Displaying all 19 publications

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  1. Toh CG
    Asian J Aesthet Dent, 1994;2(1):11-7.
    PMID: 9063109
    The development of porcelain laminate veneers has added a new dimension to dentistry in the treatment of unsightly anterior teeth. It is a less invasive procedure than the conventional crown restoration in the treatment of aesthetic problems. This paper highlights some of the considerations in the successful use of porcelain veneers.
  2. Toh CG
    Asian J Aesthet Dent, 1993 Jul;1(2):65-70.
    PMID: 7921798
    Bleaching has been accepted as one of the methods of treating discoloured teeth. The object of this study was to assess the effectiveness of treating discoloured teeth with a dual activated bleaching system (Hi Lite) that utilises both light and chemical activation of hydrogen peroxide. The results achieved with a 19% hydrogen peroxide solution were compared with those using 35% hydrogen peroxide solution provided in a standard kit. Twenty-three university students with various complaints of discoloured teeth were treated with the bleaching system utilising both concentrations of hydrogen peroxide. Colour change was monitored by using Vita Shade Guide and a camera. The teeth were observed to be 1/2 to 2 shades lighter after each treatment session. It required one to three treatment sessions to achieve the desired results except for severe tetracycline stained teeth. There was no visible difference between the results achieved by the different concentrations of hydrogen peroxide although it took 3 to 5 minutes longer for the 19% hydrogen peroxide to effect a change in colour.
  3. Omar H, Khan SA, Toh CG
    J Dent Educ, 2013 May;77(5):640-7.
    PMID: 23658411
    Student-generated videos provide an authentic learning experience for students, enhance motivation and engagement, improve communication skills, and improve collaborative learning skills. This article describes the development and implementation of a student-generated video activity as part of a knowledge, observation, simulation, and experience (KOSE) program at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It also reports the students' perceptions of an activity that introduced first-year dental students (n=44) to clinical scenarios involving patients and dental team aiming to improve professional behavior and communication skills. The learning activity was divided into three phases: preparatory phase, video production phase, and video-watching. Students were organized into five groups and were instructed to generate videos addressing given clinical scenarios. Following the activity, students' perceptions were assessed with a questionnaire. The results showed that 86 percent and 88 percent, respectively, of the students agreed that preparation of the activity enhanced their understanding of the role of dentists in provision of health care and the role of enhanced teamwork. In addition, 86 percent and 75 percent, respectively, agreed that the activity improved their communication and project management skills. Overall, the dental students perceived that the student-generated video activity was a positive experience and enabled them to play the major role in driving their learning process.
  4. Pulikkotil SJ, Toh CG, Mohandas K, Leong K
    Aust Dent J, 2016 Dec;61(4):440-445.
    PMID: 26780271 DOI: 10.1111/adj.12409
    BACKGROUND: A randomized split-mouth controlled clinical trial was conducted to evaluate the efficacy of photodynamic therapy (PDT) in reducing Aggregatibacter actinomycetemcomitans (Aa) in periodontitis patients.

    METHODS: Twenty patients with periodontitis were recruited for the trial. Following random allocation of either quadrants of the selected jaw to test or control treatment, conventional non-surgical periodontal therapy (NSPT) was performed. In addition, the test side received adjunct photodynamic therapy. Probing depth (PD), clinical attachment level, bleeding on probing (BoP) and plaque scores (PS%) were recorded at phase 0 (baseline), phase 1 (immediately after NSPT), phase 2 (7 days following NSPT), phase 3 (1 month following NSPT) and phase 4 (3 months following NSPT). Subgingival plaque samples for quantification of Aa by real-time polymerase chain reaction was performed at phases 0, 1, 2 and 4.

    RESULTS: There was a significant clinical improvement at phases 3 and 4 compared with baseline while BoP reduced significantly only in the test group at phase 4. However, no difference in the quantification of Aa was detected between the groups.

    CONCLUSIONS: Within the limits of the study, PDT adjunct to scaling and root planing does not lead to quantitative reduction of Aa in periodontitis patients.

  5. Siar CH, Toh CG, Romanos GE, Ng KH
    Clin Oral Investig, 2015 Jul;19(6):1353-62.
    PMID: 25411082 DOI: 10.1007/s00784-014-1362-7
    The aim of this study was to conduct a comparative qualitative and quantitative assessment of the interfacial soft and hard tissues investing implants and natural teeth.
  6. Seow LL, Toh CG, Wilson NH
    J Dent, 2015 Jan;43(1):126-32.
    PMID: 25448436 DOI: 10.1016/j.jdent.2014.10.001
    OBJECTIVES: The aim of this study was to investigate the recovery of cuspal stiffness and fracture resistance in endodontically treated maxillary premolars restored with bonded ceramic inlays and onlays of various designs.
    METHODS: Seventy intact premolars were selected for this study; six cavity designs were investigated: (i) mesio-occlusal-distal (MOD) inlay (I), (ii) MOD inlay with palatal cusp coverage (IPC), (iii) MOD onlay (O), (iv) MOD inlay with pulp chamber extension (IPE), (v) MOD inlay with palatal cusp coverage and pulp chamber extension (IPCPE), and (vi) MOD onlay with pulp chamber extension (OPE). Intact teeth acted as control. Strain gauges were attached to the buccal and palatal surfaces of the teeth to measure cuspal stiffness under static loading. All specimens were eventually subjected to compressive load to failure. Cuspal stiffness and fracture resistance data were analyzed using ANOVA and Tukey test.
    RESULTS: The I and IPE restorations restored cuspal stiffness to 75% of the sound tooth value. The O and OPE restored teeth had stiffness values greater than that of a sound tooth. The I, IPC, O, IPE, IPCPE and OPE restored teeth demonstrated fracture strength values of 938N±113 N (s.d.), 1073N±176 N and 1317N±219 N, 893N±129 N, 1062N±153 N and 1347N±191 N respectively.
    CONCLUSIONS: Within the limitations of this study, it was concluded that the all-ceramic onlay or inlay with palatal cusp coverage provided best biomechanical advantage in restoring an endodontically treated maxillary premolar tooth.
    CLINICAL SIGNIFICANCE: The onlay approach which is more conservative compared to full coverage restoration is considered an appropriate approach to the restoration of endodontically treated maxillary premolars. The addition of a pulpal extension to the all-ceramic restorations, apart from being technically challenging, was not found to offer any biomechanical advantage to the restored teeth.
    KEYWORDS: Endodontically treated teeth; Fracture strengths; Inlay; Onlay; Pulp chamber extension; Strains
  7. Siar CH, Toh CG, Romanos G, Ng KH
    Clin Oral Implants Res, 2011 Jan;22(1):113-20.
    PMID: 20678135 DOI: 10.1111/j.1600-0501.2010.01970.x
    collagenous and noncollagenous membranes have been investigated in many animal systems but their effects in the macaque model are unknown.
  8. Seow LL, Toh CG, Fok AS, Wilson NH
    Am J Dent, 2008 Oct;21(5):331-6.
    PMID: 19024261
    PURPOSE: To investigate the level and distribution of stresses in endodontically treated maxillary premolar teeth restored using various cavity designs of bonded all-ceramic restorations. The hypothesis tested was that the various all-ceramic approaches, including incorporating a pulp chamber extension in the restoration, had no influence on the stresses in the restored tooth unit.
    METHODS: Finite element packages Patran and Abaqus were used for the stress analysis. The cavity designs investigated include: (1) inlay (I); (2) inlay with palatal cusp coverage (IPC); (3) onlay (O); (4) inlay with pulp chamber extension (IPE); (5) inlay with palatal cusp coverage and pulp chamber extension (IPCPE); and (6) onlay with pulp chamber extension (OPE).
    RESULTS: In each case, tensile stresses were found to be concentrated subjacent to the occlusal fossa. Peak tensile stress and peak shear stress values along the tooth/restoration interface for IPC, O IPCPE and OPE cavity designs were found to be associated with the axiogingival line angle. Overall, the order of the various forms of restoration investigated in terms of the maximum principal stress (from greatest to lowest) was as follows: IPE > IPCPE > OPE > I > IPC > O.
  9. Khan SA, Omar H, Babar MG, Toh CG
    J Dent Educ, 2012 Dec;76(12):1675-83.
    PMID: 23225687
    Health economics, a special branch of science applying economic principles to the health delivery system, is a relatively young subdiscipline. The literature is scanty about teaching health economics in the medical and dental fields. Delivery methods of this topic vary from one university to another, with lectures, seminars, and independent learning reported as teaching/learning tools used for the topic. Ideally, debates should foster the development of logical reasoning and communication skills. Health economics in dentistry is taught under the community oral health module that constitutes part of an outcome-based dental curriculum in a private dental school in Kuala Lumpur, Malaysia. For this study, the students were divided into two groups: active participants (active debaters) and supporting participants (nonactive debaters). The debate style chosen for this activity was parliamentary style. Active and nonactive debaters' perceptions were evaluated before and after the activity through a structured questionnaire using a five-point rating scale addressing the topic and perceptions about debate as an educational tool. Cronbach's alpha coefficient was used as a measure of internal consistency for the questionnaire items. Among a total of eighty-two third-year dental students of two successive cohorts (thirty-eight students and forty-four students), seventy-three completed the questionnaire, yielding a response rate of 89 percent. Students' responses to the questionnaire were analyzed with the Kruskal-Wallis analysis of variance test. Results revealed that the students felt that their interest in debate, knowledge of the topic, and reinforcement of the previous knowledge had improved following participation in the debate. Within the limitations of this study, it can be concluded that debate was a useful tool in teaching health economics to dental students.
  10. Seow LL, Toh CG, Wilson NH
    Eur J Prosthodont Restor Dent, 2005 Jun;13(2):57-64.
    PMID: 16011232
    Existing literature suggests a relationship between the amount of remaining tooth structure and the fracture resistance of the restored endodontically treated tooth. This study investigated the amount of tooth structure remaining following various tooth preparations used in the restoration of the endodontically treated maxillary second premolar. Illustrations of the maxillary second premolar in buccopalatal, mesiodistal and occlusal sections were drawn to scale. Outlines of various intra- and extracoronal preparations were superim-posed on the illustrations to reveal the amount of tooth tissue remaining in each case. Preparations for a ceramic inlay, inlay with palatal cusp coverage and onlay left 2.0-2.5mm of tooth structure buccally and palatally. Following preparation for a metal-ceramic crown, approximately 1.0mm of tooth structure remained buccally, and between 1.6mm-1.8mm palatally. Preparation for an all-ceramic crown was observed to leave 1.0mm-1.2mm of tooth structure surrounding what remained of the endodontic access cavity. It was concluded that decisions as to the type of definitive restoration to restore the endodontically treated maxillary second premolar may be influenced, amongst other factors, by information on the amount of tooth tissue remaining following preparation.
  11. Seow LL, Toh CG, Wilson NH
    Prim Dent Care, 2003 Jul;10(3):87-92.
    PMID: 12929337
    AIM: The purpose of this study was to obtain data on current approaches for the restoration of endodontically treated teeth among general dental practitioners (GDPs) in Manchester, United Kingdom.

    METHOD: A questionnaire containing 19 single-answer, multiple-choice type questions was mailed to 503 GDPs practising in the Greater Manchester area in January 2002. An explanatory covering letter and a stamped addressed return envelope were enclosed. The data obtained were processed using SPSS statistical software.

    RESULTS: Three hundred and fifty-one (70%) of the practitioners responded to the questionnaire. The restoration of root-filled teeth was normally undertaken within 1-2 weeks of completing root canal therapy by 63% of the practitioners. Only 35% of the GDPs used posts routinely in the restoration of root-filled anterior teeth; the corresponding figure for posterior teeth was 15%. While a cast, precious metal post was the preferred choice in the restoration of anterior teeth, the use of prefabricated posts and related techniques predominated in the restoration of posterior teeth. Composite resin was the most popular choice of material for core build-up procedures in anterior teeth. Amalgam tended to be favoured for core build-ups in posterior teeth. The majority of the practitioners (56%) routinely restored root-filled anterior teeth by means of porcelain-fused-to-metal crowns. Seventy-three per cent of the GDPs preferred to restore root-filled posterior teeth by means of a full veneer crown.

    CONCLUSIONS: The results of this study suggest that the practitioners surveyed had a sound understanding of the principles involved in the restoration of endodontically treated teeth, with the possible exception of the need to establish a durable coronal seal as soon as possible after the placement of a root filling.

  12. Omar H, Khan S, Haneline M, Toh CG
    Eur J Dent Educ, 2021 Aug;25(3):592-599.
    PMID: 33222374 DOI: 10.1111/eje.12636
    INTRODUCTION: Interprofessional learning (IPL) is the first stage towards the goal of interprofessional collaborative care. To enhance IPL experience, the School of Dentistry, International Medical University developed an IPL model based on the core competencies and the learning outcomes for dental and chiropractic students in their second and fourth year, respectively. The model was based on experiential learning and adult learning theories in addition to Miller's framework for clinical competencies.

    METHODS: The programme was developed as a student-centred, collaborative approach to achieve the learning outcomes for dental and chiropractic students. Second-year dental students (n = 46) and chiropractic students (n = 23) in their fourth year participated in the programme. The focus of the programme was to address the prevention of work-related musculoskeletal disorders (WMSDs) amongst dental students and to provide the chiropractic students with the opportunity to assess and identify risk factors for WMSDs in the dental setting. The readiness for interprofessional learning scale (RIPLS) questionnaire was completed prior to the interprofessional education programme and once again afterwards to determine dental and chiropractic students' awareness of roles and responsibilities of the other profession, and their attitudes to interprofessional education and teamwork.

    RESULTS: Dental and chiropractic students showed similar levels of readiness for shared learning. The results of this study suggest that the IPL programme contributed to the development of the students' positive perceptions towards the positive professional identity and the roles of other healthcare professionals.

    CONCLUSION: This study provides initial support for the integrated interprofessional learning experiences within the school. The results of the study will shape future curricula changes to further strengthen interprofessional education and subsequent interprofessional collaborative care.

  13. Siar CH, Pua CK, Toh CG, Romanos G, Ng KH
    Oral Surg Oral Med Oral Pathol Oral Radiol, 2012 Nov;114(5 Suppl):S46-53.
    PMID: 23083955 DOI: 10.1016/j.tripleo.2011.07.049
    The objective of this study was to investigate the cementum status in natural teeth opposing implant-supported bridgework.
  14. Siar CH, Toh CG, Ali TB, Seiz D, Ong ST
    Clin Oral Implants Res, 2012 Apr;23(4):438-46.
    PMID: 21435011 DOI: 10.1111/j.1600-0501.2010.02145.x
    A stable oral mucosa is crucial for long-term survival and biofunctionality of implants. Most of this evidence is derived from clinical and animal studies based solely on implant-supported prosthesis. Much less is known about the dimensions and relationships of this soft tissue complex investing tooth-implant-supported bridgework (TISB). The aim here was to obtain experimental evidence on the dimensional characteristics of oral mucosa around TISB with two different abutment designs.
  15. Taiyeb-Ali TB, Toh CG, Siar CH, Seiz D, Ong ST
    Implant Dent, 2009 Oct;18(5):438-46.
    PMID: 22129962 DOI: 10.1097/ID.0b013e3181ad8e7a
    To compare the clinical soft tissue responses around implant tooth-supported 3-unit bridges using tapered abutments with those using butt-joint abutments.
  16. Siar CH, Toh CG, Romanos G, Swaminathan D, Ong AH, Yaacob H, et al.
    J. Periodontol., 2003 May;74(5):571-8.
    PMID: 12816287
    Today, one critical goal in implant placement is the achievement of optimal soft tissue integration. Reports thus far have demonstrated successful soft tissue preservation in delayed loaded implants placed in anterior jaws. The aim of this study was to histomorphometrically examine the soft tissues around immediately loaded implants placed in the macaque posterior mandible.
  17. Pau A, Omar H, Khan S, Jassim A, Seow LL, Toh CG
    Singapore Dent J, 2017 12;38:45-54.
    PMID: 29229074 DOI: 10.1016/j.sdj.2017.08.001
    BACKGROUND: To quantify participation in dental research activities in Malaysia, and investigate its association with socio-demographic and professional characteristics, and perceptions of research and development (R&D) culture.

    MATERIALS AND METHODS: Dental academics in Malaysian dental schools were invited to complete a questionnaire by email and post. The survey comprised questions on research activities in the past 12 months, socio-demographic and professional characteristics, and the R&D Culture Index. Principal components factor analysis was carried out to confirm the factor structure of the R&D Culture Index. Chi-square test was used to identify association of research activities with R&D culture, and socio-demographic and professional characteristics. Binary logistic regression was carried to identify predicators of research activities.

    RESULTS: Of 256 potential participants contacted, 128 (50%) useable responses were returned. Three R&D Culture factors accounting for 57.4% of variance were extracted. More positive perception of R&D Support was associated with Malaysians (0.025) and those employed in Government schools (0.017). R&D Skills and Aptitude were associated with older respondents (0.050), PhD qualification (0.014) and more years in academia (0.014). R&D Intention was associated with any of the socio-demographic characteristics. Thirty (23.4%) respondents reported a peer-review research publication in the past 12 months, which was associated with having a PhD (OR 12.79, CI 1.28-127.96), after adjustment in regression analyses.

    DISCUSSION: Postgraduate research training should be encouraged to promote participation in research activities. R&D culture did not appear to impact on research productivity. Other factors such as individual attitudinal interests should be studied.

  18. Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.
    J Dent Educ, 2012 Oct;76(10):1377-83.
    PMID: 23066138
    This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.
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