1.Revisiting Genetics of Cleft Lip with or without Cleft Palate and Cleft Palate Only: A Narrative Review
Mohamad Irsyad Saiful Zaaba ; Khairani Idah Mokhtar ; Zainul Ahmad Rajion
Archives of Orofacial Sciences 2023;18(no.2):73-88
Cleft lip with or without cleft palate (CLP) and cleft palate only (CP) are the most common orofacial
deformities observed in humans where almost 1 in 700 to 1 in 2,000 babies born each year are affected worldwide. This condition occurs when the specific and independently derived facial primordial
fails to fuse together, hence forming the cleft of the lip and palate or the palate alone. These orofacial
abnormalities can be divided into syndromic and non-syndromic where the deformities are either
associated with other disorders or present on their own, respectively. It is important to understand every step in the lip and palate development during the embryonic stage to pinpoint the exact problem affecting the normal development of the human face. With current technologies, more genes are identified to be associated with and cause CLP and CP in humans. Therefore, this review aims to elaborate on the latest updates on the genetics of CLP and CP. Polymorphism in some of the genes has been associated with the incidence of these anomalies. Identification of these genes provides new knowledge on how these craniofacial abnormalities occur and hopefully will enable earlier treatment of these deformities to be implemented.
2.Oral Health in the Naval Armed Forces: A Scoping Review
Nik Madihah Nik Azis ; Raja Noreihan Raja Abdullah ; Mohamad Nur Adzmi Mohamad Ayub ; Badiah Baharin
Archives of Orofacial Sciences 2023;18(no.2):89-101
Naval armed forces are commonly prone to stressors during military activities which are associated with their working environment. This can adversely impact the oral health of these personnel. This scoping review aimed to explore the literature concerning oral health among naval personnel. Relevant articles that reported oral health among naval armed forces published from 1990 to December 2022 were retrieved from five main databases. Of the 641 articles searched, 15 met the inclusion and exclusion criteria. Occurrences of caries, periodontal disease and barodontalgia were high among the naval armed forces, with a significant number of dental emergencies during deployment and training operations. The dental diseases and emergencies experienced by the naval personnel on duty may influence their performance during missions. Given the far-reaching effects of dental diseases among personnel in the naval armed forces, further prospective studies with standardised report investigating oral health and dental diseases are recommended. Oral health services in the naval armed forces can also be improved by increasing the dentist-to-navy personnel ratio both at the military bases and on board the vessels during missions, as well as designing preventive strategies to improve oral health among the naval personnel.
3.Bibliometric Analysis of Removable Partial Denture-related Research in Dentistry
Nor Faharina Abdul Hamid ; Farha Ariffin ; Rohana Ahmad
Archives of Orofacial Sciences 2023;18(no.2):103-124
The objective of this study was to characterise articles published in removable partial denture (RPD)
research from 1948 to 2022 to identify the most influential journals, publications, authors, and core
research areas using bibliometric analysis. The Scopus database was used to retrieve publications with titles containing the truncated search term (“removable partial denture*” OR “removable prostho*”). Data analysis and visualisation were done using Microsoft Excel, Biblioshiny software and VOSviewer. A total of 2,484 articles were analyses from 1948 till 2022, representing an annual growth rate of 4.9%. The Journal of Prosthodontic Research demonstrated the highest average normal citation rate, with productive authors with highest citations being from Japan. From 1948 to 1999, most in-vitro and clinical research focused on the basic concept of RPD using cobalt-chromium as a framework before shifting to titanium in 2000. RPD research after 2012 focuses on new technology and non-metalbased frameworks as an alternative to metal-based frameworks. Wakabayashi and Fueki were the most prominent researchers, according to a three-field plot analysis, with the Journal of Prosthetic Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthodontic Research among the authors’ preferred journals. “CAD/CAM” and “3D printing” were identified as emerging themes in year 2020 to 2022, while “selective laser melting” was the trending keyword in 2017 to 2019. Research on “oral health and quality of life” has been identified as core research area in RPD-related research. RPD research on digital dentistry and new framework materials is anticipated to increase in the future with the incorporation of research on quality of life.
4.Positive Pressure and Negative Pressure Irrigation Dynamics with Different Needle Designs Using Computational Fluid Dynamics
Nur Farhana Wan ; Nurul Ain Ramlan ; Nik Zarina Nik Mahmood ; Ahmad Hussein Abdul Hamid
Archives of Orofacial Sciences 2023;18(no.2):125-137
This study aimed to investigate the irrigation dynamics of the positive pressure side-vented (SV) needle, EndoVac (micropores) needle and modified apical negative pressure (mANP) open-ended needle using computational fluid dynamics (CFD). A simulation of a prepared root canal (conical frustum) of 15 mm length with an apical diameter of 0.40 mm following Protaper F4 apical preparation was created using three-dimensional (3D) CAD software. The 3D simulated needle of SV 30G needle, EndoVac with micropores needle and mANP, 30G flat open-ended needle were also created. The irrigation dynamics were evaluated through transient CFD simulations. In addition, the irrigation dynamics of mANP at 0.2 mm, 0.5 mm, and 1.0 mm short from the working length were also assessed. The EndoVac and mANP showed negative apical static pressure and streamline patterns able to reach the apical region, thus indicating negligible extrusion. Meanwhile, SV showed positive apical static pressure and almost nonexistent streamlines beyond the needle tip. The SV showed the highest wall shear stress (WSS) magnitude of 1030Pa whereas Endovac (161 Pa) and mANP1 (258 Pa). However, SV revealed lower average WSS (10 Pa) compared to mANP1 (13 Pa) and mANP2 (11 Pa). This is due to SV developed a localised maximum WSS opposite the open vent area only therefore, uneven distribution of WSS. The EndoVac system developed a localised maximum WSS in the pair of micropores furthest away from the apical. CFD analysis of the EndoVac, mANP and SV showed different technique approach, needle design and needle depths insertion affect the irrigation dynamics pattern and magnitude.
5.Physicomechanical Properties of Resin-Based Pit and Fissure Sealants Reinforced with Rice Husk Derived Nano Silica and Nanohydroxyapatite
Syed M Yassin ; Dasmawati Mohamad ; Rafi Ahmad Togoo ; Sarliza Yasmin Sanusi ; Yanti Johari
Archives of Orofacial Sciences 2023;18(no.2):139-151
Resin-based pit fissure sealants (RBS) are used to prevent occlusal caries in children. The success of RBS in preventing dental caries is largely influenced by its retention on the tooth surface, which is also affected by its physicomechanical properties. The physicomechanical properties of RBS can be enhanced through the addition of fillers. With the advent of nanofillers, the physicomechanical properties were improved without altering RBS flowability. The present study developed an RBS with a 70 wt% resin matrix and 30 wt% nanofillers. The resin matrix consisted of urethane dimethacrylate (55 wt%), triethylene glycol dimethacrylate (45 wt%), camphoroquinone (0.3 wt%), and 2-(dimethylamino) ethyl methacrylate (0.7 wt%). Silane-treated rice husk-derived nanosilica (20 wt%) and nanohydroxyapatite (10 wt%) were added as fillers. Clinpro, Fissurit FX, and an unfilled sealant were controls. All RBS were tested for surface roughness, Vickers hardness, flexural strength, and flowability. Statistical analysis with oneway ANOVA revealed significant differences between groups in surface roughness, hardness, flowability (p < 0.001), flexural strength, and flexural modulus (p < 0.05). Experimental sealants had higher flexural strength (78 MPa) and flow distance (29.05+1.16 mm) than commercial controls.However, the surface roughness of experimental sealants (0.25+0.08 μm) was higher than Clinpro (0.087+0.027 μm) but lesser than Fissurit FX (0.35+0.19 μm). The Vickers hardness of experimental sealants (23+1.63 VHN) was less than Fissurit FX (28.80+1.69 VHN) but higher than Clinpro (21.74+1.68 VHN). This novel RBS had physicomechanical properties comparable to commercial sealants. The use of nanosilica from rice husk makes this pit and fissure sealer sustainable and environmentally friendly in dentistry.
6.Assessing Inter-rater Reliability of the Dental Practicality Index and the American Association of Endodontists Endodontic Case Difficulty Assessment Form among Undergraduates
Amy Kia Cheen Liew ; Dalia Abdullah ; Eason Soo ; Norziha Yahaya
Archives of Orofacial Sciences 2023;18(no.2):153-165
Dental Practicality Index (DPI) and American Association of Endodontists Endodontic Case Difficulty
Assessment (AAECDA) form potentially can guide clinicians in making clinical decisions and triaging in
large practices and academic settings. Nonetheless, the reliability and validity should be evaluated before institution-wide implementation. This study aimed to evaluate the inter-rater reliability of the DPI and AAECDA forms. Ten randomly selected, trained students rated 25 cases with both forms. The itemby- item inter-rater and overall reliability were estimated with Gwet’s agreement coefficient (AC2) and intraclass correlation coefficient (ICC), respectively. The association between clinical decisions and the scores was analysed with the Generalised Estimating Equation. The inter-rater reliability of DPI was generally very good (AC2 = 0.81–1.00), except context (good; AC2 = 0.718; 95% confidence interval [CI] = 0.575–0.861). The inter-rater reliability of AAECDA was generally very good (AC2 = 0.81–1.00) and good (AC2 = 0.61–0.80), except the radiographic appearance of the canal(s) (fair; AC2 = 0.424, 95% CI = 0.263–0.585). Moderate overall inter-rater reliability of AAECDA (ICC = 0.53, 95% CI = 0.38–0.70) and DPI (ICC = 0.62, 95% CI = 0.48–0.77) was observed. Referral to an endodontist was positively associated with AAECDA score (odds ratio [OR] = 1.323, 95% CI = 1.145–1.52, p < 0.001). The decision of tooth extraction was positively associated with the DPI score (OR = 1.983, 95% CI = 1.539–2.555; p < 0.001). In conclusion, DPI and AAECDA are methods with moderate inter-rater
reliability when used among dental students.
7.Surgical Management of Extruded Fractured Instrument Beyond the Periapical Area: A Case Report with Two-year Follow-up
Afiq Azizi Jawami ; Eason Soo ; Dalia Abdullah ; Wong Lishen
Archives of Orofacial Sciences 2023;18(no.2):167-177
A fractured instrument is an undesirable endodontic mishap that can prevent complete root canal disinfection, thereby affecting the root canal treatment outcome. The present case discussed the surgical
management of an extruded fractured barbed broach at the apical third of maxillary right first premolar.
A 28-year-old female presented with an endodontic failure on tooth 14 and was diagnosed as previously
root canal treated with symptomatic apical periodontitis. Radiographic examination revealed a straightline
radiopacity structure that was 2 mm in length extruded from the apical root-end, suggesting a fractured instrument. The case was successfully managed through endodontic microsurgery. The present case emphasises the significance of cone-beam computed tomography as a valuable tool for diagnosis and investigation, while also offering supplementary information for the planning of surgical treatment.
8.Gingival Enlargement with Marfan Syndrome: A Case Report
Annabel Shanta Edwin Thomas ; Raja Azman Raja Awang ; Haslina Taib
Archives of Orofacial Sciences 2023;18(no.2):179-187
Marfan syndrome (MFS) is an autosomal dominant and multisystemic disorder affecting the connective
tissues. Patients with MFS may exhibit characteristic oral features including maxillary protrusion, high
palate, crowded teeth, and fragility of the temporomandibular joint. Periodontal manifestations may
include a higher prevalence of gingivitis and/or periodontitis owing to the high concentration of elastic
fibres in the periodontal ligament. This case report describes the management of gingival enlargement
associated with MFS. The patient was successfully managed with non-surgical and surgical periodontal
therapy. In patients with oral manifestations of systemic disorders, patient motivation and effective
treatment planning are able to achieve the optimum periodontal and oral health outcomes.
9.The Key Role of Interleukin-17A/Interleukin-17RA in Bone Metabolism and Diseases: A Review
Wan Khairunnisaa Wan Nor Aduni ; Asma Abdullah Nurul
Archives of Orofacial Sciences 2023;18(no.1):1-17
Bone metabolism requires a balance mechanism between intricate processes of bone formation
and resorption, which is affected by the essential interaction between osteoblasts and osteoclasts.
Interleukin-17 (IL-17) is a family of cytokines consisting of six isoforms: IL-17A, IL-17B, IL-17C,
IL-17D, IL-17E, and IL-17F. Among these isoforms, IL-17A has shown promising and novel roles in
the regulation of bone metabolism. IL-17A has also captivated the interest of many researchers since
its discovery because of its role as a pro-inflammatory cytokine which mediates a few inflammatory
processes. This review describes the biology of IL-17A and its receptor as well as summarises
the regulatory role of IL-17A in bone metabolism and diseases through some known pathways.
Understanding the function of IL-17A in bone metabolism may lead to the development of therapeutics
or diagnostic strategies for some bone diseases; as well as future therapy using tissue engineering and regenerative medicine approaches.
10.Histopathologic Changes in Dental Follicle Associated with Radiographically Normal Impacted Lower Third Molars
Ahmet Altan ; Sefa Ç ; olak ; Elif Akç ; ay ; Nihat Akbulut
Archives of Orofacial Sciences 2023;18(no.1):19-26
Impacted third molar extractions are one of the most common oral surgical procedures. In cases
where a pathological condition is observed, it is relatively easy to decide on surgery. However, cystic
changes can be observed in follicular tissues even in cases where pathological changes are not observed on radiography. The present study aimed to evaluate the histopathologic changes in dental follicles associated with radiographically normal impacted lower third molar. One hundred and one dental follicles were obtained after third molar surgeries. The patients with follicular width of less than 2.5 mm in the panoramic radiographs were included in the study. The relationships between pathological changes in follicular tissues and angular position of impacted teeth, age and gender were statistically examined. Cystic changes were observed in 65 (64.3%) of 101 follicles examined. The relationship between cystic changes and the angular position of impacted lower third molars was statistically significant (p < 0.05). Cystic changes were observed in 13 (43.3%) of 30 mesioangular teeth, 24 (80%) of 30 vertical teeth, 19 (65.5%) of 29 horizontal teeth, and 9 (75%) of 12 distoangular teeth. About 60% of cystic changes and 64.06% of inflammation occurred in patients between the ages of 20 and 30. Cystic changes can be observed in the follicular tissues of impacted lower third molars that are radiographically normal. There is a probability of histopathological changes, especially in patients over the age of 20 years and in the impacted lower third molars in the vertical position.


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