Introduction: Cone beam computed tomography (CBCT) has gained interest for improving diagnosis, treatment planning and facilitating better patient’s management in various dental fields. This study is part of the quality assurance programme in Dental Faculty, International Islamic University Malaysia (IIUM). This center offers dental radiography service not only for internal clinics but also act as a referral center for the eastern areas, Pahang, Malaysia. Aims: The aims of this study were; 1) to assess referral pattern for CBCT scans at the Dental Faculty, IIUM, Kuantan, and 2) to evaluate the completeness of the current referral form used by clinicians (for both internal and external referrals). Methods: An audit looking at both the external and internal referral CBCT forms of a four year period of examination (2010-2013) at the Radiology Unit, Dental Faculty, IIUM. Source of referrals, indications for CBCT and the referral forms were examined and analysed. Results: Total CBCT scans taken within the four-year period were 171, in which 96 were referred from internal sources whilst 75 were external referrals. External referrals were mainly from Paediatric Dentistry and Orthodontic clinics (59%), while other referrals were from implant clinic (20%), Paediatrics and Special Needs clinic (15%), Oral MaxilloFacial Surgery clinic (4%) and Periodontic clinic (1%) and Oral Medicine Oral Pathology (OMOP) clinics (1%). All forms from external sources are completely filled. In the Internal referral form, 41% of them came with no indication of why CBCT need to be taken. Out of 59% of cases with indications, 33% came from Paediatric Dentistry and Orthodontic department, followed by Oral Surgery department (10%). Implant treatment planning accounted for 7% of cases, Periodontics 4%, Temporo-Mandibular Joint assessment 2%, 1% for Conservative dentistry and Prosthodontic cases respectively and 1% cleft case. Further analysis of the internal referral forms revealed that only 14% of the forms were filled with complete patients’ details, 40% specified pregnancy status and 67% clearly stated patients’ medical status. Area of interest was not specified in 69% of cases and clinicians’ names were not stated in 94% of the cases. Majority of the forms were completed with clinicians’ signature (99%) and also radiographers’ details (97%). Conclusions: This study indicated that the majority of IIUM CBCT referrals were from internal sources. However, most of the referral forms were not completely filled. The internal form used, therefore, need to be improved and a much firmer referral framework should be in place.
OBJECTIVES: The objectives of this study were to determine the prevalence and clinical characteristics of torus palatinus (TP) and torus mandibularis (TM) in Malaysian dental patients.
METHODS: Thousand five hundred and thirty-two dental patients were examined for the presence of oral tori at the Faculty of Dentistry outpatient clinic, AIMST University. Factors such as race, age, sex, size, and shape of tori were studied.
RESULTS: The prevalence rates were 12% for TP and 2.8% for TM. A variation in the presence of tori among the three races in Malaysia-Chinese, Malays, and Indians-was noted, where the Chinese significantly had a higher prevalence of TP (17.9%) and TM (4.6%). Predominantly, tori were observed >40 years and older age group, and further both TP and TM were seen more commonly in women. Most TP were of smooth type (52.2%) and >2 cm (67.4%), while all TM were bilateral and nodular, plus most were <2 cm (67.4%).
CONCLUSION: Presence of tori (TP and TM) was detected in 12.5% of the participants. The variations noted in the prevalence and clinical characteristics of tori among people of different races living in the same country reflect its multifactorial etiology. Both genetic and environmental factors are responsible for its occurrence, and particular races are more prone genetically where its expression is enhanced by environmental factors.
KEYWORDS: Tori; torus mandibularis; torus palatinus
Study site: Dental clinic, Faculty of Dentistry, AIMST University
In response to the introduction of an integrated dental education program at University of Malaya (UM) in 2011, a study was conducted to develop a caries risk assessment model (CRA) for use in non-surgical caries management for Year 3 and 4 students of the new integrated program. Methods: The CRA model was based on risk indicators used by dental students in the Preventive Dental Clinic (PDC). Patients aged 15 years and above who attended the PDC for the first time in year 2009 and 2010 were used as study sample. Four hundred and fourteen patient names were identified from the student PDC logbook. Of the 414, 359 dental records had complete data and included in the analysis. Data were analysed using SPSS version 17.0. Chi-square test was used for group comparison and associated factors for coronal caries were analysed using Multiple Logistic Regression (MLR). Results: The final model showed that adults, brushing teeth once daily, and not having dental prosthesis/appliance were 3.31 (CI=1.64-6.69), 2.53 (CI=1.19-5.40), and 2.25 (CI=1.25-4.10) more likely to develop coronal caries, respectively, than adolescents, brushing teeth at least twice a day, and having dental prosthesis/appliance. Conclusions: The results indicate that age group, toothbrushing frequency and dental prosthesis status are significant indicators for coronal caries among patients. Outcomes of the study contributed towards bridging the gap between cariology
and preventive modules in the new integrated dental program.
Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters. Materials and methods: In this retrospective crosssectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya were examined for the presence of AR-related OMC. The study period was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
To determine the number of cases that are at risk of poor stability in terms of arch width changes following fixed appliances treatment at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. In a retrospective audit, 101 pre- and post-treatment lower study casts were selected from cases completed in the year 2015 at the Orthodontic Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur. Samples were measured using a universal caliper by a single calibrated operator. Samples was categorised as extraction or non-extraction types. Arch width changes was determined using paired T-test. The recommended limit was 0mm for inter-canine width, 2 mm for inter-first premolar width and 3mm for inter-second premolar and inter-molar width. Differences were considered “within limits”, if the changes were within the recommended limit ±0.25mm (for possible marginal measurement error) and “expanded”, if above the range for within limits. 42.6% were non-extraction while 57.4% were extraction cases. In the non-extraction group, 52.2% cases had expanded inter-canine widths, followed by inter-first and second premolars (27.9%) and interfirst molar (20.9%) widths. Arch width changes for the inter-first and second premolars and inter-molars widths were statistically significantly different (p<0.05) but bot clinically significant. In the extraction group, 67.2% had expanded inter-canine widths, followed by inter-first premolar (64.3%), inter-second premolar (9.1%) and inter-first molar (5.2%) widths. The inter-canine (M=1.43; SD=2.71, p<0.05) and inter-first premolar (M=2.87; SD=2.61, p<0.05) widths statistically and clinically significant expansion but the inter-second premolar and molar were significantly contracted (p<0.05). The number of cases with expanded arch widths was high regardless of the extraction type.
Keywords: Arch width expansion, stability
BACKGROUND AND OBJECTIVES: Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics.
MATERIALS AND METHODS: One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance.
RESULTS: The descriptive statistics of the study revealed a total of 40 (29%) patients in protocol 1, 43 (31.2%) in protocol 2, 18 (13%) in protocol 3, 16 (11.6%) in protocol 5, and 12 (8.7%) in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals.
CONCLUSION: Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors.
KEYWORDS: Extraction protocol; Malaysia; irrational extraction; orthodontic treatment
Introduction: This cross-sectional study aimed to determine association of age and gender with dental treatment need among first-visit patients at Dental Outpatient Clinic, IIUM Kuantan in 2016.
Materials and Methods: Ethical approval (IREC 762) was obtained from IIUM Human Ethics Committee. List of first-visit patients who attended clinic from 1st January to 31st December 2016 was retrieved to assess patient's age and gender. Dental treatment need was determined according to the normative need which was professionally defined by dental-officer-in-charge. All first-visit patients were included, except those attended Orthodontic department or with old Malaysian identification card or foreign passport. Included patients were classified into six age groups (≤14, 15-19, 20-34, 35-44, 45-64 and ≥ 65). Pearson's chi square test was used for statistical analysis using SPSS Version 20 software.
Results: From a total number of 2,713 patients (age range of 2 to 87), 1,210 (44.6%) were males and 1,503 (55.4%) were females. Age (p<0.001) and gender (p<0.001) were significantly associated with dental treatment need. Paediatric patients (≤14) majorly received paedodontic care (97.5%). Young-age patients (15-19, 20-34 and 35-44) mostly required conservative care (39.5%, 31.2% & 30.6%, respectively) while elder-age patients (45-64 and ≥ 65) have major need for prosthodontics (30.0% & 40.2%, respectively). Females outnumbered males in all age groups, except for the age group of ≥ 65 whereby the situation was the opposite. Females also outnumbered males in all types of treatment need, except for periodontics which was predominated by males.
Conclusion(s): Age and gender have significant associations with treatment need for dental care.
KEYWORDS: treatment need, dental, association, age, gender
Introduction: The objective of this study was to determine the prevalence and the pattern of hypodontia among orthodontic patients in Klinik Pergigian Jalan Sultan Mahmud, Kuala Terengganu.
Materials and Methods: A retrospective of 351 orthodontic patients record review study was conducted; comprised of 104 males and 247 females. The records were reviewed by trained dental officer between October 2016 and June 2017. The Chi-square and Fisher's Exact Tests were carried out for statistical analysis.
Results: The prevalence of hypodontia was 10.8%. Thirty-eight patients were found to have at least single missing tooth. A significant difference was found between males and females of having hypodontia (p = 0.048). No significant difference was found for hypodontia patients by races (p = 0.829). The maxillary lateral incisor was the most frequently missing tooth followed by mandibular second premolars and mandibular lateral incisors. Hypodontia cases observed tended to be more likely occurred in the upper left arch compared to the lower arch. The majority of hypodontia patients had single missing tooth, but rarely more than 3 missing teeth. Hypodontia patients had mainly Class III malocclusion, however no statistically significant was found (p= 0.081).
Conclusion(s): The prevalence of hypodontia of this study was within the range of what is being reported in the literature and showed gender significant. Hypodontia was mainly involved maxillary lateral incisors; more prevalent in the upper arch; and mostly observed in patients with Class III malocclusion in the study sample. Early detection and accurate diagnosis are essential. Therefore, alternative treatment modalities can be well planned under multidisciplinary team approach in restoring the aesthetic and function.
KEYWORDS: hypodontia, orthodontics, prevalence, retrospective
Introduction: The objectives of this study were to determine the prevalence and the pattern of hypodontia among orthodontic patients in Klinik Pergigian Jalan Sultan Mahmud, Kuala Terengganu.
Materials and Methods: This was a retrospective study where 351 orthodontic patients records (comprises of 104 males and 247 females), were reviewed. The records were evaluated by a trained dental officer between October 2016 and June 2017. The Chi-square and Fisher's Exact Tests were carried out for statistical analysis.
Results: The prevalence of hypodontia was 10.8%. Thirty-eight (38) patients were found to have at least a single missing tooth. A significant difference was found between males and females having hypodontia (p = 0.048). No significant difference was found for hypodontia patients by races (p = 0.829). The maxillary lateral incisor was the most frequently missing tooth followed by mandibular second premolar and mandibular lateral incisor. Hypodontia cases observed, tended to be more likely occurred in the upper left arch compared to the lower arch. The majority of hypodontia patients had a single missing tooth, but rarely more than 3 missing teeth. Hypodontia patients had mainly Class III malocclusion, however no statistically significant difference was found (p = 0.081).
Conclusion(s): The prevalence of hypodontia of this study was within the range of what is being reported in the literature and showed gender significant. In this sample, hypodontia mainly involved maxillary lateral incisors; more prevalent in the upper arch; and mostly observed in patients with Class III malocclusion. Early detection and accurate diagnosis are essential. Therefore, alternative treatment modalities can be well planned under multidisciplinary team approach in restoring the aesthetic and function.
KEYWORDS: referral letter
The timing of ABG procedure in a cleft patient is crucial to provide room and bony
support for the eruption of canine. However, there seems to be a delay in execution of this
procedure in certain centres. Material and Methods: Sample consists of records of cleft patients
treated from 2000-2016. The date and age for commencement of active orthodontic treatment,
date referred for ABG and date ABG done were retrieved. The centres that conducted these
surgeries identified. (Copied from article).
It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.
This study was done to determine the prevalence of dental anomalies and facial profile abnormality and its association with the non-syndromic cleft lip and palate (CLP) as compared to the non-cleft children. A comparative cross sectional study was conducted where the case group consist of 98 non-syndromic CLP children-unilateral (UCLP) and bilateral (BCLP) who attended the Combined Clinic at Kota Bharu Dental Clinic (KBDC) while the comparison group comprised of 109 non-cleft children who attended the outpatient clinic at KBDC. Their ages were between 3 to 12 years old. Clinical oral and facial profile examinations were carried out to look for dental anomalies (morphology, number and alignment of teeth) and facial profile abnormality. The prevalence of anomalies in morphology of teeth in CLP (24.5%) and non-cleft (10.1%), number of teeth in CLP (44.9%) and non-cleft (7.3%), mal-alignment in CLP (79.6%) and non-cleft (27.5%) and facial profile abnormality in CLP (26.5%) and non-cleft (9.1 %). There was a significant association between CLP and anomalies in morphology, number, mal-alignment and abnormality in facial profile; (p < 0.05). Therefore, there was a high prevalence and risk of dental anomalies and facial profile abnormality in the CLP children compared to the non-cleft children.
The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
The objective of this study was to evaluate compliance :0 the cliencs’ charter in a dental clinic and factors that may afect the updating of the charter. Our clients’ charter states that registration time is within IO minutes and waiting-mom time before being seen by the dentist is within 30 minutes. Convenience sampling was carried our over two weeks. Only patients above 12 years treated by dental officers were included. Data recorded included registration and wrziting-room time, treatment time, punctualiry afpaniems and workload of ajcicers. There were a total of 532 patients (407 walk»in/outpatients, 125 appointments). Results show that the mean waiting-mom time for all paticnm was nor compliant to the clients' charter (42.7 x 23.8 min for walking flll 44.9 : 32.7 min for appointments). Only 33% were seen within 30 min whilst about 23% waited for more than 60 minutes. All The mean registration time (17.9 1- 12.8 min) was ncmcomplianr everyday except on Thursdays where there were very few patients. Waiting time for elderly patients was not statistically significant from the younger patients. About 36% of appointment ariems were seen within 30 minutes; althou h hal 0 them were late, Exmzctivns, dentures and examination and diagnosis took the shortest time wrzh about 88%, 91% and 98% completed within 30 minutes respectwely. There was variable individual speed and number of patients managed by different operators, although the majority was flrsnyear dental officers. Factors that may contribute waiting time included number of patients per day, operator and punctualizy of patients.
The prevalence of periodontal abscesses in emergency dental clinics was found to be between 8%-14%. The purpose of this study was to study the clinical features of periodontal abscesses seen in a specialist periodontal unit. There were 14 patients with equal distribution of gender. The mean age was 39.6 years. Twelve upper teeth (86%) were found to be involved as compared to two lower teeth (14%). There were more posterior teeth involved, a total of nine teeth (64%) as compared to five anterior teeth (36%). The mean pocket depth associated with the abscesses was found to be 7.4mm. There were ten buccal sites (71%) as compared to four palatal sites (29%). Average temperature of patients was 36.9° C. Only one patient was found to have cervical lympadenopathy (7%). The teeth involved were found to be mostly mobile with mobility of grade I to III (71%).
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
Light intensity output is one of the determinants for adequate curing of visible light-cured materials. The aim of this survey was to evaluate the light intensity outputs (LIOs) of light curing units (LCUs) in dental clinics of Hospital Universiti Sains Malaysia (HUSM) and School of Dental Sciences, Universiti Sains Malaysia (USM). The respective LIOs of all functioning Quartz Tungsten Halogen (QTH) and Light Emitting Diode (LED) LCUs were tested using two light radiometers. For cordless LED LCUs, the testing procedure was done in situ and after being fully charged. Statistical analysis using Kruskal Wallis and Wilcoxon signed ranks tests were performed to compare the LIOs between groups and between the LIOs of in situ and post-charged cordless LED LCUs, respectively. The level of significance was set at 0.05 (p
Dental anomalies affecting the teeth are relatively common. Simultaneous occurrence of multiple dental abnormalities in a single tooth is uncommon and relatively rare. One such abnormality routinely encountered in dental clinics is the talon cusp. It is also referred to as dens evaginatus, characterized by the presence of an accessory cusp-like structure projecting from the cingulum of anterior teeth. It has an increased predilection for maxillary teeth and permanent dentition. Although numerous cases of talon cusp have been reported in the literature, occurrence of multiple talon cusps in maxillary central incisors has not been found in the literature. This case report highlights the presence of talon cusps in maxillary anterior teeth with multiple impacted supernumerary teeth.