Displaying all 14 publications

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  1. Purmal, Kathiravan, Nambiar, Phrabhakaran
    Malaysian Dental Journal, 2008;29(2):104-112.
    MyJurnal
    Radiology is important in the diagnostic assessment, treatment and monitoring progress of patients having dental and maxillofacial diseases. The central question in dental radiology is whether there is any risk with regard to low doses of radiation and what are the necessary protection needed to prevent any hazardous outcome with X-raying. With the emergence of the new millennium, major changes are happening in the field of science and technology. More efficient equipments are being discovered and more researches are being conducted to elicit better understanding of the radiation process and its effect on the human health. This article will review the latest guidelines for proper radiographic practice from the USA and Europe. It will address topics like the risks from dental radiography, selection criteria, protection for patients and staff, improvement to X-ray equipments, room dimensions and lead lining requirements. We have limited our research to intraoral, panoramic and cephalometric radiographs because these are the radiographs or images that are commonly taken in the general practice setting. (Copied from article).
  2. Purmal K, Sukumaran P
    Aust Orthod J, 2010 Nov;26(2):184-8.
    PMID: 21175030
    To investigate the shear bond strengths of buccal tubes and to determine the sites of failure.
  3. Purmal K, Nambiar P
    Int Dent J, 2009 Jun;59(3):155-60.
    PMID: 19637524
    To study the success and failures of the mediation process of complaints from 2004-2007 by the Complaints Bureau Steering Committee and the Public Complaints Bureau Committee of the Malaysian Dental Association (MDA).
  4. Iqbal S, Hamid ALA, Purmal K
    Dent Traumatol, 2009 Dec;25(6):626-630.
    PMID: 19843134 DOI: 10.1111/j.1600-9657.2009.00830.x
    This case describes surgical correction of unilateral coronoid hyperplasia in a 13-year-old boy due to trauma. Treatment included coronoidectomy by intraoral approach after the diagnosis was confirmed. Computed tomography scan and occipitomental view radiograph were utilized for investigation. The resected coronoid process was sent for histopathological study. The histopathological examination revealed decalcified sections showing osteochondroid hyperplasia at the expanded end. On clinical and radiographic review at 2 years postoperation, the patient was well, completely symptom free and had improved mouth opening. This case report demonstrates the management of sports injury related unilateral coronoid hyperplasia. Emphasis was also placed on postoperational rehabilitation to prevent any relapse.
  5. Purmal K, Alam MK, Sukumaran P
    Dent Res J (Isfahan), 2013 Jan;10(1):81-6.
    PMID: 23878568 DOI: 10.4103/1735-3327.111805
    BACKGROUND: Bonding of molar tubes is becoming more popular in orthodontics. Occasionally, these bonding are done on posterior porcelain crowns or bridges. The purpose of this study was to evaluate the shear bond strength of buccal tubes on feldspathic porcelain crowns with two different methods.

    MATERIALS AND METHODS: Forty porcelain right molar crowns were fabricated for this study. The crowns were randomly divided into two groups. In group 1, the crowns were etched with 9.6% hydrofluoric acid, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT (3M Unitek, Monrovia, Calif). In group 2, the crowns were etched with phosphoric acid 37%, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT. All the crowns were stored for 24 hours at 37°C and thermo-cycled before the shear bond test. The analysis of variance (ANOVA) was used to determine whether significant difference were present between the groups.

    RESULTS: The results of the analysis of variance (F = 0.23) indicated the shear bond strength of group 1 (3.57 ± 0.87 MPa) was not significantly different (P > 0.05) from group 2 (3.46 ± 0.65 Mpa). Fisher's exact test for the adhesive remnant index (ARI) revealed significant difference between both groups (P < 0.05). Eighty percent of group 1 buccal tubes failed at buccal tube/resin interface and eighty percent of group 2 mostly failed at porcelain/resin interface.

    CONCLUSION: Etching with phosphoric acid with the use of silane coupling agent would be safer and should make it easier for clinicians to clean the adhesive on the porcelain surface after debonding.

  6. Alam MK, Shahid F, Purmal K, Khamis MF
    J Nat Sci Biol Med, 2015 Aug;6(Suppl 1):S113-7.
    PMID: 26604597 DOI: 10.4103/0976-9668.166106
    In orthodontic treatment, three-dimensional (3D) dental casts has a significant role in diagnosis and treatment planning. The aim of this study was to evaluate Pont's index predictability in orthodontics.
  7. Purmal K, Alam MK, Pohchi A, Abdul Razak NH
    PLoS One, 2013;8(12):e84202.
    PMID: 24367643 DOI: 10.1371/journal.pone.0084202
    Intermaxillary (IMF) screws feature several advantages over other devices used for intermaxillary fixation, but using cone beam computed tomography (CBCT) scans to determine the safe and danger zones to place these devices for all patients can be expensive. This study aimed to determine the optimal interradicular and buccopalatal/buccolingual spaces for IMF screw placement in the maxilla and mandible. The CBCT volumetric data of 193 patients was used to generate transaxial slices between the second molar on the right to the second molar on the left in both arches. The mean interradicular and buccopalatal/buccolingual distances and standard deviation values were obtained at heights of 2, 5, 8 and 11 mm from the alveolar bone crest. An IMF screw with a diameter of 1.0 mm and length of 7 mm can be placed distal to the canines (2 - 11 mm from the alveolar crest) and less than 8 mm between the molars in the maxilla. In the mandible, the safest position is distal to the first premolar (more than 5 mm) and distal to the second premolar (more than 2 mm). There was a significant difference (p<0.05) between the right and left quadrants. The colour coding 3D template showed the safe and danger zones based on the mesiodistal, buccopalatal and buccolingual distances in the maxilla and mandible.The safest sites for IMF screw insertion in the maxilla were between the canines and first premolars and between the first and second molars. In the mandible, the safest sites were between the first and second premolars and between the second premolar and first molar. However, the IMF screw should not exceed 1.0 mm in diameter and 7 mm in length.
  8. Purmal K, Chin S, Pinto J, Yin WF, Chan KG
    Int J Mol Sci, 2010 Sep 16;11(9):3349-56.
    PMID: 20957099 DOI: 10.3390/ijms11093349
    This study aimed to test the sterility of new unused orthodontic buccal tubes received from manufacturers. Four different types of buccal tubes were used straight from the manufactures package without any additional sterilizing step. Of these buccal tubes tested, three genera of bacteria, implicated as opportunistic pathogens, namely Micrococcus luteus, Staphylococcus haemolyticus and Acinetobacter calcoaceticus were recovered from these buccal tubes. Our data showing microbial contamination on buccal tubes highlights the need of sterilization before clinical use. We also suggest that manufacturers should list the sterility state of orthodontic buccal tubes on their packaging or instructions stating the need for sterilization.
  9. Yin WF, Purmal K, Chin S, Chan XY, Chan KG
    Sensors (Basel), 2012;12(11):14307-14.
    PMID: 23202161 DOI: 10.3390/s121114307
    We report the isolation of N-acyl homoserine lactone-producing Enterobacter sp. isolate T1-1 from the posterior dorsal surfaces of the tongue of a healthy individual. Spent supernatants extract from Enterobacter sp. isolate T1-1 activated the biosensor Agrobacterium tumefaciens NTL4(pZLR4), suggesting production of long chain AHLs by these isolates. High resolution mass spectrometry analysis of these extracts confirmed that Enterobacter sp. isolate T1-1 produced a long chain N-acyl homoserine lactone, namely N-dodecanoyl-homoserine lactone (C12-HSL). To the best of our knowledge, this is the first isolation of Enterobacter sp., strain T1-1 from the posterior dorsal surface of the human tongue and N-acyl homoserine lactones production by this bacterium.
  10. Alam MK, Shahid F, Purmal K, Sikder MA, Saifuddin M
    J Contemp Dent Pract, 2015 Apr;16(4):299-303.
    PMID: 26067733
    This analysis was aimed to determine the mesiodistal tooth width of human teeth and to compare with the measurements on plaster model in a Bangladeshi population.
  11. Purmal K, Alam MK, Moganadass DD, Zakariat NN, Cheong NW
    Aust Orthod J, 2013 May;29(1):34-42.
    PMID: 23785936
    To assess the applicability of Pont's Index in a Malaysian population by obtaining baseline measurements of dental arch shape based on premolar arch width, molar arch width and the combined width of the maxillary incisors. A secondary aim was to determine whether a correlation exists between arch widths, Pont's Index and the facial framework.
  12. Yin WF, Purmal K, Chin S, Chan XY, Koh CL, Sam CK, et al.
    Sensors (Basel), 2012;12(3):3472-83.
    PMID: 22737019 DOI: 10.3390/s120303472
    Bacteria communicate by producing quorum sensing molecules called autoinducers, which include autoinducer-1, an N-hexanoyl homoserine lactone (AHL), and autoinducer-2. Bacteria present in the human oral cavity have been shown to produce autoinducer-2, but not AHL. Here, we report the isolation of two AHL-producing Klebsiella pneumoniae strains from the posterior dorsal surface of the tongue of a healthy individual. Spent culture supernatant extracts from K. pneumoniae activated the biosensors Agrobacterium tumefaciens NTL4(pZLR4) and Escherichia coli [pSB401], suggesting the presence of both long and short chain AHLs. High resolution mass spectrometry analyses of these extracts confirmed that both K. pneumoniae isolates produced N-octanoylhomoserine lactone and N-3-dodecanoyl-L-homoserine lactone. To the best of our knowledge, this is the first report of the isolation of K. pneumoniae from the posterior dorsal surface of the human tongue and the production of these AHLs by this bacterium.
  13. Al-Amery SM, Nambiar P, John J, Purmal K, Ngeow WC, Mohamed NH, et al.
    J Vet Dent, 2018 Jun;35(2):96-102.
    PMID: 29865987 DOI: 10.1177/0898756418776448
    This case report illustrates the teeth morphology of a chimpanzee and its anatomical variations. A well-preserved skull of a male Pan troglodytes troglodyte chimpanzee was scanned using a cone-beam computed tomography machine. Measurements included tooth and crown height, root length, root canal length and width (posterior teeth), and pulp cavity length (anterior teeth). Nonmetrical parameters included number of canals and foramina per root of every root. Interestingly, the mandibular central incisor was longer than the lateral incisor, and all the mandibular anterior teeth presented with a solitary flame-shaped or conical-calcified structure in their pulp cavity. The premolars are usually dual rooted except for the first maxillary premolar that displayed 3 roots. Other unusual discoveries were the presence of bilateral radicular dens invaginatus in the mandibular first premolars and the possibility of having 2 canals and 2 foramina in the roots of the posterior teeth. The presence of conical stone mineralizations at the pulp cavity and the presence of dens invaginatus were of particular interest.
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