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.
The objective of this study was to determine the effect of chewing commercially available meswak may have on levels of calcium, chloride, phosphate and thiocyanate in stimulated whole saliva. A total of 20 subjects participated in the investigation. They were distributed into two groups. Those in group A (10 individuals) were asked to first chew on a cotton roll (sized #1) followed by the chewing of an equivalent sized 5mm piece of commercially available meswak. Subjects in group B (10 individuals) did the same but, chewed on cotton roll (sized #2) followed by the chewing of an equivalent sized 10mm piece of commercially available meswak. After following a specified chewing protocol, samples of stimulated whole saliva were collected into a graduated tube at the end of every chewing regime. Calcium, chloride, phosphate and thiocyanate analysis were carried out using colour titration and spectrophotometer. Results from this investigation indicated that commercially available meswak chewing sticks apart from containing high amounts of calcium and chloride may possibly release phosphate and thiocyanate into whole saliva. These findings suggest that the commercially available meswak used as chewing sticks may have the potential of releasing substances into saliva that could influence the state of oral health. Further studies have to be carried out to ascertain the therapeutic benefits of chewing commercially available meswak.
The gram-positive, mesophilic and non-motile coccus Streptococcus gordonii is an important causative agent of infective endocarditis (IE). This pioneer species of dental plaque also causes bacteraemia in immune-supressed patients. In this study, we analysed the genome of a representative strain, Streptococcus gordonii SK12 that was originally isolated from the oral cavity. To gain a better understanding of the biology, virulence and phylogeny, of this potentially pathogenic organism, high-throughput Illumina HiSeq technology and different bioinformatics approaches were performed. Genome assembly of SK12 was performed using CLC Genomic Workbench 5.1.5 while RAST annotation revealed the key genomic features. The assembled draft genome of Streptococcus gordonii SK12 consists of 27 contigs, with a genome size of 2,145,851 bp and a G+C content of 40.63%. Phylogenetic inferences have confirmed that SK12 is closely related to the widely studied strain Streptococcus gordonii Challis. Interestingly, we predicted 118 potential virulence genes in SK12 genome which may contribute to bacterial pathogenicity in infective endocarditis. We also discovered an intact prophage which might be recently integrated into the SK12 genome. Examination of genes present in genomic islands revealed that this oral strain
might has potential to acquire new phenotypes/traits including strong defence system, bacitracin
resistance and collateral detergent sensitivity. This detailed analysis of S. gordonii SK12 further improves our understanding of the genetic make-up of S. gordonii as a whole and may help to elucidate how this species is able to transition between living as an oral commensal and potentially causing the lifethreatening condition infective endocarditis.
This clinical audit is aimed to provide an insight into the performance of dental technicians in rendering
fixed prosthodontics services at Faculty of Dentistry, University of Malaya. A retrospective audit was
carried out between 1st of November 2014 and 31st January 2015 using data derived from records and
monthly returns of the technicians, which are kept at the ceramic laboratory. Retrospective data on
cases of diagnostic wax-ups, full metal crowns, metal ceramic crowns, all ceramic crowns and bridges
that were sent to ceramic laboratory for fabrication from 1st of September 2013 to 31st of August 2014
was systematically extracted from the record and tabulated categorically in SPSS version 22.0. The
turnaround time in workings day for diagnostic wax-ups and the prostheses was calculated by deducting
exit date from entry date. Subsequently, the turnaround time and the complexity of cases were categorized
accordingly. The association of turnaround time and the complexity of the cases was analysed using
Fisher Exact test with p value < 0.05. Within this time frame, a total of 102 cases of diagnostic waxups,
36 cases of crown and 18 cases of bridges were fabricated. 57.8% of diagnostic wax-ups were
completed within 3 days. 100% of 1 unit crown were completed within 7 days and 94.4% of bridges were
completed within 14 days. There was a significant association of turnaround time and the complexity of
the cases for diagnostic wax-ups and crowns with p value
A study was carried out to investigate whether smoking had any effect on the Langerhans cells in the oral mucosa, which might throw light onto the mechanism of malignant transformation of some keratotic lesions in the oral cavity. Thirty-two cases of keratotic lesions from biopsy specimens of smokers and non-smokers were studied. Langerhans cells were identified by immuno cytochemical staining for 5100 proteins and their densities quantified. Smokers were associated with a significant reduction in the Langerhans cell population compared to non-smokers. The mean values of Langellans cell density in light smokers and heavy smokers were 2 2 2 28.64/mm and 33.421mm respectively compared to 66.51/mm in non- smokers. There was a dose-response relation between the number of cigarettes smoked daily and the effect on cell counts. These findings of a local immunological effect of smoking on oral epithelium may explain the means by which cigarette smoking contributes to the development of oral cancer.
Spindle-cell lipoma (SCL) of the oral cavity is very rare. There are only four such reported cases in the literature. A concise literature review of SCL and a case report of a SCL affecting the cheek and lip of a 23-year-old man is presented.
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.
The existence of numerous World Wide Web (WWW) sites devoted to dental education is proof that dental educators have been utilizing the pedagogical potential of information technology. Despite the availability of an immense quantity of information on the Internet, performing a search is often a complex, uncoordinated and time-consuming procedure, thus the usefulness of a guide on a topic of interest. Forty WWW sites devoted to dental education have been located using search engines. They were evaluated and classified as follows: guides, electronic publications, databases, patient education and undergraduate education; and according to subjects such as oral biology, morphology, histology, microbiology oral pathology, oral and maxillofacial surgery, radiology, periodontology, dental materials, orthodontics and neuroscience. The extensiveness and quality of some of these sites make them useful resources and knowledge banks for the teacher and the student.
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.
The diagnosis of oral cancer have been variously reported as being due to delay by clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer on more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
The calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955. It accounts for less than 1% of all odontogenic lesions. A case of CEOT which presented together with cardiac abnomlalities is presented here and the literature of CEOT is reviewed.
The ability of a pathologist to accurately interpret a lesion is largely dependent on a good biopsy performed by the surgeon. This article describes the common pittfalls in biopsy techniques and offers ways to minimize them. It also discusses the difficulties encountered by the pathologist in attempting to interpret artefactually damaged tissues.
The purpose of this study is to assess the effectiveness of C02 laser in relieving symptoms associated with Oral lichen planus (aLP) and lichenoid lesions (aLL) and the event of healing. Six patients were selected for this study with 13 sites treated. Each lesion was ablated with C02 laser and the wound allowed to heal undisturbed. Prior to treatment, 4 patients had both unprovoked and provoked pain and 2 patients rated for provoked pain only. After laser ablation, five out of six patients treated recorded no pain / 0 pain score. One month post-laser, the treated area was almost the same colour as the surrounding normal mucosa and soft in texture in all but one patient in which there was some fibrosis and residual plaque-like patch. Weconclude that the use of C02 laser in the treatment of aLP and aLL shows positive results in relieving symptoms associated with these lesions.
The study aimed to assess patient satisfaction with their orthodontic treatment outcome and type of cases accepted for orthodontic treatment at the Faculty of Dentistry, University of Malaya (UM) and to audit the quality of treatment outcome. The standard set were 100% patient should be satisfied with their treatment outcome and less than 5% of the proportion of cases should fall in the “worse/no different’ category with a mean reduction of Peer Assessment Rating (PAR) score being greater than 70%. Records of cases that had completed orthodontic treatment were traced. Survey forms were sent to 150 patients that had met the inclusion and exclusion criteria. Their intact study models were assessed for the Index of Orthodontic Treatment Need (IOTN) and PAR. 21.3% responded to the survey, of which 59.4% had treatment involving fixed appliances and 37.6% had either removable or functional appliances or retainers. 93.8% respondents were satisfied with their dental alignment and 87.5% with the overall treatment results. For the dental health component of the IOTN, 63.3% had ‘definite need’ and 21.1% had ‘borderline need’ for treatment. For the aesthetic component of the IOTN, 24.2% had ‘definite need’ and 32.0% had‘borderline need’ for treatment. For the PAR, 8.0% had an outcome of “worst/no different”. The mean PAR reduction score was 75.3%. In conclusion, although majority were satisfied with their treatment results, there is still a need to improve on the standard of care to address the issues of the minority who were not satisfied with the treatment outcome.
Oral cancer is the sixth most common malignancy in the world. Despite recent advances in cancer diagnoses and therapies, the five-year survival rate of oral cancer patients has remained at a dismal 50% in the last few decades. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits namely betel quid chewing, smoking and alcohol consumption. This paper provides a brief overview on the various aetiological agents and risk factors implicated in the development of oral cancer.
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.
Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters. Materials and methods: In this retrospective crosssectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya were examined for the presence of AR-related OMC. The study period was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
Thirty extracted mandibular premolars were randomly divided into 3 groups. Canals were cleaned, obturated and the teeth incubated. Guttapercha removal was performed using: Hedström files with xylene (Group 1); ProFile® alone (Group 2) and combination of both (Group 3). Time required to remove the gutta-percha was recorded. Postoperative radiographs were taken. Specimens were split longitudinally and photographed. Amount of gutta-percha left at coronal, middle and apical thirds was calculated by computer (QWIN software) and the photographs were also evaluated visually by two endodontists. Results showed that the combined technique was fastest in removing gutta-percha. Radiographically, more residual was left in Group 2. Although computer analysis also showed more residual was left in Group 2, they were in a small percentage and there were no significant differences (P>0.05, SPSS paired-samples T test) among groups. Although there were significant differences between the two evaluators in their scoring, both generally agreed (Kappa’s analysis= 0.64) there was more guttapercha residual in Group 2 compared to Group 3 in the apical thirds. Although the differences in efficacy of guttapercha removal among these techniques were not significant, the use of ProFile® increased the speed of the procedure. The combined technique showed the most superior efficacy in gutta-percha removal.
In recent years, three-dimensional (3D) in vitro cell culture models have earned great attention, especially in the field of human cancer disease modelling research as they provide a promising alternative towards the conventional two-dimensional (2D) monolayer culture of cells with improved tissue organization. In 2D cell culture systems, the complexity of cells on a planar surface does not accurately reflects the in vivo cellular microenvironment. Cells propagated in 3D cell culture model, on the other hand, exhibit physiologically relevant cell-to-cell interactions and cell-to-extracellular matrix (ECM) interactions, important in maintaining a normal homeostasis and specificity of tissues. This review gives an overview on 2D models and their limitations, followed by 3D cell culture models, their advantages, drawbacks and challenges in present perspectives. The review also highlights the dissimilarities of 2D and 3D models and the applicability of 3D models in current cancer research
Acrylic resin is commonly used to fabricate removable prostheses due to its adequate physical, mechanical
properties and cost effectiveness. There has been continuous development of the materials to improve their
properties and to widen their applications in different clinical settings. This study aimed to provide a
historical development of the acrylic resin and elaborate on the properties of different types and the
processing methods of acrylic resins used to fabricate denture base which are commercially available in the
market. This would help dental clinicians to choose the best material of choice in the market. The authors
have summarized the history, development and classification of different types of acrylic resins used in
fabricating dentures and processing methods based on published research available on this topic using
published materials available in the Dental Library, University of Malaya and the database (Science Direct,
PubMed). Every type of acrylic denture base material has its pros and cons. Therefore, careful selection of
the material and processing method is crucial to ensure patients are receiving the best outcome in
prosthodontic treatment hence upholding the patients’ best interest and improving their quality of life.