This paper describes the use of stereophotogrammetry approach to measure and hence identify accurately threedimensional (3D) coordinates of important landmarks on a craniofacial surface. A "novel" technique dubbed as "natural features" technique was employed to accurately compute the 3D coordinates of selected craniofacial landmarks. The natural features technique involves the use of 3D coordinates of the natural features (such as acne, scar, corners of eyes, edge of mouth, point of chin, etc.) that appear on the craniofacial surface as an absolute stereophotogrammetric mapping control points. The 3D coordinates of the natural features were gained using digital photogrammetric bundle adjustment method. Validation of the proposed technique has firstly been carried out using mannequin and finally, it was applied on the real-life human faces. The result shows that the craniofacial landmark measurement accuracy of 0.8mm with one standard deviation can be successfully achieved by the proposed technique.
The objective of this survey was to evaluate the knowledge of final year dental and medical students of Universiti Sains Malaysia concerning epidemiology, aetiology, clinical aspects, prevention, early detection and treatment of oral cancer and oral potentially malignant disorders (OPMD). A pre-tested, self-administered questionnaire with 36 questions was used. Forty five dental students and 147 medical students participated in the study. Dental students were relatively better informed than their medical colleagues concerning most issues addressed in the questionnaire. Yet, in some areas of knowledge, the dental students did not differ significantly from their medical colleagues. Only a small proportion of both groups of students expressed confidence in their knowledge and skills in oral cancer prevention and detection. This study revealed areas of deficiency in the awareness of these students concerning oral cancer and OPMD. It points to a necessity to strengthen these aspects of medical and dental undergraduate curricula.
Epidemiological studies of occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the aetiology of malocclusion. The objective of this article was to give an overview on occlusion, malocclusion and the various methods on measuring the occlusion. Each index and method of the assessment described was based on the opinion of an individual or a group of individuals. It had been widely agreed that no particular index or method available that are truly inclusive of all occlusal criteria. Therefore, different indices or method had been developed according to different requirements and it may be necessary to use more than one index in order to gather information to suit the objective of the particular study.
This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 - 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.
The objective of this study was to evaluate and compare the effect of times elapsed on the application of a single-step adhesive system and activation of light cured subsequently placed composite to the bond strength between composites and adhesives. This was an experimental study using fifteen teeth extracted human premolars, which were caries and pathology free. Sample of teeth were embedded up to cemento-enamel junction on box of acrylic resin. All teeth were cut to obtain flat occlusal dentin surfaces. The specimens were randomly selected and divided into three groups with five teeth each. All the teeth were assigned to single-step bonding system AQ Bond (Sun Medical Co. Ltd., Shiga, Japan) according to manufacturer’s direction. Group 1 was left for 45 seconds, group 2 for 2 minutes, while group 3 was 5 minutes before putting subsequently restorative material. Composite resin was applied in 3 mm diameter and 6 mm height of cylinder mold and cured according to manufacturer’s direction on the dentin surface. Shear bond strength were measured using a testing system (Instron 8874, Instron Corp., Canton, MA, USA) at a crosshead speed of 2 mm/min with cell load capacity of 25 KN. The bond-strengths between single step adhesive system (AQ Bond) and light cured composites were tested. Mann-Whitney test showed no significant differences in bond-strength between Group 1 and Group 2. However, there were significantly differences (p
This study was to determine the sociodemographic and clinicopathological factors that were associated with mortality of OSCC patients managed at Hospital USM. The prevalence of high-risk human papillomavirus (HPV) in these patients and its association with epithelial proliferation rate were also determined. A retrospective study was conducted whereby medical records of patients diagnosed with OSCC and tissue specimens from 2005 to 2015 were studied. Formalin-fixed paraffin-embedded (FFPE) tissue specimens were evaluated for histological grading of OSCC, p16 overexpression and Ki-67 immunostaining. Descriptive statistics, simple and multiple logistics regressions were used for data analysis. Prognostic factors for mortality includes male gender (AOR=10.89; 95% CI: 1.99, 59.65; p = 0.006), alcohol consumption (AOR = 16.45; 95% CI: 1.36, 59.65; p = 0.028), not receiving treatment (AOR = 5.88; 95% CI: 1.03, 33.61; p = 0.046) and late stage (T3, T4) at presentation (AOR = 4.85; 95% CI: 1.12, 21.02; p = 0.035). Significant association was found between high-risk HPV positivity and higher epithelial proliferation rate expression (p < 0.003) in the OSCC tissue specimens.
The aim was to study the prevalence and sociodemographic features of odontogenic, non-odontogenic and salivary glands lesions among patients seen in Hospital Universiti Sains Malaysia. This information is essential to assist clinician in formulating reliable differential diagnosis of such lesion. Data on patient demographics, lesion location, tissue of origin and microscopic diagnosis were extracted from the Laboratory and Diagnosis record registries for biopsy specimen accessioned from year 2000 to 2012. This data was subsequently analyzed based on World Health Organization Classification of Head and Neck Tumours (2005). A total of 748 cases were included in the study. Out of the total number of cases, 367 cases were males and 377 cases were females. Ninety seven cases (13%) were of odontogenic origin, while 90 cases (12%) and 197 cases (26%) were of non-odontogenic and salivary gland origin respectively. Forty five percent of cases involved oral mucosal lesions. The most prevalent odontogenic lesion reported within the twelve years period was radicular cyst and ameloblastoma. Non-odontogenic bone lesion was rarely encountered with it making up less than two percent of total cases reported. Pleomorphic adenoma was the most prevalent benign salivary glands neoplasm reported within similar time period.
Intraclass correlation coefficient (ICC) measures the extent of agreement and consistency among
raters for two or more numerical or quantitative variables. This review paper aimed to present several tables that
could illustrate the minimum sample sizes required for estimating the desired effect size of ICC, which is a
measurement of the magnitude of an agreement. Determination of the minimum sample size under such
circumstances is based on the two fundamentally important parameters, namely the actual value of the ICC and
the number of observations made by each subject. The sample size calculations are derived from Power Analysis
and Sample Size (PASS) software where the alpha and minimum required power is fixed at 0.05 and higher than
0.80 respectively. A discussion on how to use these tables for determining sample sizes required for each of the
various scenarios and the limitations associated with their use in each of these scenarios is provided.
Prevalence of dysphagia is one of the important epidemiological data which will contribute to the proper planning and support the setting up of a swallowing rehabilitation clinic at this hospital. The present study aimed to determine the prevalence of dysphagia in patients with head and neck cancer (HNC) at Hospital Universiti Sains Malaysia (Hospital USM) from 2001-2010. In this institutional retrospective study, a total of 66 records were obtained comprising of 86.4% Malay patients, 9.1% Chinese, 1.5% Indians, and 3% other ethnic groups. These data were taken from the database of HNC patients seen at the dental clinic, Hospital USM between 2001 and 2010. Difficulty swallowing, frequent coughing during meal, choking, diet modification, and non-oral nutritional support were identified as signs and symptoms associated with dysphagia. Results showed that 59.1% of patients have had dysphagia before, during, or after the treatment of HNC. Data from the present study would be instrumental in increasing awareness among clinicians involved in patient care and it may help in planning the outline of management of dysphagia. Furthermore, it is anticipated to have implications for further research in swallowing and dysphagia.
Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Ameloblastoma is a slow growing benign tumour of the jaw and patients usually present late after the tumour achieved considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and characteristic findings on plain X-rays does assist in differentiating between types of ameloblastoma. The challenges in the management of this tumour are to provide complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect in order to give reasonable cosmetic and functional outcome to the patient.
Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of
pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of
nasopharynx. Nasopharynx’s obstruction, recurrent infection or trauma may exacerbate mucous secretion
by the potential space lining. Although rare and is usually symptomless, it is not uncommon for the patients
to have some nasal, ear, cervical or oral symptoms. We report a case of Tornwaldt cyst with rare
associated dental symptoms. The patient’s initial presentations were dry mouth, cheek biting, post nasal
drip and few nasal symptoms including frequent snoring, sleep apnoea, mouth breathing, sneezing, sore
throat and itchiness. These symptoms were tremendously and immediately relieved once the cyst was
surgically removed.
This is a cross sectional study to determine the attitudes and practices in smoking cessation counselling among dentists in Kelantan and to identify the barriers that prevent them from doing so. Self-administered questionnaires were distributed to 152 dentists practising in Kelantan. A total of 84 (55.2%) questionnaires were completed and returned. Although majority of the dentists (98.8%) agreed that they have a role in smoking cessation counselling, only few of them (17.9%) were actually involved in a considerable extent. The main barriers cited were lack of training and time in their practice. In conclusion, dentists in Kelantan believed that they have a role in smoking cessation counselling but their involvement was rather limited.
Light intensity output is one of the determinants for adequate curing of visible light-cured materials. The aim of this survey was to evaluate the light intensity outputs (LIOs) of light curing units (LCUs) in dental clinics of Hospital Universiti Sains Malaysia (HUSM) and School of Dental Sciences, Universiti Sains Malaysia (USM). The respective LIOs of all functioning Quartz Tungsten Halogen (QTH) and Light Emitting Diode (LED) LCUs were tested using two light radiometers. For cordless LED LCUs, the testing procedure was done in situ and after being fully charged. Statistical analysis using Kruskal Wallis and Wilcoxon signed ranks tests were performed to compare the LIOs between groups and between the LIOs of in situ and post-charged cordless LED LCUs, respectively. The level of significance was set at 0.05 (p
Sialolithiasis is one of the commonest disease of salivary glands. Submandibular salivary gland
or its duct is a major site of sialolithiasis and it is always leads to sialadenitis. However large sialolith
formation and self-extrusion is a rare condition. A case of submandibular sialolithiasis is reported where
patient presents with recurrent submandibular swelling and subsequently end up with a spontaneous
extrusion. The mechanisms and management of the salivary gland calculi are also discussed.
The objectives of this study were to determine the normal mean value of the root-crown (R/C ratios) in Malay patients and their variations by gender and dental arch from orthopantomogram radiographs (OPGs). Two thousand nine hundred and twenty teeth with fully developed roots were measured from 112 OPGs. Subjects with history of maxillofacial trauma or orthodontic therapy were excluded. The mean age of the subjects was 19.1 (SD 2.08) years old for males while females 18.9 (SD 2.19) years old in the range from 15 to 22 years old. The intra-examiner reproducibility of the assessment method was good (Intraclass correlation coefficient 0.81). Results of this study showed that there was no significant difference between R/C ratios of males and females groups. However, the ratios of the antagonist teeth for both males and females were significantly greater in the mandible than in the maxilla (p
Study site: Dental clinic, Hospital Universiti Sains Malaysia
Cephalometric analyses using computer software have more advantages than manual analyses. However, the software should be evaluated for the accuracy and reproducibility before it can be used. The aims of the present study were: 1) to compare the differences in accuracy and precision between utilizing scanned images and soft copy images with the software 2) to assess the reproducibility of software and manual cephalometric analyses. Fifteen cephalograms were selected randomly from the Record Unit, Hospital Universiti Sains Malaysia. All films had 10 fiducial points marked and were scanned at 75 dots per inch (dpi) and 300 dpi. Manual and digital measurements were compared to obtain magnification factors. Seven digital x-ray images of a caliper were taken. The mean differences were measured between the fixed caliper measurement and digital measurements. Subsequently, 37 cephalograms were traced manually and digitally with Computer-Assisted Simulation System for Orthognathic Surgery (CASSOS) software to assess its accuracy and reproducibility after applying the obtained magnification factor. Steiner analysis was utilized and T tests were used to evaluate the mean difference. P
Resin-bonded fibre-reinforced composite bridges provide many advantages over the conventional
bridges or implant treatment in the management of a traumatically or congenitally missing anterior tooth.
Furthermore, there is an increasing demand towards providing a metal free resin-bonded bridges over the alloybased
restorations in order to meet the aesthetic needs especially in the anterior region. Advances in the
adhesive technology and tooth colored materials offer improved bonding system and better aesthetic outcome.
Nevertheless, careful selection of cases to receive this type of approach is also one of the key factor to ensure
the clinical survival of fibre-reinforced composite bridges. This report aims to present the use of fibre-reinforced
composite to construct indirect cantilever fibre-reinforced composite bridges as part of minimum intervention
dentistry.
Primary intra-osseous squamous cell carcinoma (PIOSCC) is a rare tumour which occurs centrally
within the jaws. It is believed to arise from odontogenic epithelial remnants or from pre-existing odontogenic
cysts/tumours. A case of PIOSCC arising from an odontogenic cyst in a 57-year-old female is discussed.
Initial clinical and radiographic examination was suggestive of an odontogenic cyst / cystic tumour. The
lesion was enucleated and sent for diagnostic histopathology which revealed the presence of an invasive
carcinoma arising from the walls of the odontogenic cyst. The patient then underwent right mandibular
resection and reconstruction as well as right supra-omohyoid neck dissection. Long standing odontogenic
cysts have the potential to undergo malignant transformation though this may not always be the case.
Relying only on radiographic findings for the management of cyst-like lesions without obtaining
histopathological diagnosis is extremely ill-advised.
Fluorosis is important to measure because it is a condition that can be used as biomarker for the level
of fluoride exposure during enamel formation. Increased and decreased in fluorosis prevalence may also reflect
to the different ways of measuring the disease. The choice of measuring fluorosis is depends on the objective of
the assessment such as assessing public health significant of fluorosis in the population or assessing the detailed
of biological effects of fluoride. These differences in requirement have led to the adoption of many indices and
assessment methods of enamel fluorosis, which subsequently led to evaluation of examiner agreement between
them. Several indices were developed to measure dental fluorosis in the 20th century. These include fluorosis
specific indices such as Dean’s Index; the Thylstrup and Fejerskov Index; the Total Tooth Surface Index; and the
Fluorosis Risk Index. Non-specific descriptive indices such as the Developmental Defects of Enamel index have
also been used to record fluorosis. Fluorosis has most commonly been recorded using clinical examinations and
photographs. Recent developments have seen the use of a Visual Analog Scale and automated grading systems
such as Quantitative Light Fluorescence emerge as possible enhancements to fluorosis scoring. This article aims
to review existing indices and new methods in measuring dental fluorosis, together with examiner reliability
across different methods and indices.
A tick in the ear is a very painful condition and removal is difficult because it grips firmly to the external auditory canal or tympanic membrane. Facial paralysis is a rarely reported localised neurological complication of an intra-aural tick infestation. The pathophysiology of localised paralysis is discussed, together with the safe way of handling patients with an intra-aural tick infestation.