Upon reviewing the literature, the prevalence of many systemic conditions such as diabetes,
hypertension, asthma and rheumatoid arthritis were reported to be high in Saudi Arabia. The relationship of these
conditions with tooth loss among Saudi population was not investigated. Therefore, the aim of the present study
is to explore the relationship between tooth loss and most common medical conditions among Saudi dental
patient. The study participants were 250 patients who were randomly selected from the College of Dentistry
database of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia.
Participants were requested to answer self-administered questionnaires related to their demographic as well as
general health questions concerned to the presence of systemic medical conditions. Missing teeth were
determined after examining the orthopantogram radiographs and reviewing the Romexis and SALUD databases.
Descriptive statistics, independent t-test and linear multiple regression model were performed using SPSS
software. The mean number of missing teeth among the study population was 5.8 teeth per person. The mean
number of missing teeth was higher among subjects with diabetes, hypertension, rheumatoid arthritis,
cardiovascular diseases, or osteoporosis compared to healthy individuals. A multiple linear regression analysis
model revealed that diabetes, hypertension and rheumatoid were significant predictors of missing teeth among
Saudi population. These results highlight the importance of the effect of medical conditions on oral health.
This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 - 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.
Ameloblastoma is a slow growing benign tumour of the jaw and patients usually present late after the tumour achieved considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and characteristic findings on plain X-rays does assist in differentiating between types of ameloblastoma. The challenges in the management of this tumour are to provide complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect in order to give reasonable cosmetic and functional outcome to the patient.
Sufficient knowledge on the root and root canal anatomy is essential for practicing root canal treatment. The mesiobuccal roots of maxillary molar teeth present an endodontic challenge due to their wide variability and complexity of their internal morphological landmarks. A review on the literature indicates that the prevalence of a third mesiobuccal root canal in the mesiobuccal root of maxillary molar teeth may reach 9%, and the root canal configuration usually is type XV (3-2). These reported data reveal the importance of absolute awareness for this anatomical aberration that requires special attention from dental practitioners while commencing root canal treatment in maxillary molar teeth. Hence, this article aims to report and describe the management of a maxillary first molar tooth with three mesiobuccal root canals, but with an unusual configuration.
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.
Linum usitatissimum commonly known as flaxseed is one of the oldest crops traditionally cultivated
mainly for its oil purposes. Flaxseed is widely known for its rich source of nutritive and bioactive compounds. Recently, it has gained considerable interest due to the potential health benefits attributed to its component of metabolites, including its antimicrobial properties. Two main components of flaxseed, the unsaturated fatty acids and lignan, are suggested as the main metabolites that exhibit antimicrobial activities. This paper aims to give an overview on fatty acid and phenolic compound in flaxseed and their possible activities as antimicrobial agents.
Lingual tonsil is a part of Waldeyer’s ring. It consists of lymphoid follicles and subject to proliferation and hypertrophy. Palatine tonsillitis, by far is the commonest cause of odynophagia originating from oropharyngeal region. Lingual tonsillitis is a rare occurrence. We reported a patient who presented with severe odynophagia after two months of palatine tonsillectomy. Examination revealed the lingual tonsils were inflamed and covered with exudates.
The reconstruction of the upper eyelid with medial canthal involvement post extensive removal of malignant tumour remains a challenge. Proper eyelid reconstruction is necessary to reestablish anatomic integrity, restoration of its functions and to maintain the best cosmetic appearance. These case reports illustrate an alternative reconstructive technique for large upper eyelid full thickness defect with medial canthal involvement. Two cases of upper eyelid tumours involving medial canthal region underwent staged reconstruction by glabellar flap advancement and reconstruction of the posterior lamellar with autologous graft using buccal mucosa and ear cartilage. The posterior lamellar graft and flap survived without any complication except for mild eyelid margin notching in one of the two cases. The staged reconstruction with glabellar flap advancement provides adequate defect coverage, excellent blood supply, maintains eyebrow contour and function of the eyelid. The flap also perfectly matches the surrounding tissue with minimal donor site morbidity.
A tick in the ear is a very painful condition and removal is difficult because it grips firmly to the external auditory canal or tympanic membrane. Facial paralysis is a rarely reported localised neurological complication of an intra-aural tick infestation. The pathophysiology of localised paralysis is discussed, together with the safe way of handling patients with an intra-aural tick infestation.
Intramuscular haemangioma is relatively rare and accounts for less than 1% of all haemangioma.
Most of these tumours occur in the trunk, arms and legs. Only 14% of all intramuscular haemangioma arise
from the head and neck region, with masseter muscle representing the most common site of involvement,
followed by the trapezius and sternocleidomastoid muscles. We present a case of a 60-year-old man with a
soft lump in the left cheek. Imaging of the neck showed irregular, dilated enhancing vessels seen in the left
masseter muscle suggestive of intramuscular haemangioma. Excisional biopsy was performed, and
histopathological findings confirmed the diagnosis.
Paediatric facial traumas are often accompanied by other intracranial and non-head injuries. Use of
Computed Tomography (CT) has increased diagnostic accuracy when compared to plain radiographs alone. Coexisting anomalies can sometimes be a chance finding from the imagings and this highlights the need of a formalreporting by a radiologist. We report a case of a traumatic unilateral condylar fracture with a coexisting life-threatening abnormality detected from careful assessment of the imagings.
This in-vitro study aimed to evaluate and compare the marginal leakage and penetration ability of
a moisture-tolerant (Embrace WetBondTM) and a conventional (ClinproTM) resin-based sealants under three
different enamel surface preparations (acid etched, acid etched and saliva contaminated and bur
preparation and acid etched). One hundred and twenty extracted caries free human premolars teeth were
cleaned and randomly divided into six groups of equal numbers, according to the type of sealants used and
surface preparations. All the sealed teeth were subjected to thermocycling and immersed in a methylene
blue dye. Each tooth was then embedded into acrylic resin before it was sectioned into four sections per
tooth. Marginal leakage and unfilled surface area (indicating penetration depth of resin) were then
measured using an optical 3D measurement device (Alicona Infinite Focus®). Both sealants exhibited
comparable proportion of marginal leakage on acid etched only surfaces. Moisture-tolerant sealant showed
the least proportion of marginal leakage on bur prepared and etched surfaces. Presence of saliva has
detrimental effect on adhesion of both sealants. Nevertheless, depth of penetration of sealant into the
fissures is comparable with both sealant types irrespective of the surface preparations.
The in vitro cytotoxic potential of locally produced dental porcelain was evaluated in this study. The cellular response of human osteoblast and fibroblast cell lines were assessed using MTT assay by incubating with the fluid extract of dental porcelain powder and dental porcelain discs (direct test). Aging process was carried out by submerging the discs into 3% bovine serum albumin (BSA) solution. Tests on extracts showed that dental porcelain was significantly different from the control at a concentration of 250 mg/ml. Direct test showed that dental porcelain after aging was not significantly different from the control with a mean (SD) of 89.2 (13.4)%, whereas, it was significantly different from the control before conditioning of BSA with a mean (SD) of 88.5 (12.1)%. However, the dental porcelain caused mild suppression of succinate dehydrogenase activity (
Replacing a single missing anterior tooth can be a challenge. Many factors need to be considered when choosing the appropriate treatment. Several treatment options are well established. This case report is to present the use of a cast cobalt chrome partial denture with custom made porcelain tooth to improve aesthetic. The overall shade of the artificial tooth were nicely matched with the adjacent teeth and definite enamel translucency could be achieved which would not be possible with acrylic or even with readymade porcelain tooth.
The aim of this study was to identify the position of impacted mandibular third molars based on the classifications of Pell & Gregory and Winter, the indications for extraction, and the relation of post-operative complications and position. Records of patients who attended Hospital Universiti Sains Malaysia between January and December 2007 for surgical removal of mandibular third molars were reviewed. The angulation type, width and depth of impaction were determined by reviewing the orthopantomograms. The indications of extraction and occurrence of any post- operative complications were recorded. A total of 238 impacted teeth were surgically extracted from 194 patients (97 males, 97 females). The reasons for extraction include recurrent pericoronitis (43.1%) followed by prophylactic purposes (33.5%). Mesioangular impactions accounted for 52.3% and Class IIA position of impaction accounted for 45.7% of extractions. The most common post-operative complication was persistent pain and swelling (14.7%) followed by trismus (4.1%) and dry socket (3.0%). There was no significant relationship between the angulation, width and depth of impaction and the occurrence of complication. Mesioangular type and Class IIA position of impaction were the most common impaction. Although the association was not significant, high frequency of post-operative complications was observed in mesioangular, horizontal, IIA and IIC positions.
The replacement of missing teeth with implant borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent developments in oral implantology involve the use of immediate implant placement technique that significantly reduces waiting time. This case report describes the management of an anterior missing tooth using immediate implant. The result was good, which further validate the use of this technique for suitable patient management.
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
A 69-year-old lady was diagnosed to have mucoepidermoid carcinoma of hard palate 3 years ago. She completed 20 cycles of external beam radiotherapy and 5 cycles of mould brachytherapy and remained asymptomatic until she again presented to us with the recurrence of a painless mass at the hard palate. The hard mass appeared as an ulcerated dimple measuring 2 x 1 cm located at the junction of the hard and soft palate, more towards the right. Excision biopsy of the mass was done with a 1cm circumferential margin deep to the periosteum, with the resulting exposed bony defect covered with a rotational flap from the soft palate. During follow-up, the patient complained that the saliva came up into the nose whenever she swallowed. Oral examination (Figure 1) and flexible nasopharyngolaryngoscopy (FNPLS) (Figure 2) were performed. What is your diagnosis?
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.
Haemodialysis associated amyloidosis (HAA) is a complication of long-term haemodialysis caused by deposition of β2-microglobulin in tissues that most often presents clinically at osteoarticular sites. However, in very rarecircumstances, patients do present initially with oral manifestations of HAA. In a normally functioning kidney, β2-microglobulin is cleared by glomerular filtration and is catabolized in the proximal tubules. This article describes a patient with oral manifestation of haemodialysis associated amyloidosis with an unusual presenting complaint of lingual dysaesthesia.