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?
An 11-year-old Malay boy was allegedly involved in motor vehicle accident. He sustained left lung contusion and pneumothorax which necessitate chest tube insertion at a district hospital. On arrival at Accident & Emergency Unit, general physical examination was performed. Neck examination revealed multiple jagged lacerations wound on the left side of the neck (Panel 1). (Copied from article).
A 38-year-old female presented with foreign body sensation in the throat for one year. It was
increasing in severity. There was no other associated symptom. Examination of the oral cavity showed an abnormal looking uvula(Fig. 1). The rest part of the oral cavity, oropharynx and larynx were unremarkable. What is your diagnosis?(Copied from article).
Assault injury can occur to any parts of the body. Usually the target area is the head, neck, chest and abdomen as they contain many major structures that are vital for life. However, movement of the victim few seconds before the instrument reach the body can redirect the impact to the less fatal part of the body. The outcome may be less fatal but can lead to cosmetically unacceptable condition. (Copied form article).
Tracheocutaneous fistula (TCF) is a known complication of tracheostomy. It can cause problems such as saliva leak, predispose to infection from external skin into respiratory tract and cosmetically not acceptable. Treatment of the underlying infection is paramount important. Persistence of tract after sufficient duration of observation period should be surgically treated. Cases reported in the literature are mainly regarding paediatric TCF and the procedures are usually done under general anesthesia. We describe a case of surgical treatment of an adult TCF which was done under local anaesthesia.
This is a cross sectional study to determine the attitudes and practices in smoking cessation counselling among dentists in Kelantan and to identify the barriers that prevent them from doing so. Self-administered questionnaires were distributed to 152 dentists practising in Kelantan. A total of 84 (55.2%) questionnaires were completed and returned. Although majority of the dentists (98.8%) agreed that they have a role in smoking cessation counselling, only few of them (17.9%) were actually involved in a considerable extent. The main barriers cited were lack of training and time in their practice. In conclusion, dentists in Kelantan believed that they have a role in smoking cessation counselling but their involvement was rather limited.
The purpose of this study was to determine the timing and sequence of emergence of the first 28 permanent teeth in a cross-section of Malay children in the district of Kota Bharu, in northeastern Peninsula Malaysia. The sample consists of 478 boys and 908 girls of Malay descent aged between 5-19 years. The criterion for tooth emergence was the appearance of the tooth through the gingivae. Descriptive statistics were calculated and probit regression analysis performed to determine the mean age of emergence of the permanent dentition. The mean age at emergence was found to conform to general trends, with emergence seen earlier in girls than in boys. Comparisons were made with the Chinese (Hong Kong) and the Punjabi (Chandigarh) profiles, which showed earlier emergence timings in those ethnic groups. The emergence timing in Malays, however, was earlier than in Thais (Central Thailand). The sequence of emergence was determined by referring to the mean age of tooth emergence of individual teeth and conforms to the general trend seen in other studies.
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.
Lasers were introduced into the field of clinical dentistry with the hope of overcoming some of the drawbacks posed by the conventional methods of dental procedures. Since its first experiment for dental application in the 1960s, the use of laser has increased rapidly in the last couple of decades. At present, wide varieties of procedures are carried out using lasers. The aim of this review is to describe the application of lasers in dental hard tissue procedures. Lasers are found to be effective in cavity preparation, caries removal, restoration removal, etching, and treatment of dentinal sensitivity, caries prevention and bleaching. Based on development in adhesive dentistry and the propagation of minimum intervention principles, lasers may revolutionize cavity design and preparation.
Sialolithiasis is one of the commonest disease of salivary glands. Submandibular salivary gland
or its duct is a major site of sialolithiasis and it is always leads to sialadenitis. However large sialolith
formation and self-extrusion is a rare condition. A case of submandibular sialolithiasis is reported where
patient presents with recurrent submandibular swelling and subsequently end up with a spontaneous
extrusion. The mechanisms and management of the salivary gland calculi are also discussed.
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 (
Epidemiological studies of occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the aetiology of malocclusion. The objective of this article was to give an overview on occlusion, malocclusion and the various methods on measuring the occlusion. Each index and method of the assessment described was based on the opinion of an individual or a group of individuals. It had been widely agreed that no particular index or method available that are truly inclusive of all occlusal criteria. Therefore, different indices or method had been developed according to different requirements and it may be necessary to use more than one index in order to gather information to suit the objective of the particular study.
This is a cross-sectional study in a representative sample of preschool children from 12 preschools (TADIKA KEMAS) Pasir Mas, Kelantan, Malaysia. Data on socioeconomic status and sources of water supply at home were collected through interview with mothers. Children’s anthropometric data (height and weight) and body-mass-index-for-age (BMI-for-age) was calculated. Oral examinations of ECC status was based on the dmft index (WHO, 1997). The results showed mean
carious teeth were very high (dmft 11.1±4.8) and almost every preschool child was affected with ECC (prevalence 98.1%). The majority were in “high caries” category (i.e. dmft >7) and about 51.4% of preschoolers was underweight and only a few was overweight/obese. Preschool children with high caries mostly were underweight and normal of BMI. The BMI-for-age, household income and household expenditure for food were significant correlation with ECC experience (p
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.
Primary intra-osseous squamous cell carcinoma (PIOSCC) is a rare tumour which occurs centrally
within the jaws. It is believed to arise from odontogenic epithelial remnants or from pre-existing odontogenic
cysts/tumours. A case of PIOSCC arising from an odontogenic cyst in a 57-year-old female is discussed.
Initial clinical and radiographic examination was suggestive of an odontogenic cyst / cystic tumour. The
lesion was enucleated and sent for diagnostic histopathology which revealed the presence of an invasive
carcinoma arising from the walls of the odontogenic cyst. The patient then underwent right mandibular
resection and reconstruction as well as right supra-omohyoid neck dissection. Long standing odontogenic
cysts have the potential to undergo malignant transformation though this may not always be the case.
Relying only on radiographic findings for the management of cyst-like lesions without obtaining
histopathological diagnosis is extremely ill-advised.
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.
Many studies have indicated that hearing-impaired (HI) children have poor oral hygiene mainly
contributed by difficulties in communication. The objectives of the study were to assess the difficulties
experienced by HI children during dental visit and the effectiveness of “Oral Health Care for the HearingImpaired”
(OCHI) programme in improving the oral health knowledge and practice, and reducing the dental
plaque maturity scores among HI children. A community intervention study was conducted and training of trainers
(TOT) was done to train the teachers in delivering oral health education (OHE) and practices by using developed
booklet and video. The difficulties faced by the HI children during dental visit, and the oral health knowledge and
practice (OHKP) were assessed by face-to-face interview with HI children whilst the dental plaque maturity was
assessed using GC Tri Plaque ID Gel™ (TPID) during pre-intervention, post-intervention-1 and postintervention-2.
Data were analysed using SPSS version 22. Among the teachers, there was an increase in the
mean (SD) total knowledge and attitude score during post-TOT compared to pre-TOT, 46.1 (2.44) and 43.7
(4.01); (p
The objective of this study was to evaluate the effects of salivary testing in dental caries assessment. The role of saliva flow rate, pH, viscosity and buffering capacity in subjects with high caries (DMFT>5) (group 1) against subjects with low caries (DMFT=0) (control group) were evaluated. 40 subjects between the age of 18 and 40 years old were selected (20 subjects control group and 20 subjects group 1). By using a salivary testing kit (GC Asia Dental Pte Ltd, Japan), each subject underwent test such as hydration status of the oral mucosa, viscosity and pH of resting saliva, stimulated salivary flow rate and buffering capacity of stimulated saliva. The results showed that the flow rate, viscosity, pH and buffering capacity of saliva in subjects of group 1 (DMFT>5) was significantly lower (p
Supernumerary tooth (ST) is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. When it remains embedded, it may cause disturbance to the developing teeth. The erupted supernumerary tooth might cause aesthetic and/or functional problems especially if it is situated in the maxillary anterior region. A case of supernumerary teeth is presented where the teeth have been left in place and which later gave rise to some problems. The patient had history of trauma and requested orthodontic treatment for the misalignment of his anterior teeth. The treatment options are further discussed.
Infection of the oral cavity with high-risk human papillomavirus (HPV) has been implicated as one of the risk factors for the development of oral squamous cell carcinoma (OSCC). Among the high-risk HPV types, HPV 16 and 18 are the most common infective agents in oral cancers. This study aimed to compare the presence of high-risk HPV in genetic materials obtained from saliva, blood and tissues of OSCC patients in Malaysia. The genomic DNA was extracted from saliva (n=13), blood (n=59) and tissue (n=63) and subjected to polymerase chain reaction (PCR) amplification of human beta globin gene to confirm the presence and integrity of DNA. Positive amplification was then screened for high-risk HPV by nested PCR using MY11/09 and GP5+/6+ consensus primers, followed by a further confirmation by DNA sequencing of the positive samples. As a result, two saliva samples (2/13; 15.4%) were found to harbour HPV 16 and one tissue sample (1/63; 1.6%) was shown to be positive for HPV 18. However, none of the blood samples were positive for high-risk HPV. Thus, HPV is more likely to be found in the saliva of OSCC patients as compared to blood and tissue samples. The detection of high-risk HPV in OSCC patients is useful in deciding how to manage the patient as HPV-associated OSCC has better prognosis.