COS is indexed in MyCite. Compendium of Oral Science (COS) the official journal of the Faculty of Dentistry, Universiti Teknologi MARA (UiTM) is a quality-conscious peer-reviewed journal published by UiTM Press annually in print and online form. COS is a platform for publishing research work in the field of oral health, oral sciences and technology, and dentistry. CLICK HERE TO SUBMIT MANUSCRIPT
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Evaluating the Clinical Failure of Oral Hydroxychloroquine in SARS-CoV-2 Treatment: A Systematic Literature Review Justifying the Potential for Inhaled Delivery
A systematic review was conducted to summarize the evidence regarding the administration of hydroxychloroquine (HCQ) through oral and inhalation for treating SARS-CoV-2 infection during pandemic. We limit inclusion for studies evaluating the administration of oral or inhalation of HCQ monotherapy on infected person only. Most of the treatments were given via oral delivery and no evidence on HCQ inhalation for SARS-CoV-2 infected patients. Aside from 400 mg per day is the most common HCQ treatment dosage, majority of the studies highlighted that HCQ does not significantly contribute to reduction of new incident, severity, viral shedding time and mortality when compared with control group. Further study of inhaled HCQ is needed as this route of administration could offer a promising alternative to the current oral dosing regimens, potentially improving the therapeutic outcomes and reducing the risk of toxicity for patients.
Copyright (c) 2026 Compendium of Oral Science https://creativecommons.org/licenses/by-nc/4.0
Students’ Self-Reported Confidence Level Post Completion of General Surgery and General Medicine Module: Preliminary Study in UiTM
Objectives: There is a paucity of information about the self-confidence levels of third-year dental students in the General Medicine and General Surgery (GMGS) module. Hence, this study aimed to measure the self-assessed confidence of third-year dental students in the GMGS module. Methodology: Dental students from the Faculty of Dentistry, UiTM, were recruited at the beginning of Year Four to participate in this study. The calculated sample size was 46. A questionnaire consisting of 26 items was adopted, modified, and distributed through the Google Forms platform. The questionnaire had three parts: demographic characteristics, clinical skills, and cognitive skills. Data from respondents were tabulated in Excel and analysed using SPSS (Version 30) with descriptive statistics and item correlation. Results: Responses were provided by 59 students (15 men and 44 women, 25.42% and 74.58%, respectively). The mean score was slightly higher in men compared to women (92.67% vs. 89.16%). However, the independent t-test showed no significant difference between men and women. The results showed that students’ confidence in their clinical skills mostly ranged from “average” to “good,” with four components showing a low percentage of “very poor” responses. Meanwhile, the cognitive and behavioural attitudes of students showed better results, with higher responses in each component, more “very good” responses, and no “very poor” responses. Conclusion: The students’ level of confidence in their clinical skills might be due to having just entered their clinical years. Therefore, further research is required to link students’ clinical skill performance results to their confidence responses. Furthermore, this preliminary study resulted in a new questionnaire tool, which can be implemented nationally and internationally for comparing students’ responses.
Persistent Periapical Pathology and Migraine Symptoms: Periradicular Surgery of a Radicular Cyst
This case report describes a rare presentation of a large periapical lesion, suspected to be a radicular cyst, associated with a previously treated maxillary central incisor. The lesion impinged upon the incisive foramen, and the patient presented with persistent pain and worsening migraine episodes unresponsive to pharmacological management. Surgical management of the lesion resulted in significant symptom resolution. This case highlights the need for dental professionals to consider odontogenic sources of chronic facial pain and emphasizes the importance of anatomical relationships in interpreting unusual orofacial symptomatology.
Early Implant Placement with Simultaneous Bone Augmentation and Digital Planning in the Aesthetic Zone: A Clinical Case Report
Anterior implant rehabilitation presents challenges in terms of soft and hard tissue preservation, aesthetics, and long-term function. Early implant placement with guided bone regeneration (GBR) and digital planning is a predictable approach to manage compromised anterior sites. This case report aims to highlight a multidisciplinary approach involving prosthetically driven planning, bone augmentation, and soft tissue management in a compromised central incisor case. A 33-year-old male patient presented with persistent pain in a previously root canal treated maxillary left central incisor. Clinical and radiographic evaluation revealed reinfection, periapical pathology, and insufficient ferrule, rendering the tooth unrestorable. Cone beam CT showed a narrow alveolar ridge measuring approximately 5.63. mm. Tooth 21 was atraumatic extracted, and a fixed provisional restoration was delivered for aesthetic maintenance. After 12 weeks, early implant placement (AnyRidge® Megagen Ø 4.0 x 10 mm) was performed using a 3D-printed surgical guide, along with simultaneous GBR using autogenous bone from the mandibular ramus and xenograft (Bio-Oss®), covered with a collagen membrane (Biomend®). Six months later, an apically positioned flap was used to enhance buccal keratinized tissue, and a provisional crown was placed to contour the emergence profile. Final prosthetic rehabilitation was completed with a monolithic zirconia crown supported by a prefabricated titanium abutment. This case demonstrates the benefit of combining digital planning with early implant placement and GBR in the aesthetic zone. This approach enhances aesthetic outcomes and implant stability. It reinforces the significance of prosthetically guided implant placement and supports future research comparing timing strategies in anterior implant therapy.
Vitamin D deficiency and associated risk factors among young children in Malaysia
Vitamin D deficiency in children is a global medical problem. The current study aimed to assess vitamin D status among preschool children in Malaysia, as well as to identify the risk factors associated with vitamin D deficiency. Methods: 120 healthy children were included. Blood samples were collected, and parents completed a questionnaire about family demographic characteristics, mother’s pregnancy information, nutritional habits and sunlight exposure. The ELISA Kit was used to determine serum vitamin D levels. Descriptive statistics and bivariate analyses were performed. A p-value ≤ 0.05 was considered statistically significant. Results: Vitamin D deficiency and insufficiency were reported in 35 %, 20 % of children respectively Chinese children were more likely to have sufficient vitamin D levels compared to other races (p= 0.050). Children deficient in vitamin D had significantly lower mean weight (p= 0.026). Mothers who had health issues during pregnancy were significantly more likely to have children deficient in vitamin D (p= 0.039). Only consumption of chicken (p= 0.048) and fortified cereal (p= 0.037) were associated with vitamin D status in children. Children exposed to sunlight in the last 2 weeks had sufficient levels of vitamin D (p= 0.026). Conclusion: High vitamin D deficiency was indicated among preschool Malaysian children. The lower body weight of children, mother’s health issues during pregnancy, less consumption of chicken and fortified cereal, less sunlight exposure and racial groups were associated with vitamin D deficiency. Health education and promotion programs for parents would help to increase knowledge aspects of vitamin D and its related benefit.
Effect of Nano SiO2 Treatment on Surface Roughness of Modified Acetal and Polyamide Thermoplastic Partial Denture Clasp Materials
Objectives: This in-vitro study aimed to investigate the effect of nano SiO2 coating on the surface roughness of E. glass fibres reinforced acetal and polyamide thermoplastic resin partial denture clasp materials. Materials and methods: 144 thermoplastic disk specimens were fabricated using two material groups, acetal (n=72) and polyamide (n=72). Each of these two material groups was further divided into three subgroups (n=24/subgroup), namely 1: unmodified (control), 2: internally E. glass fibres reinforced, and 3: externally nano SiO2 coated with internally E. glass fibres reinforced. Alicona non-touch profilometer was used to measure the surface roughness of all test specimens. Results: Control and E. glass fibres reinforced of acetal and polyamide resin subgroups showed the highest mean surface roughness; (Ra= 0.181 μm, 0.111μm) respectively. In the third subgroup, the acetal resin showed slightly higher surface roughness than the polyamide resin group; (Ra= 0.1114μm, 0.1113μm) respectively at (P=0.838). Conclusion: Utilization of nano SiO2 coating on acetal and polyamide thermoplastic partial denture clasp materials can significantly enhance their surface properties, resulting in improved surface roughness. This novel technique stands as a promising external approach for ameliorating the performance of these materials.
Copyright (c) 2025 Compendium of Oral Science https://creativecommons.org/licenses/by-nc/4.0
Anti-Bacterial and Anti-Biofilm Activities of Hopea ferrea Stembark Extract against Cariogenic Bacterium
Dental caries, caused by enamel-adherent cariogenic bacteria breaking down sugars into acid, gradually demineralizes tooth structure. Cariogenic biofilms contribute significantly to antibiotic resistance, treatment failure, increased morbidity, and rising healthcare costs. Hence, research is exploring strategies to interrupt biofilm formation and bacterial communication, aiming to modify the microbial pathogenic cycle. This interest is supported by studies on Hopea ferrea's therapeutic potential due to its secondary compounds like flavonoids, phenols, and tannins. Objectives: The main objective of the present study is to determine the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and anti-biofilm activity of H. ferrea extract against cariogenic bacteria namely Streptococcus mutans. Method: This study used a Brain Heart Infusion (BHI) medium for growing bacterium S. mutans. Antimicrobial activity was tested by growing bacteria on agar plates and in broth cultures. Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were determined following standard procedures. Biofilms were grown in 24-well plates, and their biomass was assessed using a crystal violet stain. Finally, data was analyzed using GraphPad Prism. Results: The results showed that the MIC and MBC results of the H. ferrea extract against S. mutans were at of 2.5 mg/mL. Anti-biofilm activity of the extract using crystal violet assay showed significant reduction of the biomass at 2.5 and 1.25 mg/mL (p<0.01). However, biofilm reduction on the biomass was not significant on formed biofilm. Conclusion: The anti-biofilm activity of H. ferrea extract against S. mutans suggests its potential as a promising candidate for further development as a natural anti-biofilm agent in dentistry.
Genetic and Epigenetic Contributions to Psychosomatic Conditions in Temporomandibular Disorder: A Systematic Review
Objectives: Temporomandibular disorder (TMD) is a complex condition with unclear causes and an uncertain diagnosis. Evidence suggests that genetic and epigenetic factors contribute to its pathogenesis and influence psychosomatic conditions. Understanding these genotype-phenotype interaction is crucial for improving diagnosis and developing targeted therapies. This systematic review aims to (i) examine the genetic and epigenetic factors involved in TMD and (ii) assess their association with psychosomatic manifestations. Methods: This review was registered in International Prospective Register of Systematic Reviews (PROSPERO, ID: CRD42024583915) and conducted in accordance with PRISMA guidelines. A systematic search of PubMed, MEDLINE, Scopus, ScienceDirect, Web of Science and Wiley databases identified studies published between 2019 and 2024. Eligible studies were selected based on predefined inclusion criteria. Extracted genomic and epigenomic data were analysed to identify predictive and diagnostic markers associated with TMD. A decision matrix analysis was performed to determine the most significant factors. Results: Ten studies met the inclusion criteria. Genetic variations associated with TMD encode for structural, transporter, regulatory, receptor, enzymatic and ion channel proteins, while epigenetic modifications affected genes encoding extracellular protein, enzyme and transcription factor. Among these, COMT rs4680 was the most extensively studied, showing strong associations with pain modulation and anxiety in TMD patients. Conclusion: The COMT gene emerges as a promising therapeutic target in TMD. This review highlights the complex interplay between genetic predisposition, epigenetic regulation and psychosomatic influences on TMD. A deeper understanding of these interactions may facilitate early diagnosis and personalized treatment strategies for managing TMD-related pain and psychological comorbidities.
Modified Method for Synthesis of Microwave-Assisted Irradiation Hydroxyapatite for Alveolar Ridge Preservation
Hydroxyapatite is one of the commonly used alloplastic material for alveolar bone regeneration. However, the currently practiced methods of synthesis are often time-consuming. The commercially available hydroxyapatite, even though were proven to attenuate alveolar bone resorption, they also showed a low biodegradability. This study is aimed to describe a new method of synthesising hydroxyapatite using microwave-assisted irradiation method. Methods: 52g Calcium nitrate tetrahydrate was dissolved in 5% hydrogen peroxide until it completely dissolved. Stoichiometric amount of 85% phosphoric acid were added dropwise, and the pH of the suspension was adjusted using ammonium hydroxide solution. The suspension was continuously stirred for additional 30 minutes at the room temperature. One part of the suspension was heated in household microwave at 800W for 10 minutes. Another half was filtered and washed using distilled water (named as filtration-HAp). Each suspension was further freeze-dried and calcined at 600C for 2 hours. The obtained powders were further characterised by using x-ray diffractometer, fourier transform infrared spectroscopy and energy dispersive x-ray fluorescence. Morphology of obtained powders were observed using field emission electron microscope. Results: X-ray diffraction pattern of microwave-HAp showed high peaks indicating a highly crystalline structure. FTIR results confirms the presence of phosphate and hydroxyl groups. EDXRF showed calcium-to-phosphorus ratio of 1.8. Microwave-HAP showed non-homogenous spherical shape with less agglomeration, whereas filtration-HAP showed amorphous and highly agglomerated structure. Conclusions: Microwave-assisted irradiation method enables the rapid synthesis of pure hydroxyapatite nano powder with high crystallinity. The modified microwave-HAp can be considered a potential bone substitute. Further in-vivo investigations are required to ascertain the desirable mechanical properties and optimal concentration of MW-Hap for tissue biocompatibility.
Bone Regeneration in Periodontal Therapy: Exploring the Compressive Strength and Structural Characteristics of Calcium Sulfate-Chitosan Composites
Objectives: This study aims to investigate the mechanical properties and structural characteristics of innovative calcium sulfate-chitosan (CS-CHT) biomaterials on human periodontal ligament fibroblasts (PDLF) to advance periodontal regeneration. Materials and Methods: The biomaterials were prepared by mixing calcium sulfate with distilled water and chitosan, followed by molding into cylindrical samples. Human periodontal ligament fibroblasts (PDLF) were grown in a complete medium until they reached 90% confluency, then seeded onto the CS-CHT biomaterial. The compressive strength of the samples was tested using a universal testing machine, with measurements taken at 24 hours, 48 hours, 72 hours, and one week. Scanning electron microscope (SEM) imaging was used to analyze the structural characteristics. Results: The results showed that the compressive strength of CS-CHT biomaterials increased over time, surpassing that of CS alone after one week, with average compressive strengths ranging from 2.93 MPa to 5.61 MPa. SEM images revealed a crystalline arrangement and textured surface with pores ranging from 6.0 µm to 89.5 µm. Successful adhesion of PDLF to the biomaterials was observed, with cytoplasmic extensions visible in the SEM images. There were no significant differences between the two groups at various time points based on the independent t-test. Conclusions: In conclusion, CS-CHT biomaterials exhibit suitable mechanical properties and structural characteristics for bone regeneration in periodontal therapy. The increasing compressive strength and successful adhesion of PDLF indicate their potential for clinical application in periodontal treatments. This study provides valuable insights into the development of effective biomaterials for bone and periodontal regeneration, highlighting the promise of CS-CHT in advancing dental tissue engineering.
Effect of Tocotrienols isomers on the Viability of Oral Cancer Cells (ORL-48): An MTT Assay Study
Objectives: This study aimed to conduct an in vitro investigation to evaluate the viability of tocotrienol isomers (α, β, γ, δ) on human oral squamous cell carcinoma (OSCC), specifically targeting the ORL-48 cell line, using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Methods: The MTT assay is a widely used colorimetric assay for measuring the cytotoxic effects of potential medicinal or active compounds. Technical triplicates were employed in this study to ensure the reliability and reproducibility of the results. Results: Among the tocotrienol isomers tested, γ-tocotrienol demonstrated significant viability inhibition, with an IC50 of 5.2 ± 1.4 µg/mL on the ORL-48 cell line. In contrast, the IC50 values for α, β, and δ tocotrienols were not determinable (ND), as their percentage of inhibition was less than 50%, indicating a lack of significant effect at the tested concentrations. Conclusions: These findings suggest that γ-tocotrienol has potential as an antiproliferative agent against oral cancer cells (ORL-48). Its significant activity underscores the need for further functional studies to better understand its mechanisms of action and potential therapeutic roles in future cancer treatment. Future research should focus on elucidating the molecular pathways effects of γ-tocotrienol and exploring its.
Orthodontic Mini Implant, a Narrative Review
Introduction: The refinement in anchorage management in recent years has magnified the superiority of the mini-implant (MI). Behind the vast clinical literature and low failure rates (Alharbi et al., 2018a), there is a steep learning curve. The lack of updated information on MI focused on understanding the multifactorial success has led to a new area in developing MI research for surface treatment and clinical application. Objective: This comprehensive review aims to address the different variables contributing to MI success. Methods: The articles were identified electronically (PubMed, Scopus, Google Scholar), ranging from 2018 to date. The articles were independently reviewed by two reviewers (SHR and MMD). Randomised clinical trials (RCT), longitudinal studies, cohort, and case/control studies, both retrospective and prospective, were all included. The following search terms were used: mini-implant orthodontics; mini-implant design; surface treated mini-implant; mini-implant success; mini-implant clinical application; mini-implant complications. Conclusions: The application of MI in orthodontics is bounded by biological factors, geometry, and operational factors. Surface modifications of MI are performed in various ways to increase the primary stability, and the clinical application of MI has expanded in complex cases to mimic surgical correction. The known risks and complications of MI provide sufficient knowledge to negate any problems encountered in clinical situations. It is critical to recognise that MI has its pearls and pitfalls, and we must constantly refine our understanding and clinical applications to maximise the success rate of MI use.
A Netnography on Misinformation and Public Perceptions towards Human Papillomavirus Vaccination for Oral Cancer Prevention in Malaysia
The amount of repeated misinformation regarding Human Papillomavirus (HPV) vaccination over social media and internet affects general public perception and knowledge about the association between HPV vaccine and oral cancer. Objective: This study aims to investigate misinformation and public perceptions towards HPV vaccination for oral cancer prevention in Malaysia, focusing specifically on X (formerly Twitter) and Facebook data. Methods: Adopting a qualitative approach, this study utilizes online ethnographic methods (social listening) to explore discussions, sentiments, and trends surrounding HPV vaccination on X and Facebook from January 2022 to March 2024. Data collection involves monitoring tweets/posts related to HPV vaccination and oral cancer prevention in the Malaysian context. Analytical techniques such as content analysis, sentiment analysis, and thematic coding are employed to identify patterns, themes, and attitudes towards HPV vaccination. Results: From the 1,399 posts by 547 unique users, findings from the study reveal prevalent misinformation and varied public perceptions towards HPV vaccination on X and Facebook in Malaysia. Content analysis identifies common themes and misconceptions (health, safety, inefficacy, and pharmacology) surrounding HPV vaccination, while sentiment analysis highlights divergent attitudes within the X and Facebook community. Conclusion: The study provides valuable insights into the prevalence of misinformation and public perceptions towards HPV vaccination for oral cancer prevention on X and Facebook in Malaysia. By understanding the dynamics of online discourse on this platform, policymakers and healthcare professionals can develop targeted interventions to address misinformation, improve vaccine acceptance, and promote public health awareness among X and Facebook users.
Determinants of Peri-implant Disease: From Biofilm Aetiology to Modifiable Risk Factors and Anatomical Predisposition
Objectives: This review critically evaluates the multifactorial determinants of peri-implant diseases, hypothesising that microbial biofilms, systemic and behavioural factors, and anatomical distinctions collectively influence disease onset and progression. Materials and Methods: A comprehensive analysis of current literature was conducted, focusing on microbiological studies, epidemiological reports, and clinical trials related to peri-implant mucositis and peri-implantitis. Special emphasis was placed on evaluating evidence related to bacterial plaque formation, systemic conditions (diabetes mellitus), behavioural habits (smoking, oral hygiene), anatomical differences between implants and natural teeth, and prosthetic complications. Results: Bacterial plaque is established as the primary etiological factor in peri-implant mucositis and significantly contributes to peri-implantitis. Disease severity and progression are modulated by systemic conditions such as diabetes mellitus, behavioural factors including smoking and inadequate oral hygiene, and prosthetic factors like residual cement. Individuals with previous periodontitis exhibit heightened susceptibility due to persistent periodontal pathogen colonisation. Anatomical differences such as the lack of periodontal ligament, reduced vascularity, and weaker soft tissue integration also increase vulnerability to peri-implant disease. Microbial analysis highlights a diverse microbiota associated with peri-implant diseases, including opportunistic pathogens such as Staphylococcus epidermidis. Conclusions: Peri-implant diseases are multifactorial, requiring tailored preventive strategies focused on meticulous plaque control, systemic and behavioural risk mitigation, and routine implant maintenance. Future research should prioritise improved diagnostic biomarkers, detailed biofilm characterisation, and innovative therapies targeting the unique biological challenges of peri-implant tissues. Keywords: peri-implantitis, peri-implant mucositis, biofilm, dental implants, risk factors
Management of Sodium Hypochlorite Accidents : A Trio Series of Case Reports
Sodium hypochlorite (NaOCl) is the most often used solution in root canal treatments due to its inexpensive cost and highly efficient antibacterial activity against diseased root canal microorganisms. Nonetheless, this solution can produce difficulties due to its cytotoxic properties. When this solution is injected into neighbouring tissues, the patient typically experiences excruciating pain, and an immediate therapy is required to prevent long-term complications. This article covers the clinical characteristics of three individuals who sustained unintentional NaOCl extrusion following endodontic treatment of variable severity and different therapies. In addition, it describes the long-term neurologic impairments that this type of accident may produce and suggests a treatment strategy for such cases.
Nano Silver Fluoride Preparation as an Anti-Caries Agent: A Scoping Review
This scoping review aims to explore existing literature on the synthesis of Nano Silver Fluoride (NSF) and to identify the key variables that may influence its effectiveness as an anti-caries agent. Following the Joanna Briggs Institute (JBI) methodology, a scoping review was conducted to examine the available studies related to NSF formulation for dental caries prevention. A systematic search across academic databases was performed. Studies were included if they described methods for preparing NSF intended for anti-caries use. A total of 704 articles were initially identified. After screening and eligibility assessment, nine studies were included in the final review. These studies varied in terms of population, study design, and evaluation methods. NSF was primarily synthesized through chemical methods using various silver precursors, reducing agents, and stabilizers. The resulting nanoparticles were all spherical, with sizes ranging from 3.2 to 16 nm. NSF concentrations ranged from 400 to 33,989 ppm. Despite methodological differences, all studies supported the anti-caries potential of NSF. NSF is a promising, non-invasive agent for caries prevention in both children and adults. Its effectiveness is supported across different synthesis methods, provided the presence and stability of NSF are verified.
Process Evaluation of Antenatal Oral Healthcare Programme: A Qualitative Study Among Healthcare Providers in Selangor, Malaysia
Objective: This study evaluated the implementation of the Oral Healthcare Programme (OHCP) for antenatal mothers in Selangor from the perspectives of antenatal care providers (ANCPs) using a SWOT framework. Materials and Methods: A qualitative exploratory design was employed involving Focus Group Discussions (FGDs) and In-Depth Interviews (IDIs) with dental officers, medical officers, and nurses/midwives from three districts in Selangor. Participants were purposively sampled, and interviews were conducted virtually using Zoom platform. Data were thematically analysed guided by SWOT analysis principles. Results: The identified OHCP’s strengths include integrating oral health into maternal services, committed healthcare personnel, and accessible services. The programme’s weaknesses include a limited workforce, inadequate cross-sectoral collaboration, and inconsistent referral mechanisms. The highlighted opportunities include digital innovation and enhanced training, while the threats of the OHCP were the funding constraints, lack of prioritization in maternal health, and sustainability concerns. Conclusions: The study identifies the need for an improvised level of interprofessional coordination, standardized workflows, and innovative educational strategies, such as digital tools, to improve programme coverage and sustainability. Strengthening resource allocation and policy support are crucial for optimizing the impact of antenatal oral healthcare. Keywords: antenatal mothers, oral health programme, SWOT analysis, healthcare providers, qualitative study
Optimising Orthognathic Surgery: A Comparative Review of the Conventional and Surgery-First Approaches
Objectives: This review explores and compares the Conventional Orthognathic Approach and the Surgery-First Approach in orthognathic surgery. Materials and Methods: A comprehensive narrative review was conducted by systematically examining peer-reviewed literature, including clinical trials, retrospective studies, systematic reviews, and meta-analyses. Databases such as PubMed, Scopus, and Web of Science were searched using relevant keywords including “Conventional Orthognathic Approach,” “Surgery-First Approach,” and “Orthognathic Surgery.” Studies were selected based on their relevance to the comparative evaluation of COA and SFA in terms of treatment duration, surgical planning complexity, postoperative stability, complication rates, and patient-reported outcomes. Results: The SFA demonstrated several advantages, including earlier facial improvement, reduced total treatment time, and improved patient cooperation. Patients treated with SFA often reported enhanced psychological well-being due to the early correction of facial aesthetics. On the other hand, COA remains widely used due to its predictable occlusal outcomes and suitability for a broader patient population. Both approaches showed similar long-term skeletal and dental stability in many studies. In terms of complications, both approaches had comparable safety profiles, though SFA demands greater surgical precision. Notably, SFA also showed promising results in selected cases of facial asymmetry and did not appear to increase the risk of temporomandibular joint dysfunction when carefully managed. Conclusions: Both COA and SFA are effective and safe strategies in orthognathic surgery. The choice should be guided by patient-specific needs and clinical judgment. SFA may be preferred when quicker aesthetic results and shorter treatment duration are priorities, assuming careful planning and appropriate case selection.
Chitosan as a Potential Pulp Capping Material for Dentin-Pulp Regeneration: A Review
Chitosan is a natural biopolymer acquired from chitin, mainly from shell of crustaceans. Its major properties include nontoxic, biocompatible, antimicrobial, anti-inflammatory, stimulate wound healing and cell proliferation. Due to these properties, chitosan has gained a significant attention due to its wide range of applications, including regenerative dentistry. Regenerative dentistry aimed to restore damaged tissues such as dentin and root structures and pulp-dentin complex. One of the important elements in regeneration of pulp-dentin structure is pulp capping material. Studies found that chitosan exhibit a great potential as a pulp capping material due to its ability to stimulate reparative dentin, maintain pulpal vitality, good antimicrobial activity, adherence properties to restorative material and dentin, and can resist forces during placement of restoration. Nanotechnology in tissue engineering may further enhance the properties and application of chitosan in biomedical field. This review discussed the potential of chitosan as a pulp capping material based on the results of current research. This article also briefly discussed on the limitations of chitosan and method to overcome the challenges
Paranormal Sightings after General Anaesthesia
Hypnagogic hallucinations are visual, auditory, tactile, or other sensory events that are not actually present, experienced during hypnagogia, a period of transition from wakefulness to sleep. These hallucinations were reported to be brief and mostly visual in nature. We hereby report a rare incidence of this phenomenon occurring in a 61-year-old woman presented with impending Ludwig’s angina at our centre. She began experiencing hypnogogic hallucinations when she started to doze off at night after an incision and drainage procedure was carried out under general anaesthesia earlier that day. Upon closing her eyes, she had a clear view of people moving around performing chores. The events were so vivid that she was convinced they were of paranormal origin, which subsequently led to sleep deprivation. These hallucinations immediately disappeared simply by opening her eyes. She eventually sought psychiatric treatment, and the symptoms gradually decreased with full remission on postoperative day 5. Her daily appetite and behaviour were normal throughout her hospital stay. Although postoperative sleep disturbances are often described, hypnagogic hallucinations post-general anaesthesia were documented in only three cases to date following cardiovascular and orthopaedic surgery. To date, the aetiopathophysiology of this type of visual hallucination remains to be unravelled.
Single-Step Regenerative Endodontic of an Immature Necrotic Maxillary Incisor using Calcium Hydroxide: A 3-Year Follow-Up
Regenerative endodontic is a treatment procedure that promotes the apexogenesis of a necrotic immature permanent tooth. This case report presents the successful management of a 9-year-old anxious Malay male patient with a necrotic, immature maxillary right central incisor via a regenerative endodontic technique. The root canal was not mechanically cleaned during the treatment period but was irrigated with normal saline. The calcium hydroxide compound was used for disinfection without inducing blood clot formation. A clinical and radiographic follow-up was performed for thirty-six months where the tooth was considered asymptomatic, vital, and with a complete root formation.
Epigenetic Mechanisms of Oral Leukoplakia: A Systematic Review
Objectives: Oral leukoplakia (OL) is the most common type of oral potentially malignant disorder and has a malignancy transformation rate ranging from 0.1% to 17.5%. The rates of malignant transformation of oral leukoplakia (OL) to oral carcinoma can reach as high as 70%. Epithelial dysplasia in OL is linked to progression toward malignant transformation. We performed a systematic review (SR) to identify the epigenetic alterations and progression of OL. Methods: The study protocol was registered in PROSPERO, ID: CRD42024497161. We searched PubMed, MEDLINE, Scopus, ScienceDirect, Web of Science, ClinicalKey and Wiley databases from 2018 to 2023. This SR was conducted following PRISMA guidelines, and articles were selected based on defined inclusion and exclusion criteria. Results: Seven studies met the inclusion criteria. Results documented that epigenetic malignant transformation of LO involved hyper and hypo methylations CpG promoter of tumor suppressor gene, Enhancer of zeste homolog 2 (EZH2) expressing cells in both the epithelium and the connective tissues, methylation in Retinoic Acid Receptor Beta (RARβ) promoter, involvement non-coding miRNA correlate positively with the degree of dysplasia, salivary miRNA demonstrated potential for the diagnosis and follow-up of OL patients. Conclusion: Epigenetic noncoding miRNA biomarkers have potential mechanistic roles as targets for early diagnosis and as prognostic markers for the transformation of OL cells to malignancy.
Antibacterial Activity of Endophytic Streptomyces spp. isolated from Medicinal Plants of Dental Importance
Wide variations of plant species in Malaysia provide suitable hosts for the isolation of endophytic streptomycetes, which can be potential sources of bioactive compounds with therapeutic applications in dentistry. Objectives: This study’s objectives were to isolate endophytic streptomycetes from medicinal plants and to evaluate their antibacterial activity against Streptococcus mutans, a key pathogen responsible for dental caries. Methods: Endophytic streptomycetes were isolated from seven fresh plants: Mauritius papeda (Kaffir lime), Cosmos caudatus (Ulam Raja plant), Lawsonia inermis (Henna plant), Piper sarmentosum (Kadok), Kaempferia galanga (Cekur plant), Ziziphus mauritiana (Bidara plant), and Psidium guajava (Guava plant), using a surface-sterilization method. Different plant parts were placed on five isolation media, namely Water Agar, International Streptomyces Project (ISP) 2, ISP 4, ISP 5, and Tap Water Yeast Agar, and incubated at 37°C for up to one month. Isolates were identified by morphological characteristics and tested for antimicrobial activities through a cross-streak assay. Results: A total of 38 endophytes were successfully isolated, with 19 identified as streptomycetes. Specifically, seven, two, five, and three endophytes were isolated from stem, root, leaf, and fruit, respectively. Three endophytic streptomycetes exhibited antagonistic activity against S. mutans. Conclusion: Endophytic streptomycetes demonstrated antibacterial activity against S. mutans, indicating their potential for further development in dental applications.
Surface Characteristics of Calcium Chloride Surface-Treated Mini Implant
Objective: This study aimed to investigate the surface characteristics of surface-treated titanium orthodontic mini-implant (MI) with acid etching and immersion in different conditions (concentrations, temperature and duration) of calcium chloride (CaCl₂). Materials and Methods: Eighty-four MI by Orthodontic Microimplant AbsoAnchor® System (Dentos Inc.) were utilised in this study. Surface roughness was assessed qualitatively and quantitatively with a scanning electron micrograph (SEM)(at 50x,500x and 1000x magnifications) and energy-dispersive spectrometer (EDS) (Fei Quanta FEG 450 Environmental Electron Microscope) of the surface-treated MI with different conditions of CaCl₂ immersions; concentrations (0.01 M, 0.1 M & 1.0 M), temperature (5°C,15°C and 25°C) and duration ( 1hour, 7 hours and 24 hours). Results: Surface topography changes were observed due to increase in surface roughness of MI treated with acid etching and CaCl2 immersions at various conditions . There was a significant difference in surface topographic changes seen by various irregularities with small cavities and protrusions were observed on surface of the MIs at different magnifications. The highest level of Ca2+ concentration detected was in 0.1 M at 5°C for 7 hours of CaCl₂ immersion. Conclusion: MI surface modification using CaCl2 surface treatment provided a significant difference in surface topographic changes seen between the MI groups. Hence, it increased the potential surface area of osseointegration and enhanced tissue renewal and repair. The physicochemical characteristics analysis showed a significant presence of calcium ions by % wt on the MI surface. Different temperatures, concentrations, and times of immersion did affect the availability of CaCl₂ on the MI surface and CaCl₂ condition of 0.1 M at 5°C for 7 hours of immersion was the optimum condition.
In Vitro Cytotoxicity Comparison of Stingless Bee Propolis and Cisplatin against ORL-48 and HGF
Objectives: To assess the impact of Malaysian Heterotrigona itama (HI) propolis on the proliferation of oral squamous cell carcinoma cell lines (ORL-48) and Human Gingival Fibroblasts (HGF) through comparative treatment at different concentrations and time intervals. Method: The ORL-48 and HGF cell lines were treated with varying HI propolis and cisplatin concentrations. Subsequently, the 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay evaluated the in vitro cytotoxicity of HI propolis and cisplatin against ORL-48 and HGF cell lines. Result: This study discovered that HI propolis could inhibit the proliferation of ORL-48 cells in a concentration-dependent manner. From the increased treatment concentrations, the HI propolis administration to HGF cells demonstrated a proportional rise in the cell proliferation percentage of HGF cells. Nevertheless, cisplatin treatment significantly decreased the cell viability of ORL-48 cells with a half maximal inhibitory concentration (IC50) of 0.0036 mg/ml at 72 h (p < 0.05). Meanwhile, no significant reduction in cell viability was observed in HGF cells. Conclusion: Propolis-based HI exhibited in vitro cytotoxic activity against human cancer cell lines while demonstrating lower cytotoxicity towards normal cells.
Ethnicity and Habits in p53 Gene Mutation in Oral Squamous Cell Carcinoma
Objectives: Our previous study demonstrated that 31% (n=58/18) of OSCC patients have p53 gene mutation. In this study, we investigate the relationship of ethnicity and habit to p53 gene mutation of oral squamous cell carcinoma (OSCC). Methods: The present study used Multiplex Ligation-dependent Probe Amplification (MLPA) to examine p53 gene mutation from exon 1 to 11. DNA specimens from 58 OSCC patients and 10 healthy people (controls) were used in this study. Our results demonstrated that 31% (n=58/18) of OSCC patients have p53 gene mutation. Among them 56% (n=10/18) of mutation occurred in exon 3, followed by exon 4 which was 50% (n=9/18). Result: The Malay, Indian, and Chinese ethnic groups each accounted for 28% of OSCC patients with p53 gene mutations. 56% of the individuals had a habit of smoking, drinking alcohol, or chewing betel quid.56% of the individuals had a habit of smoking, drinking alcohol, or chewing betel quid. Sixty percent (n=6) of Chinese and Malay patients have mutations in almost all exons, while Indian patients primarily have mutations in exon 4. Conclusion: Our current study suggests that further investigation is needed to understand the relationship between ethnicity, habits, and their interaction with genetic and epigenetic modifiers in exon-specific p53 mutations.
Parental Perceptions of Early Childhood Oral Health in Relation to Children’s Caries Experience: A Cross-Sectional Study
Recognizing parental perception about early childhood oral health holds significance for crafting effective preventive strategies, given that parental actions and habits frequently exert considerable influence on their children's dental well-being. The aim of this study was to evaluate parental knowledge and practice in the prevention of dental caries in young children and to investigate the possible association between parental knowledge and practices and their children’s caries status. Methods: A cross-sectional study was conducted among parents who brought their children under the age of six (n=330 pairs) to the Paediatric Dental Clinic at Universiti Teknologi MARA, Malaysia. The children underwent a comprehensive dental screening while the parents completed a questionnaire regarding their child’s oral health. Data were analyzed using descriptive statistics and bivariate analysis. Results: The prevelence of early childhood caries was 76.8% and the mean dmft index was 5.50±4.88. Overall, 97.2% of parents recognized the importance of the primary teeth. However, only 46.2% were aware that the first dental examination should occur 12 months and only 66.3% believed that decayed primary teeth should be restored. Conclusion: While many parents acknowledged the importance of primary teeth, they lacked sufficient knowledge about how to appropriately address carious teeth and the recommended time for the first dental visit. Therefore, parents should receive appropriate anticipatory guidance and also come to appreciate the benefits of early dental visits in preventing caries and promoting the well-being of their children.
Application of Silicone Elastomers in Extraoral Prosthesis: A Narrative Review
Objectives: The purpose of this article is to review the silicone system based on the various varieties of silicone available on the market, including classification and its properties. In addition, this article looks at the recent advancement of silicone in digital workflow as it relates to the application of extraoral prosthesis, thereby providing an overview and a guidance for practicing clinicians. Materials and Methods: Electronic literature search was conducted using the PubMed and Scopus databases. There were no restrictions placed on the publication date up until December 2022. Following MeSH term keywords were used: ‘silicone’, ‘maxillofacial prosthesis’, ‘extraoral prosthesis’ Only relevant studies published in English journal articles are included and analysed in this review article. Results: Silicone is an unique inorganic polymer chains. Due to its unique chemical structure, silicone exhibit skin-like elasticity, resistance to heat, biocompatibility, as well as translucency, making it suitable for fabrication of extraoral prosthesis despite its shortcomings. Several physical and mechanical properties of silicone should be taken into consideration. Conclusion: The properties of silicone and its application in extraoral prosthesis, including its limitations, material considerations, and manufacturing obstacles, have been discussed. High Temperature Vulcanisation (HTV) and Room Temperature Vulcanisation (RTV) silicone are the two primary classifications for extraoral prosthesis applications. As far as is known, there are five major manufacturers of silicone for extraoral prosthesis fabrication. Silicone has considerable potential for future incorporation into digital workflows via additive manufacturing processes.
Translucent Zirconia: Modifications and Current Classifications – A Review
Zirconia ceramics have undergone several modifications to improve its optical properties which expanded its indication in many clinical scenarios. Newer generations of zirconia with higher translucency and multi-layer configuration combined with high strength and biocompatibility are being developed continuously in the market. Optical properties of zirconia particularly translucency can be improved through several modifications’ techniques that utilise the understanding of its isotropic and polymorphism attributes. Various types of zirconia are now available in the market which can be classified into different parameters for selection and further aid clinicians in making accurate clinical decision making. The expanded clinical application of zirconia ceramics has been facilitated by advancements in their translucency. This progress stems from an enhanced comprehension of zirconia's intrinsic properties, which has enabled the development of innovative approaches to improve its transparency and aesthetic characteristics.
The Relationship of Body Heights, Gender and Anterior Teeth Sizes in Malaysian Population
Objective: To investigate the correlation between participants body heights and gender to the size particularly the widths and heights of anterior teeth of Malaysian population. Materials and Methods: The study samples consisted of 363 participants, including 67 males and 296 females, aged between 20 and 40 years from the Malaysian population. Digital impressions were taken of all six anterior teeth, from the right canine to the left canine and were imported into 3D software to measure tooth widths and heights digitally. Body heights of participants were recorded. Data was analyzed to see the correlation of the body heights of the participants to the measurements of the teeth using Pearson correlation coefficients and descriptive analyses for the differences of the widths and heights of teeth according to gender. Result: Pearson correlation analysis showed that several tooth measurements positively correlate with body height, indicating an increase in tooth length, particularly in right lateral incisor height, right canine height, left central incisor height, left lateral incisor height, and left canine height as height increases. On gender differences, males showed to have wider and taller teeth than females, with a notable similarity in right lateral incisor width. Conclusion: This study concludes that tooth length increases with body height. Additionally, males exhibit larger tooth dimensions in both width and height across all six anterior teeth.