There is a wide variation in the morphology of third maxillary molar which can be difficult to be identified radiographically. We present a case of a 26 year-old Yemeni female patient presented with difficult extraction of her left maxillary third molar. The extracted tooth showed a rare variation of root morphology, having four roots with three roots curving palatally at the apices. This report emphasized the potential complex morphological variation of maxillary third molar which may lead to the difficulty of a routine straight forward procedure thus needing careful extraction maneuvering to prevent any complications.
Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which
aggravated her neuralgic pain.
A case of denture hyperplasia of the upper labial sulcus with concomitant oncocytic metaplastic changes is described. The patient concerned is an elderly male wearing an ill-fitting upper full denture.
An apartment complex collapsed in Malaysia killing 48 people trapped inside.The dental disaster victim identification team comprising of officers from the Kuala Lumpur General Hospital, Armed Forces and the Dental
Faculty, University of Malaya played a very active role in the identification process. Most of the bodies were badly decomposed and some grossly disfigured. Problems were encountered due to inadequate facilities and
equipments at the mortuary.Difficulties were also encountered during the procurement and deciphering of information from dental records. Suggestions have been made to improve facilities, expertise and also to create awareness amongst dentists to ensure proper recording of their patients' dental status.
Craniofacial superimposition methods are employed for the identification of unknown skulls or living persons. There are many such methods and of particular interest is that technique developed by Furue which is inexpensive to set-up. A study was undertaken to ascertain the validity of this technique and to correlate our findings with other researchers.
Dental fear is a hindrance to the effective provision of oral health care and causes patients to delay, or even avoid necessary care altogether. The aim of this study was to determine the prevalence and level of dental fear, to identify specific fear provoking stimuli and also to explore the avoidance behaviour among the respondents. A cross-sectional study was conducted on a sample of 407 antenatal mothers utilizing the Kleinknecht's Dental Fear Survey Questionnaire. The overall prevalence of dental fear was 94.1% of which 67.6% of the subjects reported low fear levels, 26.5% were moderately fearful while none were highly fearful. Only 5.9% of the subjects reported no fear. The drill and anaesthetic needle were identified as the most fear provoking objects. Subjects with moderate fear were about 6.4 times (OR=6.39; 95%CI 3.81-10.75) more likely to avoid making appointments and 6 times (OR=6.05; 95% CI 3.20-11.50) more likely to cancel appointments compared to subjects with lower levels of fear. This. study indicates that dental fear is a common problem among antenatal mothers contributing to poor dental attendance.
This study was undertaken to investigate the number and types (fluoride or non-fluoride) of toothpaste products available in the Malaysian market based on the label. Thirty-five brands of toothpaste were identified, of which ten (29%) were specifically recommended for children. Two of the children's toothpaste recommended that children below seven years old use a pea size amount of toothpaste. One (3%) was recommended for both children and adult. The remaining 24 (69%) did not state if they were recommended for either children or adults. To improve the flavour of the toothpastes, a variety of flavours had been added especially in children's toothpaste. Almost half of the toothpastes were for prevention of tooth decay and gum disease. Other indications were for tooth sensitivity, tooth whitening and stain removal. Twentyseven (77%) of the toothpastes were imported, while eight (23%) were made in Malaysia. Twenty-six (74%) of the toothpaste contained fluoride and the most common type of fluoride used was sodium monofluorophosphate (NaMFP). The fluoride concentration was not labeled in more than half (63%) of the fluoridated toothpaste. Of those that were fluoridated, different units of measurement were used. As there is no uniformity in the labelling of these products, it is recommended that the responsible authorities should take more action in enforcing proper labelling of the fluoride concentration in the toothpaste using standardized units.
The habit of chewing betel quid has been practised since ancient times. Although the world has gone through modernization, a significant proportion of people still practices this habit. Substantial evidence has shown that betel quid chewing is associated with the occurrence of oral cancer and precancerous lesions, which has a tremendous psychosocial impact on an individual's life. Thus it becomes significantly important to dentistry to look into this matter. Since betel quid chewing is one of the causes of oral cancer, effort in cha~ging this habit is essential. This article addresses this issue.
The preliminary investigation was carried out to assess the severity of malocclusion between two centres, the dental schools in Leeds, United Kingdom and Kuala Lumpur, Malaysia. A total of 99 study models were analysed using the Index ofOrthodontic Treatment Need (lOIN). Thestudy models were ofpatients aged 8to 15years, equally distributed between male and female patients taken from the undergraduate and staff clinics. Forty nine and fifty study models were analysed at the Leeds Dental School and FacultyofDentistry,University ofMalaya,respectively.Fromthisobservation, it appeared that the sample of patients treated at the Faculty of Dentistry, Kuala Lumpur presented approximately 25%higher with casesin the severe end of the malocclusion based on the dental health component and almost 70%more with the aesthetic component. Factors contributing to this finding are discussed.
Natural products have demonstrated various activities beneficial to general health. Flaxseed (Linum usitatissimum) has been reported in many studies for its antimicrobial, antioxidant, and anti-inflammatory effects. Additionally, flaxseed extracts have skin wound healing activity and potential for treating oral ulcers.L. usitatissimum was extracted using 70% ethanol via soxhlet method and gas chromatography mass spectrum (GC-MS) was used to analyze the components of L. usitatissimum extract. The crude flaxseed oil were applied to human oral fibroblasts (HOrF), and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to assess the cell viability after 24, 48 and 72 hours. Scratched HOrF cells were treated with crude flaxseed oil and healing was monitored per wound healing assay. GC-MS indicate that the major components present in L. usitatissimum oil extract are linolic, palmitic and oleic acid. L. usitatissimum crude oil extract showed high proliferation effect on HOrF cells at 24 and 48 hours, while the highest proliferation effect was recorded at 72 hours post-treatment. The wound healing assay results showed that healing activity of HOrF cells occurred as soon as 18 hours post-treatment when treated with L. usitatissimum crude oil extract. L. usitatissimum crude oil extract has proliferating and healing effects on HOrF cell line. Therefore, it can be considered as a potential promising oral wound healing agent.
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
The objectives of this study were to compare the microhardness, flexural strength and compressive
strength of a new bulk-fill composite (SonicFill™) to a conventional nanohybrid composite (Herculite
Precis) and an established bulk-fill composite (Tetric N Ceram). In addition, the depth of cure of the
two bulk-fill resin composites was also investigated. The materials were prepared and tested for the
mechanical properties following ISO 4049:2009. Microhardness and depth of cure were measured using
Vickers hardness tester. Compressive and flexural strength were tested using a universal testing machine.
To determine the depth of cure, microhardness of the bulk-fill composites were measured as a function
of selected depth of materials at 0.5 mm, 2.0 mm and 4.0 mm. Data were analyzed by either one-way
ANOVA or Friedman test. Analysis demonstrated that SonicFill™ gave the highest microhardness value
(101.8 + 4.6 VHN) compared to the other two groups. There were no significant differences among all
groups in flexural and compressive strength. The depth of cure decreased as the thickness of both bulkfill
composites increased. In conclusion, SonicFill™ showed favorable mechanical properties compared
to other composites tested. In both bulk-filled groups, microhardness value decreased as the thickness
of the composite increased. The polymerization of the bulk-filled composites was effective only at 2 mm
or less.
Oral lichen planus (OLP) which belongs to the spectrum of LP, is a commonly encountered
oral mucosal problem among patients seeking treatment in the Oral Medicine clinic. Its counterpart, oral
lichenoid reaction (OLR), which resembled OLP clinically and microscopically, is often encountered in
these patients as well. Although the various clinical forms of OLP/OLR are well-recognized, the disease
pattern in regards to lesion-active and lesion-free periods in these patients remains poorly characterized.
Thus the aim of this study was to determine the clinical and demographic profile of those patients with
active OLP/OLR lesions and compare them with those patients who are clinically lesion-free.
Materials and methods: The study subjects comprised 20 patients who attended the Oral Medicine
Clinic at the Faculty of Dentistry, University of Malaya for follow-up appointments/management. They
were interviewed according to a pre-designed questionnaire, and clinical examination was carried out. All
these were conducted under the supervision of Oral Medicine specialists. OLP was diagnosed according
to the internationally accepted criteria.
Results: The cohort consisted of predominantly female (n=14; 70%) and Chinese (n=9; 45%) patients,
with an overall age range of 26-79 years (median, 56 years). Fifteen (75%) patients presented with
active OLP/OLR lesions and the remaining 5 (25%) were lesion-free. The lesion-active group comprised
3 (15%) males and 12 (60%) females whereas the lesion-free had 3 (15%) males and 2 (10%) females.
Reticular LP was the most common type (n=21/35; 60%) and the gingiva was the most prevalent site
(n=21/46; 45.65%). Social habits, medical histories and medications were not significantly different
between lesion-active and lesion-free OLP patients.
Conclusions: Findings suggest that demographic parameters, lifestyle and systemic diseases do not
appear to influence the disease pattern and lesion severity in OLP.
The study aimed to evaluate the quality of the hybrid
layer form by three different adhesive systems. Class V
cavities were prepared on the buccal surface of fourty
extracted human premolars. The prepared teeth were
randomly assigned into four groups according to the
adhesive system and application mode. The systems
were: Optibond S (OS, total-etch); Optibond Versa (OV,
two-bottles, self-etch); Single Bond Universal (SBU,
one-bottle, self-etch) and Single Bond Universal with
etchant (SBU + etchant). All cavities were restored with
composite (Filtek Z350XT). The samples were sectioned,
polished and pretreated to remove minerals, protein
and water prior to SEM evaluation. From the images,
thickness of the hybrid layers was measured. Present of
resin tags and adaptation failure were also recorded. The
data obtained were analyzed using ANOVA, Dunnett’s
T3, Kruskal-Wallis and Mann-Whitney tests. OS group
showed the highest average hybrid layer thickness (4.34
µm), followed by SBU + etchant (3.06 µm), OV (1.91 µm)
and SBU (0.95 µm). Both adhesive and cohesive failures
were observed in SBU group. Present of prominent resin
tags were seen in both OS and OV groups. In conclusion,
all the investigated adhesive systems were able to perform
distinguishable actions as shown in micro-morphological
alteration and hybrid layer thickness. Two-bottles, selfetch
adhesive (OV) was proven to produce negligible
adaptation failure compared to other adhesive systems in
the present study. Combined all-in-one adhesive (SBU)
was found to render a superior bonding performance in
total-etch mode comparing to self-etch mode.
The root canal walls of twenty -five deciduous molar teeth with exposed and necrotic pulps were examined using thescanning electronmicroscope. Immediately after extraction, all teeth were fixed in Kamosky's solution. The coronal portion of the tooth was sectioned at about 2mm above the enamel cemental junction.The mesial and distal roots were separat~d and either split in the mesio-distal or bucco-lingual direction. All specimens were prepared for SEM. Obsevations showed that all roots were infected with organisms consisting of cocciand short rods. Some of the coccihad penetrated the dentine layer. However, the distribution of organisms is. not uniform throughout thecanals. Bacterialinvasion ismostinthecoronal region and reduces towards the apical region: Accompanying bacterial invasion is root canal walls deterioration. The odontoblastic processes are the first to deteriorate followed by the predentine layer.
Prescription of flexible denture (FD) is non preference by the clinician in Ministry of Health Malaysia and it was not included in the curriculum of public university. However, among private dental practitioner (PDP) this treatment modality is highly favourable. Therefore, this study was conducted to assess the level of knowledge and perception on the flexible dentures by the PDP. The level of perception and knowledge on FD was analysed using validated questionnaire. 42 PDP had participated. An independent t-test was employed to determine the statistical difference between genders. One Way ANOVA was used to evaluate the statistical difference between their years of experience in private sector on knowledge and perception of flexible denture. There was no significant different in knowledge between female and male (p=0.892) and years of experience (p=0.617). Perceptions of flexible denture, was not significantly influence by genders (p=0.068) but by year of experiences between group A and B (p=0.039), and between group B and group C (p=0.039). P value was set at 0.05. In conclusion, there is a correlation between perceptions of flexible denture and years of experience of private dental practitioner.
The objectives of the study were to determine the normal dental arch width of Malays, their correlation with
the facial framework and the ideal size of orthodontic impression trays that fit the dental arch. Eighteen adult
Malays with normal Class I occlusion were evaluated. Arch width was measured on each subject’s dental
cast. Direct anthropometric measurements were taken for 8 facial landmarks. Orthodontic impression trays
were tried on each subject’s dental cast to determine the best fitting tray. Correlations analysis was made
between the arch widths and the best fitting impression trays used and also with various craniofacial
anthropometric measurements. The eight measurements from the craniofacial region were compared
with the maxillary and mandibular intercanine, interpremolar and intermolar widths. In the maxillary arch,
there were significant correlation between the face width and the interpremolar and intermolar widths
respectively, while in the mandibular arch, significant correlations were noted between the mandible depth
and the interpremolar and intermolar widths respectively. The most common fitting impression tray was size
6 for the upper jaw and size 5 for the lower jaw. There was a significant correlation between the maxillary
intercanine width and the size of the impression trays. The significant correlation between upper and lower
interpremolar and intermolar widths and the anthropometric measurements of this Malay population may
assist in predicting arch expansion to achieve Class 1 occlusion during orthodontic or maxillofacial surgical
treatment. The significant correlation between the upper intercanine width and the size of impression tray
can be a useful parameter when determining the size of impression tray.
To explore the phenomenon of tongue piercing in Klang Valley. Semi-structured in-depth interviews were
conducted with piercers and those who had their tongue pierced (“piercees”) in Klang Valley. Five piercers
and eight piercees were interviewed. Piercees had their tongue pierced at age 16-25 years. Three main
reasons for tongue piercing were to enhance appearance, express their individuality, and out of curiosity.
They reported that they experienced various immediate and late complications. However, most were aware
of and expected the complications. The majority of piercers reported adequate infection control procedures
and enquired about the client’s health prior to piercing. Although some clients reported problems, such
reports were rare. Tongue piercing is an invasive procedure with some risks, but precautions such as
proper infection control procedures minimize the likelihood of encountering serious problems. The reasons
for tongue piercing varied between individuals. Although the majority of the interviewed piercers reported
cross-infection control, their knowledge of the medical risks associated with tongue piercing varied widely.