This study aims to determine the prevalence of hand-held ProTaper® files system among UKM final year dental undergraduates and to assess their perception in performing endodontic treatments.
Methods: 85 final year dental students from 2006/2007 academic session participated in the questionnaire survey. All students underwent didactic endodontic teaching of conventional stainless steel files throughout a 2-year course and a 2-day ProTaper® hand files seminar on canal preparation. Each student had a total of 6 months clinical period before the survey was distributed to the subjects and returned for data analysis.
Results: A 100% response rate was received. About 58.8% (n=50) used hand ProTaper routinely while 41.2% claimed themselves as non-users. Amongst the users, 52.5% were moderate users and about 33.6% were frequent users. Tooth type and size of canals were the selected criteria for file use. Majority of users used ProTaper® hand for posterior teeth and regarded it as user friendly. Although almost all users expressed concern of instrument fracture during use, very few did break. Procedural errors were not experienced by 51.3% users.
Conclusion: About 2/3rd majority of UKM undergraduate dental students use ProTaper® hand-held system as an alternative for canal preparation. Procedural errors were perceived to occur much less when using the NiTi files. The system can be initiated to novice users and can be taught as part of endodontic curricula.
There is a major concern about the increased use of antibiotics in dental practice and the emergence of resistant bacterial strains. In recent years, dentists have reported a shift from narrow-spectrum to broad-spectrum antibiotic prescriptions due to increasing antibiotic resistance. The aims of this study are to investigate the prescribing patterns of the therapeutic and prophylactic use for antibiotics in various dental situations by dental practitioners. The study also specifically investigates the prescribing habits of dental practitioners regarding certain cardiac conditions and related dental procedures in patients predisposed to infective endocarditis. This study utilized a questionnaire which was designed to investigate the antibiotic prescribing patterns by dental practitioners in the Klang Valley region. The returned questionnaires were analyzed using SPSS, to identify compliance to antibiotic guidelines by Malaysia National Clinical Guidelines (MNCG) (2003) and American Heart Association Guidelines (AHAG) (2008). 217 dentists responded to the questionnaire and the responses show that there is a wide variety of antibiotic prescriptions among dentists and there is also misuse of antibiotics in some clinical dental conditions. The results also show that there is a large variation in the antibiotic prescriptions patterns for prophylaxis against infective endocarditis. Furthermore, there is uncertainty as to which cardiac conditions required prophylaxis and for which particular dental procedures. This study concludes that there is a clear need for the development of prescribing guidelines, regular monitoring of antibiotic prescriptions by dental practitioners and educational initiatives to encourage the rational and appropriate use of the antibiotics.
Objectives: To evaluate the marginal microleakage of Class II cavities restored with various types of composite resins.
Materials and Methods: Standard Class II slot cavities were prepared at the proximal surfaces of 40 intact premolars which were divided into 4 groups. Four types of composite resins (Esthet-X-Denstply, USA, FiltekTMZ350- 3M ESPE, USA, Beautifil- Shofu, Japan and Solare P-GC, Japan) were used to restore the slot cavities. All the specimens were thermocycled and immersed in 0.5% basic fuschin dye for 24 hours. The specimens were then sectioned in mesio-distal direction. The marginal microleakage at the occlusal and cervical margin was scored using the ISO microleakage scoring system. Data was entered using SPSS Version 12.0 and analyzed using STATA software programme.
Results and discussion: All composite resins exhibited worse microleakage at the cervical margin compared to occlusal margin. Esthet-X showed significantly better microleakage score at the occlusal margin compared to Beautifil and Solare P. FiltekTMZ350 and Beautifil showed mainly microleakage into enamel only at the occlusal margin. Solare P demostrated better resistance against microleakage at the cervical margin compared to other composite resin tested. Esthet-X, Filtek Z350 and Beautiful is not significantly different from each other in terms of microleakage at the cervical margin.
Conclusion: This study showed that none of the materials used in this study is able to eliminate microleakage. Composite resin restorations exhibited worse micorleakage at cervical margin in comparison to occlusal margin.
Aim of the study: To compare the weight of retrieved food accumulated under the dentures base with and without adhesive treatment.
Materials and Method: Each subject was given 32 g of non-salted dry roasted peanuts to chew and swallow. After finishing all the peanuts, the subject was asked to brush their denture using toothbrush and toothpaste without removing the denture from the mouth and rinsed their mouth vigorously with water. The weight of the retrieved peanuts accumulated under the denture base collected, dried, and weighted. All procedures were repeated with denture adhesive.
Results: On average, the mean weight of peanuts particles recovered beneath upper dentures without application of denture adhesive was 51.21 mg which is higher than the mean weight of upper denture with adhesive treatment (35.36 mg). The similar pattern was detected for the lower dentures but at higher mean weight.
Conclusion: Application of denture adhesive significantly reduced the amount of retrieved peanut particles collected under the denture base compared to no-adhesive treatment (p< 0.005).
Adenoid cystic carcinoma (ACC) is a rare malignant tumor that arises within secretary glands, most commonly the major and minor salivary glands. It has a tendency for a prolonged clinical course, perineural invasion, with local recurrences and distant metastases. The three recognized histopathologic pattern of ACC are cribriform, tubular, and solid with the cribriform being most common. Standard treatment for salivary gland ACC is surgery and postoperative radiotherapy. We report a case of ACC of palate in a 30-year-old female and review the literature.
Compliance to delivery of orthodontic appliances within specified times and factors which influenced compliance by dental technicians in Selangor was evaluated. This is a prospective 8-month study of 18 trainee/ trained technicians from 4 main government dental laboratories in Kajang, Klang, Tanjong Karang and Shah Alam. Delivery times specified by orthodontists were 1 day for plastic retainer, 3 days acrylic retainer, 5 days active plates (URA), 10 days functional appliances (FA), 10 days transpalatal arch (TPA) and 10 days for quadhelix. Punctual delivery was recorded as ‘compliant’. Compliance was compared between appliances, clinics, technicians, orthodontists and seniority of technicians. The sample comprised appliances from 365 patients; 38 (10.4%) Tanjong.Karang, 114 (31.2%) Kajang, 191 (52.3%) Klang and 22 (6.0%) Shah Alam. The majority of appliances were retainers (66.3%), followed by URA (13.4%), functionals (9.3%), TPA (9.0%) and quadhelix (1.9%). Mean compliance for all appliances in Selangor was 55%. Plastic retainers had highest compliance (77.8%), followed by acrylic retainers (59.9%), quadhelix (57.1%), FA (47.1%), TPA (45.5%) and URA (24.5%). Senior technicians (>3 years in service) were more compliant than juniors (
Evaluation of the mechanical behaviour of restoration dental materials is essential to understand their performance under different load conditions and to estimate their durability under clinical oral function. Restorative materials and dental tissues like other materials by having specific mechanical properties, such as static strength (i.e. compressive strength, tensile strength, flexural strength) and dynamic strength (i.e. fatigue strength). The selection of proper mechanical test type depends on the goals that the study claims to define. On such basis, the mechanical test can be chosen correctly. Laboratory studies should be designed as replications of the clinical oral circumstances to measure the mechanical and physical properties of a material and any arbitrary choices in the design of the study may result in large variations of data.
Objective: To audit the amount and complexity of case load and the waiting time for orthodontic treatment in Orthodontic Department of Universiti Kebangsaan Malaysia (UKM).
Materials and Methods: This study involved three waiting list records in Orthodontic department, UKM and 484 patients’ record were selected using Random Sampling technique. Demographic data of the patients were noted. Data on date of patient’s visit to ‘Klinik Rawatan Utama’ (KRU), Screening clinic and first orthodontic treatment (removable/fixed) clinics were also recorded. The severity of referred cases were graded using complexity scale (Russle et al, 1999).
Results: Patients were mostly female (76%) with age ranging from 10 to 52 years old. 75% of the referred cases were complex cases. From the year 2002-2007, 35% were referred for removable and 65% were referred for fixed clinic. In average, orthodontic screening waiting time was 6.9 ± 2.5 month. Patient would received removable and fixed appliance treatment after 4.4 ± 1.0 months and 14.5 ± 9.8 months respectively.
Conclusions: Most patients were referred to fixed waiting list. The waiting time from 2002 until 2007 for orthodontic treatment in UKM was longest for fixed followed by screening. The shortest waiting time was for the removable treatment.
Study site: Orthodontic Department of Universiti Kebangsaan Malaysia (UKM)
Congenitally missing teeth creates significant challenges to the clinicians in both diagnosis and management. The need for interdisciplinary involvement is essential for optimum dental care. The purpose of this clinical report is to describe an interdisciplinary management of a 15-year-old adolescent presented with non-syndromic oligodontia. The principle of management is presented with special emphasis on prosthodontic aspects. Various restorative treatment modalities specified for oligodontia patients are outlined.
It is the aim of all clinicians to accomplish biological tooth movement, which implies the use of low, continuous force. Constant unrelented search for a better wire, which can deliver optimal orthodontic force, has led to the invention of a lot of orthodontic wires such as Stainless steel, Beta Titanium, Nickel Titanium and multi stranded wires. In this study, the loading and unloading properties of 0.016 inch, 0.016x0.022 inch and 0.017x0.025 inch dimensions of stainless steel, conventional NiTi, Super elastic NiTi, and TMA arch wires were determined by means of a modified three point bending test for two inter bracket widths of 5 mm and 6.5 mm for deflection of 1 to 3 mm. The applied forces dependence on cross-sectional size differs from the linear-elastic prediction in super elastic NiTi wires. The stainless steel wires had the highest force values on all the three dimensions and cross section. On loading and unloading, TMA wires had force values in-between stainless steel, conventional NiTi and super elastic NiTi. The conventional NiTi had much lower force values compared to stainless steel and TMA and were linearly progressing compared to Super elastic NiTi. On loading and unloading the super elastic NiTi had force values in the range of conventional NiTi and had constant forces on higher deflection. The studies showed that the force value was comparatively higher in 5 mm inter bracket width than the 6.5 mm inter bracket width for all the cross section and dimension of wires.
Medical emergencies or unexpected events are situations that all dental practitioners are trained to face, yet none hope they become a reality. Although they occasionally happen, the prevalence is rather low. This special article will touch on three aspects: before, during and after an unexpected event happening in a general dental practice. Emphasis will be given on the ‘during and after’ phases, which includes the activation of basic life support when necessary, and the documentation that a dental practitioner needs to prepare in the event of adverse outcome despite of efforts made to prevent and manage it.
Aim: Orthodontic treatment duration is variable and associated with many factors Very few studies looks at operator changes influencing treatment duration and outcome. This study aims to evaluate the influence of operator changes on treatment time and quality.
Methodology: This is a 4-year cross-sectional retrospective study of preadjusted Edgewise two-arch appliance cases treated by single/ multiple operators and finished/debonded by the author. 60 singleoperator (Group 1) and 82 multiple-operator (Group 2) cases were selected and the Peer Assessment Rating (PAR) Index was used to measure treatment outcome.
Results: Group 1 (2.31 years, SD.86) had statistically significantly shorter treatment time than Group 2 (3.25 years, SD1.23). Mean % reduction in PAR scores was high (88.7%), although single operators (92%) showed a slightly higher (p=.04) reduction than multiple-operator cases (86.2%). Post-treatment PAR score was slightly higher in Group 2 (4.6, SD5.4) compared with Group 1 (2.6, SD2.9). There was no significant difference in post-treatment PAR scores with operator changes from within and outside the clinic although there was difference in treatment duration (p=.0001). Possible predictors of treatment duration included number of failed/changed appointments, extractions and pre-treatment PAR. Multiple linear regression model showed significant association of treatment time with failed/changed appointments (p=.0001) and number of operators (p=.0001) although this contributed to 57.5% of possible factors (r=.762) .
Conclusion: Change of operator contributes to increased treatment time by 11.3 months. Although standard of treatment was high in both groups there was slightly better outcomes in single operators. The reduction in PAR score can be predicted more accurately in single operators.
In 2013, the Malaysian Education Blueprint (Higher Education) was developed by the Ministry of Education to guide the transformation process of the education system in this country for the next decade, starting from 2015 (1). The blueprint highlighted core aspirations for Malaysian higher education, which includes rapid expansion of research output and quality (1). This effort is in line with the nation's aspiration to uplift the standard of service provision among healthcare professionals, whose practice should advance on the essence of high quality scientific evidence.(Copied from article)
Full mouth rehabilitation of the severely collapsed dentition is one of the most challenging procedures in restorative dentistry. The treatment aims are not only to restore function with sustainable restorations and to provide patients with an aesthetic smile, but also to conserve the remaining dentition and maintain the health of supporting structures. This case report describes the complete oral rehabilitation of a patient with severely broken down dentition and loss of posterior support. Loss of posterior support will not only result in breakdown of remaining dentition in the anterior region due to occlusal overload, it also adds years to the patient’s appearance. A complete treatment plan was outlined involving multidisciplinary team treatment included sessions of oral hygiene instructions and re-assessments, a diagnostic stage with provisional overlay denture at an increased occlusal vertical dimension (OVD), endodontic treatment and retreatment, crown lengthening as well as implant surgery. Final restoration involved both fixed and removable prostheses. Maintenance review was carried out periodically after completion of treatment for two years and good outcome was observed.
Introduction: Cone beam computed tomography (CBCT) has gained interest for improving diagnosis, treatment planning and facilitating better patient’s management in various dental fields. This study is part of the quality assurance programme in Dental Faculty, International Islamic University Malaysia (IIUM). This center offers dental radiography service not only for internal clinics but also act as a referral center for the eastern areas, Pahang, Malaysia. Aims: The aims of this study were; 1) to assess referral pattern for CBCT scans at the Dental Faculty, IIUM, Kuantan, and 2) to evaluate the completeness of the current referral form used by clinicians (for both internal and external referrals). Methods: An audit looking at both the external and internal referral CBCT forms of a four year period of examination (2010-2013) at the Radiology Unit, Dental Faculty, IIUM. Source of referrals, indications for CBCT and the referral forms were examined and analysed. Results: Total CBCT scans taken within the four-year period were 171, in which 96 were referred from internal sources whilst 75 were external referrals. External referrals were mainly from Paediatric Dentistry and Orthodontic clinics (59%), while other referrals were from implant clinic (20%), Paediatrics and Special Needs clinic (15%), Oral MaxilloFacial Surgery clinic (4%) and Periodontic clinic (1%) and Oral Medicine Oral Pathology (OMOP) clinics (1%). All forms from external sources are completely filled. In the Internal referral form, 41% of them came with no indication of why CBCT need to be taken. Out of 59% of cases with indications, 33% came from Paediatric Dentistry and Orthodontic department, followed by Oral Surgery department (10%). Implant treatment planning accounted for 7% of cases, Periodontics 4%, Temporo-Mandibular Joint assessment 2%, 1% for Conservative dentistry and Prosthodontic cases respectively and 1% cleft case. Further analysis of the internal referral forms revealed that only 14% of the forms were filled with complete patients’ details, 40% specified pregnancy status and 67% clearly stated patients’ medical status. Area of interest was not specified in 69% of cases and clinicians’ names were not stated in 94% of the cases. Majority of the forms were completed with clinicians’ signature (99%) and also radiographers’ details (97%). Conclusions: This study indicated that the majority of IIUM CBCT referrals were from internal sources. However, most of the referral forms were not completely filled. The internal form used, therefore, need to be improved and a much firmer referral framework should be in place.
Forensic odontology has been an interdisciplinary part of forensic science for many years. In Malaysia, this forensic discipline has been practiced for more than two decades however it is still considered a new discipline as there are a limited number of specialists. To date, there are less than ten practicing forensic odontologists in Malaysia. Many dentists do not have a clear perception of this field, thus forensic odontology rarely becomes a career of choice. The purpose of this article is to highlight the attributes of a competent forensic odontologist and encourage dentists towards this challenging career path.
This study was conducted on Royal Malaysian Navy submariners who were having training in France. It was designed to compare the oral health experiences and practices while under water and on land. Methods Eightysix Royal Malaysian Navy (RMN) submariners, who had undergone at least one cycle (288 hours) of under water training, were selected to participate in a self-administered questionnaire survey. Results Seven percent of the respondents reported oro-facial pain and discomfort; 9.3% reported bleeding gums and 12.8% experienced halitosis while under water. Of those experience oral problems, 82% reported disruption of their daily activities while under water. The study showed that 82.5% of them brush their teeth at least twice a day and 94.2% rinse after meals when there were under water. Meanwhile studies on land showed that 90.7% of them brush their teeth at least twice a day and 96.5% rinse after meals. Flossing was not practiced by most of the respondents. Conclusion It is concluded that brushing and rinsing are practiced regularly by submariners regardless whether they are on land or under water but flossing is not a common practice both on land and under water. Dental emergencies, such as toothache, TMJ pain and discomfort do occur during submarine operations and disrupt their daily activities. This might poses a threat to submarine operations.
It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.
Aim: To assess the prevalence and clinical features of aggressive periodontitis in newly referred patients to the Periodontal Clinic in Seremban.
Methodology: Sample size calculation was done using Epi Info software with minimum sample estimated at 279. 583 new patients who were referred to this clinic from year 2013 to July 2015 were examined clinically and radiographically. Patients were diagnosed using American Academy of Periodontology workshop 1999 definition.
Results: Thirty-one (5.3%) patients were identified as having aggressive periodontitis with 28 (90%) of these patients exhibiting generalized form of aggressive periodontitis. Mean age of these patients was 34.9 years. In terms of gender and ethnicity, 21 females and 18 Malays were diagnosed with Aggressive periodontitis. First molars had the highest amount of clinical attachment loss (CAL=5.4mm). The number of missing teeth at the first visit was at median 2 (Interquartile range=4). The number of prognostically hopeless teeth at first visit was at median 1 (Interquartile range=2). Canines were preserved in most of the patients.
Conclusion: Aggressive periodontitis was found in 5.3% of our samples. It was diagnosed at mean age of 34.9 years old.
People with hearing and/or speech impairments (HSI) reported having difficulty communicating with the dental team, indicating the need for the profession to develop an effective communication strategy when dealing with these patients. This paper discusses the development of a toolkit designed to guide delivery of oral hygiene instruction, oral health education and dental consultation for patients with HSI, and how its use had resulted in an improved oral health outcome in a patient with such disabilities.