There is a wide variation in the morphology of third maxillary molar which can be difficult to be identified radiographically. We present a case of a 26 year-old Yemeni female patient presented with difficult extraction of her left maxillary third molar. The extracted tooth showed a rare variation of root morphology, having four roots with three roots curving palatally at the apices. This report emphasized the potential complex morphological variation of maxillary third molar which may lead to the difficulty of a routine straight forward procedure thus needing careful extraction maneuvering to prevent any complications.

his is a short-term longitudinal study of physical, cognitive, psychological and functional outcomes following mild traumatic brain injury (mTBI) in adults, caused by road traffic accident (RTA). Outcome measures were the Montreal Cognitive Assessment (MoCA), the Neuropsychological Assessment Battery Screening Module (S-NAB), the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7) scale. Functional outcomes included returning to working/academia and driving, lifestyle changes, financial claims and litigation status. A total of 285 individuals were diagnosed with mTBI, involving young male motorcyclists (90%): uncomplicated mTBI, n=201; complicated mTBI, n=84. Ethnic distribution consisted of 204 Malays, 58 Indians and 23 Chinese. MoCA detected cognitive deficits (mean=23.11, SD=3.41) within 72 hours of injury. At two weeks, somatic manifestations, physical injuries, cognitive deficits and psychological symptoms were detected. At three months of injury, the language domain was persistently impaired, with a lower score on most cognitive domains in the complicated mTBI category than the uncomplicated mTBI. Psychological and somatic symptoms had improved. Almost 50% of patients had returned to a functional baseline within two weeks of injury and a further 24% within three months. A small proportion of patients made active lifestyle changes (<25%), financial injury claims (38%) and were involved in litigation (11%). In conclusion, mTBI in multi-ethnic Malaysia has multifaceted deficits and outcomes. Early management of symptoms may promote maximum recovery.
Brain Concussion

ABSTRACT The study aimed to quantify the impact of lockdown during the COVID-19 pandemic on new case referrals to the Oral and Maxillofacial Surgery (OMS) service. The researchers retrospectively reviewed all new referrals received during a government-imposed 47-day lockdown period and a similar period pre-lockdown as a control group. The main outcome was the differences in the number of new case referrals between the two periods. The contributing clinical and demographic factors were also explored. Appropriate bivariate statistics were computed and the level of significance was set at 0.05 for all tests. A total of 309 referrals were received during the study period. There was a reduction of new referrals due to the lockdown from five to two cases per day. There was a statistically significant reduction of cases referred from outpatient and emergency departments. There was also a statistically significant difference with regard to home address distance to the centre. Medically compromised and orofacial infection referrals were not affected by lockdown. The lockdown imposed due to the pandemic has significantly impacted the pattern of new OMS referrals. Referrals for orofacial infections, the medically compromised and inpatients were minimally affected by lockdown.
Oral and Maxillofacial Surgeons ; Quarantine ; COVID-19