggressive periodontitis. Mean age of these patients was 34.9 years. In terms of gender and ethnicity, 21 females and 18 Malays were diagnosed with Aggressive periodontitis. First molars had the highest amount of clinical attachment loss (CAL=5.4mm). The number of missing teeth at the first visit was at median 2 (Interquartile range=4). The number of prognostically hopeless teeth at first visit was at median 1 (Interquartile range=2). Canines were preserved in most of the patients.
Conclusion: Aggressive periodontitis was found in 5.3% of our samples. It was diagnosed at mean age of 34.9 years old.
The tooth provides a non-shedding surface ideal for microbial and plaque accumulation. Despite being exposed to regular environmental perturbations, the microbial composition and proportions in the plaque often remains in homeostasis and is relatively stable over time. Supragingival plaque sampled from various sites on the tooth surface was pooled and conventionally analyzed for its microbial constituent. Classification of microbial isolates was made based on the characteristics exhibited by the growth colonies, Gram-stained cells, as well as biochemical reactions using the API Identification System kit. Observation was also made of the colony forming units on both non-selective and selective agar culture plates. A variety of bacteria, both of the facultative and anaerobic types, were isolated from the supragingival plaque of the Malaysian population. Among those found to predominate the supragingival plaque include the Gram positive and Gram negative cocci and rods from the genera Streptococcus, Staphylococcus, Actinomyces, Fusobacterium, Corynebacterium, Clostridium, Bacteroides, Veilonella and Lactobacillus. In addition, yeast within the genus Candida was also isolated from the plaque samples.
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
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.
Platelet Rich Fibrin (PRF) is a natural autologous fibrin matrix and is an effective biomaterial product. The application of PRF in oral surgery is not limited to tissue regeneration, but it has been utilized in several minor and major oral surgical procedures. Numerous studies have proven that either alone or in combination with bone graft, PRF acts as bone and soft tissue regeneration and it is able to stimulate physiological wound healing. This case report will introduce the utilization of PRF combined with autogenous bone graft in restoring four walls dental socket defect due to post-surgical extraction complication and plan for implant placement in the future. It acts in the form of a resorbable membrane and stem cell connector to the bone. After 3 months post-surgery review, there was no signs of infection or tissue rejection and the harvested bone was still viable. The PRF is comparable to commercially available membrane in the market, where clinical results can be predicted and possibility of reduction in post-surgical complications is achieved. This is due to 1) its compatibility with bone graft materials notably autogenous type, 2) induced neovascularisation and 3) reduction in inflammatory reaction. Our team is confident that the result of PRF at the edentulous region for rehabilitation purposes is beneficial and cost-effective to our patients.
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.
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.
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.
Objectives: To evaluate the marginal microleakage of Class II cavities restored with various types of composite resins.
Materials and Methods: Standard Class II slot cavities were prepared at the proximal surfaces of 40 intact premolars which were divided into 4 groups. Four types of composite resins (Esthet-X-Denstply, USA, FiltekTMZ350- 3M ESPE, USA, Beautifil- Shofu, Japan and Solare P-GC, Japan) were used to restore the slot cavities. All the specimens were thermocycled and immersed in 0.5% basic fuschin dye for 24 hours. The specimens were then sectioned in mesio-distal direction. The marginal microleakage at the occlusal and cervical margin was scored using the ISO microleakage scoring system. Data was entered using SPSS Version 12.0 and analyzed using STATA software programme.
Results and discussion: All composite resins exhibited worse microleakage at the cervical margin compared to occlusal margin. Esthet-X showed significantly better microleakage score at the occlusal margin compared to Beautifil and Solare P. FiltekTMZ350 and Beautifil showed mainly microleakage into enamel only at the occlusal margin. Solare P demostrated better resistance against microleakage at the cervical margin compared to other composite resin tested. Esthet-X, Filtek Z350 and Beautiful is not significantly different from each other in terms of microleakage at the cervical margin.
Conclusion: This study showed that none of the materials used in this study is able to eliminate microleakage. Composite resin restorations exhibited worse micorleakage at cervical margin in comparison to occlusal margin.
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.
Delayed eruption of permanent upper incisors is a cause for concern to patients. It causes aesthetic, function and speech problems. This case report describes a technique of managing impacted dilacerated maxillary central incisors using removable appliances over one and a half year. It is a simple, operator- friendly and economical treatment option with favorable result.
Radiology is important in the diagnostic assessment, treatment and monitoring progress of patients having dental and maxillofacial diseases. The central question in dental radiology is whether there is any risk with regard to low doses of radiation and what are the necessary protection needed to prevent any hazardous outcome with X-raying. With the emergence of the new millennium, major changes are happening in the field of science and technology. More efficient equipments are being discovered and more researches are being conducted to elicit better understanding of the radiation process and its effect on the human health. This article will review the latest guidelines for proper radiographic practice from the USA and Europe. It will address topics like the risks from dental radiography, selection criteria, protection for patients and staff, improvement to X-ray equipments, room dimensions and lead lining requirements. We have limited our research to intraoral, panoramic and cephalometric radiographs because these are the radiographs or images that are commonly taken in the general practice setting. (Copied from article).
There is a major concern about the increased use of antibiotics in dental practice and the emergence of resistant bacterial strains. In recent years, dentists have reported a shift from narrow-spectrum to broad-spectrum antibiotic prescriptions due to increasing antibiotic resistance. The aims of this study are to investigate the prescribing patterns of the therapeutic and prophylactic use for antibiotics in various dental situations by dental practitioners. The study also specifically investigates the prescribing habits of dental practitioners regarding certain cardiac conditions and related dental procedures in patients predisposed to infective endocarditis. This study utilized a questionnaire which was designed to investigate the antibiotic prescribing patterns by dental practitioners in the Klang Valley region. The returned questionnaires were analyzed using SPSS, to identify compliance to antibiotic guidelines by Malaysia National Clinical Guidelines (MNCG) (2003) and American Heart Association Guidelines (AHAG) (2008). 217 dentists responded to the questionnaire and the responses show that there is a wide variety of antibiotic prescriptions among dentists and there is also misuse of antibiotics in some clinical dental conditions. The results also show that there is a large variation in the antibiotic prescriptions patterns for prophylaxis against infective endocarditis. Furthermore, there is uncertainty as to which cardiac conditions required prophylaxis and for which particular dental procedures. This study concludes that there is a clear need for the development of prescribing guidelines, regular monitoring of antibiotic prescriptions by dental practitioners and educational initiatives to encourage the rational and appropriate use of the antibiotics.
In 2013, the Malaysian Education Blueprint (Higher Education) was developed by the Ministry of Education to guide the transformation process of the education system in this country for the next decade, starting from 2015 (1). The blueprint highlighted core aspirations for Malaysian higher education, which includes rapid expansion of research output and quality (1). This effort is in line with the nation's aspiration to uplift the standard of service provision among healthcare professionals, whose practice should advance on the essence of high quality scientific evidence.(Copied from article)
Full mouth rehabilitation of the severely collapsed dentition is one of the most challenging procedures in restorative dentistry. The treatment aims are not only to restore function with sustainable restorations and to provide patients with an aesthetic smile, but also to conserve the remaining dentition and maintain the health of supporting structures. This case report describes the complete oral rehabilitation of a patient with severely broken down dentition and loss of posterior support. Loss of posterior support will not only result in breakdown of remaining dentition in the anterior region due to occlusal overload, it also adds years to the patient’s appearance. A complete treatment plan was outlined involving multidisciplinary team treatment included sessions of oral hygiene instructions and re-assessments, a diagnostic stage with provisional overlay denture at an increased occlusal vertical dimension (OVD), endodontic treatment and retreatment, crown lengthening as well as implant surgery. Final restoration involved both fixed and removable prostheses. Maintenance review was carried out periodically after completion of treatment for two years and good outcome was observed.