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Fulltext Increasing percentage of preschool children receiving dental treatment at kindergartens in Machang District

Nor Azee Azwa Kamarudin, Afifah Adilah Asshaari

Q Bulletin, 2020;1(29):46-55.
MyJurnal

Preschool children are one of the major target groups of the Oral Health Program, Ministry of Health Malaysia. However, caries prevalence of preschool children due to unmet treatment needs remains high. Thus, it is imperative for preschool children to receive dental treatment to maintain or restore function and aesthetics, prevent premature tooth loss and improve their quality of life. We aimed to increase the percentage of preschool children receiving dental treatment at kindergartens from 9.8% to 30% in a year. A cross-sectional study was conducted in January 2015 to March 2015 to identify factors contributing to low percentage of preschool children receiving dental treatment using a structured questionnaire modified and adapted from literatures. Ten kindergartens in Machang District were randomly selected, and a total of 200 preschool children, 180 parents and 13 dental therapists in Machang District were recruited for this study. Remedial measures were implemented in April 2015 until September 2015, followed by a post-remedial evaluation in October 2015 to December 2019. The factors contributing to low percentage included inconvenient visit schedule, lack of monitoring system, preschool children at kindergartens refusing dental treatment, and lack of oral health knowledge and awareness among parents. A series of interventions were introduced including improvement of care process, systematic planned visits, and formation of a dedicated team for kindergartens. Oral Health Education and seminars were given to parents. Supportive environment and innovations were created, including colorful attire, cartoon accessories and Benzo Kids’ eye-wear tools. The Benzo Kids functioned as a smart phone holder for a child to watch their favourite video during treatment to divert the child’s attention and reduce anxiety. The percentage of preschool children receiving dental treatment at kindergartens increased from 9.8% (2014) to 55.9% (2019), which exceeded the initial target of 30%. This study has had a significant impact on the number of deciduous teeth with dental caries of these preschool children when they progress to primary one. The HMIS data showed a decreasing trend of dental caries per 100 children from 80(2013) to 58(2019).

Matched MeSH terms: Tooth, Deciduous
Fulltext Comparative evaluation of osteogenic differentiation potential of stem cells derived from dental pulp and exfoliated deciduous teeth cultured over granular hydroxyapatite based scaffold

Hagar MN, Yazid F, Luchman NA, Ariffin SHZ, Wahab RMA

BMC Oral Health, 2021 May 15;21(1):263.
PMID: 33992115 DOI: 10.1186/s12903-021-01621-0

BACKGROUND: Mesenchymal stem cells isolated from the dental pulp of primary and permanent teeth can be differentiated into different cell types including osteoblasts. This study was conducted to compare the morphology and osteogenic potential of stem cells from exfoliated deciduous teeth (SHED) and dental pulp stem cells (DPSC) in granular hydroxyapatite scaffold (gHA). Preosteoblast cells (MC3T3-E1) were used as a control group.
METHODOLOGY: The expression of stemness markers for DPSC and SHED was evaluated using reverse transcriptase-polymerase chain reaction (RT-PCR). Alkaline phosphatase assay was used to compare the osteoblastic differentiation of these cells (2D culture). Then, cells were seeded on the scaffold and incubated for 21 days. Morphology assessment using field emission scanning electron microscopy (FESEM) was done while osteogenic differentiation was detected using ALP assay (3D culture).
RESULTS: The morphology of cells was mononucleated, fibroblast-like shaped cells with extended cytoplasmic projection. In RT-PCR study, DPSC and SHED expressed GAPDH, CD73, CD105, and CD146 while negatively expressed CD11b, CD34 and CD45. FESEM results showed that by day 21, dental stem cells have a round like morphology which is the morphology of osteoblast as compared to day 7. The osteogenic potential using ALP assay was significantly increased (p

Matched MeSH terms: Tooth, Deciduous
Fulltext Orbital Cellulitis Secondary to Dental Abscess in Children

Abdul Satar H, Yaakub A, Md Shukri N, Ahmad Tajudin LS

Cureus, 2021 Apr 09;13(4):e14392.
PMID: 33981511 DOI: 10.7759/cureus.14392

Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications, including blindness, cavernous sinus thrombosis, cerebral venous sinus thrombosis, meningitis, subdural empyema, and brain abscess. Of the patients with orbital cellulitis, 17% died from meningitis, and 20% of the survivors had permanent loss of vision. Therefore, the potential for sight- and life-threatening complications makes prompt diagnosis and early treatment very important. We report here a case of a two-year-old girl who presented with a three-day history of left periorbital swelling, preceded by left upper perioral swelling that extended upward to the left cheek and left lower lid and was associated with low-grade fever. The patient had been admitted and was treated as having left preseptal with facial cellulitis; the patient was started on intravenous amoxicillin/clavulanic acid (200 mg three times per day dose), and chloramphenicol ointment was applied to the periorbital area. On day 3, the condition worsened, and dental examination showed multiple dental caries, upper gum swelling and abscess, and mobility of teeth 61 and 62 (two baby teeth). Contrast-enhanced computed tomography (CECT) of the orbit, paranasal, and brain showed a left periosteal abscess collection extending to the inferomedial region of the orbit. Examination and tooth extraction were performed under general anesthesia. The intraoperative results showed the presence of a left upper gum abscess, which was possibly the primary source of infection. Clinical improvement was observed postoperatively. Orbital cellulitis can be a complication of a dental abscess. This case emphasizes the importance of primary tooth care in children. A lack of care can result in fatal complications.

Matched MeSH terms: Tooth, Deciduous
Fulltext Fabrication of cellulose acetate film from oil palm empty fruit bunch (OP-EFB) and cytotoxicity evaluation

Dasmawati Mohamad, Wan Suzaini Wan Hamzah, Wan Rosli Wan Daud, Zainul Ahmad Rajion, Wan Zaripah Wan Bakar, Mazlan Ibrahim

Pertanika Journal of Science & Technology, 2012;20(1):189-207.
MyJurnal

The aims of this study were to fabricate cellulose acetate (CA) film from oil palm empty fruit bunch (OP-EPB), as well as to characterize and evaluate their biocompatibility. Several processes were carried out, and these included prehydrolysis-soda method, chlorine free bleaching method, including oxygen, ozone and peroxide, to produce the cellulose pulp. Then, a liquid phase acetylation method was applied through acetic acid-acetic anhydride-sulphuric acid. Triethyl citrate (TEC) ester was used as additive at different percentages of 10, 20, 30 and 40 wt%. The film produced was characterized by FTIR to identify the functional group of the CA film and their tensile properties were further characterized. Biocompatibility of the film was evaluated using cytotoxicity test. Stem cell derived from human deciduous teeth (SHED) was used with MTS assay. The results showed at 30% of TEC, the tensile strength and elongation of CA (OP-EFB) film was at the optimum and is therefore suitable to be used in dental application. The cytotoxicity evaluated showed that the fabricated CA (OP-EFB) films were non-toxic up to the concentration tested, and are thus compatible with SHED.

Matched MeSH terms: Tooth, Deciduous
Fulltext Ex-vivo differentiation of stem cells from human extracted deciduous teeth into bone forming cells

Fazliah, S.N., Jaafar, S., Shamsuddin, S., Zainudin, Z., Hilmi, A.B., Razila, A.R., et al.

ASM Science Journal, 2010;4(1):1-14.
MyJurnal

Stem cells from human extracted deciduous teeth (SHED) have the ability to multiply much faster and double their population in culture at a greater rate, indicating that it may be in a more immature state than other type of adult stem cells. Mesenchymal stem cells (MSC) from human primary molars were isolated and cultured in media supplemented with 20% fetal bovine serum. The MSCs were confirmed using CD 105 and CD 166 and the identification of the osteoblast cells were done using reverse transcriptase polymerase chain reaction (RT-PCR) analysis. Differentiated osteoblast cells (DOC) were characterized by alkaline phosphotase and von Kossa staining followed by immunocytochemistry staining using osteocalcin and osteonectin antibodies. Further validation of SHED was done by RT-PCR to detect the presence of insulin-like growth factor 2 (IGF-2) and discoidin domain tyrosine kinase-2 (DDTK-2) transcripts, while the presence of Runx-2 mRNA was used to characterize DOC. The results showed that SHED was found positive for CD 105 and CD 166 and could differentiate into osteoblast, bone forming cells. The findings revealed the presence of distinct MSC population which had the capability to generate living human cells that could be a possible source for tissue engineering in the future.

Matched MeSH terms: Tooth, Deciduous
Fulltext Medico-legal implications of dental prenatal age estimation with reference to a case report

Nambiar, P., Paul, G., Swaminathan, D., Nadesan, K.

Ann Dent, 2000;7(1):46-50.
MyJurnal

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.

Matched MeSH terms: Tooth, Deciduous
Fulltext Dental caries experience and treatment needs in the mixed dentition in North East Malaysia

Oo, Mon Mon Tin, Naing, Lin, Mani, Shani Ann, Abdul Rashid Ismail

Archives of Orofacial Sciences, 2011;6(2):1-8.
MyJurnal

Dental caries is an important community dental health problem with limited studies in the mixed dentition stage. The aim of this study was to determine the caries prevalence and treatment needs among 7- 9 year old school children in Kelantan which is situated in North East Malaysia. A retrospective dental record review of fully documented dental records belonging to primary school children attending a paediatric dental clinic was conducted. Dental caries was recorded using dmft index and DMFT index for deciduous teeth and permanent teeth respectively. Three hundred and nineteen dental records of 175 (54.9%) boys’ and 144 (45.1%) girls’ were selected and subjected to a ‘dental record study’. The prevalence of dental caries was 93% (95% CI : 89,97) in primary dentition and 50.5% (95% CI : 42.2, 58.8) in permanent teeth. Mean dmft and DMFT was 6.2(SD 3.39) and 1.04(SD 1.34) respectively. Regarding treatment needs in the primary dentition, 35.4% of teeth needed one surface filling, 34.7% needed extraction, 24.5% needed two or more surfaces filling and 5.6% needed pulp care. In the permanent dentition, 54.7% required sealants and 21.9% required one surface restoration. The caries prevalence and treatment needs were high among this study population in the mixed dentition stage, particularly showing the early involvement of newly erupted permanent teeth. It appears that high caries prevalence in the primary dentition is a risk factor for caries in newly erupted permanent teeth. Oral health promotions programmes are required in the mixed dentition stage and may reduce the risk of caries in permanent dentition.

Matched MeSH terms: Tooth, Deciduous
Fulltext Stem cells from childrens' teeth

Mohd Hilmi, A.B., Fazliah, S.N., Siti Fadilah, A., Asma, H., Siti Razila, A.R., Shaharum, S., et al.

Archives of Orofacial Sciences, 2008;3(1):29-31.
MyJurnal

The aim of this study was to isolate stem cells from dental pulp of primary molars and incisors to be used as possible source for tissue engineering. Human primary molars and incisors were collected from subjects aged 4-7 year-old under standardized procedures. Within 24 hours, the tooth was cut at the cemento-enamel junction using hard tissue material cutter. The dental pulp tissue was extracted, digested and then cultured in Alpha Modified Eagles's Medium (α-MEM) supplemented with 20% FCS, 100 mM L-ascorbic acid 2-phosphate, 200 mM L-glutamine and 5000 units/ml Penicillin/Streptomycin. The cells were observed daily under the microscope until confluence. Children's tooth pulp- derived progenitor cells were found positive for stem cell markers CD105 and CD166, which are consistent with the finding for mesenchymal stem cells (MSCs) from bone marrow.

Matched MeSH terms: Tooth, Deciduous
Fulltext Gypsum-Based Material for Dental Pulp Capping: Effect of Chitosan and BMP-2 on Physical, Mechanical, and Cellular Properties

Subhi H, Reza F, Husein A, Al Shehadat SA, Nurul AA

Int J Biomater, 2018;2018:3804293.
PMID: 30147725 DOI: 10.1155/2018/3804293

Effective pulp capping material must be biocompatible and have the ability to induce dentin bridge formation as well as having suitable physical and mechanical properties; however, many current materials do not satisfy the clinical requirements. This study aimed to assess the physical and mechanical properties of gypsum-based chitosan material (Gp-CT) and to evaluate its effects on cellular properties of stem cells from human exfoliated deciduous teeth (SHED). The experimental material was prepared with different concentrations of chitosan (CT) with or without BMP-2. Then, setting time, compressive strength, and pH were determined. In addition, cell viability, alkaline phosphatase (ALP) activity, and cell attachment were assessed. The setting time, compressive strength, and pH obtained were 4.1-6.6 min, 2.63-5.83 MPa, and 6.5-5.7, respectively. The cell viability to gypsum (Gp) with different CT concentrations was similar to that of the control on day 1 but statistically different from that of Gp alone on day 3. The ALP activity of SHED was significantly higher (p < 0.05) in CT- and BMP-2-containing materials than those in the control and Dycal at days 3 and 14. The scanning electron microscopy (SEM) image revealed that flattened cells were distributed across and adhered to the material surface. In conclusion, Gp-CT material shows promise as a potential material for direct pulp capping.

Matched MeSH terms: Tooth, Deciduous
Differentiation of dental pulp stem cells into islet-like aggregates

Govindasamy V, Ronald VS, Abdullah AN, Nathan KR, Ab Aziz ZA, Abdullah M, et al.

J Dent Res, 2011 May;90(5):646-52.
PMID: 21335539 DOI: 10.1177/0022034510396879

The post-natal dental pulp tissue contains a population of multipotent mesenchymal progenitor cells known as dental pulp stromal/stem cells (DPSCs), with high proliferative potential for self-renewal. In this investigation, we explored the potential of DPSCs to differentiate into pancreatic cell lineage resembling islet-like cell aggregates (ICAs). We isolated, propagated, and characterized DPSCs and demonstrated that these could be differentiated into adipogenic, chondrogenic, and osteogenic lineage upon exposure to an appropriate cocktail of differentiating agents. Using a three-step protocol reported previously by our group, we succeeded in obtaining ICAs from DPSCs. The identity of ICAs was confirmed as islets by dithiozone-positive staining, as well as by expression of C-peptide, Pdx-1, Pax4, Pax6, Ngn3, and Isl-1. There were several-fold up-regulations of these transcription factors proportional to days of differentiation as compared with undifferentiated DPSCs. Day 10 ICAs released insulin and C-peptide in a glucose-dependent manner, exhibiting in vitro functionality. Our results demonstrated for the first time that DPSCs could be differentiated into pancreatic cell lineage and offer an unconventional and non-controversial source of human tissue that could be used for autologous stem cell therapy in diabetes.

Matched MeSH terms: Tooth, Deciduous
Fulltext Comparative analysis of cardiovascular development related genes in stem cells isolated from deciduous pulp and adipose tissue

Loo ZX, Kunasekaran W, Govindasamy V, Musa S, Abu Kasim NH

ScientificWorldJournal, 2014;2014:186508.
PMID: 25548778 DOI: 10.1155/2014/186508

Human exfoliated deciduous teeth (SHED) and adipose stem cells (ASC) were suggested as alternative cell choice for cardiac regeneration. However, the true functionability of these cells toward cardiac regeneration is yet to be discovered. Hence, this study was carried out to investigate the innate biological properties of these cell sources toward cardiac regeneration. Both cells exhibited indistinguishable MSCs characteristics. Human stem cell transcription factor arrays were used to screen expression levels in SHED and ASC. Upregulated expression of transcription factor (TF) genes was detected in both sources. An almost equal percentage of >2-fold changes were observed. These TF genes fall under several cardiovascular categories with higher expressions which were observed in growth and development of blood vessel, angiogenesis, and vasculogenesis categories. Further induction into cardiomyocyte revealed ASC to express more significantly cardiomyocyte specific markers compared to SHED during the differentiation course evidenced by morphology and gene expression profile. Despite this, spontaneous cellular beating was not detected in both cell lines. Taken together, our data suggest that despite being defined as MSCs, both ASC and SHED behave differently when they were cultured in a same cardiomyocytes culture condition. Hence, vigorous characterization is needed before introducing any cell for treating targeted diseases.

Matched MeSH terms: Tooth, Deciduous/cytology*
Transplantation of human dental pulp stem cells: enhance bone consolidation in mandibular distraction osteogenesis

Alkaisi A, Ismail AR, Mutum SS, Ahmad ZA, Masudi S, Abd Razak NH

J Oral Maxillofac Surg, 2013 Oct;71(10):1758.e1-13.
PMID: 24040948 DOI: 10.1016/j.joms.2013.05.016

The main aim of the present study was to evaluate the capacity of stem cells from human exfoliated deciduous teeth (SHED) to enhance mandibular distraction osteogenesis (DO) in rabbits.

Matched MeSH terms: Tooth, Deciduous/cytology
Fulltext Proliferative activity of cells from remaining dental pulp in response to treatment with dental materials

Lutfi AN, Kannan TP, Fazliah MN, Jamaruddin MA, Saidi J

Aust Dent J, 2010 Mar;55(1):79-85.
PMID: 20415916 DOI: 10.1111/j.1834-7819.2009.01185.x

The biological examination of pulp injury, repair events and response of dental pulp stem cells to dental restorative materials is important to accomplish restorative treatment, especially to commonly used dental materials in paediatric dentistry, such as glass ionomer cement (GIC) and calcium hydroxide (Ca(OH)(2)) lining cement.

Matched MeSH terms: Tooth, Deciduous/pathology
Age-related changes in the location of the mandibular and mental foramen in children with Mongoloid skeletal pattern

Lim MY, Lim WW, Rajan S, Nambiar P, Ngeow WC

Eur Arch Paediatr Dent, 2015 Oct;16(5):397-407.
PMID: 25894248 DOI: 10.1007/s40368-015-0184-x

To observe age-related changes in the locations of mandibular foramen (MF) and mental foramen (mf) using dental panoramic tomographs (DPTs).

Matched MeSH terms: Tooth, Deciduous/radiography
Fulltext Knowledge and attitudes of parents of children with nursing bottle syndrome in Serdang, Malaysia

Syahrial D, Abdul-Kadir R, Yassin Z, Jali NM

J Nihon Univ Sch Dent, 1995 Sep;37(3):146-51.
PMID: 7490607 DOI: 10.2334/josnusd1959.37.146

A study was conducted to investigate the relationship between the parents' level of knowledge, and their attitudes to nursing bottle syndrome. Of 284 children aged 2-6 years clinically examined, 153 were diagnosed as having nursing bottle syndrome based on the criterion that at least one upper maxillary incisor was affected by caries. The parents of the 153 affected children were then interviewed by questionnaire. The findings suggested that parents had adequate knowledge and a positive attitude towards maintaining satisfactory dental care for their children. However, these attitudes were not reflected in the dental health of their children. The implications of these findings are discussed.

Matched MeSH terms: Tooth, Deciduous
Fulltext The immunologic properties of undifferentiated stem cells from human exfoliated deciduous teeth (SHED) and its potential application in bone regeneration

Nurul, A.A., Tan, S.J., Asiah, A.B., Norliana, G., Nor Shamsuria, O., Nurul, A.S.

International Medical Journal Malaysia, 2013;12(1):19-26.
MyJurnal

Introduction: Stem cells from human exfoliated deciduous teeth (SHED) are highly proliferative, clonogenic cells capable of differentiating into osteoblasts and inducing bone formation. It is a potential alternative for stem cell bone regeneration therapy. However, stem cell therapy carries the risk of immune rejection mediated by inflammatory cytokines of the human defense system. Objective: This preliminary research studies the interaction between SHED and the immune system by determining the inflammatory cytokines profile and osteogenic potential of SHED. Methods: Human fetal osteoblasts (hFOb) cell line and isolated SHED were cultured and total RNA was extracted, followed by reverse transcription cDNA synthesis. Semi-quantitative reverse transcription PCR and Multiplex PCR were performed to detect the expression levels of OPG/RANKL and TNF-α, IL-1β, IL-6, IL-8 and TGF-β in both cell types. Results: Analysis showed that SHED expressed significantly lower amounts of IL-1β, IL-6, and IL-8 compared to hFOB. IL-1β is a potent bone-resorbing factor, while IL-6 and IL-8 induce osteoclastogenesis and osteolysis respectively. SHED did not express TNF-α which stimulates osteoclastic activity. SHED demonstrated high OPG/RANKL ratio, in contrast with that of marrow stem cells described in previous studies. Our findings suggest that SHED may have improved immunomodulatory profile in terms of promoting relatively lower inflammatory reaction during transplant and enhancing bone regeneration. Conclusion: SHED has a potential to be a good source of osteoblasts for bone regeneration therapy. Further studies on the immunomodulatory properties of SHED-derived osteoblasts are necessary to enable stem cell therapy in immunocompetent hosts.

Matched MeSH terms: Tooth, Deciduous
Inherent differential propensity of dental pulp stem cells derived from human deciduous and permanent teeth

Govindasamy V, Abdullah AN, Ronald VS, Musa S, Ab Aziz ZA, Zain RB, et al.

J Endod, 2010 Sep;36(9):1504-15.
PMID: 20728718 DOI: 10.1016/j.joen.2010.05.006

Lately, several new stem cell sources and their effective isolation have been reported that claim to have potential for therapeutic applications. However, it is not yet clear which type of stem cell sources are most potent and best for targeted therapy. Lack of understanding of nature of these cells and their lineage-specific propensity might hinder their full potential. Therefore, understanding the gene expression profile that indicates their lineage-specific proclivity is fundamental to the development of successful cell-based therapies.

Matched MeSH terms: Tooth, Deciduous

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