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.
Discovery of drugs from medicinal plants continues to provide major leads against various
pharmacological targets, particularly in cancer diseases. Hence, there are increasing demands to discover
more therapeutic agents from various species of medicinal plants. Chemical compounds in plants are
important for human beings due to their therapeutic properties. Goniothalamus umbrosus, Typhonium
flagelliforme, Myrmecodia pendens, Strobilanthes crispus and Clinacanthus nutans, are among the herbal
species, which are consumed by cancer patients in order to combat against the growth of cancer cells. The
present review aims to highlight on the anti-cancer properties of the listed Malaysian herbs.
Perivitelline fluid, extracted from the fertilized eggs of horseshoe crabs, has been reported to play a
vital role in supporting embryogenesis as well as cell proliferation. The present study aims to evaluate the effect
of PVF on the expression of COL1A1 in human dental pulp stem cells (DPSCs). The cells were grouped into two;
untreated (control) and treated with a single dose of PVF (0.019 mg/ml). Gene expression was quantified for
COL1A1 on day 1, 3 and 7 using reverse transcriptase PCR. The expression of COL1A1 on day 3 of treated
group with PVF was the highest though there was a decline of COL1A1 expression on day 7. Mann Whitney test
was utilized to determine the significance of COL1A1 expression between treated and untreated groups.
Significant difference in the expression of COL1A1 was observed between the treated and untreated groups on
day 3 though there was no significance in the expression on day 7. The present study indicates that PVF may
have the potential to increase cell proliferation in human DPSCs.
Dental caries is the main oral health problem in hearing-impaired (HI) children and remains the most neglected need. The present study aimed to determine caries prevalence and treatment needs in HI children and the association with salivary parameters. A cross-sectional study was conducted on 63 HI children aged between 7-14 years who attended a special school for the deaf. Clinical oral examination was done and salivary parameters (resting flow rate and resting pH) were measured. Caries experience was charted using the index of decay-filled teeth (dft) and Decay-Missing-Filled Teeth (DMFT) for primary and permanent dentition respectively. Data were analysed using SPSS version 12.0. The mean age was 11.5 (SD 2.39) years and 53.8% were female. Dental caries prevalence was 88.0% (95% Cl: 73.0, 100.0) in primary dentition and 85.0% (95% Cl: 73.0, 96.0) in permanent dentition. The mean dft was 6.1 (SD 4.14) and the mean DMFT was 4.9 (SD 3.28). The mean resting flow rate was 0.14 (SD 0.08) ml/min while mean pH was 6.8 (SD 0.79). Both pit and fissure sealants and restorations were the highest (83.1%) treatment needs. Only 3.1% of the children did not require any treatment. There were no significant association between both salivary flow rate and salivary pH with caries experience in the primary (p=0.342, p=0.610 respectively) and permanent (p= 0.99, p=0.70 respectively) teeth. In conclusion, children with HI have high caries prevalence and unmet need for dental treatments. Salivary pH and resting flow rate of the children were not associated with their caries experience.
This study aimed to assess the nutritional status (BMI), oral health behaviour, sugar consumption and the associated factors with dental caries among a group of 7 to 11 years old children in Kuala Lumpur, Malaysia. Three hundred and twelve students were recruited from February to July 2013. Information gathered were their socio-demographic characteristics, body mass index, sugar consumption, oral-health behaviour, oral hygiene index and decay-missing-filled teeth (dmft) index. Anthropometry measurements and sugar intake was measured using verified tools. Meanwhile, dmft was examined using the World Health Organization (WHO) criteria. 53.7% of the children were of the normal body weight with mean sugar consumption of 31.81±4.24 g/day. Prevalence of dental caries was reported at 44.6% (95% CI: 42.2, 53.3) with a mean (SD) dmft of 1.27(1.84). No association was found between dental caries and weight status distribution. Most children tend to brush their teeth 2 times or more in a day (75%), however, they spent lesser time in tooth brushing (5.4%) and do not practice flossing (78%). Regression analysis showed that age (p
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
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
Congenital epulis is a fairly rare soft tissue tumour occurring exclusively on the alveolar ridge of newborns. The exact origin of congenital epulis is still debatable. The objective of the study is to determine the clinicopathological features and immunohistochemical findings of congenital epulis. A retrospective study was carried out to determine the clinicopathological features of congenital epulis, diagnosed histologically in the main oral histopathology laboratory in Malaysia from 1967 to 2014. Immunostaining using vimentin, muscle specific actin, smooth muscle antigen, desmin, S100, CD34, CD68 and CD1a was carried out. Twelve cases of congenital epulis were reviewed. All of the patients were females and the presentation age ranged from 2 to 90 days. The patients comprised of 6 Malays, 3 Chinese, 2 Indians and 1 Orang Asli. Most of the cases (n=7) involved the maxillary ridge and presented as pedunculated well-defined lumps (n=8). Excisional biopsy was performed in all cases. Via immunohistochemistry, vimentin expression was observed in all cases; but negative for CD34, muscle specific actin, smooth muscle antigen, and desmin. CD1a and S100 positivity was seen in five cases. The interstitial cells were highlighted by CD68. Although congenital epulis has been first described 130 years ago, the exact nature of its histogenesis remains a mystery.
The practice of quack dentistry worldwide is a challenge to the profession of dentistry as it undermines the trust of the general public and places the patients at unnecessary risks through their illegal practices. Although the ratio of patients to dentists is rapidly decreasing in Malaysia due to the increased output of qualified dentists from both local and foreign institutions, quack dentistry is still practiced in many areas. This report intends to highlight a popular treatment prescribed by these quack dentists which is removable partial dentures that is fixed to the adjacent teeth by cold cure acrylic. We also aim to discuss the design of the denture and the means employed to remove this ’fixed partial denture’. It is hoped that this case report will highlight the prevalence of the practice of quack dentistry especially in geographical area of this case report and allow the authorities to devise means to stop this illegal practice.
Dermoid cysts are anatomic embryonic abnormalities that are rarely seen in the oral cavity. Histologically, they are further classified as epidermoid, dermoid or teratoid. We report a case in which an 18- year-old girl who developed an epidermoid cyst presenting as a large sublingual swelling occupying the entire floor of the mouth causing snoring and speech difficulty. We emphasized on the clinical steps in achieving an accurate diagnosis, possible differential diagnosis, necessary imaging techniques and management of epidermoid cyst.
Managing a patient with a huge intraoral mass is always challenging. Manipulation or even a simple biopsy of the mass may lead to hemorrhage and further compromise the airway. An examination under anesthesia is not without risk. The method of securing the airway itself may become an issue if the mass is fully occupying the airway before intubation. Usually a tracheostomy is indicated. We share a gentleman presented with a huge intraoral mass occupying the oropharynx, which initially necessitates tracheostomy. We utilized the ultrasonic scalpel-assisted instrument to biopsy by debulking the tumour, thus avoiding the tracheostomy while waiting for the definitive treatment.
Some of the beneficial bio compatible properties of hydroxyapatite [Ca10(PO4)6(OH)2]; the major componentand an essential ingredient of normal bone and teeth, are that it is rapidly integrated into the human body and will bondto bone forming in distinguishable unions. But, before new materials are approved for medical use, mutagenesis systems to exclude cytotoxic, mutagenic or carcinogenic properties are applied worldwide. This study aimed to detectany chromosomal aberrations induced by the synthetic hydroxyapatite granules [Manufactured by Universiti Sains
Malaysia, (USM) Penang, Malaysia] in the bone marrow cells of mice. The mitotic indices of the groups treated with synthetic hydroxya patite granules did not show any significant difference as compared to the negative control group treated with distilled water. Also the groups of mice treated with synthetic hydroxyapatite granules and distilled waterdid not induce significant change in chromosome aberrations as compared to the positive control group treated with Mitomycin C. The mitotic indices and chromosomal analyses indicate that under the present test conditions, synthetichydroxya patite granules (manufactured by USM) are non cytotoxic and do not induce chromosome aberrations in the bone marrow cells of mice.
his study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like
erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal displacement in the presence of crossbite was poor, and kappa statistic was incalculable for recording openbite and number of upper incisors rotated 30° or more. Kappa was also incalculable for recording IOTN dental health subcategory due to the creation of asymmetric tables caused by rarely chosen subcategory options. Despite prior agreement between previously calibrated examiners on evaluation criteria, detection of certain malocclusion parameters during an epidemiological examination can prove to be challenging. Epidemiological studies that report on prevalence of malocclusion in the population should always report on the kappa reproducibility, especially if the study is carried out by multiple examiners.
In the present case, granuloma formation and loss of tooth vitality following the use of bone wax in third molar surgery in a 16 - year- old male patient were reported. Endodontic and surgical treatments were carried out on the patient. As foreign body granulomatous reaction to bone wax is not uncommon in the literature review, alternative haemostatic agents should be taken into consideration to avoid any potential complications and untoward effects of using bone wax for haemorrhage control in surgical procedures.
Paediatric facial traumas are often accompanied by other intracranial and non-head injuries. Use of
Computed Tomography (CT) has increased diagnostic accuracy when compared to plain radiographs alone. Coexisting anomalies can sometimes be a chance finding from the imagings and this highlights the need of a formalreporting by a radiologist. We report a case of a traumatic unilateral condylar fracture with a coexisting life-threatening abnormality detected from careful assessment of the imagings.
Rubinstein-Taybi syndrome is a multiple anomalies congenital disorder characterised by broad thumb and halluces, facial dysmorphism with mental and growth retardation. Oral features include small mouth, retro and micronagthic jaws, highly arched and narrow palate. Dental anomalies such as teeth with talon cusps and screwdriver shaped permanent incisors together with crowded teeth are common features in these patients. Although hyperdontia is said to be one of the features of this condition, nevertheless, presence of multiple supernumerary teeth has never been documented. This report highlighted a case of an eleven-year-old boy with Rubinstein-Taybi syndrome referred for unerupted permanent incisors who exhibited multiple supernumerary teeth radiographically.
The purpose of this study was to assess the feasibility of the use of Index of Orthodontic Treatment Need (IOTN) on labial segment malocclusion in determining the need for orthodontic treatment among 8 to 10- year old children. Convenient sample of one hundred and six (106) children (54 boys and 52 girls) were examined extra and intra-orally. Their skeletal and dental discrepancies were assessed in all three dimension planes. Any presence of mandibular displacement was identified. The IOTN score was determined for each child. Respectively it was found that 39.6%, 49.1% and 11.3% of the children presented with skeletal Class I, Class II and Class III malocclusion(p
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
Hamartomatous polyps of the tonsil are very rare. They have been described using various terms such as a lymphangiomatous polyp, lymphangiectatic fibrous polyp, lipomatous polyp or pedunculated tonsil, thus the actual incidence is difficult to be quantified. We present a case of hamartomatous polyp of the palatine tonsil in a 30-year-old female presented with recurent tonsillitis. Histopathological examination of the resected tonsils showed features of chronic tonsilitis with incidental finding of hamartomatous polyp characterized by a polypoidal tissue covered by stratified squamous epithelium and composed of thin-walled blood vessels, lymphatic channels, fibrofatty tissues, seromucinous glands and striated muscle fibres. An unusual incidental histopathological finding of a rare condition has been discussed along with the review of literature.
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.