Compendium of Oral Science

Review of Materials for the Fabrication of Microparticles in the Context of Bone Tissue Engineering

Ahmad Fareez Mohd Rawi — 2024-09-01

Bone tissue engineering (BTE) is a rapidly advancing field that seeks to repair or regenerate damaged or diseased bone tissue. Microparticles play an increasingly significant role in BTE by serving as drug delivery systems, cellular carriers, and scaffold components. This review aims to provide a comprehensive understanding of the variety of materials used in the fabrication of microparticles for bone tissue engineering applications. Natural polymers discussed include chitosan, collagen, gelatin, hydroxyapatite (HA), and silk fibroin, each offering unique biocompatibility and biochemical properties. Synthetic polymers such as ceramics, poly (lactic acid) (PLA), poly (lactic-co-glycolic acid) (PLGA), polyethylene glycol (PEG), and polycaprolactone (PCL) offer advantages in terms of mechanical stability and controlled degradation. The review also explores composite materials that combine the strengths of natural and synthetic polymers for enhanced biocompatibility, mechanical strength, and bioactivity. The functionalization and surface modification of these microparticles to meet specific requirements in bone tissue engineering are additionally covered. The objective is to guide researchers in selecting the most appropriate materials for specific applications within the realm of bone tissue engineering, considering factors such as biocompatibility, mechanical properties, and bioactivity.

The Management Approach for a Large Periapical Lesion: A Review

Nazrin Mohd Isa — 2024-09-01

Endodontic therapy of large periapical lesions presents a substantial challenge to the clinician. The destruction of periapical tissues, including bone and adjacent structures, characterizes these lesions.

A systematic approach that incorporates multiple treatment modalities for optimal healing is necessary for the effective management of such lesions.

This article discusses the management strategy for large periapical lesions in endodontics, emphasizing the significance of accurate diagnosis, appropriate treatment planning, and the application of effective therapeutic techniques. It has been reported that endodontic therapy has a more favorable prognosis for minor lesions as opposed to larger lesions.

A conservative approach, such as non-surgical root canal therapy, should be the initial course of action prior to surgical endodontic intervention.

Dental Implant Surgery: A Concise Review of the Literature

Fatimah Al Khateeb — 2024-09-01

Edentulism is a global challenge affecting patients’ psychosocial well-being, now well-treated by dental implants. Due to the advancement in the field of oral implantology, there is a plethora of surgical techniques and protocols at the disposal of clinicians, backed by an ever-divided body of research. Treatment with dental implants has become ever more sought after because of their high survival and success rates and increased affordability. In turn, this has put increased demand on clinicians who owe their patients the highest standard of care backed by sound scientific evidence. However, dentists are expressing concern over ambiguous dental implant guidelines and protocols. Implant survival, success and failure rates have been reported differently for various modalities and justified differently in various research. This lack of consensus appears to stem from erroneous or non-standardized study designs, yielding inconsistent results. Therefore, correctly designed and well-reported high-level studies are needed to aid clinicians in treatment decision-making.

Genetic Mechanisms of Oral Leukoplakia: A Systematic Review

Jamil Ahsan Kazi — 2024-09-01

Objectives: Oral leukoplakia (OL) is the most common type of oral potentially malignant disorder. It is currently managed through lesion removal either by laser excision or resection. However, its multifactorial aetiology often results in recurrence and cancer transformation. Therefore, findings on novel biomarkers are emerging to understand OL formation and progression towards malignancy. We performed a systematic review to identify the genetic factors for the risk of OL conditions. 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. The study was conducted following PRISMA guidelines and articles were selected based on predefined inclusion criteria. Genomic profiles of OL tissues collected from study patients were summarised based on outcome determinants of predictive or diagnostic markers, in relation to OL histopathological features. Results: Seventeen studies met the inclusion criteria. Results showed that OL formation and progression involve genetic factors such as cytokines, proliferation antigen, major histocompatibility complex and CD molecules of lymphocytes, caspase, immune checkpoint, oral cancer key genes, nuclear proteins and transcription factors, toll-like receptor, macrophage and polycomb complex. Among them, the transcription factor p53 is the most investigated factor. However, the cytokine was found to play critical roles in OL progression towards the advanced stages, and is closely associated with dysplastic changes. Conclusion: Exposure to genetic alterations results in OL malignant transformation. Future studies on differential cytokines profiling of differentiated dysplasia, may reveal the novel stage-wise biomarkers for molecular pathological grading.

Investigation on the Impact of Bisphenol A Exposure from Dental Materials: A Systematic Review

Nur Amirah Syafiqah Shamsudin — 2024-09-01

Bisphenol A (BPA) has been reported to have many impacts on human health due to its excessive exposure in human daily life. This includes patients that received dental treatment as they may be exposed to dental materials containing BPA. Few studies discuss the alternatives to replace BPA to reduce its exposure to humans as well as clinical practice prevention to reduce BPA leaching retained in the oral cavity. Thus, the aim of the study is to systematically review the impact of BPA exposure from dental materials on human health and to provide suggestions on the substitution of BPA with other materials or free-BPA materials. This study was performed through PubMed, ScienceDirect, and Scopus databases. The data were extracted by all authors independently and tabulated according to the topic, author, impact of BPA on human health, suggestion on substitution of BPA with other materials or free BPA materials, and limitation of the studies. About fifty-eight studies related to BPA usage in dental treatment, short- and long-term exposure of BPA, and health risk exposure to BPA were shortlisted. Almost all studies reported that BPA exposure from dental material showed negligible dosage that may not harm human health. However, there is a clear indication showing a small amount of BPA leaching from dental materials in the short term after application. About fifteen papers suggested an approach to minimize the usage of BPA materials including the introduction of free-BPA materials such as G- IEMA, ISBGBMA, TTM monomer, FDMA monomer, BCF-GMA, PCDMA and TMBPF- Ac, and prevention in clinical practice. In conclusion, BPA is known to affect human health but there is a low risk when related to BPA exposure from dental materials. However, it should not be neglected due to the lack of studies on long-term effects that may create a possible risk to human health. Therefore, suggestions on free-BPA material should be considered to reduce the exposure of BPA in humans.

Scoping Review: Evaluation of Sea Cucumber as a New Therapeutic Agent for Wound Healing Treatment in Clinical Trials and in vivo Studies

Nurshazwani Azmi — 2024-09-01

Objectives: The development of biomaterials with the potential to hasten wound healing is a major concern in the biomedicine industry. Sea cucumbers, also known as bêche-de-mer or gamat, have long been used for food and folk medicine in Asian and Middle Eastern countries. Due to their pharmacological benefits, sea cucumbers have been explored for medical use, especially in dermatological formulas for wound healing treatment. The biological activities of sea cucumbers, such as their anti-inflammatory, anti-bacterial, antioxidant, and anti-coagulant properties, are imperatively facilitating the wound healing process owing to their abundance of bioactive compounds, such as phenolic peptide, glycosaminoglycan, saponin, collagen, and fucoidan chondroitin sulphates. However, there were still insufficient studies that systematically reviewed the existing literature on the evaluation of sea cucumber as a wound healing agent. Thus, this scoping review will encompass the wound healing potential of sea cucumber for in vivo and clinical trials. Materials and Methods: The searches were conducted using three main databases, which are PubMed, Science Direct, and Google Scholar, with papers released between 1970 and 2022. Twelve studies met the inclusion criteria in which these studies compromise in vivo and clinical trials that evaluate five different types of wounds, which are excision, incision, ulcer, diabetic, and burn wounds. Results and Conclusion: Findings from in vivo and clinical trials provide consistent evidence through macroscopic and microscopic observation; the studies prove that sea cucumber can enhance tissue repair and wound healing through regulation of inflammatory response, fibroblast proliferation and amplifying the angiogenesis process.

Radiology Teaching in Syiah Kuala University: Assessment of Dental Students’ Knowledge in Intra-Oral Radiograph Procedure

Kemala Hayati — 2024-09-01

This study sought to assess dental students’ level of knowledge in intra-oral radiograph procedure at the Faculty of Dentistry of Syiah Kuala University. Methods: This is a descriptive study with a cross-sectional approach, using a validated online questionnaire for data collection. Purposive sampling technique was utilised to determine the subjects used for this study. The number of subjects was 100 clinical dental students. Results: The results of this study showed that, pertaining to the knowledge of clinical dental students of the Faculty of Dentistry, Syiah Kuala University on the procedure for intra-oral radiographs, 55 students had a good level of knowledge, 38 students had a sufficient level of knowledge, and 7 students had a poor level of knowledge. Conclusion: The knowledge of dental students of the Faculty of Dentistry, Syiah Kuala University in intra-oral radiograph procedure is good (79.63%).

Clinical Manifestation of Academic Stress in Temporomandibular Joints Disorders (TMDs) among Undergraduate Dental Students of Universiti Teknologi MARA, Malaysia

Nik Mohd Mazuan Nik Mohd Rosdy — 2024-09-01

Objectives: Numerous studies have indicated that academic stress is associated with detrimental impacts on mental well-being among undergraduate students. Here, we examined the clinical manifestations of the temporomandibular disorder (TMD) of perceived academic stress among dental students in Universiti Teknologi MARA. Methods: 27 TMD-diagnosed students with perceived academic stress were examined for the clinical manifestations of temporomandibular disorder. Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) a widely acceptable international TMD diagnostic tool was applied for this examination. RDC/TMD contains axis I and II. Statistical analysis was performed using the Fisher exact test using SPSS 20.0. The significance level was set at P≤0.05. Result: Regardless of the year of study, out of the 27 TMD-diagnosed students, 19 students (9.4%) had disk displacements with reduction, 8 students (3.9%) had TMJ arthralgia (n=7) and arthrosis (n=1), and 3 TMD patients (1.5%) presented myofascial pain (n=2) with limited jaw opening (n=1). Conclusion: Moderate to severe academic-related stressors may have contributed to the pathophysiological complications of TMD. Further research is needed to understand the pathophysiological mechanism of academic stressors in TMD development and progression.

A Case Report of Management of Intruded Mandibular Incisors in a Young Child with Epilepsy

Dayang Fadzlina Abang Ibrahim — 2024-09-01

The most common dental trauma during early childhood is intrusive luxation, which results in the displacement of the tooth into its alveolus. It is a severe form of dental trauma that can cause damage to the periodontal ligament, pulp, and alveolar bone. The International Association of Dental Traumatology recommends either extraction or spontaneous re-eruption of the intruded primary tooth, depending on the severity of the intrusion. This case report provides a brief insight into the management of intruded mandibular primary incisors caused by an epileptic attack in a 4-year-old boy diagnosed with refractory spastic cerebral palsy. After 6 weeks of the traumatic incident, spontaneous eruption of the intruded teeth was observed. However, the teeth were found to be mobile after 9 months of clinical and radiographic monitoring, necessitating extraction. Conservative management including waiting for spontaneous eruption with close monitoring is a treatment option for intrusive primary teeth in young children.

Mandibular Reconstruction with Deep Circumflex Iliac Artery Osteomyocutaneous Free Flap in a Severe Case of Osteoradionecrosis of the Mandible: A Case Report

Namkabir Singh — 2024-09-01

Introduction
Osteoradionecrosis (ORN) can be accompanied by several signs such as tissue loss, exposed necrotic bone, presence of fistula, pain, infection, trismus, and even pathological fracture of bones. Early-stage ORN is usually managed conservatively with medication while severe progression of the disease requires aggressive treatment such as free flap reconstruction surgery.

Case report
This case involves a 52-year-old lady who was previously diagnosed with well-differentiated squamous cell carcinoma of the left side of the tongue (T3 N2b M0) and had undergone surgery, followed by 6 cycles of chemotherapy and 30 cycles of radiotherapy. She presented to our centre complaining of pain and pus discharge over her lower jaw for the past 3 months. Upon examination, the skin around her neck and chin was erythematous, firm and tense, limiting not just her mouth opening but also the flexibility of her neck movement. She also had two oral-cutaneous fistulas, at the submental and submandibular region, with thick pus discharge. Intraorally, there was a broken and exposed titanium plate. She was subjected to segmental resection of the anterior mandible together with fistulectomy, reconstruction with deep circumflex iliac artery osteomyocutaneous flap and tracheostomy.

Conclusion
Despite not being a life-threatening disease, ORN has a significant impact on the well-being of patients, leaving them with possible disfiguration, pain and chronic wounds. This case report summarizes the journey of our patient from initial presentation, surgery, and post operative follow-up, highlighting the rare need for aggressive treatment in managing advanced ORN.