Diagnosis and management of orofacial pain of non-odontogenic origin has always been a challenge to dentists. Inaccurate diagnosis would result in delay of treatment and in cases of orofacial pain, affects patient’s quality of life. Temporomandibular pain dysfunction syndrome is the most common temporomandibular disorder that presents to dental clinics. Trigeminal neuralgia, also known as ticdouloureux is a relatively rare condition that causes electric shock-like pain when the trigger zone is stimulated by triggering factor. Case report: A case of temporomandibular pain dysfunction syndrome in a 52 years old Indian lady that was managed as trigeminal neuralgia for 7 years is presented. Conclusion: The aim of this case report is to make dentists aware of the signs and symptoms of different orofacial pain, so that early and accurate diagnosis can be made and appropriate treatment instituted.
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.
A case is described in which a compound odontoma erupted into the oral cavity in an 8 1/2-year-old girl. The odontoma was initially discovered as a chance radiographic finding 2 years 8 months previously.
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.
To determine the number of cases that are at risk of poor stability in terms of arch width changes following fixed appliances treatment at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. In a retrospective audit, 101 pre- and post-treatment lower study casts were selected from cases completed in the year 2015 at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. Samples were measured using a universal caliper by a single calibrated operator. Samples was categorised as extraction or non-extraction types. Arch width changes was determined using paired T-test. The recommended limit was 0mm for inter-canine width, 2 mm for inter-first premolar width and 3mm for inter-second premolar and inter-molar width. Differences were considered “within limits”, if the changes were within the recommended limit ±0.25mm (for possible marginal measurement error) and “expanded”, if above the range for within limits. 42.6% were non-extraction while 57.4% were extraction cases. In the non-extraction group, 52.2% cases had expanded inter-canine widths, followed by inter-first and second premolars (27.9%) and interfirst molar (20.9%) widths. Arch width changes for the inter-first and second premolars and inter-molars widths were statistically significantly different (p<0.05) but bot clinically significant. In the extraction group, 67.2% had expanded inter-canine widths, followed by inter-first premolar (64.3%), inter-second premolar (9.1%) and inter-first molar (5.2%) widths. The inter-canine (M=1.43; SD=2.71, p<0.05) and inter-first premolar (M=2.87; SD=2.61, p<0.05) widths statistically and clinically significant expansion but the inter-second premolar and molar were significantly contracted (p<0.05). The number of cases with expanded arch widths was high regardless of the extraction type.
Keywords: Arch width expansion, stability
Decalcified permanent teeth were sectioned and stained with Van Gieson and Gomori trichome dyes. Sections dyed with the Van Gieson dye did not produce any zones in dentine but with the Gomori trichome dye, four different zones of dentine were produced. Zone 1 begins at the predentine-dentine junction while zone 4 ends at the enamel - dentine junction. In zone 1, the intertubular dentine was stained clearly while in zone 3 intense staining of the peritubular dentine was observed. The result of this study supports the previous findings reported by other workers that the formation of intertubular dentine takes place in zone 1 while peritubular dentine occurs in zone 3.
This article reviews the concept of Combination Syndrome and presents a clinical case of a patient with a modern variation to this clinical scenario': The clinical procedures involved in the provision of a maxillary complete denture against a mandibular implant-supported complete fixed prosthesis is described with some suggestions on how to optimise the treatment outcome for the patient.
The objectives of this study were to assess the practice of molar root canal treatment (RCT) among general dental practitioners (GDPs), confidence level of GDPs in performing molar RCT and to identify factors that influence their confidence in managing molar RCI. One hundred questionnaires were distributed to GDPs in Kuala Lumpur and Selangor. Fifty questionnaires were delivered by mail and the remaining fifty were hand-delivered. All data was coded and verified. Fiftysix OOPs rcsponded to the questionnaires. Only fortyfive questionnaires were accepted (n=45) as eleven OOPs had never performed molar RCI. Most of the OOPs followed the standard quality guidelines while performing molar RCT except for vitality testing (36.4%) and rubber dam usage (27.3%). In this study, 100% of the GDPs were confident in making diagnosis of perinidicular diseases and 95.4% were confident in performing molar RCT from history taking until obturation. Patients' tolerance and availability of instruments and materials (97.7%) were two factors that most influence the GDPs' confidence level. The. least influcncing factor was undergraduate training (78.1 %). Attending seminars and lectures on endodontic, large number of molar teeth treated for ReT, patLents' affordability to pay for RCT and postgraduate training also influencc GDPs' confidence to a certain degree. From this study, it can be concluded that majority of OOPs complied standard quality guidelines except for vitality testing and rubber dam usage. Most of them were confident in performing molar RCT and were greatly influenced by the availability or"instruments and materials in their clinic and patients' tolerance in receiving molar RCI.
Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.
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.
To determine the amount of displacement of a structure
noticed on an image when the tube of a dental X-ray
machine was shifted vertically and horizontally. In
addition, various intraoral images were combined with
dental panoramic images to determine the location of
structures. Our research is based on the parallax
technique which requires manipulation of horizontal
and vertical angulations of the X-ray tube. A metal
object is positioned on the buccal and palatal side of
the maxilla on the canine area of a skull. The X-ray
tube is shifted incrementally to obtain images on
phosphor plates. Subsequently, panaromic and occlusal
images were taken to assist in localization of the metal
object. To obtain a clear image shift of 2-3mm using
the parallax method, there must be an adequate
horizontal tube shift of approximately 30-35 degrees.
When images were used in combination of dental
panoramic images, it was found that the buccally
placed structures can be accurately located with the
periapical or occlusal images. However, the
displacement of images in the palatally placed
structures in panoramic imaging is not fully
appreciated with the principle of parallax method. Tube
movement of 30-35 degrees horizontally is needed for
a 2-3 mm image shift. To successfully localize a buccal
structure, a combination of either periapical or occlusal
images with a dental panoramic imaging can be
employed. However, this combination with panoramic
imaging is limited when looking at palatally placed
structures.
Background: In Malaysia, preschool teachers have long been utilised as oral health educators. However their level of oral health knowledge and effectiveness of the training they received are seldom investigated. This study aims to evaluate the of oral health education seminar (OHE) held for public preschool teachers (KEMAS) in terms of the improvement of their knowledge, practices and attitudes.
Methods: This was a one arm interventional study (before and after survey following OHE seminar intervention). All KEMAS preschool teachers (n=107) in Hulu Terengganu were invited to attend OHE seminar which consisted of 1 hour lecture and 40 minutes OHE demonstration. Pretest questionnaire was collected before the seminar started and post-test questionnaire was collected two weeks later. A self-administered questionnaire used in this study was adapted from “preschool teachers’ knowledge, practices and attitudes towards oral health”, National Oral Health Survey of Preschool Children, 2005. Data were analysed using descriptive and McNemar test, SPSS version 15.0.
Results: Of 107 subjects, only 61 teachers responded yielding to 57% response rate. All subjects were female with mean age of 46 years (SD: 6.03). Overall, there was an improvement of teachers’ oral health knowledge, practices and attitudes after the seminar. Several items seem to have be improved significantly after the seminar, for example knowledge item on factors causing periodontal disease (p=0.03). In terms of practice, all teachers reported they brushed teeth at least twice daily using fluoridated toothpaste and use of dental floss was increased significantly after the seminar (p<0.001). Majority of teachers have positive perceptions on their roles in oral health education.
Conclusion: Oral health education seminar appeared to be effective at influencing certain aspects of teachers’ oral health knowledge, practices and attitudes.
Keywords: attitudes, knowledge, oral health promotion, practice, preschool teachers
Dental quackery has been a problem for decades and is becoming a major concern in many countries, including Malaysia. Recent development of a new service offered by quacks in Malaysia is “fake braces”, which alarmed dental professionals. The fake braces appear similar to the professionally fitted orthodontic appliances comprising of archwires that are secured on brackets by coloured ligatures except they are fitted by unqualified individuals who have no formal clinical training. In addition, the orthodontic materials and dental equipment used for this illegal service were substandard and unregulated. Therefore, such fitted appliances are harmful to the teeth and oral health. Efforts to record the extent of fake braces practice and its oral health consequences have been challenging as they are marketed through the social media, and the victims were either reluctant to come forward or did not know the appropriate channel to file a complaint to the health authority. This is an expert opinion paperwith theaimsto highlight typical presentation of fake braces, modus operandi of fake braces providers, the harmful effects of fake braces on the patient’s oral health, the role of social media advertising in promoting fake braces, and the impacts to the illegal providers.
This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.
Polishing of dental ceramics has become an increasingly important procedure in restorative dentistry as allceramic restorations, which require post-cementation occlusal adjustment, are gaining in popularity. There are numerous studies in both dental and ceramic literature on polishing of dental ceramics and the effects of polishing on their mechanical properties. However, lack of standardization in polishing parameters, precludes comparison among these studies. A clear understanding is lacking of the relative roles and interdependence of handpiece speed, abrasive characteristic, and polishing load. This paper will discuss the mechanism of polishing and review the literature on polishing and its effect on the mechanical properties of ceramic restorations.
Solanum ferox L. is a plant species which belongs to the Solanaceae family and the genus Solanum. The Solanum genus was found to exhibit anticariogenic activity and was traditionally used to treat oral diseases. However, there is no scientific study done specifically for Solanum ferox L. Hence the aim of the study is to determine the anticariogenic properties of flesh and leaf of ethanolic extract of Solanum ferox L. Alkaloids, flavonoids and tannins were detected in the leaf ethanolic extract via preliminary phytochemical screening. The presence of these phytochemicals may contribute to the anticariogenic activity. Treatment with different concentrations of flesh and leaf of ethanolic extract were used against Streptococcus pyogenes and Staphylococcus aureus via the method of agar well diffusion to indicate zones of inhibition. The antibiofilm activity of the flesh and leaf ethanolic extracts was tested. The flesh and leaf ethanolic extracts possess antimicrobial activity dose-dependently and positive antibiofilm activity against respective pathogens. The flesh ethanolic extract has stronger anticariogenic activity compared to leaf ethanolic extract against respective pathogens. Streptococcus pyogenes exhibited higher susceptibility as compared to Staphylococcus aureus. In conclusion, it has been shown that the ethanolic extract of Solanum ferox L. exhibit anticariogenic properties against Streptococus pyogenes and Staphylococcus aureus.
This clinical case report details the clinical sequence of a 78-year-old male receiving prosthetic rehabilitation using an implant-supported screwretained fixed partial denture. Despite the limitations imposed, the aesthetic and functional demands of the patient were fulfilled by this prosthetic rehabilitation. The importance of detailed prosthetic planning and evaluation prior to implant surgery is essential, therefore ideally, it should be done by the same operator or a team of operators working together. Problems can arise when the construction of the prosthesis is performed by other people who are not involved in the planning stage.