Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.
The main objective of a root end filling material is to provide an apical seal that prevents the movement of bacteria and the diffusion of bacterial products from the root canal system into periapical tissues. The aim of this study was to compare the microleakage of three root end filling materials Mineral trioxide aggregate (MTA), Glass ionomer cement (GIC) and Silver GIC (Miracle Mix) using dye penetration technique under stereomicroscope. Forty-five extracted human maxillary central incisors were instrumented and obturated with gutta percha using lateral compaction technique. Following this, the teeth were stored in saline. After one week, teeth were apically resected at an angle of 90ï° to the long axis of the root and root end cavities were prepared. The teeth were divided into three groups of fifteen specimens each and were filled with Group I -MTA, Group II - GIC and Group III - Miracle Mix. The samples were coated with varnish and after drying, they were immersed in 1% methylene blue dye for 72 hours. The teeth were then rinsed, sectioned longitudinally and observed under stereomicroscope. The depth of dye penetration was measured in millimeters. Microleakage was found to be significantly less in MTA (0.83 mm) when compared to GIC (1.32 mm) (p < 0.001) and with Miracle Mix (1.39 mm) (p < 0.001) No significant difference was found when microleakage in Miracle Mix was compared to that of GIC (p = 0.752). Thus we concluded that MTA is a better material as root end filling material to prevent microleakage, in comparison to GIC and Miracle Mix.
Complicated crown-root fractures are rare and often need complex treatment planning. This paper describes a simplified treatment option for a complicated crown root fracture that minimally encroached into the biologic region in a growing child without the need for surgery or orthodontic treatment.
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.
Ameloblastoma is a slow growing benign tumour of the jaw and patients usually present late after the tumour achieved considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and characteristic findings on plain X-rays does assist in differentiating between types of ameloblastoma. The challenges in the management of this tumour are to provide complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect in order to give reasonable cosmetic and functional outcome to the patient.
The use of fluoride as a preventive measure for dental caries has been established more than 50 years ago. The recommendations for fluoride use has been modified over the years due to factors like decreased prevalence of caries, increased prevalence of dental fluorosis and the widespread availability of fluoride in various forms to the community. In recent years, the role of evidence-based recommendations has come to the forefront, in an attempt to ensure the most favorable treatment for the individual. This review has attempted to appraise the most recent evidence- based recommendations for different fluoride modalities put forth by various organizations worldwide, in order to appreciate the current status of fluoride in the early 21st century.
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.
A case of a large dentigerous cyst associated with canine tooth in the maxillary antrum is presented. This case is of interest because of its extensiveness and the presence of an ectopic tooth in the roof of the maxillary sinus. Theoretical aspects of canine impaction and cyst formation are reviewed. The management of a jaw cyst, in particular, the still popular Caldwell-Luc procedure is discussed.
Given that the germline mutations of BRCA1 and BRCA2 confer genetic susceptibility to cancer, the
genetic variations, polymorphisms or mutations are widely analyzed in Western countries. However, in Asian
population, the prevalence of BRCA1 and BRCA2 polymorphisms is very limited. In Asia, breast cancer occurs in
women early with an age of onset under 50 years. This review comprises the incidence of BRCA1 and BRCA2
polymorphisms in the Japanese, Korean and Malaysian population. Founder mutations of BRCA1 and BRCA2
were also compared to mark the genetic difference in these populations. The mutational analysis performed to
analyze the entire coding region of BRCA1 and BRCA2 include the next generation sequencing and full
sequencing of all exons and intron-exon junctions. From the diagnosis of triple negative breast cancer (TNBC)
patients, TNBC is associated with the lack of tailored therapies and the treatment option available for TNBC
patients is mainly chemotherapy. The poor prognosis of TNBC leads to determine the predictive biomarkers in
order to develop treatment efficacy. This review will address the current clinical therapies available to treat TNBC
patients.
Prosthodontic rehabilitation and management of microstomia patient presents challenges at all stages
during prosthesis fabrication; from making primary impressions to the prostheses insertion. These patients have
reduced mouth opening, and hence it can be extremely challenging to make impressions and to fabricate
dentures using the conventional methods. The present case report describes prosthodontic management of a
partially dentate patient with microstomia that developed secondary to surgical resection and radiation therapy of
head and neck cancer. A simplified novel approach has been advocated using the patient’s existing metal
removable partial denture as a key in master cast preparation.
Foreign bodies (FB) are most often lodged in the upper digestive tract and amongst the common encounter in outpatient clinic. In most instances, the ingested FB passes uneventfully through the gastrointestinal tract without any harm but in certain cases, it can migrate extraluminally and lead to serious complication. Long standing migrated FB can cause devastating complications like neck abscess and injuries to the major blood vessels. In the present case, a wooden toothpick had migrated to the soft tissue of the neck. A careful and detailed history with clinical-radiographic investigation helped to locate the ingested FB and aided in its successful removal.
Study site: Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Taiping, Perak, Malaysia
Fluorosis is important to measure because it is a condition that can be used as biomarker for the level
of fluoride exposure during enamel formation. Increased and decreased in fluorosis prevalence may also reflect
to the different ways of measuring the disease. The choice of measuring fluorosis is depends on the objective of
the assessment such as assessing public health significant of fluorosis in the population or assessing the detailed
of biological effects of fluoride. These differences in requirement have led to the adoption of many indices and
assessment methods of enamel fluorosis, which subsequently led to evaluation of examiner agreement between
them. Several indices were developed to measure dental fluorosis in the 20th century. These include fluorosis
specific indices such as Dean’s Index; the Thylstrup and Fejerskov Index; the Total Tooth Surface Index; and the
Fluorosis Risk Index. Non-specific descriptive indices such as the Developmental Defects of Enamel index have
also been used to record fluorosis. Fluorosis has most commonly been recorded using clinical examinations and
photographs. Recent developments have seen the use of a Visual Analog Scale and automated grading systems
such as Quantitative Light Fluorescence emerge as possible enhancements to fluorosis scoring. This article aims
to review existing indices and new methods in measuring dental fluorosis, together with examiner reliability
across different methods and indices.
The present study compared and evaluated the shear bond strength (SBS) of two types of glass
ionomer cement (GIC), Riva Self Cure HVTM (SDI Ltd., Victoria, Australia) and GC Fuji IX GP EXTRATM (GC
America Inc., Alsip, USA) with and without the use of Riva Bond LCTM (SDI Ltd., Victoria, Australia), a lighted
cured resin-modified glass ionomer cement (RMGIC) universal adhesive. Sixty extracted sound premolars with
prepared exposure of the dentine on the occlusal surface were randomly assigned into four groups according to
the tested restorative materials. Shear bond strength (SBS) tests were performed by using the Shimadzu
Universal Testing Machine at a crosshead speed of 0.5 mm/minute, and the values obtained were statistically
analysed using one-way ANOVA and Tukey tests. The inter-group comparison showed statistically significant
differences in the SBS values between all the test groups (p < 0.001). A stereomicroscope was used to assess
the modes of failure. Adhesive failures were predominant in adhesive groups (>80%) compared to higher
cohesive failures found in the non-adhesive groups (>86%). A Spearman's rho correlation test performed to
determine the association between SBS values and mode of failures had indicated positive correlations between
the adhesive failure and SBS values in the adhesive groups (rs=0.86, p
Surgical ciliated cyst of the maxilla is a rare complication following surgical procedures or trauma
involving the maxillary sinus. It can occur at any time after any procedures or trauma involving the maxillary
sinus even though many years have lapsed. Clinically it may mimic other cysts of the maxillary sinus
therefore a thorough history taking is necessary for diagnosis. Treatment is usually by enucleation or
marsupialisation. This report highlighted a case of surgical ciliated cyst involving the right maxillary sinus
probably secondary to maxillary sinus procedures, which were performed 30 years prior to presentation.
Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery. The result of this study showed that there is no significant difference between the three irrigating solution used in surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.
Study site: Oral surgery clinic, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia
Perivitelline fluid (PVF) of the horseshoe crab embryo has been reported to possess an important role
during embryogenesis by promoting cell proliferation. This study aims to evaluate the effect of PVF on the
expression of cell cycle regulatory genes from human dental pulp stem cells (DPSCs) between different cell
passages viz. 4, 5, 6. The cells were treated with a single dose of PVF (26.89 mg/ml) PVF. Gene expression was
quantified for CDKNA2A, PTEN, MDM2 and TP53 genes using reverse transcriptase PCR. CDKN2A and MDM2
expression for treated and untreated DPSCs, expressed a similar pattern of expression. The higher expression of
CDKN2A showed that the treatment increased cell proliferation and prevented cell senescence. DPSCs with PVF
treatment showed increased expression of MDM2 at passage 4 and drastically declined expression at passage 5
and slightly increased at passage 6. TP53 expression of DPSCs treated group showed a higher expression
compared to untreated group. On the other hand, the expression of PTEN in DPSCs treated group started to
increase from passage 5 to 6. However, on the whole, the PTEN expression was higher than the untreated group
in all the passages studied here. The results showed that PVF could enhance cell cycle regulatory gene
expression in DPSCs as indicated by the higher expression of all the genes considered in this study at different
cell passages in the treated group compared to the untreated group. Mann Whitney test was utilized to determine
the significance of cell cycle regulatory genes expression between treated and untreated group. Significant
difference in expression of genes between the treated and untreated groups were found at all passages except
for CDKN2A gene whereby, its expression was not significantly different at passage 5 though it did express
slightly higher in PVF treated DPSCs.
The unilateral nasal symptom should trigger a treating physician to a certain diagnosis. The differential
diagnosis includes foreign body, rhinolith and tumour. The chronicity of symptom helps a lot with the diagnosis.
Foreign body for example, tends to present with positive history of insertion, mainly by children or the acute
symptom of local infection. In the presence of prolonged symptom, rhinolith should be suspected especially when
the patient presents with pathognomonic nasal obstruction with foul smelly discharge. A referral should be made
for a nasoendoscopy evaluation whenever a rhinitis-like symptoms remain after a period of medical treatment for
allergy. We share a case of a missed diagnosis of a rhinolith after six years of symptoms.
Prolonged work with highly repetitious flexion and extension of the wrist and forceful grip task were shown to increase the risk of developing carpal tunnel syndrome (CTS) among dental personnel. The present study was carried out to determine the prevalence, risk factors and coping strategies of probable CTS among clinical dental support staff in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted and a set of questionnaire consisting of socio-demographic status, work-related and psychosocial risk factors and coping strategies was distributed. Ninety-five clinical dental support staff completed and returned the questionnaire with a response rate of 80.5%. The prevalence of probable CTS was 38.9%, with the highest prevalence was found among dental surgery assistants (40.5%) followed by dental technologists (29.7%). There was no significant association between work-related or psychosocial risk factors with probable CTS (p>0.05). Most of the respondents with symptoms of CTS chose religion as the coping mechanism; mean 7.11 (SD 1.13). Awareness training should be emphasized among clinical dental support staff on the prevention of CTS.
Study site: Hospital Universiti Sains Malaysia (HUSM)
Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is relatively a rare tumour of head and
neck region. Without histopathological confirmation, it appears and behaved as like malignant epithelial tumor of
the head and neck region as will be illustrated in the present case. Cutaneous involvement of the tumor with
distant metastasis has made the prognosis unfavorable. This isolated case of head and neck PC-ALCL was
highlighted as it has a tendency to behave aggressively and early diagnosis and treatment is crucial to avoid poor
survival outcome.
Resin-bonded fibre-reinforced composite bridges provide many advantages over the conventional
bridges or implant treatment in the management of a traumatically or congenitally missing anterior tooth.
Furthermore, there is an increasing demand towards providing a metal free resin-bonded bridges over the alloybased
restorations in order to meet the aesthetic needs especially in the anterior region. Advances in the
adhesive technology and tooth colored materials offer improved bonding system and better aesthetic outcome.
Nevertheless, careful selection of cases to receive this type of approach is also one of the key factor to ensure
the clinical survival of fibre-reinforced composite bridges. This report aims to present the use of fibre-reinforced
composite to construct indirect cantilever fibre-reinforced composite bridges as part of minimum intervention
dentistry.