To assess the oral health behaviors of children with Autism Spectrum Disorder (ASD) and explore attitudes
and barriers in providing oral care by their parents. A cross-sectional, mixed method study design, which
comprised of quantitative and qualitative sections was conducted. The quantitative part assessed the oral
health behavior through a parent-proxy report questionnaire whilst the qualitative part assessed parents’
overall perspective on maintenance of oral health in children with ASD through an in-depth interview using
semi-structured questions. All children below the age of 16 who have been clinically diagnosed with ASD and
registered at the Pediatric Dental Clinic were included. The sample consisted of twenty children with ASD.
Most of the sample were male and between 5-8 years old. Majority had good oral health behaviors but some
exhibited self-injurious behaviors that may affect oral health. Severe characteristics of ASD, co-morbid
conditions and incompetent health professionals were reported as barriers in oral care by parents of these
children. Despite having good oral health behaviors, several barriers and challenges were expressed by these
parents with ASD when providing home oral care or bringing them for dental appointment. Continuous
support for parents with ASD child by dental professionals is essential to help overcome the real challenges
and barriers in providing oral care among these parents.
The audit aimed to investigate the availability of
orthodontic instruments and materials at Faculty of
Dentistry, University of Malaya. The standard was set as
100% of instruments and materials should be available
when required for orthodontic treatment. The form
comprised of six sections, which listed the commonly
used instruments and materials involved in the procedures
of impression taking, fitting and removal of molar bands,
bonding and debonding of orthodontic brackets and
activation of orthodontic appliances. The fifth section listed
the less commonly used instruments and materials and a
part for the clinician to list down instruments that were
used but not listed in the form. Whilst the last section is for
the clinician to list down the instruments or materials that
were not available when requested. A total of 567 forms
were completed and it was found that 97.6% instruments
and 98.6% materials were available. Overall, 22 types of
instruments were temporary not available with frequency
mean of 2.1 (Minimum: 1; Maximum: 7) whilst 6 types of
materials were temporary not available with a frequency
mean of 2.3 (Minimum: 1; Maximum: 8). In conclusion,
majority of the instruments and materials required during
orthodontic clinical sessions were available. The check list
of frequently used orthodontic instruments and materials
from this audit could aid inventory and help future
management of the material and instruments.
Objective: This study aimed to assess the awareness of periodontal disease and level of knowledge of the relationship between smoking and periodontal disease amongst subjects who were smokers verses non-smokers.
Methods: A questionnaire looking at knowledge of respondents regarding gum disease and knowledge and awareness about oral impacts of smoking on periodontal disease was developed and pretested in Dental Faculty University of Malaya. Basic Periodontal Examination (BPE) index was used to assess periodontal status.
Results: The questionnaire was answered by 130 subjects. Prevalence of smoking was 14.6%. A total of 58.6% non-smokers and 57.9% smokers knew about periodontal disease. However, only 26.1% non-smokers and 10.5% smokers knew that the cause for periodontal disease was plaque. More non-smokers than smokers knew that smoking affected periodontal health (80.2% and 68.4% respectively) (p>0.05) and tooth mobility was an effect of smoking on periodontal health (27.0% and 0%) (p<0.05). Regarding source of information on effect of smoking on periodontal health, 63.2% smokers and 63.1% non-smokers reported obtaining information through the mass media. However, only 31.6% smokers and 28.8% non-smokers were informed by their dentist.
Conclusion: The awareness of periodontal disease and knowledge of the relationship between smoking and periodontal disease was low in this selected population of smokers and non-smokers.
Keywords: Awareness, knowledge, periodontitis, smoking
Study site: Primary Care Unit, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
This study aims to identify the relationship between dietary intakes of β-carotene with risk of oral cancer.
Methods: A hospital-based, case-control study was conducted on 306 Malaysians who seek treatment at participating centres/hospitals. Subjects selected from the Malaysian Oral Cancer Data and Tissue Banking System (MOCDTBS) consisted of 153 cases and 153 controls that were matched for gender, age (±5 years) and ethnicity. Food consumption was measured using Food Frequency Questionnaire (FFQ). NutrieMart Version 2.0.0 software was used to estimate daily nutrient of each subject from the FFQ. Logistic Regression analysis was conducted to compute the odds ratio (OR) for intakes of β-carotene and oral cancer risk.
Results: Intake of β-carotene was found to be not associated with risk of oral cancer (OR 0.83, 95%CI: 0.42-1.66, p>0.05).
Conclusion: No significant association was found between dietary intakes of β-carotene with oral cancer risk in this study population.
The aim of this study was to assess the viability of coating collagen to Hydroxyapatite (HA) coated commercially pure Titanium (cpTi) samples. Five samples of cpTi were immersed in a simulated body fluid (Tas-SBF) after stages of gritting, sandblasting and acid etching. One sample was taken out after 3, 5 and 7 days of immersion in Tas-SBF respectively. The 7 days Tas-SBF coated sample was coated with collagen by physical adsorption method. Analysis was performed to study the surface roughness, morphology and elemental analysis of the coated surfaces.The equipment used wereAlicona, Scanning Electron Microscope (SEM), Energy-dispersive X-ray Spectroscopy (EDS) and Fourier Transform Infrared Spectroscopy (FTIR). Process of sand blasting and acid etching were able to produce desired morphology and surface roughness. The average surface roughness, Sa of sand blasted cpTi surface and acid etched cpTi were 2.17 ± 0.75 µm and 2.12 ± 0.15 µm respectively. Immersion in Tas-SBF produced a crystalline coating and morphology that were similar to bone-like apatite. Roughness value of cpTi after being immersed in SBF for 7 days was 2.23 ± 0.31 µm and the Ca/P ratio was 7.076. Collagen coated samples had the highest Sa value which was 3.91 ± 0.31 µm and the Ca/P ratio was 1.190. This study showed that it is possible to achieve apatite and collagen coating on a modified cpTi surface using physical adsorption method.
The information of biomechanical properties is crucial in the study of biological tissue and its clinical relevance. 3mm x 3mm free gingival human tissues was taken using disposable punch biopsy (Accu sharp blade, India) and stored in 0°C Freezer. The sample was sectioned to a thickness of 10μm using high profile microtome blade (Leica 818, Germany) and cryostat (Leica CM1850UV, United Kingdom). The sample was analysed using Atomic Force Microscope (Nanowizard® 3, JPK Instruments, Germany) at room atmosphere. The collagen fibrils of the free gingival tissues appeared to be stacked in basket weave like structure. The mean value of free gingival collagen fibrils width and the length of D-band were 106.71±11.18nm and 65.82 ± 3.04nm respectively. The Young’s modulus of collagen fibrils for human free gingival tissue at overlap region was 212.88 ± 242.58 MPa, whereas at the gap region was 207.00 ± 230.71 MPa. Within the limitation of the study, the collagen fibrils appeared to be stacked in basket weavelike structure. The length and width of the collagen fibril were similar to the values investigated using other techniques. There was significant linear relationship between Young’s modulus of overlap and gap regions.
The objective of this retrospective study was to investigate what percentage of the dental students in the University of Malaya has a tooth size discrepancy. The sample comprised 40 good quality pre-treatment study models with fully erupted and complete permanent dentitions from first molar to first molar, which were selected from the dental students of the University of Malaya. The mesiodistal diameter tooth sizes were randomly measured manually from first molar to first molar using digital calliper (Mitutoyu) accurate to 0.01 mm, and the Bolton analyses for anterior and overall ratios were calculated by scientific calculator. Reproducibility analysis for intra- and interexaminer calibrations was assessed by measuring 10 study models twice, a week apart. A paired sample t-test and the correlation coefficient were used to evaluate the systematic and random errors of the measurements using Statistical Package for Social Sciences (SPSS) version 12.0. The reproducibility of the intra and inter-examiners for the sum of upper and lower mesiodistal tooth size were high (average mean difference = 0.62, r = 0.82). This study found 47.5% of the samples had anterior, and about 10% had overall· tooth width ratios greater than 2 standard deviations from Bolton's mean. Large percentage of the dental students of the University of Malaya has tooth size discrepancies outside of Bolton 2 standard deviations. It would seem prudent to routinely perform the tooth size analysis and include the findings into orthodontic treatment planning.
The calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955. It accounts for less than 1% of all odontogenic lesions. A case of CEOT which presented together with cardiac abnomlalities is presented here and the literature of CEOT is reviewed.
The palatal root of the first permanent molar is the most commonly deflected root into the maxillary sinus during extraction. A rational approach to the surgical removal of a root from the antrum is important. Some surgeons prefer the alveolar approach while others prefer the Caldwell-Luc operation. A case is presented where the palatal root tip of the left upper first molar was removed from the maxillary sinus by the Caldwell-Luc approach with simultaneous closure of the oro-antral fistula resulting from dental extraction. A fibreoptic light probe was used. The advantages and disadvantages as well as how to avoid the common complications of this surgical technique are discussed. A good result was achieved with successful removal of the root and no loss of sensibility of the teeth and/or gum for this case.
The main aim of this study is to get the Malaysian chief dentists’ perceptions of the oral health promotion activities currently taking place in their respective states in terms of the strengths and weaknesses of these activities. A qualitative method using an open-ended questionnaire was used to obtain this information. The study samples consist of all the chief dentists in Malaysia who represented a majority of population in their states. The results showed that the main current oral health promotion activities is dental health education talks which aims to disseminate oral health information through health education talks, toothbrushing drills, dental exhibition, pamphlets, brochures and publications. Half of the respondents felt that the commitment of the staff, the support of the public sectors and collaboration with other agencies are the main strengths while the lack of staff and fund has been said as the weaknesses. A range of opportunities however exist to strengthen oral health promotion in Malaysia.
According to the 3rd edition of the international
classification of headache disorders (ICHD3 2013),
Trigeminal Neuralgia (TN) is classified into two types:
1. Classical TN, purely paroxysmal 2. Classical TN
with concomitant persistent facial pain. In this article,
the authors describe a 47 year-old, male with unilateral,
severe, recurring, electric shock-like pain involving left
lower jaw, teeth and gingiva. Diagnosis of classical TN
of the left 3rd division of the trigeminal nerve was made.
The patient was treated with pharmacotherapeutic agents
but without relief. Magnetic resonance imaging (MRI)
of the brain showed medial vascular compression of left
trigeminal pontine root entry zone caused by superior
cerebellar artery. A microvascular decompression (MVD)
surgery was done at the left trigeminal pontine root entry
zone resulting in good relief of pain. This article highlights
the differential diagnoses to be considered with TN and
also emphasize the difference between the two types of
the TN according to ICDH3 (2013). It also highlights the
difference between classical TN purely paroxysmal with
and without vascular compression by imaging techniques
and their differing treatment modalities, which therefore
should be reflected in future ICDH classification.
The most prevalent oral mucosal lesions are aphthous ulcerations commonly referred to as canker sores. The clinical characteristic of oral recurrent aphthous ulceration/stomatitis(ORAS) is well defined and can be partly described as an oval or rounded ulcer covered by a grey-white or yellowish fibrinous exudate and surrounded by an erythematous halo. There is intense or moderate pain and the ulcers heal in about 10 - 14 days for the more common type and more than 2 weeks for the severe type. Recurrence of the ulcers occurs at intervals within a year or over several years. Variations of ORAS described above have made studies on aetiology and treatment difficult to interpret due to differing descriptions of differing diseases with similar clinical signs and symptoms and possibly differing aetiologies. A classification that was considered useful as a working model for ORAS was formulated in 1978. While the classification of ORAS had been widely accepted since 1978, the cause for ORAS is still unknown and its aetiology in general remains unclear. However, its immunopathogenesis is now becoming more clearly defined.
The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
The aim of this retrospective study was to study the clinical patterns of oro-facial infections presented and their management (or trends of management) at the Department of Oral and Maxillofacial Surgery, Dental Faculty, University of Malaya. These included the predisposing factors, presentations and management. This study reviewed the oro-facial infection cases over 15 years. The data was obtained from case note reviews of patients using specially designed proforma. A total number of 409 samples were included in this study. Majority of the patients were generally healthy with about 6.6% having diabetes mellitus. The common presentations were pain (47.4%), pus discharges (16.9%) and limitation of mouth opening (12.5%). The major site was in the submandibular region (18.9%) followed by cheek (13.2%). Most of the infections were from odontogenic source (63.2%). Other sources includes cysts (15.4%) and tumours (6.7%). Incision and drainage were the treatment of choice performed on 57.55% of patients. Monoantimicrobial therapy was the treatment instituted in 20.8% of cases.
This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.
The aim of the present study is to determine the “community indicator” for dental caries among secondary school children within the Federal Territory of Kuala Lumpur (FTKL). School factors were investigated for their ability to be used as community indicators. The components encompassing school factors include: type of school, school’s examination performances at the Peperiksaan Menengah Rendah (PMR) level, in the subjects of Mathematics, Bahasa Melayu (Malay Language), Science and English, school’s socioeconomic circumstances and school’s material deprivation. The study design is ecological in nature where schools were the unit of analysis. It used aggregated data for caries experiences acquired from the Oral Health Management Information System and the school factors which were extracted from the schools’ database. The subjects involved in this study were all the (75) day type secondary schools in FTKL. However, only 55 schools had complete information both for the dental caries factor and the school factors which were available for analysis. The use of bivariate analysis suggested that the school mean DMFT was significantly associated with the schools’ performance in English (p= 0.02) and the schools’ socioeconomic code (p= 0.005). The schools’ performance in English and socioeconomic code were able to explain about 10 percent and 14 percent of the variation in the school mean DMFT respectively. The final model that included both variables together explained about 17 percent of the variation in school mean DMFT. As a conclusion, this study suggests that the schools’ performance in English at the PMR level and the schools’ socioeconomic code could be used as community indicator to identify secondary schools with higher caries level in FTKL. Nevertheless, further
improvement of the model is needed in order to create a more reliable indicator.
This study is conducted to compare two resin luting cements (Rely XTMARC,3M and Compolute™ESPE) on their microleakage with one composite inlay system (Filtek™ Z250 Universal Restorative Materials, 3M). Thirty conventional inlays, Class II MOIDO cavity with gingival margin I mm above the cementoenamel junction, were prepared in premolar teeth. The composite inlays were fabricated directly on the prepared teeth using layering technique. Fifteen of the inlays were cemented with RelyTMX ARC and fifteen with Compolute™ (ESPE). The specimens were kept at 370 C for 10 days before thermocycling and immersed in methylene blue 2% solution for 24 hours. The teeth were sectioned mesio-distally. The site and degree of leakage of each section was scored using a visual scoring system under a stereomicroscope at a magnification of 1.5X. Results showed that there was no significant difference in'leakage extent (p>O.05), between Rely X™ARC and Compolute™. For both materials, leakage occurred most commonly within the enamel surface and between the cement-tooth interfaces. None of the leakage occurred between inlay - cement interface. There is no significant difference in the extent of leakage between Rely XTMARC compared to Compolute™.
The construction of an electrical pain stimulator was described.
The parameters of pulse width and frequency on the quality of
pain stimulation was determined. The best design and construction
of the electrode for the stimulator was produced.
Simulated canals in clear resin blocks have been widely used in pre-clinical endodontic teaching. The artificial canal provides direct visualisation of procedures in root canal treatment. Stanuardised simulated root canals have been produced in the Faculty of Dentistry, University of Malaya for dental education and research. The canals are easy and inexpensive to construct. An outline of the method of construction of resin simulated canals is presented in this paper.