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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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.
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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.
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.
Key Consideration in the Construction of Endocrown Restorations: A Review
As a method of tooth restoration, endocrowns have acquired popularity in recent years. Endocrown is one of the treatment options recommended after endodontic treatment. Endodontically treated teeth are more prone to crown failure compared to healthy teeth. This results from its biomechanical preparation. Recent advancements in restorative materials, such as adhesive systems, have reduced the requirement for post-core restoration in endodontically treated teeth. A monoblock ceramic crown is bonded to the remaining tooth structure to provide both functional and aesthetic benefits. This literature review intends to offer a comprehensive summary of the endocrown construction. It focuses on the advantages of endocrown restoration, including the preservation of dental structure and its aesthetic outcomes. This review also highlights the importance of tooth selection, tooth preparation, adhesive techniques, and contraindications in attaining optimal clinical outcomes and long-term restoration success. Endocrowns are a reliable alternative to conventional restorative options, provided that clinicians adhere to the prerequisites and indications outlined for this procedure.
Assessing Oral Healthcare Accessibility in Elderly through Geographic Information Systems: A Scoping Review
Objectives: Disparities persist, especially for the elderly, in accessing oral healthcare. GIS was widely used in spatial aspects to examine access to oral healthcare services and highlight multiple factors that might influence access to healthcare facilities. This study aims to conduct a scoping review of the available literature on the accessibility of oral healthcare (OHC) for the elderly population across countries using GIS. Materials and Methods: Electronic search was performed in the following databases: PubMed, Scopus, Web of Sciences (WOS), and Science Direct. There are no restrictions on the types of studies included that use GIS or a comparative geospatial mapping program in studying the accessibility of oral healthcare for the elderly population across countries. The population included the elderly aged 60 years and above. All English publications were accepted except abstract-only papers as proceeding papers, conference, editorial, and author response theses and books. Articles without full text available and duplicate studies were excluded. Results: Nine studies were included in the final review. All studies are from high-income countries: Australia, the United States, Japan and Great Britain. The spatial analysis techniques utilised here include proximity, overlay, Kernel Density, statistical, and network analysis. Conclusions: Overall, elderly access to OHC appears sparse in rural regions, and the density of OHC is higher in urban areas. GIS is a powerful tool that aids healthcare planners, policymakers, and researchers in assessing and improving accessibility to oral healthcare and other essential services.
Marketing Match: How Sociodemographic Influence User Acceptance of Social Marketing Appeals in Oral Health Promotion
Objective: This study aimed to evaluate how sociodemographic factors influence user acceptance of different social marketing appeals. Materials and Methods: This study was designed as a three-armed randomized controlled trial, with the non-emotional (rational) appeal serving as the control group. We utilized an adapted, translated, and validated modified Technology Acceptance Model (TAM) questionnaire consisting of 23 items on a five-point Likert scale to assess user acceptance. Participants were randomly assigned to watch one of three intervention videos on oral cancer, each featuring a distinct appeal: rational (Video 1), humor (Video 2), and fear-based messaging (Video 3). Results: A total of 322 participants viewed videos featuring rational (34.0%), humor (33.0%), and fear (33.0%) appeals. Gender distribution was 51.2% male and 48.8% female, with age groups comprising 34.2% in early adulthood, 33.8% in middle adulthood, and 32.0% in the elderly. Educational levels were evenly split between high school or below and tertiary education or higher, each at 50%. Overall, participants showed consistent positive acceptance across demographics for all videos (p > 0.05). Results indicated no significant differences in acceptance based on these factors, with all mean scores being positive: age (4.20-4.62), gender (4.31-4.45), education level (4.31-4.48), household income (4.23-4.49), smoking status (4.12-4.46), and marital status (3.87-4.55). Conclusions: The study revealed that sociodemographic factors do not significantly impact the overall acceptance of social marketing videos, suggesting the potential for generalized social marketing campaigns. Future research could delve deeper into how different demographic variables impact user acceptance in diverse health promotion media.
Mandibular Reconstruction with Deep Circumflex Iliac Artery Osteomyocutaneous Free Flap in a Severe Case of Osteoradionecrosis of the Mandible: A Case Report
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.
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A Case Report of Management of Intruded Mandibular Incisors in a Young Child with Epilepsy
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.
Scoping Review: Evaluation of Sea Cucumber as a New Therapeutic Agent for Wound Healing Treatment in Clinical Trials and in vivo Studies
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.
Investigation on the Impact of Bisphenol A Exposure from Dental Materials: A Systematic Review
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.
Genetic Mechanisms of Oral Leukoplakia: A Systematic Review
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.
Clinical Manifestation of Academic Stress in Temporomandibular Joints Disorders (TMDs) among Undergraduate Dental Students of Universiti Teknologi MARA, Malaysia
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.
Radiology Teaching in Syiah Kuala University: Assessment of Dental Students’ Knowledge in Intra-Oral Radiograph Procedure
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%).