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.
A late adolescent patient presented with a Class III malocclusion on a skeletal Class III base, complicated by severe upper arch and moderate lower arch crowding, reverse overjet, anterior and bilateral posterior crossbites with displacement, proclined upper incisors, retroclined lower incisors, distally tipped lower canines and non-coincident centrelines. Treatment was undertaken on an extraction basis by employing the use of an upper removable appliance with Z-springs and posterior bite blocks to correct the anterior crossbite, quad helix and jockey arch for arch expansion, and pre-adjusted edgewise fixed appliance to level and align, space closure and achieve a mutually protective functional occlusion. This paper discussed the rational and evidences behind the treatment employed.
Conventional oral squamous cell carcinomas are readily
recognized histopathologically but the presence of
additional atypical features may be challenging from
a diagnostic point of view. We present a case of a welldifferentiated
oral squamous cell carcinoma with pseudoglandular
differentiation and discuss the possible differential
diagnoses on a histopathological basis. Accurate diagnosis
is imperative for timely and appropriate intervention and
denotes distinctive prognostic implications. The presence
of perivascular and perineural infiltrations as observed in
this case would indicate the need for further post-operative
therapeutic decision-making aimed at controlling local
spread as well as distant metastases
The purpose of this study was to assess the association of bottle feeding and oral hygiene practices with the
severity of caries among 3 to 5-year-old children with Early Childhood Caries (ECC). This cross-sectional
study was carried out on pediatric dental patients with ECC attending a public university hospital. The
parents or guardians were interviewed for the bottle-feeding pattern and oral hygiene practices followed
by a clinical dental examination of their children with ECC. Data analysis was done using Chi squared test.
Out of 32 children, 69% had severe early childhood caries with mean dft of 8.88. In this study, 87.5% of
the subjects had a history of bottle feeding, with 53.1% still being bottle fed at the time of study. Current
bottle-feeding habit was found to be statistically significant with the severity of caries (p=0.021). Majority
(69 %) of the children were introduced to tooth brushing only after 1 year of age. About 40% of the children
consumed either pre-chewed rice and/or shared spoons or feeding utensils with their parents or siblings
but there was no significant association with the severity of caries (p=1.00). Because of its association with
ECC, prolonged bottle feeding is significantly associated with the severity of caries in our study population.
Besides, vertical and horizontal transmission of bacteria was also a risk factor for ECC, but it did not show
any significant association with severity of ECC.
The purpose of this study was to gather information on the oral hygiene behaviour among the visually impaired adolescents. Interview and observation methods were used to collect data. A total of 114 visually impaired adolescents were interviewed and 10 of the interviewees were selected for observation on the actual oral hygiene practices. The mean age of the sample was 16 years old. The sample comprised of 53.5% female, majority were Malays (86.8%) and most of them were from the lower income group. Fifty four percent of the sample had low vision and 45.6% were blind. All of the participants reported that they brushed their teeth daily and most of them brushed twice a day or more. Flossing (6.1%) was not common practice among this group. It was observed that they encountered some difficulties, especially when putting the toothpaste on the toothbrush and also the way that they brushed their teeth could cause detrimental effect to the oral cavity. Thus, they need to be taught on proper oral hygiene care so that they can practice safe oral hygiene care and maintain their own oral health.
To assess the oral health related quality of life
(OHQoL) of a selected population of Malaysian adults and to compare the OHQoL by periodontal status. Material & Methods: This cross-sectional study comprises a convenient sampling of fifty subjects from the Primary Care Unit, Faculty of Dentistry, University of Malaya. OHQoL was assessed using the Malaysian version of Oral Health Impact Profile-14 (OHIP-14). Basic periodontal examination (BPE) was performed on all subjects to determine their periodontal status. Descriptive statistics and bivariate analysis were performed.
Results: Psychological discomfort, physical pain and psychological disability domains were the most affected dimensions in this population. Subjects with income levels >RM2,500 had higher impacts on their OHQoL as compared to those from other income levels (p0.05).
Conclusion: Subjects with high income levels had high impacts on their OHQoL. Those with periodontitis experienced higher impacts on their OHQoL as compared to those who had a healthy periodontium or gingivitis and affected a wide range of domains of quality of life.
Oral health literacy (OHL) is important in empowering people to improve their general and oral health. Carers’ OHL may be associated with their ability to deliver good oral healthcare to their children. The aim of this pilot study was to assess the OHL among carers of special needs children. This is a descriptive cross-sectional study of carers in four Community-Based Rehabilitation Centre. Data were collected through a structured face-to-face interview of 40 carers. Oral Health Literacy Malay Version (OHLI-M) was measured using text passages and prompts with a total of 57 items. These items were used to assess comprehension and numerical ability of carers based on domains namely, accessing dental care, understand appointment and following medication instructions. The results showed that majority of the participants had ‘marginal’ and ‘adequate’ OHL level of 32.5% and 52.5%, respectively. Only four (10%) participants had ‘inadequate’ OHL level. The ‘reading comprehension’ and ‘numeracy’ sections’ mean scores were 37.54 (95% CI 35.7-39.4) and 38.17 (95% CI 34.8-41.6). The total OHL mean score was 75.7 (95% CI 71.2-80.2). In conclusion, majority of the carers of special needs children in this sample had moderate OHL. Such information is important to develop more appropriate intervention programmes for carers to match their OHL.
To assess the oral health behaviour and preventive dental care experiences of patients with special health
care needs (SHCN) who attended the Special Care Dental (SCD) Clinic at University of Malaya. Data
were collected from 31 patients using a self-administered questionnaire which consisted of questions
pertaining to their oral health behaviours and experiences on receiving preventive dental care (PDC).
For patients who were unable to answer due to existing health conditions, parents or primary caregivers
were approached as proxy. Descriptive analysis was conducted and reported based on percentages to
identify the oral health behaviour and PDC of the individuals. Majority brushed their teeth at least once a
day (84%), used fluoridated toothpaste (87%) and oral hygiene aids (58%). However, almost half of them
(48%) required assistance from parents or caregivers during tooth brushing and consumed sugary snacks
in between meals (58%). About 80% had received PDC where the type of care received was mainly oral
hygiene advice (77%). Slightly more than 80% preferred the one-to-one demonstration method during
PDC. Most gave positive evaluation on their PDC experience especially on items pertaining to the dentist’s
attitude. Whilst most of the SHCN patients in this study had positive perception on the PDC that they
received and practised good brushing behaviour, their dietary habits need to be improved. Thus, regular
preventive dental visit amongst SHCN patients is important for appropriate and comprehensive dental care
in maintaining oral health.
Diagnosis by histopathology remams as one of the most important investigative methods used to establish a definitive diagnosis of a lesion or disease state. The provision of oral tissue diagnostic services is therefore an essential function of an Oral Pathology unit. A review of the English language literature disclosed that much of the documented information on the patterns of oral diagnostic services were from the United States, Canada and the United Kingdom. This paper provides an overview of such surveys carried out in these countries.
A study was undertaken to identify the oral health status and treatment needs of 403 drug abusers enrolled in a drug rehabilitation center in Perak, Malaysia. The prevalence of dental caries was 97.0%. Calculus was present in 82.1% of the dentate individuals, but only 14.6% had pockets greater than 3mm. The mean DMFT observed was 11.7, with missing teeth (MT=9.6) constituting the major component. Denture needs were high (67.2%), but only 11.4% of individuals had prostheses.
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.
This paper represents a study of35casesofodontogenic keratocyst (OKC) diagnosed in a Malaysian population. The clinical, radiological and histopathological features, treatment modalities and recurrence of this lesion were analysed. There was a higher prevalence rate among Malaysian Chinese (51.42 percent), while the Malays and Indians accounted for22.86 percent and 25.72 percent respectively. The male to female ratio was 16 : 19.Age at presentation ranged from nine to 71 year,with about 70percent occurring between ages ten to 39 years. A total of40cysts were analysed. Of these, 67.5 percent occurred in the mandible and 32.5 percent in the maxilla. About 88percent of OKC presented as unilocular radiolucencies and 42.0 percent were associated with unerupted or impacted teeth. Histologically, the parakeratinized OKC was the predominant variant found (75.8 percent). The majority of caseswere treated by enucleation (85 percent), and a recurrence rate of20percent was recorded.
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.
Supernumerary teeth have a genetic predisposition
with a predilection for males. This article reports an
uncommon radiological finding in a non-syndromic
sibling pair who presented with supernumerary teeth
of different morphologies on opposite and different
regions of the dental arches. A 14-year-old Chinese
male presented with a conical supernumerary palatally
placed between the upper right central and lateral
incisors. His older brother had unerupted bilateral
supplemental supernumerary teeth between the roots
of the lower second premolars and first permanent
molars. Trends of the phenotypic presentation of
familial non-syndromic supernumerary cases are
discussed. Familial supernumerary teeth have been
suggested to be due to autosomal dominance or
recessive traits. Variation in the numeral, spatial and
morphological phenotypic expressions suggests a
multifactorial model of multiple genetic, epigenetic
and environmental influences. Clinicians need to be
mindful of the possible phenotypic variations that may
present when treating cases with family history of
dental anomalies.
Missing teeth can be due to hypodontia, trauma or extraction. In general, the options for treatment depend on the severity of the hypodontia and the severity of the malocclusion. Occasionally, the space from missing teeth has to be maintained for prosthetic replacement and require an orthodontic/restorative approach. It is very important to ensure the space maintained is adequate for aesthetic reason so that it can be replaced with a prosthesis after the orthodontic treatment is completed. This article discusses a new innovation and clinical technique for maintaining this space during orthodontic treatment by using an acrylic tooth with several modifications. This innovation will be illustrated using two cases.
The presence of macroglossia, a tendency towards poor cooperation and the inability to adapt to compl~te dental prostheses due to motor and mental deficiencies makes the oral rehabilitation of Down Syndrome patients difficult. This article reports on the use of mini implant supported overdenture to rehabilitate a Down Syndrome patient who had difficulty adapting to his new mandibular complete denture. The patient's ability to cooperate during treatment as well as the maintenance of an optimal oral hygiene practice enabled mini-implants to be inserted and maintained 20 months post insertion as evidenced by clinical and radiological findings. To the author's knowledge, this is the first reporting of a successful mini implant supported overdenture in a Down Syndrome patient.
This study aimed to evaluate the coronal microleakage of different thickness of different restorative materials (glass ionomer cement (GIC, GC Gold Label 2), composite restoration (SDR, Dentsply Sirona) and (Filtek Z350 XT, 3M ESPE)) used as final restoration in endodontically treated teeth. 72 sound maxillary incisors were used. Following instrumentation, all canals were obturated with gutta-percha (Dentsply Maillefer) and Roth sealer (Roth International Ltd). After 2mm of gutta-percha removal below cemento-enamel junction, the crown was cut until length of 6mm from the gutta-percha to the incisal edge was achieved. The teeth were divided into four experimental groups (n=18) and access restorations were placed in different thickness combinations. Group 1 (G1): 2mm SDR + 4mm Filtek; Group 2 (G2): 4mm SDR + 2mm Filtek; Group 3 (G3): 2mm GIC + 2mm SDR + 2mm Filtek; Group 4 G4): 6mm SDR. All samples were thermocycled (500 thermal cycles between 5o and 55o C and dwell time of 30s), coated with nail varnish leaving 1mm margin around the filling material, immersed in 2% Rhodamine B solution and sectioned longitudinally. The dye penetration was observed under a stereomicroscope (Olympus SZX7) with 1.25x magnification. The data were analysed using Kolmogorov-Smirnov test, ANOVA test and post-hoc Tukey’s HSD test. There was significant difference of microleakage among all groups. G1 showed least microleakage but with no significant difference between G1 and G3 (p=0.513) and G1 and G4 (p=0.477). G2 showed significant microleakage compared to G1, G3 and G4 (p
Microleakage testing has been used to determine the possible clinical performance of a restorative material. Many microleakage testing materials have been developed and performed through the years. There has been no agreement as to which testing methodology would give the most accurate results. Attempts have been made to simulate the oral conditions and to give a more quantitative representation of micro leakage. The different micro leakage testing methodologies are presented in this paper.