Diagnosis by histopathology remams as one of the most important investigative methods used to establish a definitive diagnosis of a lesion or disease state. The provision of oral tissue diagnostic services is therefore an essential function of an Oral Pathology unit. A review of the English language literature disclosed that much of the documented information on the patterns of oral diagnostic services were from the United States, Canada and the United Kingdom. This paper provides an overview of such surveys carried out in these countries.
The aim of this research is to study how the physical changes in the maxillofacial trauma patients affect them psychologically in patients of different ages, sexes, races, socioeconomic backgrounds, types and severity of injury. The study was conducted by doing a questionnaire survey, which was divided into physical and psychological components. In the physical component, the questions were mainly related to the physical injuries to the patient, which could be visualized clinically and functionally. The psychological component consisted of analyzing the impact of the maxillofacial trauma to the psychological profile. Twenty patients of both sexes and ages, ranged from 15 to 62 years old were interviewed. The main cause of trauma was from motor vehicle accidents. This study appears to show that maxillofacial trauma may have a psychological impact on patients.
The prevalence of developmental defects of enamel was assessed in 4805 16-year-old schoolchildren in fluoridated and non-fluoridated areas in Malaysia. In this sample, the mouth prevalence was 56.0%; tooth prevalence was 21.8%. There were significant differences between children in fluoridated and non-fluoridated areas, urban and rural areas as well as between the ethnic groups. However, there was no significant gender difference. Prevalences were lower than those reported in most other Asiancountries. However, direct comparisons could not be madedue to differences in indices and methodology used.
Oral recurrent aphthous stomatitis is the most common oral mucosal disease. Despite much clinical and research attention, the causes remain incompletely understood. Treatment options include no treatment, treatment of associated systemic diseases, topical medications, systemic treatment and palliative treatments. The most effective treatments involve agents that suppress or modulate the immune function. Topical agents are preferred due to its limited side-effects. Adjunct pain control and prevention of secondary infections is sometimes necessary.
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.
The most prevalent oral mucosal lesions are aphthous ulcerations commonly referred to as canker sores. The clinical characteristic of oral recurrent aphthous ulceration/stomatitis(ORAS) is well defined and can be partly described as an oval or rounded ulcer covered by a grey-white or yellowish fibrinous exudate and surrounded by an erythematous halo. There is intense or moderate pain and the ulcers heal in about 10 - 14 days for the more common type and more than 2 weeks for the severe type. Recurrence of the ulcers occurs at intervals within a year or over several years. Variations of ORAS described above have made studies on aetiology and treatment difficult to interpret due to differing descriptions of differing diseases with similar clinical signs and symptoms and possibly differing aetiologies. A classification that was considered useful as a working model for ORAS was formulated in 1978. While the classification of ORAS had been widely accepted since 1978, the cause for ORAS is still unknown and its aetiology in general remains unclear. However, its immunopathogenesis is now becoming more clearly defined.
The estimation of age of human foetal remains is of great medico-legal importance. When the remains are intact and fresh, various morphological features such as crown-heel length, weight, appearance of ossification centres particularly around the ankles and knees and other parameters could be used to make a reasonable estimation of the period of gestation. In cases of criminal abortion, infanticide and child murder the question of age of the foetus, viability, live birth and a separate existence become very important. In practice, often at the time of detection, the remains are decomposed or skeletonised. In such a situation the examination of developing teeth will provide a reliable answer pertaining to the foetal age, the possibility of a separate existence and even the period of survival after birth. The.age determination from dental examination is possible from approximately 10 weeks intrauterine up to old age. The presence of neonatal line (birth line) in both dentine and enamel indicates live birth and a separate existence. It is possible that the time period of survival can be estimated by measuring postnatal deposition of these hard tissues. An intact human foetus that has undergone mild to moderate putrefaction was studied. The study of the morphological features and the ossification centres suggested that its approximate age was around nine months intrauterine. It was not possible to decide whether it was a live birth and had a separate existence. The examination of the developing first deciduous molar of the mandible suggested the approximate age was around 30-32 weeks intrauterine. The importance of examination of developing teeth in foetal remains (including neonates), particularly associated with putrefaction or skeletonisation is emphasized.
Tissue-integrated oral implants have opened-up a new perspective in oral rehabilitation of tumour patients who had undergone surgery. The present case demonstrated a simple approach to rehabilitate a patient who had subtotal maxillectomy using dental implant. The use of an implant in combination with a natural abutment tooth was shown to improve the retention and stability of the obturator. Magnetic attachment and telescopic restoration were the retainers of choice and they provided good aesthetic result.
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
A cross-sectional study was conducted to ascertain the relationship between parental oral health perception on the importance of the deciduous dentition and the dental caries status of their preschool children. Clinical oral examination of the preschool children was performed and self-administered questionnaires were given to the parents to be completed. Four hundred and eight preschool children were examined and 390 of their parents responded to the self-administered questionnaire. Those parents who brought their children for regular dental check-up at least once a year; favoured restorative treatment and practised tooth brushing habit before bedtime were more likely to have children with significantly lower mean 'dft' as well as higher proportions of caries free mouth (> 50 %). Those children who started early in practising tooth brushing also had better dental caries status but the differences were not significant. However, there were no significant and appreciable differences in their mean 'dft' with respect to the frequencies of tooth brushing per day. It was concluded that parents with better oral health perception as reflected by those parents who (a) practiced regular dental check-up for their children; (b) favoured restorative treatment for their children's decayed deciduous teeth; (c) ensured their children brushed their teeth before bedtime are associated with better dental caries status of their preschool children.
Formalin is a clear solution of 37% formaldehyde in water. It is used in dentistry as a disinfectant, antiseptic and mainly as tissue fixative for preserving biologic specimens for histopathologic examination. The human knowledge on systemic formaldehyde intoxication is inadequate as only few cases of formalin ingestion have been reported. This paper presents a brief communication of the adverse effect of formalin to the human tissue.
The aim of the study was to determine the characteristics and pattern of the betel/tobacco quid chewing habit in the estate Indian community. The study was conducted in 6 randomly selected estates. It involved oral mucosal examination and an interview to solicit personal data as well as history and details of oral habits. Of a total of 618 subjects studied, 19.3 % (n= 119; 89 females and 30 males) were betel !tobacco quid chewers. The youngest age of onset of betel quid chewing is 10 years. The mean frequency of chewing quid is 4.3 times/day and the mean duration of chewing is 8.1 minutes. Initiation to the habit occur at a young age and a major role is played by family and friends in initiation to the habit. Practises of adding tobacco and lime appear to have adverse effects and are associated with higher occurrences of precancer lesions in this study (p
The paradental cyst is an odontogenic cyst occurring near to the cervical margin of the lateral aspect of a root as a consequence of an inflammatory process in a periodontal pocket. A distinct form of the paradental cyst occurs not infrequently on the buccal aspects of erupted mandibular third molar, where there is an associated history of pericoronitis. A search of the literature revealed that these cysts had all been reported in relation to partially, newly or fully erupted molars. This report presents one case in which the cyst was noticed to be associated with an unerupted third molar. The histological appearance of the cyst and the gross relationship to the cemento-enamel junction is similar to those typical of paradental cysts reported in the literature. However, the radiographic and clinical appearance of the tooth being unerupted do not tally with paradental cyst and yet exclude the diagnosis of dentigerous cyst. The diagnosis of dental follicular tissue was excluded based on the histopathological presentation. The authors suggested that this case may represent an early form of paradental cyst which in the past may have been dismissed as dental follicular residues and thus, the prevalence of paradental cyst may have been under reported in the literature.
The purpose of the present study was to determine the periodontal profile, toothbrushing habits and oral hygiene status of patients referred to a teaching institution for periodontal treatment, based on patients' treatment records. A total of 207 consecutive patients diagnosed with periodontitis who had been interviewed and clinically examined over a period of approximately one year were included in this study. The assessments of plaque levels, bleeding on probing (BOP) scores, probing pocket depth (PPD) and degree of bone loss from radiographs were made. The average age of this study group was 45 ± 12.8 years old with an age range of 20 to 76 years. The subjects comprised of 40% Malays, 34% Chinese and 26% Indians. The male to female ratio was almost 1.5: 1. These patients presented with high plaque and BOP scores. These findings do not concur with the high frequency of toothbrushing reported (86.5 % of subjects brushing twice or more times per day). This may reflect on the ineffectiveness of brushing as evident from their high plaque scores. Periodontal pockets were detected in 69 % of the teeth in these patients with an average of 17 teeth per patient being involved. Probing pocket depths of >6mm was found on the average in 3 teeth per patient. Alveolar bone loss as assessed from radiographs was detected in 52 % of the teeth in this study group of which 12 teeth per patient on the average exhibited this. Advanced bone loss involving about 2/3 and more of the root length was detected on the average on 1 tooth per patient. Early onset periodontitis accounted for about 5% of the total cases seen. About 21 % of subjects suffered from advanced adult periodontitis. Hence about a-quarter of the patients referred already had marked periodontal destruction.
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.
The CO2 laser has been actively used clinically for soft tissue surgery. The advantages have been widely acknowledged. In implant related tissue surgery, the use .6f CO2 laser has been debated on whether the heat generated during the procedure would be detrimental to the bone thus losing the implants through disosseointegration. In this preliminary work, CO2 laser was used to perform a simulated gingivectomy of tissue surrounding plasma coated titanium implants. The purpose was to observe the pattern of heat generated at different levels of the implant body. The safe power range and standard precaution was also identified. The results suggested that power output between 6 Watt to 8 Watt in repeated pulsed mode with duration of 5 seconds is considered safe. With this mode the operator
This pilot survey was conducted to determine the main reason and the motivating factors which, influence patients in seeking orthodontic treatment. 115 patients aged 11-30 years old were taken from the orthodontic waiting list at the Dental Faculty, University Malaya dated December 1999 - May 2000. A structured questionnaire was designed and the survey of patients was carried out using the telephone. The desire to have a better dental appearance was the main reason (65 %) given by patients who were seeking orthodontic treatment. The most important motivating factor that influences patients in seeking orthodontic treatment was to attain straight teeth (48 %). In conclusion, patients seek orthodontic treatment mainly due to psychological reason, which is to improve dental appearance and aesthetic. Perceived needs of an orthodontic patient should also be taken into consideration before commencing orthodontic treatment to increase chances of mutually satisfying result for both the orthoqontist and patient.
Several national studies have been undertaken to assess the prevalence of fluorosis utilizing the Dean's Index. However, the latest national study undertaken in 1997 (1) had utilized the DDE Index and hence does not allow comparisons to be made with the earlier set of national data. This cross-sectional study was undertaken to evaluate the prevalence of dental fluorosis using the Dean's Index in a sample of 12-13 year-old schoolchildren and to assess the relationship between fluorosis and their caries status. The sampling procedure involved a multistage, clustered and stratified random sampling. The sample comprised of 1519 schoolchildren attending 20 secondary government and governmentaided schools in fluoridated urban and rural areas of Klang District in Peninsular Malaysia. There were 772 males and 747 females. Each subject was administered a questionnaire to elicit the demographic information. Intra-oral examination for dental fluorosis and caries was performed for each subject. The results demonstrated that more than half of the subjects (54 %) had no fluorosis, 13.2% had questionable fluorosis, 31.3% had very mild to mild fluorosis, 1.4% had moderate fluorosis and only 0.1 % exhibited severe fluorosis. The mouth prevalence was 32.8 %. The Community Fluorosis Index was 0.48 indicating a borderline score for public health significance. Fifty-two percent of the children were caries free. The mean DMFT for all subjects was 1.1, F(0.6) being the main component. Although girls had a higher mean DMFT score as compared to boys this difference was not significant. Significant differences in DMFT scores were observed by urbani rural distributions and ethnic groups (p < 0.01). No significant correlation was found between fluorosis and caries status. It is concluded that dental fluorosis does not appear to be a public health problem. Further coordinated in-depth research using similar criterias for assessing dental fluorosis is highly recommended.
The aim of this study is to evaluate the treatment outcome using fixed and removable appliances, in the Faculty of Dentistry, University of Malaya (U.M.). The study models of 25 fixed and 30 upper removable appliance cases, with complete written records were examined before and after orthodontic treatment using the PAR (Peer Assessment Rating) Index. All the data were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows. Eighty five percent of the cases selected as sample were either 'improved' or 'greatly improved'. Among the 10 cases which were 'greatly improved', all had high pre-treatment PAR points (> 35 PAR points). Conversely, all the eight cases classified as 'worse or no different' were with low pretreatment PAR scores « 20 PAR points). The mean treatment duration in this study was 23. I months, ranging from 2 months to 78 months. The results of this study showed that the standard of treatment in this Faculty were fairly acceptable.
This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.