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.
Introduction: The peer assessment rating (PAR) index was used to self-audit 4 years of completed pre-adjusted edgewise appliance cases treated by a single orthodontist in a government clinic. The objectives of this study were to evaluate orthodontic treatment standards and factors which may influence treatment outcomes and treatment time.
Methodology: Pre and post-treatment study models were scored using the PAR index by the author. 17 models were re-examined for intra-examiner reliability using intra-class correlation coefficient (ICC). ICC was excellent for pretreatment (0.96), post-treatment (0.98) and reduction in PAR (0.96) scores.
Results: There were 173 cases (51 males; 122 females) with mean age 17.6 (SD 5.75) years. Mean treatment time was 18.6 (SD 6.47) months with range between 5-40 months. There was no statistically significant difference between one-arch and two-arch cases and between routine and compromised cases. Treatment time in extraction cases (mean 19.5, SD 6.17) was significantly different (p=0.000) compared with non-extraction cases (mean 11.6, SD 4.10) although this accounted for 15% of the variation only (r=0.388). 76.3% cases were ‘greatly improved’, 22.0% ‘improved’ and 1.7% ‘worst/ no different’. Mean pretreatment, post-treatment and reduction in PAR score was 34.1(SD 9.68), 6.4 (SD 6.84) and 27.9 (SD 9.69) respectively. Mean percentage PAR score reduction was 82.0% (SD 1.96). Pretreatment (p=0.000), post-treatment (p=0.000) and reduction (p=0.489) in PAR scores was significantly different between routine and compromised cases. There was significant difference (p=0.000) between category of improvement and pretreatment scores but not with treatment time.
Conclusion: Severe malocclusions had larger reduction in PAR scores and required longer treatment time. Extraction cases took longer to complete and routine cases had better outcomes than compromised cases with severe skeletal discrepancy.
Introduction: There is generally inconsistent appropriate orthodontic referral among local dentists. Orthodontic indices are not routinely used to assess the need for treatment. The aim of this pilot study is to evaluate the efficacy of the Index of Orthodontic Treatment Need (IOTN) as an educational tool to improve their ability to assess orthodontic treatment need.
Methodology: Local dental officers assessed 30 study models on two occasions (before and after IOTN training) and their findings compared with an expert group for agreement in IOTN scores and referral decisions. Training comprised oral/visual presentation, instruction manuals, ‘hands-on’ and self-study. Kappa statistic (?) was used to assess agreement.
Results: As a group there was no significant improvement in referral decisions after training with only ‘moderate’ agreement (?=0.47), although half of the subjects improved. Agreement was better with aesthetic (?=0.51) than functional (?=0.41) assessment. ‘Sensitivity’ was 82.4% and ‘Specificity’ was 58.2% but both were not statistically significant before and after training.
Conclusion: The IOTN has potential as an educational tool for improving the diagnostic skills of dental officers. More accurate assessment of the Dental Health Component with the IOTN ruler and familiarity with the Aesthetic Component has to be emphasized in future training.
Certain beverages e.g. coffee, tea, soft drinks, fruit juices, alcoholic beverages, may affect the physical properties of composite resins. Objectives: The objectives of this study were to: (1) evaluate the effect of different beverages and chilli sauce on the wear resistance of composite resins, (2) evaluate effect of the duration of immersion in the beverages and chilli sauce on the wear resistance of composite resins.
Materials and methods: Disc specimens were fabricated using two different types of composite resins: (i) Filtek Z350 (3M ESPE, USA, nano-filled composite, 40 specimens) and (ii) Solare P (GC Dental Products Corp, Japan, microhybrid composite, 40 specimens). After polymerization, all the specimens were polished using Enhance Polishing System (Dentsply International Inc.,USA). The specimens were air-dried before weighing using Sartorius BP 221S weighing balance (Sartorius AG, Goettingen, Germany). Ten specimens from each type of composite were immersed in distilled water (control group), Coca cola®, orange juice (Peel Fresh®) and chilli sauce (Maggi®) respectively. The duration of immersion was 6 hours and 1 week. A reciprocal compression-sliding system was used to evaluate the wear resistance of the specimens. The specimens were moved back and forth with a loaded counter-body (235g) against sand paper (P1000, 3M ESPE, USA) in running water. The weight of the specimens were measured after 6 hours of immersion and 20,000 wear cycles and also at 1 week of immersion with further 20,000 wear cycles. The wear resistances were tabulated as percentage of weight loss from the specimens. Results were statistically analyzed using one way ANOVA and post-hoc Tukey’s test (p= 0.05).
Results: The results showed that Solare P has significantly lower wear resistance compared to Filtek Z350. There was no significant difference in wear resistance for Filtek Z350 when immersed in chili sauce, Coca-cola® and orange juice in comparison with control group for 6 hours and 1 week. Similar findings were observed for Solare P.
Conclusion: Within the limitations of this study, it was concluded that Solare P has poorer wear resistance than Filtek Z350. The soaking medium investigated and duration of immersion have no influence on the wear resistance of Solare P and Filtek Z350.
This clinical case report describes an aspect of restorative management of worn teeth. It illustrates the use of diagnostic overlay removable partial denture or DORPD, which has the same function as occlusal splint but with advantages of providing immediate aesthetic improvement and function.
The aim of the study was to assess the potential role of dentists as smoking cessation counsellors in their practice. The target group comprised of all public and private sector dentists in the Federal Territory of Kuala Lumpur (FTKL) and Selangor. Data were collected via a twenty-six item questionnaire which was mailed to 831 dentists. A response rate of 67.1% was obtained. Results revealed that the majority of the respondents (97.8%) perceived that in addition to providing oral care, dentists should also be interested in their patients’ general health. Generally, about two-thirds of dentists (69.1%) and especially those from the public sector (76.4%) considered that they have an important role to play as smoking cessation counsellors. However, less than half of the respondents (40.3%) perceived that patients do not expect smoking cessation advice from their dentists. Yet, more than half of the respondents (55.1%) provided advice or helpful hints in order to motivate their patients to quit smoking. About 65% of the overall respondents did explain to their patients regarding the health risk due to smoking and its detrimental effects. Perceived obstacles to smoking cessation include lack of information between dentistry and smoking cessation (86.1%) followed by lack of training and lack of time.
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 (
Gingival overgrowth is a well-recognized unwanted effect associated with three major drugs / drug groups - phenytoin, cyclosporine and the calcium channel blockers. Cyclosporine is the first-choice immunosuppressant for preventing allograft rejection in patients who have received organ or bone marrow transplants. This report aims to highlight a case in which the patient on cyclosporine therapy had also contracted Hepatitis C virus infection.
The aim of the present study was to assess the current approaches and philosophies pertaining to direct restorations, bleaching and root canal treatment amongst general dental practitioners (GDPs) in the Klang Valley, Malaysia. A questionnaire, together with a stamped addressed envelope and an explanatory letter, was sent to 200 GDPs in the Klang Valley in April-July 2005. The GDPs were selected at random. A total of 153 (76.5%) of the GDPs responded to the survey. 46.4% of the respondents stated that the use of amalgam was decreasing whereas 79.7% stated an increase in the use of composite resins. Clinical indication (85.6%) and patients’ demand for aesthetics (73.9%) appeared to be the main factors influencing the choice of restorative materials. Fractured restorations was the main reason for the replacement of amalgam restorations (77.1%) whilst secondary caries was the main reason for the replacement of composite resin restorations (73.9%). Almost two thirds of the GDPs surveyed provided chair side bleaching while 75.8% of the GDPs would supervise home bleaching. Sodium hypochlorite was the most common endodontic irrigant used amongst the GDPs surveyed and cold lateral compaction was the most commonly used obturation technique.
Collaborative learning: a peer group teaching in oral hygiene instructions activity
Introduction: The objectives of this survey were to investigate whether an oral health education activity through collaborative learning and peer group teaching by students would give a positive impact and to evaluate its effectiveness, sufficiency and relevancy of the activity content.
Methods: Three third year dental students in each group were assigned to demonstrate to their group mates the myriad of oral hygiene device for plaque removal and how they are used. Fifteen students were appointed each as a ‘toothbrushing specialist’, ‘flossing specialist’ and interdental toothbrush specialist’ respectively. The others acted as participants in the group. The students then teach each other in the group on how to use these oral hygiene measures. A self-administered questionnaire assessing the activity outcome was given to fifty-two third year dental students who attended the demonstration. The data were entered in the computer using the SPSS version 12.0 for analysis.
Results: Overall response rate was 100%. Slightly more than half of the students felt confident to teach their patients effective toothbrushing and flossing and able to indicate the usage of interdental toothbrush. Most of the students preferred a small group teaching rather than a larger one. The result shows that student’s knowledge, attitudes and practices on effective oral hygiene has gained.
Conclusion: Collaborative learning in the clinical environment appears to give positive impact on the dental student’s ability to impart oral health education to their patients.
The prevalence of periodontal abscesses in emergency dental clinics was found to be between 8%-14%. The purpose of this study was to study the clinical features of periodontal abscesses seen in a specialist periodontal unit. There were 14 patients with equal distribution of gender. The mean age was 39.6 years. Twelve upper teeth (86%) were found to be involved as compared to two lower teeth (14%). There were more posterior teeth involved, a total of nine teeth (64%) as compared to five anterior teeth (36%). The mean pocket depth associated with the abscesses was found to be 7.4mm. There were ten buccal sites (71%) as compared to four palatal sites (29%). Average temperature of patients was 36.9° C. Only one patient was found to have cervical lympadenopathy (7%). The teeth involved were found to be mostly mobile with mobility of grade I to III (71%).
Cancer causes approximately 12% of all deaths throughout the world and is the third leading cause of death in developing countries. In Malaysia, Indians have the highest incidence of mouth cancer compared to other races, and females are more affected compared to males.
Objective: The main objective of this study was to analyze the cases of oral cancer treated in the dental department of Penang hospital, Malaysia and to determine the risk factors associated with oral cancer.
Methodology: We reviewed the medical reports of all the patients with oral cancer treated in the dental department of Penang General Hospital from 1994 to 2004.
Results: There were 46 cases of oral cancer treated by the dental department of Penang General Hospital during this time period. 22 were males and 24 females. The mean age of the patients was 61.2 years old. Indians comprised the majority of the cases (n=23; 50%) followed by Malays (n=12; 26.1%) and Chinese (n=11; 23.9%). Of these cases, 54.3% (n=25) had used quid, 39.1% (n=18) smoked cigarettes and 32.6% (n=15) consumed alcohol. Indians made up 76% (n=19) of all quid users (p=
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.
The aim of this literature review is to review the current care setting for conscious sedation for dentistry in the primary and secondary care sectors in the United Kingdom (UK) and to recommend a plan for setting up a service for the provision of conscious sedation in Malaysia based on the UK models. An electronic search using various databases and web-based search engines were conducted during the period from January to March 2016. Various combinations of keywords were used to help the literature search including dental care settings, conscious sedation, equipment for conscious sedation, referral pathway for sedation and training in sedation. The findings have shown that, although there are specific requirements for the facilities practising sedation, the majority of the requirements are common to all dental practices, such as health and safety, infection control, emergency drugs etc. The good integration between primary and secondary care in providing conscious sedation relies on the compliance with the referral pathway. It is recommended that the practice of conscious sedation in the dental setting in Malaysia begins at the Special Needs Dentistry (SND) Unit, Kajang Hospital because the unit has been partly equipped for conscious sedation and the specialist in charge has received appropriate training in Conscious Sedation for Dentistry at King’s College London Dental Institute. Ensuring safety, effectiveness and appropriateness of the sedation techniques used are the major aims when delivering care to fit individual needs. It is highly recommended to look into the country in which the service has been well established such as United Kingdom as a reference for future development of the conscious sedation service in Malaysia.
Aim: The Shortened Dental Arch (SDA) concept, proposed as a strategy to prevent prosthodontics overtreatment, is defined as a specific type of dentition with an intact anterior region and a reduction in the occluding pairs of posterior teeth. While this concept has been accepted worldwide, little is known about such a situation in Malaysia. This study was undertaken to determine the attitudes, awareness and opinion of dentists working at the Faculty of Dentistry, Universiti Teknologi MARA Malaysia (UiTM) towards the SDA concept. Methods and Methods: All dentists (n=71) working at the Faculty of Dentistry, UiTM were invited to participate in a paper-based questionnaire survey to assess their attitudes, awareness and perception towards the SDA concept. Results: The response rate was 59% (n=42). Overall, 85.7% of respondents were aware of the Kayser’s SDA concept. A majority of them (61.1%) learnt about it through undergraduate studies. Only some respondents reported patients’ dissatisfaction in chewing (29.4%), appearance (8.8%) and comfort (6.3%) following application of the concept. Most participants disagreed that missing molar teeth should be replaced in all patients (52.4%), and supported the application of SDA concept in clinical practice (88.1%). However, some would choose to replace missing molars for older patients in order to provide posterior support (90.5%), prevent anterior wear (52.4%) and improve masticatory function (83.3%). Conclusion: Respondents’ awareness and support for the SDA concept suggested its acceptance as a possible strategy in patient care.
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.
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.
The primary obligation and ultimate responsibility of a dental surgeon is not only to restore aesthetic and function, but also to relieve pain which originates from dental pathology or surgical procedures performed. Post operative dental pain is mainly of inflammatory origin. Common traditional oral analgesics, namely salicylates, paracetamol and non-steroidal anti-inflammatory drugs have been the drugs of choice, but are increasingly being superseded by newer designer analgesics, the cyclooxygenase-2 (COX-2) inhibitors. This article reviews the advantages and disadvantages of prescribing common traditional oral analgesics as well as exploring the potential use of COX-2 inhibitors as an alternative to these analgesics for the control of post operative pain in dentistry.
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).
Squamous cell carcinoma (SCC) is the commonest cancer in the mouth. Multiple risk factors, such as smoking, alcohol consumption, irradiation, viruses infection and chronic irritation are thought to be responsible for the formation of oral squamous cell carcinoma. Although SCC can develop through a series of precancerous stages manifested as various degrees of epithelial dysplasia, this is not always the case. p53 is the commonest mutated gene in human cancers. Mis-sense mutation of the gene or complexing of the protein with viral or cellular proteins prolongs its half-life and leads to its detection by immunohistochemistry. This study was designed with the aim of demonstrating any possible relationship between p53 and oral squamous cell carcinoma by immunohistochemical staining techniques. A total of 66 specimens from the oral cavity (10 normal mucosa, 11 hyperkeratosis without dysplasia, 11 mild dysplasia, 11 moderate dysplasia, 10 severe dysplasia and 13 SCC) were examined for the presence of p53. The results show p53 was not expressed in normal mucosa, but was found with increasing frequency in increasingly severe dysplasia and SCC. In conclusion, this study shows p53 mutation is common in oral squamous cell carcinoma and probably occurs early in the multisteps of oral carcinogenesis.