IIUM Journal of Orofacial and Health Sciences

Periodontitis prevalence based on the current classification system among patients attending Dental Clinic Hospital Pakar Universiti Sains Malaysia

Syawal Fitri Rosli — 2026-07-31

Periodontal disease is among the most prevalent oral health issues globally. This condition compromises the supportive structures of teeth and is influenced by both local and systemic factors. The 2017 Diagnosis and Classification of Periodontal Diseases and Conditions characterized the severity and progression of periodontitis by staging (I to IV) and grading (A, B, C), respectively. Although this classification scheme has been gradually adopted in local settings since its introduction in 2018, data on the prevalence of periodontitis using this framework remain limited. This study intended to determine the prevalence of periodontitis and its associated factors based on the current classification system among patients attending Hospital Pakar USM (HPUSM). This is a retrospective record review study that utilized the retrieval of patients’ records, spanning 2018 to 2024. Data on sociodemographic and periodontal diagnosis were collected. Data were analysed by using descriptive statistics, chi-squared tests, and an independent t-test. Of 300 records retrieved, 262 had complete periodontal records. The mean age of patients was 42.48 years (SD14.32), with 91.2% being Malays. The overall prevalence of periodontitis was 50.8%, with generalized periodontitis stage III grade C being the most reported (31.4%). Significant associations were found between periodontitis and age (p<0.001), systemic diseases (p<0.001), medication taken (p=0.001), and smoking habits (p<0.001). Within study limitations, periodontitis stage III grade C was prevalent among the study population. Age, systemic diseases, medications, and smoking habits are the possible risk factors for periodontitis.

Perceptions and utilization of the Index of Orthodontic Treatment Need (IOTN) among final year dental students: a qualitative study

Chun Hown Ng — 2026-07-31

The Index of Orthodontic Treatment Need (IOTN) is widely used to assess malocclusion severity and prioritize orthodontic treatment. However, its perception and utilization among undergraduate dental students remain unclear. This qualitative study aimed to explore the perceptions and utilization of the IOTN among 13 final-year dental students at AIMST University, Malaysia. Participants were recruited using convenience sampling, and data were collected through semi-structured interviews conducted via Zoom. The interviews were transcribed verbatim and analysed using thematic analysis until data saturation was achieved. Five main themes emerged: subjectivity in perception of criteria, neglect of patients’ psychological well-being, time-consuming application, lack of training and exposure, and potential facilitators for improvement. Although the participants acknowledged the IOTN as a valuable standardized tool, its consistent application in clinical practice was perceived to be limited by variability in interpretation and practical constraints. These findings highlight the need for improved undergraduate training, greater standardization, and the incorporation of digital technologies to enhance the reliability and clinical applicability of the IOTN. Strengthening these aspects may better prepare future dental practitioners for effective orthodontic assessment and treatment prioritization. Future research should consider multi-centre studies involving both public and private universities to improve generalisability and to better understand variations in training exposure, curriculum structure, and clinical experience across institutions.

The assessment of quality of life measured by General Oral Health Assessment Index (GOHAI) among complete denture patients at a public university

Hazira M Yusof — 2026-07-31

Edentulism remains a public health issue globally, especially in low to middle-income countries. To combat the associated problems with edentulism, complete dentures are prescribed to improve their function, speech, and comfort. The aim of this study is to assess the quality of life using the General Oral Health Assessment Index (GOHAI), focusing on physical function, oro-facial pain and psychosocial impact among complete denture patients in the USIM polyclinic. Patients included in this study consisted of 58% male and 42% female patients with an average age ranging from 60 to 69 years old. 98% of the patients requested new dentures to improve their chewing ability. The highest mean score was 3.34 (+1.39) for satisfaction with appearance, while the lowest mean score was 0.72 (+ 1.10) for limiting themselves from contact with others. In conclusion, edentulousness greatly affects patients’ oral function and complete denture treatment had a positive effect on patient’s quality of life.

Palm mixed-carotenes promote viability and exhibit non-cytotoxic effects on human oral mucosal fibroblasts

Anis Nadiah Azian — 2026-07-31

Palm mixed-carotenes (PMC), a carotenoid-rich fraction obtained from crude palm oil, contain provitamin A compounds with reported antioxidant and cell-protective activities. However, limited information is available on their biological effects in oral soft tissue cells. This study evaluated the effects of PMC on the viability of human oral mucosal fibroblasts (HOMFs) under in vitro conditions. Primary HOMFs were isolated from healthy donors and exposed to PMC at concentrations of 1.56 –100 µg/mL for 72 hours. Cell viability was determined using the MTT assay. Serum-free medium containing 0.1% dimethyl sulfoxide served as the negative control, while medium supplemented with 10% fetal bovine serum was used as the positive control. Data were analyzed using SPSS version 29.0, and group comparisons were performed using one-way ANOVA followed by Tukey’s post hoc test, with significance set at p < 0.05. PMC treatment maintained or increased HOMF viability across all tested concentrations. The greatest viability response was observed at 6.25 µg/mL, which was significantly higher than the negative control (p = 0.005). All PMC-treated groups showed viability values above the 70% cut-off specified by ISO 10993-5, indicating that the tested concentrations were non-cytotoxic. These findings suggest that PMC are biocompatible with HOMFs and may support cellular viability, particularly at lower to intermediate concentrations. This study provides early in vitro evidence to support further investigation of PMC in oral soft tissue research.

An audit of the quality of dental panoramic radiographs in the Orthodontic Unit, Klinik Pergigian Cahaya Suria

Juliza Lepi — 2026-07-31

This audit aimed to assess the quality of dental panoramic radiographs in the Orthodontic Unit at Klinik Pergigian (KP) Cahaya Suria by evaluating adherence to radiographic standards, the proportion of diagnostically acceptable images, and the parameters that frequently failed to meet established criteria. A total of 192 pre-treatment panoramic radiographs were analysed, and obtained from two radiology units: Hospital A (28.65%) and Hospital B (71.35%). Each radiograph was assessed using a standardized checklist covering patient identification, exposure parameters, artifact prevention, anatomical structure visibility, and overall diagnostic acceptability based on a two-point grading system. Intra-examiner reliability was ensured through repeated assessments. Data analysis identified trends and areas requiring quality improvement. The audit revealed that 98.96% of the panoramic radiographs were diagnostically acceptable, exceeding the 90% benchmark. Artifact removal compliance was 99.48%, ensuring minimal diagnostic interference. Right/left marking was consistently present in all images. Key anatomical structures such as condyles (93.75%), sinus floor (91.15%), crestal bone (95.83%), and teeth/developing follicles (100%) were highly visible. However, mental foramen visibility was low (42.71%), indicating potential limitations in exposure settings and positioning. Documentation gaps were noted, with 0% age recording and 36.98% missing exposure values, impacting record-keeping and retrospective analysis. The findings indicate that the radiograph quality assessed is highly satisfactory, with most images meeting diagnostic standards. However, improvements are needed in mental foramen visualization, exposure parameter documentation, and record-keeping. Regular audits, staff training, and a quality assurance checklist are recommended to further enhance diagnostic accuracy and compliance with radiographic standards.

Periodontal status, knowledge, and dental barriers among Kuantan healthcare workers

Normah Yacob — 2026-07-31

Periodontal disease remains a pervasive global health challenge, affecting 94.6% of Malaysian adults. Despite this high national prevalence, data regarding healthcare workers remain scarce. This study addresses this gap by evaluating periodontal status, knowledge, and barriers to dental care among Ministry of Health (MOH) employees in Kuantan, Pahang, a cohort that is expected to exhibit high health literacy. Our objectives are to evaluate periodontal status and to determine associated factors for knowledge, barriers to dental attendance, and source of dental knowledge. A cross-sectional study was conducted among 224 MOH employees. Data were collected via a self-administered questionnaire and a clinical Basic Periodontal Examination (BPE). Simple and multiple linear regression analyses identified associated factors for each domain. Periodontal disease was highly prevalent (99.6%), with 42.0% exhibiting moderate (CPI 3) and 23.2% severe (CPI 4) forms. Multiple linear regression showed that being female (adjusted ? = 0.533, p = 0.001) and having no deep periodontal pockets (adjusted ? = 0.428, p = 0.008) were associated with higher knowledge scores. Conversely, being non-dental personnel (adjusted ? = -1.029, p < 0.001) was the strongest factor associated with lower knowledge scores. No specific personal or clinical factors explained the barrier scores. This shows that obstacles like being 'busy' are widespread workplace hurdles rather than differences between individual employees. A striking knowledge–practice gap exists among MOH employees, marked by high disease prevalence despite adequate knowledge. Targeted education strategies addressing specific predictor groups particularly non-dental personnel and individuals with existing deep periodontal pockets are warranted.

Root separation and resection of a tooth with class II subclass B2 furcation involvement in a periodontitis patient: a case report

Nur Ayman Abdul Hayei — 2026-07-31

Furcation involvement is a clinical condition resulting from severe attachment loss and consequently requires complex periodontal management. Successful furcation closure can be achieved through nonsurgical and surgical management, although this is limited to proper case selection. This is a case report of a periodontitis patient with class II subclass B2 furcation involvement associated with moderate attachment loss. Based on the amount of bone loss and depth of furcation involvement, root separation and resection were planned for tooth 27 aimed at eliminating furcation involvement and facilitate plaque control. Following comprehensive nonsurgical periodontal therapy and elective endodontic therapy root separation and resection were performed. Buccal furcation was eliminated with larger space existed for oral hygiene maintenance. The objective of this case report was to comprehensively discuss the management of furcation involvement which involve resection of the root that cause inaccessibility to plaque control. The prognosis and alternative options for such therapy are comprehensively discussed. The results of this case may help clinician to decide the best therapy for their patient.

A case report of minimally invasive strategies for denture support in a geriatric patient with medical comorbidities

Ayuni Maisarah Ridzuan — 2026-07-31

Geriatric patients in dentistry commonly present with medical comorbidities. It is necessary to thoroughly evaluate the patient's medical condition and then develop appropriate treatment plans, which provide greater benefits and help prevent medical complications. This case report describes the prosthodontic management of a geriatric female with partial edentulism, longstanding denture use, and systemic diseases, emphasising individualised care in a high-risk patient. A 69-year-old Chinese woman attending the Universiti Sains Islam Malaysia Polyclinic complained of a loose upper acrylic denture worn for 30 years, and presented with multiple caries, generalized recession and partial edentulism in both arches. She had a history of hepatitis B managed with medication and maintained follow-up, and shoulder cancer that finished chemotherapy 10 years ago. A black, purplish lesion on the left buccal mucosa adjacent to tooth 28 was detected during clinical examination. Strict infection control protocols were employed throughout treatment following her medical history. Pre-prosthetic procedures, including maintaining her oral hygiene, restoration, root canal treatment before denture construction, were done under proper management due to the patient's history of trismus. The case emphasized the challenges of prosthodontic management in geriatric patients with systemic disease and compromised dentition. The integration of restorative procedures and denture construction aimed to restore function and improve quality of life is discussed while considering the patient's systemic comorbidities.

Unusual presentation of ameloblastoma and a review of its biological behaviour

Choo Xiang Tan — 2026-07-31

Ameloblastoma is a benign odontogenic tumour occurring primarily in the mandible with rare occurrence outside the jaw. We report a case of an ameloblastoma presenting as a polypoidal mass in the right nasal cavity of a 72-year-old woman. She presented with progressive nasal blockage symptoms and examination revealed a mass occupying the right nostril. Initial tissue biopsy confirmed conventional ameloblastoma. Subsequent imaging study showed a mass involving the right maxilla. Primary tumour from the maxilla extending into the sinonasal tract was favoured over a much rarer primary ameloblastoma of the sinonasal tract, in view of the tumour bulk in the maxilla. Unfortunately, the patient defaulted her follow-up. Ameloblastomas are known to recur locally thus excision with clear margins is paramount. Recurrence is also influenced by factors such as the presence of B-Raf proto-oncogene (BRAF) and Smoothened, frizzled class receptor (SMO) genetic mutations, with SMO mutation found to be associated with maxillary location in the older age group. Ameloblastomas can metastasise without undergoing malignant cytological changes, with mandibular tumours being far more likely to do so. Long-term follow-up and regular computed tomography (CT) monitoring is required post excision.

From conventional to advanced approaches in the endodontic-restorative interface: a narrative review

Musliana Mustaffa — 2026-07-31

In the ever-evolving panorama of dental science, the interface between endodontics and restorative dentistry stands as a crucible where traditional doctrine battles cutting edge innovation. This article aims to analyse the strengths and weaknesses of conventional approaches in the endodontic-restorative interface, contemporary bonding materials and restorative plans, including the use of bioactive materials and minimally-invasive approaches. A literature search for English-language publications from January 2000 to July 2025 with a predetermined criteria was conducted via Google Scholar and PubMed using the search terms ‘endodontics AND restorative’, and Scopus using the search term ‘restoration of endodontically treated teeth’. Additional relevant articles were identified through manual review of the reference list from selected publications. Advanced techniques for the restoration of endodontically treated teeth emphasises structural reinforcement, function, and aesthetics, with a focus on preserving as much of the natural tooth as possible. Emerging materials and techniques have demonstrated comparable, or in some respects, superior performance to conventional post-core retained crowns. However, application of these approaches require careful case selection, precise clinical technique, appropriate material choice, and awareness of their limitations in order to secure successful treatment outcomes.

Hamartomas, choristomas and teratomas of the oral cavity: a contemporary narrative review

Vinesh Raj.S — 2026-07-31

Hamartomas, choristomas and teratomas represent an important group of developmental lesions that may occur within the oral and maxillofacial region. Although each entity is benign in nature, their clinical and histopathological resemblance to odontogenic tumours, soft-tissue neoplasms and other intraoral proliferations frequently results in diagnostic uncertainty. The overlap in clinical appearance among these developmental lesions demands a clear understanding of their biological basis and diagnostic criteria. This review provides an updated narrative synthesis of the current perspectives on hamartomas, choristomas and teratomas of the oral cavity, including their etiopathogenesis, clinical presentations, diagnostic considerations and management.

Artificial intelligence in diagnostic dentistry: technology and Islamic ethical compliance

Munirah Mohd Rosali — 2026-07-31

Artificial Intelligence (AI) has advanced in dental diagnostics, improving accuracy, efficiency, and clinical decision-making through Machine Learning (ML) and Deep Learning (DL). However, ethical concerns, particularly those from an Islamic perspective, remain inadequately explored. This narrative review aims to (1) summarise current applications of AI in dental diagnostic practice, (2) discuss ethical challenges of AI, and (3) evaluate these applications through an Islamic ethical point of view. A structured, non-systematic narrative was conducted using a two-stream literature search. The first stream identified peer-reviewed studies on AI applications in dental diagnostics. Meanwhile, the second stream explored Islamic ethics, bioethics, and jurisprudential sources relevant to healthcare technologies. Building on this, searches utilised predefined keywords, with inclusion restricted to English language full-text articles, primarily published between 2015 and 2025. Accordingly, titles, abstracts, and full-text availability were screened for relevance. While AI demonstrates high diagnostic performance in various dental fields, it faces ethical challenges related to data quantity, quality, bias, transparency, generalisability, and clinical integration. In line with this, Islamic ethical principles, particularly the purpose of Islamic law (Maqasid al-Shariah and Al-Masadir al-Aqliyya), can serve as the primary basis for AI applicability in dentistry. Integrating Islamic ethical values into AI-driven dental diagnostics promotes a human-centred, accountable, and ethically robust approach, ensuring technological rapid expansion aligns with patient safety, social justice, and moral respectability.

Artificial intelligence and the future of oral health equity

Muhd Firdaus Che Musa — 2026-07-31