Pathologic tooth migration (PTM) is a common complication following moderate to severe chronic periodontitis, which lead to the undesirable consequences such as traumatic occlusion and impaired aesthetic appearance. Multidisciplinary approach had been successfully used in overcoming the problem. However, since periodontal tissue support is reduced in PTM, further migration of teeth may occur as they were always subjected to the external forces such as occlusion and soft tissue pressure during function. This case report described a 41 year-old male with a further migration of his upper right central incisor after periodontal therapy. After multidisciplinary approach was carried out to overcome the problem and the tooth was on stable condition, permanent splinting was placed to secure the tooth.
Xeroderma pigmentosum-D (XPD) is one of the genes that play a role in the Nucleotide-Excision Repair (NER). Polymorphisms in XPD gene have been identified and reported to be associated with many types of cancer with two common single nucleotide polymorphisms (SNPs), namely, XPD312 and XPD751. The XPD312 polymorphism is at exon 10 codon 312 Asp to Asn (A→G) and the association of this polymorphism with oral cancer is very little known, especially, in Malaysia. The aim of this study was to screen for XPD312 gene polymorphisms in human oral cancer patients attending Hospital Universiti Sains Malaysia (HUSM), Malaysia. Blood samples were collected from 10 oral cancer and 10 normal healthy subjects with their consent. DNA was extracted using commercial DNA extraction kit and Polymerase Chain Reaction (PCR) was performed to amplify the XPD312 gene. The PCR products were digested using restriction enzyme, Sty I and analyzed on a 3% agarose gel for the detection of polymorphisms. This was followed by DNA sequencing to confirm the findings. In the current study, only homozygous wild type polymorphisms in the XPD312 gene was noticed in the oral cancer tissues as revealed by the restriction enzyme and DNA sequencing analyses.
An 11-year-old Malay boy was allegedly involved in motor vehicle accident. He sustained left lung contusion and pneumothorax which necessitate chest tube insertion at a district hospital. On arrival at Accident & Emergency Unit, general physical examination was performed. Neck examination revealed multiple jagged lacerations wound on the left side of the neck (Panel 1). (Copied from article).
Tracheostomy is a life saving surgical procedure performed to maintain upper airway ventilation. The
indications include providing relief of upper airway obstruction, to replace endotracheal intubation in patients needing prolonged assisted ventilation, protection of tracheobronchial tree and facilitates tracheobronchial toilet.More importantly, post operative tracheostomy care is very crucial for the success of the treatment and avoiding complications. We report a rare case of an obligate parasite which had infested the tracheal stoma due to poorhygiene.
A 38-year-old female presented with foreign body sensation in the throat for one year. It was
increasing in severity. There was no other associated symptom. Examination of the oral cavity showed an abnormal looking uvula(Fig. 1). The rest part of the oral cavity, oropharynx and larynx were unremarkable. What is your diagnosis?(Copied from article).
A survey was conducted to assess dental caries experience and oral health related behaviour among Malaysian Territorial Army (TA) personnel. This cross-sectional study involved 284 personnel covering their socio-demography, oral hygiene habits and related behaviour and past utilization of dental services pattern. Dental caries were assessed using DMFT index. Caries prevalence was very high (97.2%; DMFT 8.15±5.36). Untreated decay (DT) was 3.67 (±3.15) and missing teeth (MT) 2.90 (±3.73). However, few were treated teeth (FT) at only 1.58 (±2.02). Almost everyone (98.2%) claimed they brushed their teeth at least once daily and 80% used fluoridated toothpaste. However, very few participants used dental floss (11.3%) while majority (60.2%) did not know about flossing. More than 70% were current smokers. Only 13.7% were regular attendees with the majority (86.3%) visiting the dentist only when they had dental problems. The most common reason (49.7%) for their last dental visit was related to presence of symptoms and few were (27.4%) for prevention. Symptomatic attendees are significantly more likely to have more severe caries experience than preventive oriented individuals (p=0.003). These findings support the importance of promoting preventive oral health utilization behaviour among army personnel.
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
his study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like
erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal displacement in the presence of crossbite was poor, and kappa statistic was incalculable for recording openbite and number of upper incisors rotated 30° or more. Kappa was also incalculable for recording IOTN dental health subcategory due to the creation of asymmetric tables caused by rarely chosen subcategory options. Despite prior agreement between previously calibrated examiners on evaluation criteria, detection of certain malocclusion parameters during an epidemiological examination can prove to be challenging. Epidemiological studies that report on prevalence of malocclusion in the population should always report on the kappa reproducibility, especially if the study is carried out by multiple examiners.
Several studies on job stress have been conducted among nurses, teachers, clerks, lecturers, laboratory technicians, petroleum and automotive workers and the calculated prevalences ranged from 20-35%; associated factors identified include high job demand, low job control and poor social support. Thus, the aim of the present study was to determine the prevalence and associated factors of stress in dental healthcare workers of an institution of higher learning in Kelantan. A cross-sectional study of the prevalence and associated factors of stress in 54 dental healthcare workers of an institution of higher learning in Kelantan [response rate of 63.5 percent] was conducted in March 2006. The Malay version of the validated Depression, Anxiety and Stress Scale and Karasek’s Job Content Questionnaire were used as research instruments in this study. Informed consents were obtained from all participants. The prevalence of stress was 22.2%. One (1.9%) staff member experienced severe stress whilst 20.4% experienced mild to moderate stress. After controlling for age, sex, marital status and duration of work, psychological job demand (adj. b 0.61, 95% CI 0.21, 1.00, p=0.003), toxic exposures (adj. b 1.41, 95% CI 0.47, 2.35, p=0.004) and overtime work (adj. b 5.67, 95% CI - 1.18, 10.16, p=0.015) were directly associated with reported stress in dental healthcare workers. High psychological job demand, increased toxic exposures at work and increased overtime work were significantly associated with stress in dental healthcare workers. These findings can be used to guide preventive measures to reduce stress in dental healthcare settings.
Sociodemographic factors have received considerable attention in the literature with regards its relationship with caries. However, the related information among children ages 12-17 is fairly limited. Birth order has been consistently found to be associated with diseases hypothesized to have an infectious aetiology but only few studies have examined its relationship with dental caries. The aims of this study were to determine the association of birth order and the sociodemographic background of subjects with caries and high caries experience among 16-year-old schoolchildren in Tumpat district, Kelantan. This was a case-control study. A total of 1087 16-year-old schoolchildren were examined intraorally for their caries status. They were categorized into three groups namely caries free (DMFS=0) mild caries (DMFS= 1-7) and high caries (DMFS ≥8) group based on DMFS score. Cases were the caries group and the controls were the caries free group. In each group, 163 subjects were selected by using simple random sampling. A questionnaire was used to obtain personal information of the subjects, birthweight and sociodemographic background. Analysis involved was ordinal logistic regression. The factor that was found to have association with caries and high caries experience determined using multiple ordinal logistic regression analysis was educational level of parents (OR=1.55, 95% CI: 1.06; 2.28). This study showed that birth order was not a significant factor associated with caries experience. Among the sociodemographic factors, only parent’s educational level was found to be associated with caries and high caries experience.
Euphorbia tirucalli Linn. is traditionally used as medicine especially in the treatment of diseases
caused by bacterial pathogens. The objectives of the present study were to identify the bioactive
compounds in the stem of Euphorbia tirucalli Linn. using the gas chromatography-mass spectrometry (GCMS)
analysis, and to investigate their potentials as an alternative for antimicrobial activity. Two-microliters
of dried powdered of Euphorbia tirucalli Linn. stem were mixed with methanol followed by injection into
splitless mode of GC-MS. Separation was achieved by Elite-5MS fused capillary column. The mass spectra
were compared with the spectra of known components stored in the NIST and WILEY databases for
compound identification. Forty-six chemical constituents were identified. The major constituents were
lanosta-8,24-dien-3-ol, (3β)- (13.60%), (23S)-ethylcholest-5-en-(3β)-ol (7.02%), linoleic acid (2.96%) and
viminalol (2.57%). Most of the active compounds present in the stem of Euphorbia tirucalli Linn. have
previously been shown to exhibit antimicrobial properties.
Osteomyelitis of the mandible, a serious complication of untreated odontogenic infection has been reported. This case report describes an interesting presentation of chronic suppurative osteomyelitis (CSO) of the mandible in a 13 years old anaemic male patient. Investigations revealed inversion of his permanent teeth leading to trans-cutaneous extra-oral eruption along with marked destruction of mandible on the affected side. The treatment included a pre surgical course of antibiotics followed by the removal of the retained second premolar tooth, surgical debridement of the affected bone, and resection of the cutaneous sinus tract. The post-operative healing was uneventful. A combination of antibiotic therapy and surgical debridement were effective in the treatment of chronic suppurative osteomyelitis.
One of the roles expected of dental personnel is to promote dental seeking behaviour to the public. It is to ensure that adults maintain an optimum number of teeth for overall health and quality of life by enabling them to eat, speak and socialise without pain, discomfort or embarrassment. The objective of this study was to determine the reasons for seeking dental care and the factors that influence this decision among adult patients. This was a retrospective study of clinical records among patients of 18 years old and above who attended Universiti Sains Islam Malaysia (USIM) Dental Polyclinic, an academic dental centre, for the first time from January 2015 to December 2016. Socio-demographic data on age, gender and occupation as well as the reason for the visit were retrieved from the clinical records. Analysis of data was conducted using SPSS software version 21.0 and the pvalue was set at p
Desensitization of teeth after cavity preparation has been recommended in an attempt to avoid post-operative sensitivity. However, there is concern regarding application effect of desensitizing agent on shear bond strength of the adhesive system used. The purpose of our study was to compare the shear bond strength of adhesive system in two different dentin surface treatments, with and without desensitizing agent. Sixteen extracted human premolars were sectioned off at the coronal portion to expose the flat dentin surfaces. The surfaces were finished using 600 Grit Wet Silicon Carbide abrasive papers. The premolars were randomly assigned to two groups: control and treated with MS Coat desensitizing agent. The desensitizer was applied according to manufacturer’s instruction. Resin composite was bonded to each dentin surface using Prime & Bond ® adhesive system. The composite resin was debonded by shear stress. Mann-Whitney Test was used in statistical analysis. Our result showed that application of MS Coat desensitizing agent on dentin surface had significantly reduced the shear bond strength of the adhesive system used (z = - 0.14, p < 0.05). Thus, we conclude that shear bond strength of Prime & Bond ® NT (Dentsply, USA) adhesive system will be reduced if dentin surface is treated with MS Coat (Sun Medical, Japan) desensitizing agent.
Hamartomatous polyps of the tonsil are very rare. They have been described using various terms such as a lymphangiomatous polyp, lymphangiectatic fibrous polyp, lipomatous polyp or pedunculated tonsil, thus the actual incidence is difficult to be quantified. We present a case of hamartomatous polyp of the palatine tonsil in a 30-year-old female presented with recurent tonsillitis. Histopathological examination of the resected tonsils showed features of chronic tonsilitis with incidental finding of hamartomatous polyp characterized by a polypoidal tissue covered by stratified squamous epithelium and composed of thin-walled blood vessels, lymphatic channels, fibrofatty tissues, seromucinous glands and striated muscle fibres. An unusual incidental histopathological finding of a rare condition has been discussed along with the review of literature.
Many studies have indicated that hearing-impaired (HI) children have poor oral hygiene mainly
contributed by difficulties in communication. The objectives of the study were to assess the difficulties
experienced by HI children during dental visit and the effectiveness of “Oral Health Care for the HearingImpaired”
(OCHI) programme in improving the oral health knowledge and practice, and reducing the dental
plaque maturity scores among HI children. A community intervention study was conducted and training of trainers
(TOT) was done to train the teachers in delivering oral health education (OHE) and practices by using developed
booklet and video. The difficulties faced by the HI children during dental visit, and the oral health knowledge and
practice (OHKP) were assessed by face-to-face interview with HI children whilst the dental plaque maturity was
assessed using GC Tri Plaque ID Gel™ (TPID) during pre-intervention, post-intervention-1 and postintervention-2.
Data were analysed using SPSS version 22. Among the teachers, there was an increase in the
mean (SD) total knowledge and attitude score during post-TOT compared to pre-TOT, 46.1 (2.44) and 43.7
(4.01); (p
The present study aims to investigate and compare the hard and soft tissue cephalometric measurement among Malaysian Malay and Chinese subjects. This study is a cross-sectional study of secondary data. Data consists of 470 standardized lateral cephalometric radiographs of Malaysian Malay and Chinese adults which were picked randomly among orthodontic patients of Hospital USM. The criteria of selection were pre-treatment lateral cephalometric film of Malay and Chinese orthodontic patients aged 18-25 years which has good quality with visible landmarks. All cephalometric landmarks were located and determined and subsequently all measurements were done per COGS analysis using CASSOS software. Independent t-tests were performed for statistical comparison. Out of the 38 measurements, 4 were found significantly different between the sexes for Malaysian Chinese and 18 were found significantly different between the sexes for Malaysian Malay. Statistically significant disparities were also found between Malaysian Malay and Chinese as 16 measurements has p-value of < 0.05. Disparities were observed in COGS values between the two races and each sex group.
Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery. The result of this study showed that there is no significant difference between the three irrigating solution used in surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.
Study site: Oral surgery clinic, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia
Dentin morphology and the lesion found in dental caries have been studied for many years. It was first observed under optical microscopy, and later using electron microscopy. Confocal laser scanning microscopy (CLSM) applied with several fluorescent dyes such as alizarin red to see normal dentinal tubules. However, as far as authors aware, the CLSM studies of dentinal tubules in human caries using alizarin red is rare. The aim of this study is to examine histopathological and morphological changes in dentinal tubules of dentin caries stained with alizarin red using CLSM. Fifteen extracted carious teeth (premolar or molar) was collected and fixed in neutral formalin solution buffered with phosphate buffer, rinsed and stored in calcium free phosphate buffer saline (PBS) at 4°C. The specimens were dehydrated and embedded in resin. Longitudinal or cross sections were cut and polished and then stained with alizarin red S (100 μg/ml) in 0.5 M HCl solution for 24-48 hour at 37°C. After dehydration specimens were mounted on glass slide and examined under CLSM using epi-flourescent mode or transmission light mode with wave length of 512 nm. The images of dentinal tubules were taken serially and optimum images of three-dimensional structures were reconstructed using software of CLSM. Histopathological changes of dentinal tubules in human caries showed area of demineralized dentin, translucent zone, and normal area. The dentinal tubules were thin and had numerous branches. In conclusion, confocal microscopy revealed Study shows that confocal microscopy revealed histopathological changes in dentinal tubules affected by carious lesions.
The use of fluoride as a preventive measure for dental caries has been established more than 50 years ago. The recommendations for fluoride use has been modified over the years due to factors like decreased prevalence of caries, increased prevalence of dental fluorosis and the widespread availability of fluoride in various forms to the community. In recent years, the role of evidence-based recommendations has come to the forefront, in an attempt to ensure the most favorable treatment for the individual. This review has attempted to appraise the most recent evidence- based recommendations for different fluoride modalities put forth by various organizations worldwide, in order to appreciate the current status of fluoride in the early 21st century.