A case of bullous pemphigoid with extra-oral and intraoral lesions in a 60-year-old female is reported. Diagnosis is based on histopathology and direct immunofluorescence, and the treatment regime described included oral prescription of prednisolone and topical application of a mixture of fluocinonide ointment and triamcinolone acetonide in Orabase on the oral lesions.
A clinical analysis of 304 cases of pyogenic granuloma (excluding pregnancy tumour) were obtained from the clinical evaluations submitted by clinicians while sending specimens for biopsy. The average age of the patients with pyogenic granuloma was 28.9 years with a peak age incidence in the second decade. More female patients were affected and the lesions present mainly in the Chinese. The majority of the lesions were ulcerated and pedunculated. The lesions had a mean diameter of 10.8 mm with a mean lesion duration of 6.0 months. The gingiva was the prevalent site for these lesions with a greater number being located in the maxilla. The recurrence rate was found to be 14.1%.
Samples of stimulated whole saliva were obtained from ninety-four 12-14-year-old school children living in inner London to evaluate if there was a correlation between Streptococcus mutans counts in saliva with plaque amount, gingival inflammation and caries experience. S. mutans counts were obtained by a dip-slide method (Dentocult 'Strip Mutans') in which the count was expressed as 0, 1, 2, 3, or 4 based on visual estimation of the colony density. There was no association between counts' of S. mutans in saliva with plaque amount and gingival inflammation. However, there was a significant trend of increased decayed, missing, filled surfaces (DMFS) with increasing S. mutans counts.
A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.
A case of unicystic ameloblastoma which recurred after 15 years showing unusual histological features is reported. The prominent pseudo-glandular features present are described. This case highlights the importance of extensive histological examination for more characteristic features of ameloblastoma to reach a correct diagnosis.
The disinfective and fixative properties of glutaraldehyde are now widely investigated. Glutaraldehyde is effective against micro-organisms and their spores. Recently, studies have shown the effectiveness of glutaraldehyde against the HIV virus. 2% glutaraldehyde is now recommended for the sterilisation of surgical instruments, operating areas, dental impressions and root canals during endodontic therapy. Studies have also shown that glutaraldehyde is an effective fixative with minimum side effects, limited penetration and quick acting. Pulpotomy studies using glutaraldehyde as the fixative agent produce high success rates. The important feature is the vital pulpal tissue at the apical third suggesting its limited penetration. The small amounts that get distributed systemically are quickly metabolised and excreted in the urine or exhaled as carbon dioxide.
Records of 302 root-filled teeth treated by dental undergraduates were reviewed by four lecturers in the Department of Conservative Dentistry, University of Malaya. Preoperative and operative factors were evaluated for their association with postoperative pain experience of patients during the visit immediately after completion of biomechanical preparation. Eighty four percent of patients did not experience any pain after biomechanical preparation whilst the remaining 16 percent only complained of slight or moderate pain. The incidence of pain after biomechanical preparation is not high even when performed by inexperienced undergraduates. Teeth with a pre-existing painful condition had a higher chances of postoperative of pain. The incidence of postoperative pain was halved when teeth were associated with a sinus tract.
Two hundred and twenty-nine children aged 12-15 years who were continuous residents of Penang island, in the north of Peninsular Malaysia were examined for caries and enamel defects. Caries prevalence was 82.2% with a DMFT score of 3.4 and DMFS score of 4.9; there were very few missing teeth and very little untreated caries in the population examined. Majority of DF (decayed/filled) lesions were pits and fissures with approximal and smooth surfaces relatively caries free. The prevalence of enamel defects was 76.4% with 19.1% of all teeth examined being affected. More posterior than anterior teeth were affected by enamel defects just as there were more maxillary than mandibular teeth affected by enamel defects. Diffuse patchy opacities were the most common defect diagnosed and this was found in 60.2% of the population examined. A bilateral distribution of diffuse patchy opacities was seen in 41.5% of the population examined. Tooth surfaces with enamel defects were no more susceptible to caries than defect-free surfaces.
Adenomatoid odontogenic tumours (AOT) are benign, hamartomatous odontogenic lesions that not uncommonly mimic a dentigerous cyst radiographically. Such a case as found involving an unerupted left maxillary canine in a 19-year-old Chinese female is described. The differential diagnosis of some common odontogenic cysts and neoplasms occurring in Malaysians, that may present in a dentigerous relationship to an unerupted tooth is discussed. A brief review of the radiographic literature on AOT is also included.
Fractures of the mandible and their management are discussed in detail in textbooks and articles dealing with facial trauma. This paper presents the management and treatment of a case of a unilateral comminuted and complicated fracture of the mandible due to dog attack on a geriatric patient. The attack also severed the patient's right arm. Due to the severity of the trauma, an emergency surgery was performed on the mandible and arm.
Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.
Many studies have been reported on radiographic lesion sizes of periapical lesions. However no studies have been reported on prevalences of subjective radiographic features in these lesions except for the early assumption that a periapical cyst usually exhibit a radiopaque cortex. This study is conducted to evaluate the prevalences of several subjective radiographic features of periapical cysts and granulomas in the hope to identify features that maybe suggestive of either diagnosis. The results showed that a regular (circular or semi-circular) radiographic outline is likely to be a periapical cyst while an irregular radiographic outline is not indicative of either a cyst or a granuloma. The association between the regular/irregular radiographic outline and the type of periapical lesion was found to be statistically significant (p less than 0.001). The associations of two other radiographic features and the type of periapical lesion were found to be just statistically significant (p less than 0.01). These features are the symmetry/asymmetry of the radiolucency in relation to the apex and the funnel-shaped/angular-shaped extension of the radiolucency. The widely accepted criteria that the possession of a radiopaque cortex surrounding the radiolucency can discriminate between a periapical cyst and granuloma cannot be statistically supported in this study.
An important relationship should exist between the periodontist and restorative dentist. Periodontics and restorative dentistry should not be divisible and all forms of restorations, from a simple filling to a complex precision-retained bridge, should be performed with the health and biology of the periodontium in mind. A very crucial concept which should be borne in the mind of every restorative dentist is the concept of biologic width.
Like dental caries, epidemiological assessment of periodontal disease is important for purposes of recognizing the extent of the disease in the population as well as a basis for planning and evaluating preventive and treatment programmes. while present day measurement methods for dental caries are excellent such is not true for periodontal diseases. This paper reviews the development and usefulness of different indices for the assessment of periodontal disease and treatment needs in epidemiological investigations.
Mucoepidermoid tumours of the minor salivary glands of the tongue are rarely encountered. A case of a high-grade malignant type is reported here. Merits of subdivision of the mucoepidermoid tumour on the basis of its malignant potential are outlined, and variations of histological presentation of the present tumour at its primary and nodal sites are discussed.