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).
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.
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.
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).
This study was conducted on Royal Malaysian Navy submariners who were having training in France. It was designed to compare the oral health experiences and practices while under water and on land. Methods Eightysix Royal Malaysian Navy (RMN) submariners, who had undergone at least one cycle (288 hours) of under water training, were selected to participate in a self-administered questionnaire survey. Results Seven percent of the respondents reported oro-facial pain and discomfort; 9.3% reported bleeding gums and 12.8% experienced halitosis while under water. Of those experience oral problems, 82% reported disruption of their daily activities while under water. The study showed that 82.5% of them brush their teeth at least twice a day and 94.2% rinse after meals when there were under water. Meanwhile studies on land showed that 90.7% of them brush their teeth at least twice a day and 96.5% rinse after meals. Flossing was not practiced by most of the respondents. Conclusion It is concluded that brushing and rinsing are practiced regularly by submariners regardless whether they are on land or under water but flossing is not a common practice both on land and under water. Dental emergencies, such as toothache, TMJ pain and discomfort do occur during submarine operations and disrupt their daily activities. This might poses a threat to submarine operations.
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).
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.
The objective of this survey was to understand the current trend of readership of professional dental journals among Malaysian dentists. A total of 225 questionnaires were sent out to Malaysian dentists who attended various dental related conferences throughout Peninsular Malaysia from February 2006 to July 2006. Questionnaires comprised of questions relating to dentists’ socio-demographic status and a list of journal(s) read by them. Malaysian dentists’ view on the content and quality of a particular dental journal, i.e. the Malaysian Dental Journal (MDJ) was also enquired. The details of this finding are highlighted in Part II of this study. A total of 156 questionnaires were returned; the respondents were made up of 61 male and 91 female dentists. Almost 80% of the respondents aged between 20-49 year-old and most respondents (n= 132; 84.62%) only had a basic Bachelor of Dental Surgery or equivalent degree while another 19 (12.18%) had in addition, a post-graduate degree. Almost equal numbers of respondents were working in the Ministry of Health (MOH) or Armed Force (n=73; 46.8%) and private practice (n=74; 47.4%). Also, equal number of respondents (n=67; 42.95%) were found to be working as single-handed practitioner and in a partnership/assistant/working-with-other specialties type of practice Almost two-thirds (n=103; 66%) of the respondents read more than one professional journal, and a majority of them worked in the private sector. The percentage of readers reading more than one journal from the private practice (n=67, 60.0%) was close to twice of that from the MOH (n=36, 35.0%). No specific age-group pattern was present but the least number of subscribers were from those 60 year-old and above (n=3), whereby none of them subscribed to any professional dental journal/magazine. The highest percentage of subscribers were from those in the age group of 40-49 year-old, whereby 86.49% (n=32) of dentists in this age-group subscribed to at least one professional dental journal/magazine. Out of the list of journals/magazines provided, it was found that the MDJ has the most number of readers. The MDJ was most read by dentists in the private practice while the Annals of Dentistry of the University of Malaya was most read by dentists in the MOH. In conclusion, it was found that almost two-third of the respondents read more than one professional journal, with the MDJ receiving the most number of readers. More dentists in the private practice read professional dental journals than dentists in the MOH.
The objective of this part of the study was to understand the current trend on readership of the Malaysian Dental Journal (MDJ) among Malaysian dentists. Their views on the contents and quality of the Malaysian Dental Journal were enquired. We also enquired the reasons they chose-to/chose-not-to read the MDJ. Of the 225 dentists surveyed, the number of MDJ readers was 101; with only 24.75% reading all issues published. The editorial section was rated as “useful” by 70.3% of readers, while 79.2%, 87.1%, 87.1% and 80.2% of readers rated the research article section, the review article section, the case reports section and book recommendation section similarly respectively. Feedback from readers indicated that they wanted more case reports, more review articles on “how to do it” and on medical problems in dentistry. More than half (55.45%) of the MDJ readers preferred to receive the journal in both hard and soft copies. For the non-readers, the most common reasons cited for not reading the MDJ was not being able to access to the journal, followed by not having time to read. Our finding suggested that the respondents preferred to learn from colleagues’ experience and to read article that can improve their clinical knowledge and skill.
Medical emergencies or unexpected events are situations that all dental practitioners are trained to face, yet none hope they become a reality. Although they occasionally happen, the prevalence is rather low. This special article will touch on three aspects: before, during and after an unexpected event happening in a general dental practice. Emphasis will be given on the ‘during and after’ phases, which includes the activation of basic life support when necessary, and the documentation that a dental practitioner needs to prepare in the event of adverse outcome despite of efforts made to prevent and manage it.
It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.
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.
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.
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.
People with hearing and/or speech impairments (HSI) reported having difficulty communicating with the dental team, indicating the need for the profession to develop an effective communication strategy when dealing with these patients. This paper discusses the development of a toolkit designed to guide delivery of oral hygiene instruction, oral health education and dental consultation for patients with HSI, and how its use had resulted in an improved oral health outcome in a patient with such disabilities.
Perceived and normatic needs for dental treatment is increasing globally, as patients in various parts of the world demonstrate different patterns of oral diseases (1). Some regions showed an increasing demand for aesthetic dentistry (2), while some demonstrated a rise in procedures relating to tooth preservation and functional restoration (3). In spite of the variable market demands, it is evident that utilisation of oral health care services has improved worldwide, regardless of patients’ socioeconomic status and other personal or environmental circumstances (1). (Copied from article)
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)
Collaborative teaching is an educational approach that seeks to involve participation of teachers and learners in achieving learning goals and outcomes in an interactive manner (1). Such approach has been effective in equipping students with knowledge and/or skills via high levels of learning, while allowing interpersonal development such as teamwork, time management, as well as communication and written competencies (2, 3). (Copied from article)
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.