This study was undertaken to investigate the number and types (fluoride or non-fluoride) of toothpaste products available in the Malaysian market based on the label. Thirty-five brands of toothpaste were identified, of which ten (29%) were specifically recommended for children. Two of the children's toothpaste recommended that children below seven years old use a pea size amount of toothpaste. One (3%) was recommended for both children and adult. The remaining 24 (69%) did not state if they were recommended for either children or adults. To improve the flavour of the toothpastes, a variety of flavours had been added especially in children's toothpaste. Almost half of the toothpastes were for prevention of tooth decay and gum disease. Other indications were for tooth sensitivity, tooth whitening and stain removal. Twentyseven (77%) of the toothpastes were imported, while eight (23%) were made in Malaysia. Twenty-six (74%) of the toothpaste contained fluoride and the most common type of fluoride used was sodium monofluorophosphate (NaMFP). The fluoride concentration was not labeled in more than half (63%) of the fluoridated toothpaste. Of those that were fluoridated, different units of measurement were used. As there is no uniformity in the labelling of these products, it is recommended that the responsible authorities should take more action in enforcing proper labelling of the fluoride concentration in the toothpaste using standardized units.
Ludwig's angina is a rare type of facial infection usually reported in adults. This paper presents a case of Ludwig's angina infection occurring in a 3 year-old Malay boy. The dentists must be able to detect such presentation early. Hospitalization for monitoring of airway is essential.
The population in Malaysia use various types of health and food supplements. These products are considered safe and are used without any concern for their toxicity. Among the products used as health supplements are products that contain lactic acid bacteria. This project studied the acute and subacute toxicity of a product containing minerals, herbs, vitamins and live lactic acid bacteria, on Sprague- Dawley rats. Acute toxicity was tested 24 hours after a single dose and subacute toxicity was studied 24 hours after 7 days of daily dosing. The parameters that were studied were alanine aminotransferase (AL T,SGPT), aspartate aminotransferase (AST, SGOT), serum urea, ratios of weight of kidney and liver weight to body weight and percentage changes in body weights. The contents of capsules of the product (6, 8 or lO capsules for acute studies and 6, 10 and 12 for subacute studies) were mixed with corn oil and fed orally to rats. Control rats were fed with corn oil alone. In the acute studies, the level of ALT in the rats treated with the contents of the capsule was lower than controls. There were no significant changes in the other parameters of the rats in the treatment groups as compared to controls. There were no significant differences in all the parameters between rats in the treatment groups as compared to controls in the subacute studies. Sprague-Dawley rats fed with high doses of the product did not show signs of toxicity in the parameters that were studied.
The epithelial cystic linings and adjacent connective tissues of 61 cases of odontogenic cysts (radicular cysts[RC], dentigerous cysts[DC] and odontogenic keratocysts[OKC]) and unicystic ameloblastomas(UA) were described and compared histopathologically. The type of epithelium in relation to the presence of rete processes and the distribution of chronic inflammatory cells were analyzed statistically. Significant associations between the presence of rete processes in the non-keratinized epithelial linings and inflammation in the subjacent connective tissues of RC and DC were found in this study. There was also a statistically significant association between the presence of rete Processes and nonkeratinized epithelial linings in OKC. The results also showed that in inflamed OKC, the cystic lining epithelium exhibited hyperplasia indistinguishable from lining epithelium of RC and DC. This study further showed that ameloblastomatous-like epithelial cystic linings were present in inflammed odontogenic cysts. All except for one case of unicystic ameloblastomas in this study showed ameloblastomatous epithelial cystic linings. It is recommended that the lining epithelium of RC and DC be examined carefully in order to rule out OKC. Similarly, ameloblastomatous-like lining epithelium arising from chronic inflammation in RC and DC should be differentiated from true ameloblastomatous cystic lining. Such careful examinations are diagnostically important in view of the similarities of epithelial cystic linings of inflamed OKC with DC and RC aggressive behavior ofOKC and UA.
The impaction of dental prostheses in either the airway or esophagus is an under-recognized problem which may result in severe morbidity or even mortality. The radio-opacity and the size of fixed and removable dental prostheses in an animal carcass was investigated. Prostheses were placed one at a time in the oro-laryngopharynx or in tho trachea and the esophagus. Lateral radiographs were taken for each prosthesis in site. The radio-opacity and size of the prostheses on the radiograph was graded. Most of the prostheses investigated were radio-opaque though the removable prostheses were more likely to be radiolucent and differ in size. In a symptomatic patient with a missing dental prosthesis, a negative chest or abdominal radiograph does not exclude impaction, inhalation or ingestion. Further evaluation with endoscopy or even computed tomography may be essential to reduce the possibility of severe morbidity or even mortality.
Odontogenic carcinomas of the jaws are subclassified into malignant ameloblastoma, ameloblastic carcinoma and primary intraosseous carcinoma arising from within the bone. These may arise from residual islands of epithelium derived from dental lamina or epithelial lining of dental cysts. Ameloblastic carcinoma is extremely rare. An aggressive case of ameloblastic carcinoma occumng in a 59-year-old Malay man is presented. Wide excision of the primary lesion with radical neck dissection was carried out. He developed lung metastasis 4 months post-operatively. Despite chemotherapy upon discovery of lung metastasis, he expired 7 months following the initial diagnosis.
Saliva collection is non-invasive and less stressful when compared with blood collection. Extensive studies on saliva has been carried out and the use of saliva as a biological sample in clinical diagnosis and for monitoring hormones, drugs and pollutants and viruses has been recommended. The complexities associated with saliva such as proper collection device and strict standardisation of a number of factors which include time of collection, types of saliva and storage made it less favourable to blood.
Much interest has been generated in tooth-co loured inlays/onlays especially with patient's concern for esthetic appearance and the dentist's appreciation for additional strength of the restored tooth, together with bonding. Many types of tooth-coloured inlay/onlay restorations are available but none have undergone extensive and long term research. The different types of inlay/onlay restorations together with steps in their preparation are presented in this paper.
Chlorhexidine gluconate and hexitidine have been used in many oral health care products as antiplaque and antigingivitis agents. Based on the clinical observations and the plaque and gingivitis scores, chlorhexidine gluconate has been reported to be a better agent. In this study, the anti-adherence properties of chlorhexidine gluconate and hexitidine on individual bacteria strains isolated from a 3-hour plaque (Streptococcus sanguis, Streptococcus mitis 1 and Actinomyces sp.) and on a whole 6-hour plaque culture were determined and compared. The study showed that chlorhexidine gluconate inhibited almost 100 % the adherence of the individual bacteria strains and 87.7 % the adherence of a whole 6-hour plaque culture to the saliva-coated glass surface. Hexitidine appeared to be more selective in its effect. It was shown to inhibit the adherence of S. sanguis and Actinomyces sp. to saliva-coated glass surface by 86.5 % and 51.4 % respectively. Its effect on the S. mitis 1 strains is comparable to that of a whole 6-hour plaque culture where inhibition to adherence were less than 4 % for both.
This paper revisits the prescription of drugs for pregnant patients and the dental and oral changes during pregnancy. The management of these patients is also outlined. Emphasis should be placed on prevention of dental problem during pregnancy.
Teaching is a complex activity which consists not only of giving instructions but also promotion of learning. Different students have different preference for learning styles. Dental educators must therefore attempt to mix and match their methods of teaching to accommodate students with differing learning styles to provide an opportunity to maximize their learning. This paper aims to share the writer's experience and students' perceptions towards a different mode of teaching/learning method. The Jigsaw Classroom method was employed on University of Malaya's third-year dental students during their Water Fluoridation lecture. At the end of the session, students were asked to reflect upon the learning experience and to inscribe their feelings. Initially, students showed their resentment towards the new learning style but their resistance changed once they got into a group and started to learn from each other. In the reflective essay, most students expressed that learning through teaching and discussing as required in the Jigsaw method enhanced their understanding of the topic and they claimed that they were able to retain the information better. In this study, the Jigsaw method proved that learning in the lecture hall can be fun, educational and enriching.
The aims of this study were to determine the prevalence and factors that influenced smoking behaviours among male adolescents in Kuantan, Pahang. A cross-sectional study was conducted among the form four male students in Kuantan District. Three hundred and twenty three students were randomly selected from eight secondary schools. A self-administered questionnaire was distributed to all the respondents. Almost half of the sample was smokers (45.8%) and half of them were Malays (53.1%). Students whose parents had lower level of occupation were more likely to smoke (58.8%). Among smokers, 34.5% of them smoked since primary school and a majority (91.7%) smoked 10 or less cigarettes per day. Half of them (53.4%) reported that they bought loose cigarettes and most of them used their school pocket money to purchase the cigarettes (81.7%). From the multivariate analysis, it was found that Non-Science Stream classes (OR=3.92, 95% CI= 2.10, 7.32), peers' smoking (OR=6.07, 95% CI= 2.32, 15.92), and attitude towards smoking (OR= 21.93, 95% CI= 9.71,49.51) were significantly associated with smoking habit. The prevalence of smoking among male adolescents was considerably high'in this population. It is recommended that antismoking activities in school be carried out regularly and should involve an active participation from the adolescents themselves since peers have great influence on smoking habits.
Objective: this study was carried out to evaluate the relationship between smoking and periodontal status in a selected Malaysian population. The sample for this cross-sectional study involved 39 subjects who were smokers. Each subject was required to answer the guided questionnaire followed by clinical examination. The questionnaires had 11 questions and were set in English and Bahasa Melayu. Basically, the questionnaire consisted of 3 sections: socio-demographic data, smoking status and subject's knowledge on periodontal health. The clinical parameters used in this study were: Community Periodontal Index, Visible Plaque score, Gingival Bleeding Index and Calculus Surface Index. Results showed that out of 39 subjects, 28 subjects (71.8%) were current smokers, followed by 6 subjects (15.4%) and 5 subjects (12.8%) who were former and who never smoked respectively. From the 216 sextants examined, 42 sextants (19.4%) were healthy gingival, 127 sextants (58.8%) suffered from gingivitis and 47 (21.8%) sextants suffered from periodontitis. There were positive relationships between smoking and periodontal status.
Aim: To manufacture a clinical simulation apparatus for the undergraduates' endodontic radiography teaching Objectives: • To provide a model for teaching of parallax method using Kelly's forcep • To provide a model for undergraduates to practice radiographic localization employing parallax method. • To allow students to practice taking radiographs in a way that simulates the clinical situations with a good diagnostic quality Methods: Impressions of a dentate arch (maxillary and mandibullary) were used to form a stone cast. A section of the cast, in the area where the natural teeth were to be placed, is sectioned and removed. Three maxillary extracted teeth (canine, first and second premolar) were selected and mounted with acrylic resin at the sectioned area. The resin was cured in a light box. The arches were mounted in a phantom head with a placement of rubber cheek. The first premolar was isolated with rubber dam. The intraoral holder (Kelly's forcep) was attached to a robotic arm. The students were taught the correct angulations of the x-ray cone for the paralleling technique and parallax method using Kelly's forcep during root canal treatment. Results: All students managed to complete the exercise and were considered competent when they produced acceptable quality of radiographs. Conclusion: The model described was improvised from a model that has been used during the past 2 years for undergraduates' endodontic courses. It has been well accepted as it simulates the clinical situation more closely than was possible previously.
This study aimed to detect the presence of enterococci in the root canals of untreated and treated teeth with periapical disease and to compare this to their presence in the saliva and in the immediate surgical environment during root canal treatment. Using an aseptic technique, 33 samples were obtained from 27 untreated and 6 previously treated teeth associated with apical periodontitis. Reduced Transport Fluid (RTF) was used as transport medium. Saliva samples and areas in the surgical environment were also sampled. These were performed prior to chemo-mechanical debrjdement and obturation for every case. The saliva was diluted to 10- J and was plated on Bile Aesculin Azide (BEA) agar whereas the rest of the samples were plated on Bile Aesculin (BE) agar. These plates were then incubated aerobically at 37°C for 48 hours. All the colony types that blackened the agar were sub-cultured to obtain pure isolates and tested on 6.5% sodium chloride (NaCI). Growth on this medium was Gram stained for further confirmation of cell morphology. Gram positive cocci isolated from previous positive test were identified as enterococci. Enterococci were recovered from untreated cases only; from 2 teeth (in 2 patients) prior to chemo-mechanical debridement, from 3 teeth (in 3 patients) prior to obturation and I from saliva sample. A 'total of 5 samples from 5 different patients were positive for enteroco•cci. Sampling in the immediate surgical environment revealed a low occurence in the range of3.0% (1/33) to 15_2% (5/33). In conclusion, the occurence of enterococci in patients and the immediate surgical environment was low number.
The objectives of this study were to assess the practice of molar root canal treatment (RCT) among general dental practitioners (GDPs), confidence level of GDPs in performing molar RCT and to identify factors that influence their confidence in managing molar RCI. One hundred questionnaires were distributed to GDPs in Kuala Lumpur and Selangor. Fifty questionnaires were delivered by mail and the remaining fifty were hand-delivered. All data was coded and verified. Fiftysix OOPs rcsponded to the questionnaires. Only fortyfive questionnaires were accepted (n=45) as eleven OOPs had never performed molar RCI. Most of the OOPs followed the standard quality guidelines while performing molar RCT except for vitality testing (36.4%) and rubber dam usage (27.3%). In this study, 100% of the GDPs were confident in making diagnosis of perinidicular diseases and 95.4% were confident in performing molar RCT from history taking until obturation. Patients' tolerance and availability of instruments and materials (97.7%) were two factors that most influence the GDPs' confidence level. The. least influcncing factor was undergraduate training (78.1 %). Attending seminars and lectures on endodontic, large number of molar teeth treated for ReT, patLents' affordability to pay for RCT and postgraduate training also influencc GDPs' confidence to a certain degree. From this study, it can be concluded that majority of OOPs complied standard quality guidelines except for vitality testing and rubber dam usage. Most of them were confident in performing molar RCT and were greatly influenced by the availability or"instruments and materials in their clinic and patients' tolerance in receiving molar RCI.
The aim of the present study is to determine the “community indicator” for dental caries among secondary school children within the Federal Territory of Kuala Lumpur (FTKL). School factors were investigated for their ability to be used as community indicators. The components encompassing school factors include: type of school, school’s examination performances at the Peperiksaan Menengah Rendah (PMR) level, in the subjects of Mathematics, Bahasa Melayu (Malay Language), Science and English, school’s socioeconomic circumstances and school’s material deprivation. The study design is ecological in nature where schools were the unit of analysis. It used aggregated data for caries experiences acquired from the Oral Health Management Information System and the school factors which were extracted from the schools’ database. The subjects involved in this study were all the (75) day type secondary schools in FTKL. However, only 55 schools had complete information both for the dental caries factor and the school factors which were available for analysis. The use of bivariate analysis suggested that the school mean DMFT was significantly associated with the schools’ performance in English (p= 0.02) and the schools’ socioeconomic code (p= 0.005). The schools’ performance in English and socioeconomic code were able to explain about 10 percent and 14 percent of the variation in the school mean DMFT respectively. The final model that included both variables together explained about 17 percent of the variation in school mean DMFT. As a conclusion, this study suggests that the schools’ performance in English at the PMR level and the schools’ socioeconomic code could be used as community indicator to identify secondary schools with higher caries level in FTKL. Nevertheless, further
improvement of the model is needed in order to create a more reliable indicator.
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.
This systematic review focuses on the management of two types of osseous defects, i.e. dehiscence and fenestration that arise during the placement of dental implant in the edentulous area (delayed implant placement). A systematic online search of main database from 1975 to 2009 was made. Five randomised controlled trials have been identified based on the inclusion criteria. Different management procedures were identified, in which guided bone regeneration procedure was most commonly advocated. Resorbable and non-resorbable m'embranes were compared, in which resorbable membrane was preferred as it caused less complicatiQn of membrane exposure or risk of infection. The benefit of using bone substitute along with membrane in rypairing bony defects cannot be concluded.
Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.