A survey was conducted to assess dental caries experience and oral health related behaviour among Malaysian Territorial Army (TA) personnel. This cross-sectional study involved 284 personnel covering their socio-demography, oral hygiene habits and related behaviour and past utilization of dental services pattern. Dental caries were assessed using DMFT index. Caries prevalence was very high (97.2%; DMFT 8.15±5.36). Untreated decay (DT) was 3.67 (±3.15) and missing teeth (MT) 2.90 (±3.73). However, few were treated teeth (FT) at only 1.58 (±2.02). Almost everyone (98.2%) claimed they brushed their teeth at least once daily and 80% used fluoridated toothpaste. However, very few participants used dental floss (11.3%) while majority (60.2%) did not know about flossing. More than 70% were current smokers. Only 13.7% were regular attendees with the majority (86.3%) visiting the dentist only when they had dental problems. The most common reason (49.7%) for their last dental visit was related to presence of symptoms and few were (27.4%) for prevention. Symptomatic attendees are significantly more likely to have more severe caries experience than preventive oriented individuals (p=0.003). These findings support the importance of promoting preventive oral health utilization behaviour among army personnel.
Some restorative materials are susceptible to erosion but whether it also causes microleakage is still questionable. The aim of this study was to assess the microleakage of few restorative materials after immersion in acidic solution. Standardized ‘U’ shaped cavity of 4mm diameter and 2mm depth were prepared on buccal or lingual surface of 52 human premolar and molar teeth. The teeth were divided into 4 groups which contains 13 samples and 3 controls for each and were restored either with Filtek Z250 (Group 1), Fuji IX (Group 2), Fuji II LC (Group 3), or Silverfill amalgam (Group 4).
All surfaces were painted with nail varnish leaving only 2mm of tooth structure surrounding the restoration before the study samples were immersed in acidic solution, lemon juice (pH 2.74) and control samples in deionised distilled water for 24 hours. Surface photos for erosion were taken before immersion in methylene blue for 7 days. After sectioning, the assessment of dye penetration was done using Leica Imaging System DMLM (Germany). Photos showed that Fuji IX demonstrated severe erosion but no obvious changes were seen on other materials. Kruskal-Wallis test indicated that microleakage between all four groups were statistically significant. The most significant difference was between Filtek Z250 and Fuji IX (p
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
Dentistry has searched for an ideal material to place in osseous defects for many years. Endogenous bone replacement has been the golden standard but involves additional surgery and may be available in limited quantities. Also, the exogenous bone replacement poses a risk of viral or bacterial transmission and the human body may even reject them. Therefore, before new biomaterials are approved for medical use, mutagenesis systems to exclude cytotoxic, mutagenic or carcinogenic properties are applied worldwide. The present preliminary study was carried out in five male New Zealand white rabbits (Oryctolagus cuniculus). Porous form of synthetic hydroxyapatite granules (500 mg), manufactured by School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Penang, was implanted in the femur of the rabbits. Blood samples were collected prior to implantation and one week after implantation. The blood was cultured in vitro and the cell division was arrested at metaphase using colcemid. This was followed by the hypotonic treatment and fixation. Then, the chromosomes were prepared and stained for analysis. The modal chromosome number of rabbit (Oryctolagus cuniculus) was found to be 2n=44. The mean mitotic index values prior to and after implantation were 3.30 ± 0.66 and 3.24 ± 0.27 per cent respectively. No gross chromosome aberrations, both numerical and structural were noticed either prior to or after implantation of the biomaterial. These findings indicate that the test substance, synthetic hydroxyapatite granules does not produce gross chromosome aberrations under the present test conditions in rabbits.
Tooth wear is the non-carious loss of tooth tissue due to attrition, erosion and/or abrasion. The amount of wear that accelerates physiological tooth wear is referred as pathological tooth wear. This study aims to determine the prevalence and mean scores according to mouth quadrant of raw tooth wear (RTW) and pathological tooth wear (PTW) and investigate sex association with PTW among 16-year-old secondary school children in Kota Bharu, Kelantan. This cross-sectional study involves 688 participants randomly selected from eight government secondary schools. The Smith and Knight Tooth Wear Index (TWI) was used. Data were analyzed using a simplified Microsoft Excel program developed based on the index to quantify PTW. Bar graphs were plotted to highlight the mean scores according to mouth quadrant. About 44% of participants were male and 56% were female. The prevalence of RTW and PTW among subjects was 100% and 20.1% respectively. It was found that 32.8% of tooth surfaces were affected with RTW and 0.7% of study subjects already had exposed dentine. The most affected quadrant for RTW and PTW was the upper and lower incisal quadrant respectively. Males had 92% more odds of developing tooth wear compared to females. In conclusion, all subjects have some degree of wear. About one-fifth of the study subjects were affected by PTW. The patterns of wear were similar to those encountered in the Western societies. There was statistically significant association between sex and PTW.
We present an algorithm to reduce the number of slices from 2D contour cross sections. The main aim of the algorithm is to filter less significant slices while preserving an acceptable level of output quality and keeping the computational cost to reconstruct surface(s) at a minimal level. This research is motivated mainly by two factors; first 2D cross sections data is often huge in size and high in precisions – the computational cost to reconstruct surface(s) from them is closely related to the size and complexity of this data. Second, we can trades visual fidelity with speed of computations if we can remove visually insignificant data from the original dataset which may contains redundant information. In our algorithm we use the number of contour points on a pair of slices to calculate the distance between them. Selection to retain/reject a slice is based on the value of distance compared against a threshold value. Optimal threshold value is derived to produce set of slices that collectively represent the feature of the dataset. We tested our algorithm over six different set of data, varying in complexities and sizes. The results show slice reduction rate depends on the complexity of the dataset, where highest reduction percentage is achieved for objects with lots of constant local variations. Our derived optimal thresholds seem to be able to produce the right set of slices with the potential of creating surface(s) that traded off the accuracy and speed requirements.
The objective of this study was to evaluate and compare the effect of times elapsed on the application of a single-step adhesive system and activation of light cured subsequently placed composite to the bond strength between composites and adhesives. This was an experimental study using fifteen teeth extracted human premolars, which were caries and pathology free. Sample of teeth were embedded up to cemento-enamel junction on box of acrylic resin. All teeth were cut to obtain flat occlusal dentin surfaces. The specimens were randomly selected and divided into three groups with five teeth each. All the teeth were assigned to single-step bonding system AQ Bond (Sun Medical Co. Ltd., Shiga, Japan) according to manufacturer’s direction. Group 1 was left for 45 seconds, group 2 for 2 minutes, while group 3 was 5 minutes before putting subsequently restorative material. Composite resin was applied in 3 mm diameter and 6 mm height of cylinder mold and cured according to manufacturer’s direction on the dentin surface. Shear bond strength were measured using a testing system (Instron 8874, Instron Corp., Canton, MA, USA) at a crosshead speed of 2 mm/min with cell load capacity of 25 KN. The bond-strengths between single step adhesive system (AQ Bond) and light cured composites were tested. Mann-Whitney test showed no significant differences in bond-strength between Group 1 and Group 2. However, there were significantly differences (p
Several studies on job stress have been conducted among nurses, teachers, clerks, lecturers, laboratory technicians, petroleum and automotive workers and the calculated prevalences ranged from 20-35%; associated factors identified include high job demand, low job control and poor social support. Thus, the aim of the present study was to determine the prevalence and associated factors of stress in dental healthcare workers of an institution of higher learning in Kelantan. A cross-sectional study of the prevalence and associated factors of stress in 54 dental healthcare workers of an institution of higher learning in Kelantan [response rate of 63.5 percent] was conducted in March 2006. The Malay version of the validated Depression, Anxiety and Stress Scale and Karasek’s Job Content Questionnaire were used as research instruments in this study. Informed consents were obtained from all participants. The prevalence of stress was 22.2%. One (1.9%) staff member experienced severe stress whilst 20.4% experienced mild to moderate stress. After controlling for age, sex, marital status and duration of work, psychological job demand (adj. b 0.61, 95% CI 0.21, 1.00, p=0.003), toxic exposures (adj. b 1.41, 95% CI 0.47, 2.35, p=0.004) and overtime work (adj. b 5.67, 95% CI - 1.18, 10.16, p=0.015) were directly associated with reported stress in dental healthcare workers. High psychological job demand, increased toxic exposures at work and increased overtime work were significantly associated with stress in dental healthcare workers. These findings can be used to guide preventive measures to reduce stress in dental healthcare settings.
Pyogenic granuloma is a benign lesion which is commonly found in the oral cavity. It is a reactive inflammatory process of the injured mucosa to trauma. It can appear as a sessile or pedunculated mass with smooth or lobulated surface, which sometimes can mimic malignant lesion. Excision biopsy of the lesion is the confirmatory investigation which also a treatment tool. We report a case of middle-aged lady who had pyogenic granuloma of the tongue, which was safely excised using ultrasonic scissors. This case highlights the new technique of using ultrasonic instruments for excision of benign tongue lesion, with marked reduction of blood loss and operation time.
Abstract Water quality in the dental unit waterlines (DUWLs) is important to the patients and dental health care personnel as they are at risk of being infected with opportunistic pathogens such as Pseudomonas or Legionella species. In this study, a total of 86 samples were collected from DUWLs of 19 dental units in 11 Malaysian Armed Forces dental centres (MAFDC). 350 ml water sample was collected in sterile thiosulphite bags from the outlets of 3–way syringe, high speed handpiece, scaler, cup filler, independent water reservoir or the tap of the same surgery respectively. Samples were transported to the laboratory within 24 hours and kept in the refrigerator at 40C. 100ml of each sample was filtered through a 0.45 μm polycarbonate membrane filter. The filter was then inoculated onto plate count agar and incubated at 370 C for 24 hours, after which the formed colonies were enumerated. Another separate 100ml of water sample was poured onto buffered charcoal yeast extract agar and cetrimide agar to culture Legionnella and Pseudomonas respectively. Identification of these bacteria were confirmed by polymerase chain reaction and sequencing. Pseudomonas aeruginosa was detected in 9.5% of the samples but Legionnella was not detected in any of the samples. 77% of the samples met American Dental Association (ADA) recommendation of less than 200 cfu/ml. The result of this study showed that it is difficult if not impossible to eliminate biofilm from the DUWLs. Regular monitor of water quality from DUWL is required to maximise the health of the dental patients and dental health care personnel.
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
The purpose of this study was to determine the dimensional accuracy of the skull models produced by Rapid prototyping technology using stereolithography apparatus. Computed tomography images were captured from four dry normal adult human skulls. The resultant 2-D images were stored in Digital Imaging and Communications in Medicine (DICOM) format. The segmentation of the images was prepared in MIMICS software. The slice files were then exported to a stereolithography apparatus (SLA) to produce the replica of each skull. Eight linear measurements were repeatedly made between identified landmarks on each of the original skull and its replica model using an electronic digital calliper. Each of the linear measurements was repeated 5 times and the average was taken to determine the absolute difference and percent difference between the original skull and its replica model. The overall absolute difference between the four human adult skulls and its replica models was 0.23 mm with a standard deviation of 1.37 mm. The percent difference was 0.08% with a standard deviation of 1.25%. The degree of error established by this system seems affordable in clinical applications when these models are used in the field of dental surgery for surgical treatment planning.
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.
Submasseteric abscess is unusual in the head and neck region. Patients with this condition may be misdiagnosed as a parotid abscess due to the similarities in their presentation. Awareness and due recognition should be given to this unusual problem.
Gingival overgrowth is frequently observed in patients taking certain drugs such as calcium channel blockers, anticonvulsants and immunosuppressant. This can have a significant effect on the quality of life as well as increasing the oral bacterial load by generating plaque retention sites. Amlodipine, a third generation calcium channel blockers has been shown to promote gingival overgrowth although in very limited cases reported. The management of gingival overgrowth seems to be directed at controlling gingival inflammation through a good oral hygiene regimen. However in severe cases, surgical excision is the most preferred method of treatment, followed by rigorous oral hygiene procedures. This case report describes the management of gingival overgrowth in a hypertensive patient taking amlodipine. Combination of surgical gingivectomy and CO2 laser treatment was used to remove the gingival overgrowth. CO2 laser surgery produced good hemostasis and less pain during the procedure and post operatively. This case report has also shown that periodontal treatment alone without a change in associated drug can yield satisfactory clinical response.
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.
A 48 years old Malay lady with a case of painless soft fluctuant swelling of left parotid gland is reported. The lesion was found to be a cystic lesion through the pre operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called “branchial cyst”. Through the literature reviews of parotid lymphoepitelial cyst the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre operative evaluation of the parotid swelling furthermore it is non-invasive, harmless, painless and relatively quick.
The purpose of this study was to evaluate hardness (indicator for polymerization) and thickness of two types of resin cement at coronal, middle and apical level of tooth root canal. Ten extracted maxillary incisors were instrumented and post space was prepared for cementation of titanium post. Samples were divided into two groups and each group was cemented either of the two types of resin cements; Panavia F [dual-cured (PF)] and Rely X Luting 2 [self-cured (RL)]. The teeth were longitudinally sectioned; hardness and thickness was measured using Vickers hardness tester and a microscope (Leica DMLM). SEM observations along the cement line at the 3 different root levels were performed. Statistical analysis was performed to test significance of differences in hardness and thickness of the two types of cement (t-test; p= 0.05) and at different levels of the same type (one-way ANOVA followed by multiple comparison; p= 0.05). Significant difference of hardness was found at the apical level between the two groups and between the coronal and apical level of PF (p0.05). Moreover, voids were more obvious within the dual-cured group of cement. Dual-cured resin cement was found to be less polymerized than self-cured type at apical level. Increased thicknesses of resin cements in comparison to post space size were observed in both groups. Use of metallic post with resin cements needs further evaluation.
The reconstruction of the upper eyelid with medial canthal involvement post extensive removal of malignant tumour remains a challenge. Proper eyelid reconstruction is necessary to reestablish anatomic integrity, restoration of its functions and to maintain the best cosmetic appearance. These case reports illustrate an alternative reconstructive technique for large upper eyelid full thickness defect with medial canthal involvement. Two cases of upper eyelid tumours involving medial canthal region underwent staged reconstruction by glabellar flap advancement and reconstruction of the posterior lamellar with autologous graft using buccal mucosa and ear cartilage. The posterior lamellar graft and flap survived without any complication except for mild eyelid margin notching in one of the two cases. The staged reconstruction with glabellar flap advancement provides adequate defect coverage, excellent blood supply, maintains eyebrow contour and function of the eyelid. The flap also perfectly matches the surrounding tissue with minimal donor site morbidity.
Osteomyelitis of the mandible, a serious complication of untreated odontogenic infection has been reported. This case report describes an interesting presentation of chronic suppurative osteomyelitis (CSO) of the mandible in a 13 years old anaemic male patient. Investigations revealed inversion of his permanent teeth leading to trans-cutaneous extra-oral eruption along with marked destruction of mandible on the affected side. The treatment included a pre surgical course of antibiotics followed by the removal of the retained second premolar tooth, surgical debridement of the affected bone, and resection of the cutaneous sinus tract. The post-operative healing was uneventful. A combination of antibiotic therapy and surgical debridement were effective in the treatment of chronic suppurative osteomyelitis.