When fixed partial dentures (FPDs) are being suggested to patients, the frequent inquiry by patients is the anticipated longevity and length of service. Previous reports have provided limited information on the accurate measurements of good clinical outcome and the length of good years in service. This confuses the clinicians as well as the patients in determining the treatment of choice. In the present article, the indicator of ‘success’ and ‘survival’ will be discussed in determining the longevity of various FPDs such as conventional, resin bonded and implant retained. After reviewing the articles, it is good if the indicator of ‘success’ can be used as an indicator of longevity and good clinical outcome. Besides that, studies with at least 10 years of observation are probably of higher evidence for longevity of restorations.

The introduction of the recent 2017 classification of periodontal diseases has been welcomed by the periodontal fraternity. The new classification has used available evidence as the backbone for its development. It has been felt by many experts that a good understanding is required for its practice. Towards this, a Malaysian PerioSymposium was organised in May 2019 to comprehend the classification and also to identify the right path towards its learning among undergraduate students of dentistry in Malaysia. The symposium was conducted and moderated by local and international experts. Apart from the few limitations identified, the new classification was recommended to be taught in the undergraduate dental programme across schools in Malaysia.

For a long time, oral exfoliative cytology (OEC) has been implemented as an effective preliminary diagnostic tool for pathological lesions and various methods for fixation of the cytology specimens have been studied. The present study was undertaken to compare the efficacy between the wet and spray type of fixation methods for Papanicolaou (PAP) stained oral cytosmears. The study comprised of 45 healthy subjects in the age group of 20-25 yrs. For each subject, two smears were collected from the buccal mucosa and subjected to wet and spray fixation methods respectively. Both the smears were stained using a commercial Rapid Pap Kit. Smears were observed microscopically and evaluated for cytomorphological features involving uniformity of staining, cellular morphology, nuclear morphology, cellular staining, nuclear staining and presence of impurities. Comparisons were made between the two methods of fixation and statistically analysed using McNemar non-parametric test. Cells were evenly distributed in wet-fixed smears (n=38, 95%) compared to spray fixed smears (n=19, 47.5%). Wet-fixed smears showed lesser impurities (n=13, 32.5%) than spray fixed smears (n=27, 67.5%). However, other parameters such as cytological and nuclear morphology, staining of cytoplasm and nucleus were found to be not significant when compared between the two methods of fixation (p<0.05). The study shows that wet-fixed smears have better cellular distribution and relatively fewer impurities when compared to the spray fixed smears. The method of wet-fixed smears may be used as an alternative to spray fixed smears. A larger sample size may be required for further validation.

With the advancement of the transportation system and improvement in road conditions, the number of high-velocity accidents has also increased. Almost all of these reported cases involve individuals who had travelled in vehicles without adhering to personal protection standards and with rash driving. Injuries to the facial region can be profoundly disturbing and particularly in children. Parents find it very distressing to see their child in pain with a disfigured or injured face. It is difficult to manage such crying & sometimes uncontrollable children. The most commonlyinjuredfacialbonesareNasal,Zygomaticandthe Mandible. The incidence of facial bone fracture in children is uncommon, and we present a case report of an18-month old child with a history of road traffic accident and swelling on the right side of the face. Intraoral examination shows limited mouth opening with submucosal ecchymosis in the right buccal mucosa and based on clinical and computed tomographic scan working diagnosis of fracture in the right body of the mandible was arrived. The child was treated with the circum-mandibular wiring to stabilize the mandibular fracture under general anaesthesia. After three weeks the splint was removed. The injury healed without complications in the post-operativeperiod.

microRNAs (miRNAs) constitute a family of small, non-coding RNA molecules that regulate gene expression and protein expression. microRNAs have influence on a broad range of physiologic and pathologic conditions. They are also considered as promising biomarkers especially when they are secreted extracellularly. In the inflammatory pathways, they dysregulate the molecular processes and contribute to the development of chronic inflammatory diseases including periodontitis. In this review, we provide an overview of miRNA characteristics, biogenesis, mechanisms of action and profiling methods. In addition, the role of miRNAs in the pathobiology of periodontitis, especially those pertaining to the cellular and molecular pathways of inflammation has been considered to enhance our understanding of the pathobiology of periodontitis.

Platelet concentrates are derivatives of blood that aid in haemostasis and wound healing after periodontal regenerative procedures. Its ability to act as a natural scaffold of growth factors has gained significance in many surgical procedures. This narrative review discusses the different platelet concentrates, their centrifugation protocols, advantages and disadvantages and their application in periodontal regenerative procedures. An electronic search of PubMed or MEDLINE was conducted for relevant material from the published literature up to 2020. The key words looked for were “Platelet concentrates, Platelet rich plasma, Platelet rich fibrin and periodontal regeneration.” We have used the filters comparative human studies, animal studies, randomized controlled trials, case reports and systematic reviews. The searches were limited to articles in English language and articles describing platelet concentrates and its relation to periodontal regeneration were collected and used to prepare a concise review.

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.

Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.

Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.

The amount of incisor decompensation during pre-surgical orthodontics may affect the outcome of Class III orthognathic cases. The purpose of this study was to assess the lower incisor changes post-orthodontic decompensation in Class III surgical cases and to investigate the amount of crowding as a predictive factor. This was a retrospective study reporting on 22 Class III orthognathic cases. The lower incisor angulation (LIA) and distance of the lower incisor edge to the A-Pogonion line (Li-APo) were measured on pre-treatment and presurgical lateral cephalograms whereas crowding was measured on digitised pre-treatment study models. Pearson’s correlation (p <0.05) was used to assess the correlation of crowding with LIA and Li-APo changes, and prediction of the lower incisor decompensation was conducted using linear regression analysis. Results showed lower incisors were retroclined at 79.84° ± 7.08° and positioned ahead of APo line by 6.52 mm ± 2.97 mm at the start of treatment. Pre-surgical LIA and Li-APo were found to increase following orthodontic decompensation to 90.43° ± 5.96° and 10.34 mm ± 3.25 mm, respectively. There was a moderate positive correlation (r = 0.592) between crowding and Li-APo changes which was statistically significant, p value = 0.004, and had a strong predictor with 31.8% predictability. However, LIA showed a weak correlation (r = 0.329) with crowding and was not statistically significant (p = 0.135). Li-APo changes during orthodontic decompensation can be predicted with 31.8% predictability using the formula; Li-APo change = 2.064 + 0.503 (crowding).