The purpose of this study was to assess the tissue
response of Type 2 diabetic subjects towards non surgical
periodontal therapy as compared with matched, nondiabetic
subjects. This was a retrospective, comparative
study using periodontal case notes of 40 subjects attending
undergraduates’ periodontal clinics (20 diabetics, 20 nondiabetics),
who were selected based on the inclusion
and exclusion criteria. Response towards non surgical
periodontal therapy was assessed through three clinical
periodontal parameters, namely plaque score, gingivitis
score and number of periodontal pocket ≥5mm at the
baseline and after initial non surgical periodontal therapy.
Data obtained was then analyzed by SPSS Version 12.
Both diabetic and non-diabetic subjects showed significant
improvements (p-value = 0.021; 0.000; 0.001 and 0.010;
0.014; 0.001) in all three parameters after the therapy.
However, when comparison was made between the two
groups, there was no significant difference (p-value = 0.913;
0.892 and 0.903) in any of the parameters. Periodontal
conditions improved clinically in both diabetic and nondiabetic
subjects after non-surgical periodontal therapy.
Therefore, both groups responded similarly towards the
therapy and thus it can be postulated that well-controlled
diabetic status does not have a significant effect on the
outcome of periodontal therapy.
Microleakage testing has been used to determine the possible clinical performance of a restorative material. Many microleakage testing materials have been developed and performed through the years. There has been no agreement as to which testing methodology would give the most accurate results. Attempts have been made to simulate the oral conditions and to give a more quantitative representation of micro leakage. The different micro leakage testing methodologies are presented in this paper.
The widespread use of aesthetic fillings has highlighted their advantages and disadvantages. One
of the most troublesome features of earlier aesthetic materials was the difficulty of finishing the restoration surface to decrease adherence of food debris. The rougher the finished surface, the greater the possibility of bacterial accumulation and discolouration of restoration along the restoration margin with secondary caries formation. Aside from these clinical implications, patients are highly discerning and could detect roughness of 0.30 μm with their tongue. The aesthetic restoration should mimic the appearance of natural dentition and should have an enamel-like appearance. An increased demand for superior aesthetics from composite resin has increased the
demand for more eff icient and simple polishing techniques. The development of nanocomposites has given a new perspective to the polishing of composite resins. Nanocomposites claim the advantage of improved gloss, optical characteristics and reduced wear. To date, results of in vitro studies have been equivocal regarding the most efficient and effective polishing system. There is variation in the effects of different finishing and polishing instruments on the surface roughness due to great diversity in size, shape, composition and distribution of the filler particles of composite resins, type of resin and a wide variety of finishing and polishing instruments. This paper will
review the different factors that affect polishing techniques used in achieving the desired polish on
composite resin restorations.
The objective of this study was to determine the effect chewing of two differently sized commercially available meswak might have on flow rate and pH of whole saliva. Twenty subjects participated in this study. They were distributed into two groups (A and B). Subjects in both groups A and B were asked to first chew on either a sized #1 or #2 cotton roll followed by the chewing of an equivalent sized piece of meswak (approximately 5 mm. and 10 mm. diameter) respectively. For subjects in group A, no differences in mean flow rate was seen after both the chewing regimes. In group B however, the increase in mean flow rate after the chewing of meswak compared to cotton roll was statistically significant at p < 0.05. Statistically significant lower values for pH were registered after the chewing of meswak compared to cotton roll in both groups A and B at p
Conventional oral squamous cell carcinomas are readily
recognized histopathologically but the presence of
additional atypical features may be challenging from
a diagnostic point of view. We present a case of a welldifferentiated
oral squamous cell carcinoma with pseudoglandular
differentiation and discuss the possible differential
diagnoses on a histopathological basis. Accurate diagnosis
is imperative for timely and appropriate intervention and
denotes distinctive prognostic implications. The presence
of perivascular and perineural infiltrations as observed in
this case would indicate the need for further post-operative
therapeutic decision-making aimed at controlling local
spread as well as distant metastases
Recurrent aphthous ulcers of the mouth are difficult to treat because of no known definite aetiology. This paper presents the use of lactic acid bacteria thought to modulate the host immune response to affect improvements in the disease. Twenty-five patients with the disease were treated with 6 lactic bacteria capsules (in the form of OMX capsules) daily for a period of six months, and their responses were evaluated. Seventeen patients (73.9%) became free of the disease six months later, while 6 (26.1 %) experienced very dramatic improvements. Two patients were lost to follow-up. It is concluded that lactic acid bacteria is beneficial in the treatment of recurrent aphthous ulcers of the mouth.
Until today there are still a high percentage of oral microorganisms have not been identified due to inability to isolate using the cultural method. However, identification of uncultivable microorganisms associated with disease will permits clinicians for a more accurate diagnosis, treatment and preventive measures. Unculturable microorganisms are also involved in disease and may account for treatment failure since their susceptibility to antimicrobial agents would be unknown. Thus, the opportunity for a rational approach to the treatment of disease relies on the state of knowledge concerning its aetiology and pathogenesis. Recently developed molecular methods have made it possible to characterise mixed microflora in their entirety, including the substantial numbers of unculturable bacteria. The development of rapid molecular methods like PCR provides a reliable identification of unculturable microorganisms. This paper will review the current literature regarding the PCR techniques used to identify uncultivable oral microflora.
Human saliva contains a large number of proteins which can be separated using polyacrylamide gel electrophoresis (PAGE). In this study the protein profiles of whole saliva of diabetic and non-diabetic were compared. Considerable variations between individuals in the protein profiles were observed. The saliva from diabetic patients appeared to have more of proline-rich protein bands in the molecular weight region below 56 KOa. Further investigations using individual gland saliva should be carried out.
The aim was to examine the protein profiles of whole and parotid saliva using Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) and MALDI-TOF mass spectrometry. The banding patterns of proteins exhibited by the unstimulated whole saliva samples on the gel remained quite constant but the intensity of the protein bands were slightly different from one sample to another. Comparison of the protein profiles of unstimulated whole saliva and stimulated parotid saliva showed almost similar banding pattern. The exception is the presence of a pink protein band in the 65-67 kD region in the stimulated parotid saliva samples which was also observed in the unstimulated whole saliva sample contributed by a cerebral palsy patient. Analysis of the saliva samples using MALDI-TOF mass spectrometry also revealed that the stimulated parotid saliva samples exhibited some peaks that were in the same region as those for the unstimulated whole saliva sample of the cerebral palsy subject. This may imply that there is ineffective control of the parotid secretion in cerebral palsy subject under unstimulated condition. The SDS-PAGE and MALDI-TOF analyses may provide more information on the profiles of the salivary proteins which could be beneficial in the diagnosis of salivary gland dysfunction.
This study aim to evaluate antimicrobial efficacy of sodium hypochlorite (NaOCl) and ozonated water against Enterococci faecalis biofilm. The bacterial biofilm was exposed to 2.62%, 1.31% NaOCl and 0.1 ppm ozonated water over a range of time periods. The presence of viable cells was determined by enumeration of colony forming units (CFU). All experiments were repeated four times (n=4). The effectiveness of the agents was compared using nonparametric Kruskal- Wallis test. The result revealed that 2.62% of NaOCl can completely kill E. faecalis biofilm in 15 minutes whereas 1.31 % NaOCl required a longer time to produce such effect. 0.1 ppm ozonated, however, did not exhibit any antimicrobial effect within the period of time tested. From this study, it can be concluded that 0.1 ppm ozonated water was not comparable with 2.62% and 1.31% NaOCl in antimicrobial efficacy against E. faecalis biofilm.
Currently many dental implant systems with varied and numerous components are available commercially, and with new implant systems and designs emerging, it is essential that the user understands that any system selected should be based on sound scientific principles and capable of osseoil!tegration. This has been defined in many different ways, with biomaterial, biological and biomechanical factors being the main considerations. The final restoration is based on both biological tissue and mechanical components. As the success of osseointegration is based on the clinical outcome, clinicians must ensure that the stresses that the superstructure, implant, and surrounding bone are subjected to are within the tolerable limits of the various components, even though the degree of tolerance has not yet been fully defined.
A preliminary investigation to assess the relationship
in the severity of periodontal disease in diabetics when
compared with non-diabetic subjects. Materials and
Methods: A retrospective, comparative study using
periodontal case notes of 40 subjects (20 Type 2 diabetics,
20 non-diabetics) who were selected based on the
inclusion and exclusion criteria. Severity of periodontal
disease was assessed through number of periodontal
pocket ≥5mm. The results were compared between
subjects whose age, gender and plaque scores are matched
with the test group. Data obtained was then analyzed by
SPSS Version 12. Results: When comparisons were made
between test (Type 2 diabetic) and control (non-diabetic)
groups, there were no significant difference (p>0.05) in
the severity of periodontal disease. However, there was
a clinically mean difference between the two groups.
Conclusions: This preliminary investigation indicated
that the severity of chronic periodontitis, as indicated in
periodontal pocketing, increased in diabetic patients when
compared to non-diabetics clinically, although it was not
statistically significant. The finding of this investigation
was thus not conclusive as it was only a retrospective
study using patients’ case notes. However, the results
are now being further investigated with a proper clinical
trial which examines periodontal parameters and diabetic
status (HbA1c) of the subjects to determine the association
between periodontal disease and diabetes mellitus.
The objective of the study was to attempt to verify the cause of self-reported oro-facial pain among 12-yearold children, objectively via a clinical examination. This is a descriptive, cross-sectional survey using a combination of self-reported questionnaire, face-to-face interview and clinical oral examination. The children were first asked to answer a self-filled questionnaire about their oro-facial pain experience in the past 4- weeks. In order to verify its cause, a clinical examination and an interview followed. Normative oral health status data was also collected. The sample was 1492 Malay schoolchildren with diverse socioeconomic background from the states of Johore, Kelantan and Sabah. The sample size for each state was calculated to give a sampling error of not more than 5 %. In each state, quota sampling was done to achieve a balanced distribution between gender and location. The data collected were normative status for caries, periodontal disease and traumatized teeth. Orofacial pain experience represented the subjective status for oral well-being. The cause of pain was confirmed through a clinical examination. The normative oral health status data implies a very low untreated disease and good oral health among the schoolchildren. However the subjective health status, as reflected by the prevalence of pain suggested that oro-facial pain and suffering was high (27.3%) with about 49% "of moderate and severe" intensity. The two main causes were caries and mouth ulcers. However in about onequarter of pain cases, diagnosis cannot be confirmed in the field survey setting. More than one-half of those with pain experienced disturbed sleep and study. It was concluded that overall oral health status and well-being can be better described if normative data is complemented with subjective data such as pain prevalence. The study shows that the majority (more than 75 %) of cases of subjective pain can be objectively verified in a field epidemiology survey setting. The reliability of the subjective data can be improved by a clinical examination as compared to unverified self-report. The study also confirms that the major source of oro-facial pain among the 12 year-olds were caries and mouth ulcers.
A pilot study was conducted on 135 sixteen-year-old students from three rural schools in Kelantan to establish the prevalence of orofacial pain and discomfort. About 44% reported to have experienced some oro-facial pain in the preceding four weeks. About 27% of those with pain, still experienced the pain at the time of clinical examination but only 8% have consulted professional help. Most of the pain encountered were only mild or moderate in nature. Only 7% and 10% respectively, reported that the pain affected their sleep and concentration to study. The main cause was toothache and sensitivity. The prevalence of discomfort was 22%, the most common causes being recurrent oral ulcers and bleeding gums. The impacts of orofacial pain was mainly manifested at the personal level, and very few affecting social functioning. However, untreated decay and missing teeth were very low (mean DT 0.47, mean MT 0.27), while filled teeth (mean Ff 2.9) was the main component of the DMFf (mean 3.66, sd ± 2.6). Severe periodontal disease and the prevalence of traumatised teeth was not a major public health problem. The high prevalence of pain merit further research. Therefore a larger study involving other age-groups in other states is planned.
The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.
This retrospective study aimed to determine the prevalence of temporomandibular disorder (TMD)
secondary to orthognathic surgery (OGS) in various types of dentofacial deformities, to access the
relationship of new onset of TMD in different types of OGS to pain-related TMD and intraarticular TMD,
and to evaluate the chronic facial pain, temporomandibular joint (TMJ) function, and masticatory efficiency
after OGS.
A total of 26 patients who were previously treated with OGS in University Malaya Medical Centre,
Kuala Lumpur from January 2005 to June 2015 agreed to participate. The subjects had either undergone
bilateral sagittal split ramus osteotomy (BSSRO) or bimaxillary osteotomy (BIMAX). All subjects were
assessed using Diagnostic Criteria for Temporomandibular Disorder (DC/TMD). Data collected from
patients’ records showed absence of TMD at presurgical stage. The present study showed 42.3% of 26
patients experienced TMD after OGS in various types of dentofacial deformities, 19.2 % of them presented
with post-operative facial pain, 30.8 % had limitation in mastication, 19.2 % experienced limitation in
mobility of the jaw, and 11.5% of them experienced limitation in verbal and emotional commences. In
conclusion, there was no association between prevalence of TMD secondary to OGS in either type
of dentofacial deformities or type of surgery involved. We also noted that the minority of the patients
suffered chronic facial pain and jaw function limitation after OGS.
Severe gingival recession caused by dehiscence usually present a challenging task to the clinician as any mucogingival surgery without bony regeneration will not 'prevent the condition from recurring. The procedures of guided tissue regeneration ( GTR ) which allow regeneration of the lost periodontium may offer some solution to the condition. This paper reports on the use of a non-resorbable GTR membrane to treat an isolated lower incisor gingival recession associated with dehiscence.
The purpose of this study was to determine the
DNA yield and quality from different non-invasive
sampling methods and to identify the method which
gave the highest DNA yield. Method: Thirty-eight
volunteers had been recruited in this study where
blood, buccal cells and saliva were collected using
various collection techniques. Buccal cells were
collected by 1) cytobrush and 2) saline mouth rinsing
or “swish”. Meanwhile saliva was collected by passive
drooling method. Upon processing the white blood
cell (WBC), buccal cells and saliva samples, DNA
extraction was performed according to the
manufacturer’s protocol. Quantification and quality
(DNA ratio at A260/A280) of the extracted DNA were
determined using NanoDropND-1000®. T-test was
performed to compare means between DNA obtained
from various collection methods. Results: DNA yields
from buccal cells collected with cytobrush, “swish”,
saliva and WBC (mean ± SD) were (8.2 ± 5.9)ng/μl,
(28.2 ± 14.9)ng/μl, (5.9 ± 9.5)ng/μl and (105.3 ±
75.0)ng/μl respectively. Meanwhile the mean DNA
ratio at A260/A280 for cytobrush, “swish”, saliva and
WBC were 2.3, 2.0, 1.7 and 1.8 respectively. Post hoc
test with Bonferroni correction suggested that DNA
yield from “swish” technique exhibited the least mean
different as compared to the DNA extracted from WBC
(p