MyMedR

Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?

Ngeow WC

J Can Dent Assoc, 2010;76:a61.

PMID: 20579448

Fulltext Lower lip numbness due to peri-radicular dental infection

Ngeow WC

Med J Malaysia, 1998 Dec;53(4):446-8.

PMID: 10971994

Lower lip numbness has always been a sinister symptom. Much has been written about it being the sole symptom of pathological lesions and metastatic tumours in the mandible. It may also be a symptom of manifestations of certain systemic disorders. A case of lower lip numbness resulting from the compression of the mental nerve by a peri-radicular abscess is presented because of the unusual nature of this spread of infection.

Transcultural oral health care of the Chinese

Ngeow WC

Dent Update, 2000 Dec;27(10):515.

PMID: 11218618

Management of the fractured maxillary tuberosity: an alternative method

Ngeow WC

Quintessence Int, 1998 Mar;29(3):189-90.

PMID: 9643254

The maxillary tuberosity can fracture during extraction of a molar tooth. If a small bony fragment is affected, the extraction of the tooth and tuberosity continues; however, a conservative approach is advised if the bony fragment is large. In a modified blind surgical technique, the tooth is removed without the fractured bone.

Fulltext The use of gutta-percha point to locate the origin of facial sinus

Ngeow WC

Med J Malaysia, 1997 Jun;52(2):181-2.

PMID: 10968080

Infection from the wisdom teeth usually causes severe swelling at the region of the angle and body of the mandible. Occasionally, it tracts outward to form a cervicofacial sinus. This paper demonstrates the use of gutta-percha point to locate the origin of a cervicofacial sinus due to an asymptomatic impacted wisdom tooth. The advantage of using gutta-percha point is discussed.

Dental fellowship training in Malaysia--a personal experience

Ngeow WC

J Ir Dent Assoc, 1997;43(3):82-4.

PMID: 9584759

Commentary

Ngeow WC

J Neurosci Rural Pract, 2012 May;3(2):158.

PMID: 22865968

Injection of botulinum toxin type A (BOTOX) into trigger zone of trigeminal neuralgia as a means to control pain

Ngeow WC, Nair R

Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010 Mar;109(3):e47-50.

PMID: 20219585 DOI: 10.1016/j.tripleo.2009.03.021

This article illustrates a case of persistent trigeminal neuralgia in a medically compromised 65-year-old female who did not respond to pharmacotherapy. She had undergone several peripheral neurectomies as well as a failed right posterior fossa exploration that resulted in a cerebrospinal fluid leak. Persistent pain over the right external nasal area and right mental region was relieved for several hours after daily injections of bupivacaine. A trial of a single dose of 100 units of botulinum toxin type A (BOTOX) diluted in 2.5 mL saline was injected into the external nasal trigger zone (60 units) and to the mental nerve region (40 units). She achieved complete pain relief in the external nasal region for 5 months. Pain recurred and the site was again injected with 100 units of botulinum toxin type A (BOTOX). Pain relief at the mental region was partial. This was finally controlled with peripheral neurectomy. The patient was pain free with a maintenance dose of 200 mg carbamazepine daily for about 1 year, after which she elected to undergo stereotactic gamma knife radiosurgery when pain recurred at the external nasal region.

Fulltext Do Corticosteroids Still Have a Role in the Management of Third Molar Surgery?

Ngeow WC, Lim D

Adv Ther, 2016 Jul;33(7):1105-39.

PMID: 27287853 DOI: 10.1007/s12325-016-0357-y

INTRODUCTION: The use of corticosteroids to reduce the post-operative sequelae of lower third molar surgery, namely pain, swelling and trismus, has been well studied by many researchers over the past 6 decades. This study reviewed the reported outcome of corticosteroids used in controlling the above sequalae after third molar surgery.

MATERIALS AND METHODS: A PubMed, Medline, EMBASE and Google search was undertaken of all controlled clinical trials on the effects of corticosteroids on pain, swelling and trismus after lower third molar surgery. The review was limited to studies published over the last 10 years (2006-2015).

RESULTS: Of the 46 initially retrieved articles, 34 were finally included. Eleven studies compared the effect of 2 similar (but different dose) or different group of corticosteroids. Thirty-one studies reported the effects of corticosteroids on all sequale, 2 reported the outcome on swelling and trismus and another 1 on swelling and pain only. In 16 of the studies, corticosteroid use resulted in significant reductions in pain after third molar removal. Twenty-two out of 29 studies reported reduced swelling against negative control while 18 out of 25 studies reported improved mouth opening. Fourteen studies reported the benefit of corticosteroids on all 3 sequelae, with 71.4% resulted from the use of methylprednisolone.

CONCLUSION: Although there are some conflicting effects, the results of this analysis shows in general the benefits derived from short-term use of corticosteroids in relation to pain, swelling and trismus following third molar surgical extraction, with no side effects observed.

FUNDING: This work was supported by the University of Malaya's High Impact Research grant UM.C/625/1/HIR/MOHE/05.

The location of the mental foramen in a selected Malay population

Ngeow WC, Yuzawati Y

J Oral Sci, 2003 Sep;45(3):171-5.

PMID: 14650583

Knowledge of the position of the mental foramen is important both when administering regional anesthesia and performing periapical surgery in the mental region of the mandible. This study determines the position of the mental foramen in a selected Malay population. One hundred and sixty nine panoramic radiographs of Malay patients retrieved from a minor oral surgery waiting list were selected to identify the normal range for the position of the mental foramen. The foramen was not included in the study if there was any mandibular tooth missing between the lower left and right first molars (36-46). The findings indicated the most common position for the mental foramen was in line with the longitudinal axis of the second premolar (69.2%) followed by a location between the first and second premolar (19.6%). The right and left foramina were bilaterally symmetrical in three of six recorded positions in 67.7% patients. The mental foramen was most often in line with the second premolar.

In reply

Lim D, Ngeow WC

J Oral Maxillofac Surg, 2018 06;76(6):1141-1142.

PMID: 29596795 DOI: 10.1016/j.joms.2018.03.001

A Comparative Study on the Efficacy of Submucosal Injection of Dexamethasone Versus Methylprednisolone in Reducing Postoperative Sequelae After Third Molar Surgery

Lim D, Ngeow WC

J Oral Maxillofac Surg, 2017 Nov;75(11):2278-2286.

PMID: 28666096 DOI: 10.1016/j.joms.2017.05.033

PURPOSE: To compare the efficacy of preoperative submucosal injection of 4 mg of dexamethasone versus 40 mg of methylprednisolone in reducing postoperative sequelae after surgical removal of impacted mandibular third molars.

PATIENTS AND METHODS: This prospective, randomized, double-blind study included 65 patients who required surgical removal of impacted mandibular third molars with Class II or position B impaction (Pell and Gregory classification). Patients were randomly assigned to 1 of 3 groups: dexamethasone, methylprednisolone, or placebo (control). Surgery was performed with patients under local anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on postoperative day 1, 2, 5, and 7 to measure postoperative facial swelling by use of 2 linear measurements: interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Wound healing also was assessed on postoperative day 7. Descriptive and multivariate statistics were computed, and significance was set at P

Numbness of the ear following inferior alveolar nerve block: the forgotten complication

Ngeow WC, Chai WL

Br Dent J, 2009 Jul 11;207(1):19-21.

PMID: 19590550 DOI: 10.1038/sj.bdj.2009.559

This article presents a distant complication in the auricle following the administration of a standard inferior alveolar nerve block. The patient experienced profound numbness of the auricle on the ipsilateral side of the injection that lasted for about an hour following unintended injection to the auriculotemporal nerve.

Fulltext Craniofacial anthropometric norms of Malaysian Indians

Ngeow WC, Aljunid ST

Indian J Dent Res, 2009 Jul-Sep;20(3):313-9.

PMID: 19884715 DOI: 10.4103/0970-9290.57372

OBJECTIVE: This study was done to establish the craniofacial anthropometric norms of the young adult (18- 25 years) Malaysian Indian.
MATERIALS AND METHODS: The study group consisted of convenient samples of 100 healthy volunteers, with equal number of female and male subjects who had no history of mixed racial-parentage. Twenty-two linear measurements were taken twice from 28 landmarks over six craniofacial regions. The methodology and evaluation of indices of the craniofacial region was adapted from Hajnis et al.
RESULTS: The minimum measurements are always contributed by the female Indian except for the nose height (n-sn), (left) eye fissure length (ex-en), upper vermillion height (ls-sto), and lower vermillion height (sto-li). There is a gender difference in all the measurements except the (left) eye fissure height (independent t-test; P < 0.05). The Malaysian Indians exhibit some North American White Caucasian (NAWC) features in all regions. The cephalic index indicates a brachycephalic or relatively short wide head with a tendency towards mesocephaly. From the low nasal index, the Malaysian Indian female have a nose that is narrow or leptorrhin similar to the NAWCs. The lower value of the upper lip height to mouth width index in the Indian female indicates a relatively shorter upper lip height compared to the mouth width, also similar to the NAWC.
CONCLUSION: This study establishes the craniofacial anthropometric norms of the Malaysian Indian over 22 parameters. Male in general has a significantly higher measurement than female. The Malaysian Indians do exhibit some NAWC features.

Making your own retrograde carrier

Chai WL, Ngeow WC

Endod Prac, 1999 Feb;2(1):20-1.

PMID: 10740484

One of the problems faced by manufacturers is the difficulty in constructing a robust and reliable, angled applicator tip. This can be overcome by handmaking your own retrograde carrier. The applicator tip may be bent to about 50 degrees and, if a kink occurs while bending the tip, it can be replaced easily by a new modified needle. Because the wire used is flexible, it can adapt to the bend without a problem. Narrower carriers can also be made using a 20-G needle, perhaps more suitable for retrograde fillings of molar apices. Because the carrier is designed to be used once only, the problems of it being difficult to load and liable to blockages should not arise.

Median mental sinus in twins

Ong ST, Ngeow WC

Dent Update, 1999 May;26(4):163-5.

PMID: 10765768

Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection.

Familial cases of missing mandibular incisor: three case presentations

Chai WL, Ngeow WC

Dent Update, 1999 Sep;26(7):298-302.

PMID: 10765775

Hypodontia is the congenital absence of one or more teeth because of agenesis. The most commonly missing teeth are the third molars, the maxillary lateral incisors and the second premolars. Cases are presented of three patients with a missing mandibular incisor.

Fulltext Understanding the dental need and care during pregnancy: a review

Ngeow WC, Chai WL

Med J Malaysia, 1999 Mar;54(1):146-50.

PMID: 10972020

This paper reviews the oral and dental lesions that are seen during pregnancy. Trimester approach should be adopted in the management of the pregnant patients. A good dental preventive programme is essential. The significance of prescribing fluoride supplements and the use of dental radiography during pregnancy is also briefly reviewed.

Dens evaginatus on a wisdom tooth: a diagnostic dilemma. Case report

Ngeow WC, Chai WL

Aust Dent J, 1998 Oct;43(5):328-30.

PMID: 9848984

Pericoronitis is the most common odontogenic problem associated with the wisdom tooth in young men and women. Patients may present with problems associated with infection, swelling and pain. However, other associated pathology such as caries, periodontal disease and referred pain from the temporomandibular joint must be investigated when treating pain from the wisdom tooth. The authors wish to present a case in which the pain from a wisdom tooth was due to a fractured dens evaginatus. The importance of this dental anomaly should not be overlooked.

Gaining access through a calcified pulp chamber: a clinical challenge

Ngeow WC, Thong YL

Int Endod J, 1998 Sep;31(5):367-71.

PMID: 9823142

Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.

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