IIUM Journal of Orofacial and Health Sciences

Association of temporomandibular joint space and condylar head position with different skeletal patterns among the Malaysian population

Rafiq Khalid — 2024-07-31

During growth and development of the head and neck, some degree of interaction and interdependence between skeletal pattern with temporomandibular joint (TMJ) space and condylar head position occurs. Results from previous studies are varied; some reporting significant difference of TMJ space or condylar head position among the skeletal patterns, whilst others have shown that no such association is present. Considering that previous studies have been conducted in populations outside of Malaysia and the importance of determining the correlation between skeletal and TMJ morphology, this retrospective study was done to evaluate the TMJ space and condylar head position in different skeletal patterns among the Malaysian population using computed tomography (CT) images. A total of 90 CT images of the head and neck were included. Skeletal pattern (class I, II, III) was determined from each CT image based on the ANB angles obtained from reconstruction of these images. The TMJ space measurement and condylar head position were determined from sagittal images based on established landmarks from the reconstructed CT images. Statistical analysis was used to compare the TMJ space and condylar head position across the three skeletal classes and assess its significance. The results of this study demonstrated that there was no significant association between TMJ space or condylar head position in the different skeletal patterns among the Malaysian population. It is recommended that a prospective study with large sample size and standardized measurement techniques be implemented in the future to determine the precise association between TMJ morphology and different skeletal patterns.

A randomised controlled trial comparing online versus face-to-face smoking cessation course for Malaysian dental officer

Khairul Fikri Sebri — 2024-07-31

Oral health professionals play a vital role in tobacco cessation efforts, but there is a notable gap in their training and skills in this area. Online Smoking Cessation Course was developed by UiTM to benefit the oral health professionals however it has not been evaluated yet. Thus, the aim of this study is to evaluate the effectiveness of online smoking cessation module in comparison with the face-to-face method, in term of the level knowledge. This randomized controlled trial involved 185 new dental officers from four states in Peninsular Malaysia, divided into online and face-to-face (F2F) delivery groups. They were assessed using validated questionnaire, both pre- and post-intervention. The results showed that both the control (F2F) and intervention (online) groups demonstrated significant improvements in knowledge post-training. The control group's average score increased from 6.05 to 7.99, while the intervention group saw an increase from 6.22 to 8.20, with both groups showing statistically significant improvements (p< 0.001). This indicates the effectiveness of the smoking cessation course in enhancing knowledge. The study concluded that the online module is suitable for new dental officers, equipping them with knowledge and skills for smoking cessation counselling as it found that online delivery is as effective as F2F training. This suggests that online training could provide a more cost-effective and accessible method for future smoking cessation training, reaching a broader audience.

Evaluation of anatomic variations in the posterior superior alveolar artery – A Cone-beam Computed Tomography (CBCT) study

Izzati Nabilah Ismail — 2024-07-31

Anatomical variation of the course of posterior superior alveolar artery (PSAA) within maxillary bone are vital information for surgeons before any maxillary surgery. This study was designed to evaluate the variations of PSAA by determining the prevalence of intraosseous PSAA and assessing the anatomical reference points and diameter of the PSAA. Comparison between dentate and edentulous alveolus was also done. One hundred CBCT images were included in this study to enumerate the prevalence of intraosseous PSAA in maxilla. Anatomical reference points which include the horizontal position of the PSAA and the vertical distance from the PSAA to the maxillary sinus floor and alveolar crest were identified. The diameter and horizontal position of PSAA were also analysed. The results were tested using independent t-test and chi square test. The PSAA was seen in 73.5% of the cases and 70.1% were located intraosseously. There was no significant difference in the vertical distance between PSAA and alveolar crest, as well as between maxillary sinus floor and alveolar crest for dentate and edentulous patients. Meanwhile, there was a significantly greater vertical distance between the PSAA and the maxillary sinus floor in edentulous (9.24 ± 4.75 mm) than in dentate patients (6.78 ± 3.43 mm) with p-value of 0.002. Mean diameter of the canal was 1.09 ± 0.43 mm. In conclusion, this study provides useful information regarding the most prevalent location and diameter of the PSAA which indicates the importance of preoperative evaluation through CBCT to reduce the risk of intraoperative bleeding that may complicate the treatment.

The effect of disinfection protocols on dimensional accuracy of irreversible hydrocolloids and Candida albicans colonisation

Norfaezah Ahmad — 2024-07-31

Irreversible hydrocolloid is a widely used impression material in dental practices. However, improper disinfectant protocols may affect the dimensional accuracy of the cast and increase susceptibility towards cross-infection. This study investigated the effect of disinfectants and disinfection protocols on the dimensional accuracy of alginate impression and Candida albicans biofilm formation. For methodology, an alginate impression was developed using an acrylic maxillary edentulous master cast with 3 reference points. 60 3cm round alginate beads were synthesised and treated with 2% Aseptoprint, 1% sodium hypochlorite (NaOCl) or 3% MD 520 solutions for 2 min, 1 h, 6 h, and 24 h. For the antibiofilm assay, beads were inoculated with C. albicans (ATCC MYA 4901) for 24 h, and Colony-Forming Units (CFUs) were counted using a haemocytometer, then analysed via two-way Analysis of Variance (ANOVA). Dimensional accuracy was assessed by treating the developed alginate impressions in 2% Aseptoprint, 1% NaOCl, and 3% MD 520, respectively, for 2 min, 1 h, 6 h, and 24 h. Three linear measurements were obtained and compared against the master cast and analysed statistically using Friedman Tests. The results showed that a significant reduction of CFUs was recorded after disinfection with 3% MD 520 and 2% Aseptoprint (P < 0.05). Dimension of alginate impressions was significantly changed after 6 and 24 h of disinfection time. In conclusion, the use of 3% MD 520 and 2% Aseptoprint with 1 hour immersion time is recommended for effective alginate impression disinfection with minimal change in dimensional accuracy.

Comparison of the perceived image quality of intraoral orthodontic photographs taken with DSLR camera and mobile phone camera: A double-blinded prospective study

Lawrence Tan Soon Lee — 2024-07-31

Clinical orthodontic photography is a vital skill that every orthodontist should master to record the patients’ details and to permit the orthodontist to carefully plan, monitor and execute the treatment. With the advancement of technology, some clinicians opt to take intraoral photographs with their mobile phone rather than DSLR camera. Hence, this study aimed to answer one main question: whether there was any significant difference in the perceived quality image between intraoral photos taken with a mobile phone and a standard DSLR camera. The cameras used were a DSLR (Nikon D300s with AF-S Micro NIKKOR 105mm lens and NIKON R1C1 Twin Flash) and Mobile Phone (Apple I-Phone 11 with Selfie Ring Light). Assessment of 20 sets of intraoral photographs (100 individual images) by five IIUM orthodontists using a perceived quality Likert scale of Zero (0) to Ten (10). The assessors and the lead investigator were blinded to the source of the photographs. Reliability was evaluated using a test-retest method on 4 sets of intraoral photographs (20 individual images), a few weeks after their initial assessment. There was no significant difference (p=0.35) in perceived quality of intraoral photographs taken between DSLR and mobile phone, with the mean value of 7.34 and 7.12 respectively. Reliability was good (ICC=0.549). This prospective study showed that there was no statistical difference between the perceived quality of intraoral orthodontic photographs taken with a DSLR camera and a Mobile Phone camera.

Stereolithography (STL) model in dental autotransplant: A case report

Wan Nur Zahidah Wan Zullkefli — 2024-07-31

The goal of this case report was to describe the use of the stereolithography (STL) model in dental autotransplantation. This report described autotransplantation of the lower wisdom tooth (48) to replace a missing lower first molar (46) due to caries. This approach used an STL model of 48 fabricated in the laboratory from cone-beam computed tomography (CBCT) images to assist in recipient site preparation before autotransplant. In conclusion, the use of the STL model could potentially increase the success rate of autotransplantation as it can help to preserve the periodontal ligament (PDL) cells on the root surface of the donor tooth, shorten the extraoral time of the donor tooth, and provide optimum contact between the recipient bone and the root surface of the transplanted tooth.

A prosthetic-surgical approach for aesthetic treatment of peri-implant soft tissue defects: A case report

Mohamad Adib Jaafar — 2024-07-31

Peri-implant soft tissue defects (PSTD) in the esthetic zone affect approximately 54% cases of post-implant insertion, leading to aesthetic concerns and increasing the risk of peri-implantitis. Various surgical techniques are aimed at addressing these issues, but the outcomes can be unpredictable, especially for severely mispositioned implants. This report details a combined prosthetic and surgical approach to treat a severely angulated single central maxillary implant with mid-labial mucosal recession. A 38-year-old female expressed dissatisfaction with the implant at 21 area, which appeared elongated due to peri-implant mucosal recession of almost 4 mm. Treatment involved two phases: 1) prosthetic phase involves replacing the original crown of implant at 21 area with a temporary crown to promote mucosal growth and 2) surgical phase that involves soft tissue surgery three months later using an envelope flap technique at the recipient site and a connective tissue graft harvested from the palate. Upon three months after the surgery, full coverage with thick mucosal tissue was achieved, and a new zirconia crown was placed. The outcome remained stable throughout the nine-month follow-up. This case demonstrates that PSTD in angulated implants in the esthetic zone can be effectively treated through a combination of prosthetic and surgical modalities.

The resurrection of an immature upper anterior tooth: A case report

Hema Devi Sivan — 2024-07-31

Revascularization of necrotic dental pulp has regained interest as an alternative treatment for immature permanent teeth. An 18-year-old female patient was referred for management of an immature upper anterior tooth with symptomatic apical periodontitis. Patient presented with an unsightly tooth 21 with no symptoms. Patient experienced dental trauma approximately 10 years ago. Clinical examination revealed a light-yellow discoloration with Class IV composite restoration on tooth 21, no carious lesion, Grade 1 tooth mobility, tenderness to percussion, and probing depths within normal limit. Periapical radiograph of tooth 21 revealed a periapical lesion, root of normal length but thin root dentin, and an open apex. Revascularization of tooth 21 was carried out in two visits. The first visit focused on disinfection of the root canal, while the second visit focused on the induction of bleeding followed by placement of mineral trioxide aggregate (MTA). The 6-month and 24-month follow-up visits revealed an absence of periapical lesion, although a significant reduction in the size of root apex could not be observed. An immature permanent tooth presents clinical challenges that affects both the short-term and the long-term treatment outcomes, therefore, an appropriate case selection taking into consideration various factors, and the skills and experience of the clinician are of upmost importance to ensure the predictability of the treatment provided. This procedure could eliminate intraradicular infection, however, increased dentin thickness on the root canal wall could not be observed, suggesting an indeed challenging procedure despite meticulous technical steps to perform the procedure.

Single nucleotide polymorphism of leptin and leptin receptor genes in oral cancer - A systematic review

Siti Hana Ilyana Hasanbasri — 2024-07-31

Oral cancer is one of the serious health problems diagnosed worldwide including Malaysia. While much research has been done on the gene polymorphism of leptin and leptin receptor genes in other cancers, few researchers have considered oral cancer. Hence, this study aims to provide an insight into the association of a single nucleotide polymorphism of leptin and leptin receptor genes with oral cancer, as well as its contribution in increasing the risk for oral cancer development. Literature searches were conducted in six databases including Scopus, ScienceDirect, Web of Science, PubMed, Google Scholar, and Dimensions; focusing on articles published between 2000 to 2020. All relevant articles were screened accordingly using search terms “leptin”, “leptin receptor”, “single nucleotide polymorphism” and “oral cancer”. A total of 2699 articles were retrieved. After following the inclusion and exclusion criteria, only four articles were included in this systematic review highlighting the three commonly studied polymorphic variant of leptin and leptin receptor which are LEP -2548 G/A, LEPR Gln223Arg, and LEPR K109R. Single nucleotide polymorphism of leptin and leptin receptor genes specifically LEPR Gln223Arg and LEP -2548 G/A may increase the risk of development of oral cancer. There were limited sources available to support the findings. Further research and investigations are needed to explore the mechanism of leptin and leptin receptor genes in the development of oral cancer.

Endodontic management and outcome of non-surgical root canal treatment for radix entomolaris associated mandibular molar teeth: A scoping review of case reports

Sobrina Mohamed Khazin — 2024-07-31

Radix entomolaris (RE) is an anatomical variant of the permanent mandibular molar (MM) with various complex anatomy. However, there is limited literature on the guideline on endodontic management of RE, resulting in unclear understanding on the endodontic treatment outcomes. Hence, this study aimed to map current case reports on endodontic treatment modalities, occurrence of endodontic mishaps, and outcome of MM associated with RE. A systematic search was performed in PubMed, Google Scholar, Scopus, Science Direct, PLOS, and Lilac databases for English articles published between 2000 and 2022 that met the inclusion criteria. The search yielded 1435 results; after screening was completed, only 58 articles were included in the study and critically appraised using JBI critical appraisal tool. Amongst the modifications made in endodontic management of RE were utilising angulated periapical radiograph supplemented with cone-beam computed tomography, extending the access cavity distolingually, and maintaining a small apical size of #25. There were 12% incidence of endodontic mishaps (separated instrument, ledge, missed canal, and extruded sealer) on RE. The success and survival rate of MM associated with RE were 58.7% and 40% respectively, at an average of 8.4 months. The basic management of MM with RE is similar to that of other MM. However, emphasis should be made on RE identification to prevent endodontic mishaps that can influence the endodontic treatment outcome.

Overview on bioceramics used in endodontics

Musliana Mustaffa — 2024-07-31