Cleft lip and palate (CLP) is one of the most prevalent birth defects. CLP can have a profound physical impact on the child and a psychological impact on both the parents and child. The systemic collection and audit of data on CLP has traditionally been an integral part of comprehensive cleft care. This requires the development of a national cleft registry. This article describes the current orthodontic cleft care, the benefits of a registry and assesses the challenges faced in developing a national cleft registry in Malaysia from an orthodontic point of view.

Orofacial clefts (OFC) are the most common craniofacial anomalies. There is no published data regarding the demographic of OFC cases seen in International Islamic University Malaysia (IIUM), since the establishment of the IIUM Multi-Disciplinary Cleft Team (IIUM-MDCT). The present study aimed to build a database on demographic profile of OFC cases seen in IIUM from 2009 until 2018. Data from all registered OFC cases were obtained from the medical records. Birth prevalence was tabulated against the population statistics for the period, obtained from the Department of Statistics Malaysia. A total of 20 cases were seen over the period of nine years. The registry recorded about 60% of females and 40% of males. Age distribution was 40% below the age of 10 years old, 40% between 11 to 20 years old and 20% of 21 years old and above. As for race, 90% were Malay, 5% were Chinese and Indian, respectively. Majority of patients (75%) were from Kuantan, 10% from Kemaman and 5% from Pekan, Kuala Terengganu and Kota Bharu, respectively. The most common OFC was cleft lip and palate (80%), followed by cleft palate (15%) and facial cleft (5%). The LAHSHAL classification was recorded with 75% of cases were unilateral, of which 73% affecting the left side. Other health anomalies were recognised in 45% of cases and 20% of them has family history of cleft. The present study could provide a baseline information on the status of OFC patients seen by IIUM-MDCT.

Any metallic object within the CT scanning field can produce metal artefacts, which will degrade the diagnostic image quality. Previous methods described for quantifying this kind of artefacts were complicated and difficult to reproduce. The purpose of this study was to introduce a new rapid method for quantifying the artefacts produced in craniofacial CT images. This is an in-vitro experimental study. Four different compositions of orthodontic brackets were bonded consecutively in the tooth surfaces of a cadaveric skull head. All scans were performed by a single operator using the same CT machine followed by a standard scanning protocol. Artefact intensity for all data sets was quantified by following a modified method with a freely available open-source software ImageJ. All datasets were duplicated where metal artefacts were quantified according to the previous conventional method. Statistical analysis included independent samples t-test for validation and intraclass correlation coefficient (ICC) with a 95% confidence interval for both intra- and inter-examiner reliability. The modified method of measuring artefact score exhibited excellent intra (0.997–0.941) and inter-rater (0.996–0.905) reliability. In addition, no significant difference (p = 0.072) of mean artefact score was noted between the groups measured by the modified method and the conventional method. This modified method for measuring the artefact intensity is valid and reliable.

The first, second and third mandibular molars (M1, M2, M3) show variations in the number of cusps and some distinction in size, occlusal design, and the relative lengths and number of roots. However, there are also genetic and racial related variations within them. This study determined the tooth length and related root-to-crown ratio (RCR), and root morphology variations in M1 and M2. We also determined the root length relative to the mandibular height of these teeth. Sixty-one conebeam computed tomography (CBCT) images of patients who had a good set of lower teeth with no sign of mandibular pathology or defect were included. Relevant measurements were made along the axes of the mesial and distal roots of these mandibular molars. The measurements obtained were used to calculate RCR and root-to-mandible (R/M) ratio. The crowns of 226 teeth and 465 roots were reviewed in 61 CBCTs of Malay patients. M1 and M2 were 19.41 mm and 18.15 mm long. The respective anatomical RCR and clinical RCR were 1.90 and 1.59 for M1, and 1.86 and 1.60 for M2. Thirteen molars (5.8%) presented with three roots, with twice the number affecting M1 than M2. More M1 (4.3%) had C-shaped morphology than M2 (1.8%). The R/M ratio at M1 was 42.32% and, at M2 this was 43.94 %. In summary, the morphometric measurements of M1 and M2 in Malay were established. These teeth did not have a high prevalence of supernumerary roots, but there is a high prevalence of C-shaped morphology in M1.

Genetic studies have reported the association between polymorphism in MYO1H with mandibular prognathism. MYO1H is found in skeletal muscle sarcomeres and is expressed in the mandibular jaw cartilage signifying its importance during craniofacial development. This study aimed to characterise the genotype and allele of MYO1H single nucleotide polymorphism (SNP) (rs3825393) and to associate the SNP with mandibular prognathism in Class III skeletal malocclusion. This was a casecontrol study, which involved 57 Malay subjects with 30 Class I (control) and 27 Class III skeletal base patients (case). Cephalometric measurements were taken prior to collection of saliva samples. MYO1H SNP (rs3825383) was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Chi-square (χ2 ) test was used to compare genotype and allele frequencies between the groups while Hardy-Weinberg Equilibrium (HWE) was applied to assess distribution of genotype frequency in both classes. MYO1H SNP (rs3825393) did not yield significant association with mandibular prognathism with p = 0.33; OR = 0.66; 95% CI = 0.289~1.518, that was reflected by no significant difference in allele (p > 0.05) and genotype (p > 0.05) frequency between control and study group. Nevertheless, AA genotype depicted the highest frequency in both groups. The genotype distribution in both groups was in concordance with HWE (p > 0.05). Our data showed no association of MYO1H SNP (rs3825393) with mandibular prognathism. Interestingly, we observed Allele A representing the major allele in Malay population. Presence of MYO1H SNP (rs3825393) was detected in samples analysed. Larger number of samples is required to confirm the involvement of MYO1H polymorphisms in mandibular prognathism.

The titanium exfoliation level during dental implant installation has not yet been available. The present study aims to confirm the presence of titanium exfoliation in different implant surfaces throughout the installation and identify the association between insertion torque and surface abrasion. Three different implant surfaces were assigned to low and high insertion torque groups. The implants were installed into porcine bone blocks. Then, the surrounding bone at the ostomy site was analysed for the titanium exfoliation using an inductively coupled plasma mass spectrometry. The low and high insertion torques were 30 Ncm and 58 Ncm, respectively. The average titanium content from all samples was 4.9 ± 2.7 μg. Anodised implant released significantly less titanium compared to others (p < 0.05). All implants released titanium indifferently compared to low and high insertion torques (p > 0.05). Within the limitation of the present study, anodised implant released the least amount of titanium exfoliation. The insertion torque was not associated with titanium exfoliation.

Mepivacaine is a common local anaesthetic used with claims of a high safety profile. There are two commercial types, 2% mepivacaine with vasoconstrictor and 3% without vasoconstrictor. There are many suggestions regarding the usage of plain 3% without vasoconstrictor for systemic medical problems, however, there have not been any previous studies to confirm this necessity in impacted lower third molar surgery (ILTMS). This study aims to evaluate the anaesthetic efficiency and the effect on the patient of 2% and 3% mepivacaine, adding vasoconstrictor to the 3% mepivacaine. This crossover study comprised of 24 patients with bilateral, symmetrically positioned, impacted lower third molars. Patients received either 2% or 3% mepivacaine for the inferior alveolar nerve block (IANB). Onset and duration of anaesthesia, and haemodynamic considerations were analysed as primary outcomes. Furthermore, pain, duration of postoperative anaesthesia and pulp vitality were analysed as secondary outcomes. Different concentrations of mepivacaine showed similar anaesthetic onset time (p > 0.05). There was no statistically significant difference regarding the duration of anaesthesia, as well as the postoperative analgesia (p > 0.05). The two concentrations did not lead to any haemodynamic changes or complications during ILTMS. Thus, adding the vasoconstrictor to mepivacaine 3% did not cause any adverse effects on the patients intra or postoperatively. Therefore, it is possible for dentists to use only 2% mepivacaine with vasoconstrictor for IANB effectively and safely when the case necessitates the need for a vasoconstrictor, or in other words, longer duration of haemostasis.

Optimal learning space enhances teaching and learning experience and may differ from one discipline to another. This research aimed to explore the opinions on learning spaces for teaching and learning orthodontic course among recent dental graduates. Focus group discussions (FGD) were conducted in 2018 with two groups of recent graduates (eight participants per group) based on their orthodontic examination results (high and low grades). They were asked to give their opinions on the learning space provided for orthodontic lectures, tutorials, clinics, self-study and networking. Discussions during the FGD were audio and video recorded. Data were transcribed and thematically analysed using the NVivo version 12 software. For lectures, the graduates preferred a conventional lecture hall layout with an individual power outlet and a desk large enough for a laptop. For tutorials, the graduates with higher grades preferred e-tutorials while the graduates with lower grades preferred the conventional tutorials. For clinical teaching, the graduates perceived the laboratory’s operating hours as limited and suggested a 24-h access card. The graduates preferred live-streaming sessions instead of on-site teachings for combined clinics. They also felt that they do not have time for self-study and networking during their time in the campus. The findings of the study showed that learning space preferences of undergraduate dental students for lecture, tutorial, clinic, self-study and networking were more focused towards their learning activities, which were different from the current concept of learning space. Future planning of learning space should consider students’ preferences in order to fulfil their learning goals.

This study aims to assess the association of parents’ knowledge, children’s feeding pattern, and other contributing factors with caries experience of a child. This was a cross-sectional study using a validated questionnaire of 145 children aged two to eight years old attending the Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Malaysia. The questionnaires were given to the parents during their children’s dental visit in paediatric clinic and primary care. Dental caries was traced from the patient’s record in the Integrated Dental Records Management System (IDERMS) and clinical examination was done for those who did not have the dental record. Charting was recorded using dentition status and treatment need based on the 1997 World Health Organization (WHO) criteria. Data were analysed using the independent t-test and one-way ANOVA to examine the association of dental caries with two and three or more categorical variables respectively using SPSS 23.0. The study participants were 74 (51%) boys and 71 (49%) girls. The mean dmft score of the participants was 3.31 (4.36). Caries experience was statistically significant with the reason for first dental visit (p < 0.001), the age of the children discontinues bottle-feeding (p < 0.001), habits of leaving bottle-feeding while sleeping (p = 0.011), children wake up for milk at night (p = 0.050) and knowledge of parents on the effect of leaving bottle while sleeping (p = 0.037). Children feeding patterns and parents’ knowledge of the risk factors of dental caries were significantly associated with caries experience among children aged two to eight years old.

Basal cell adenocarcinoma (BCAC) is a very rare slow-growing malignant basaloid tumour of the minor salivary gland. We reported a case of BCAC of the minor salivary gland of the hard palate occurring in a 56-year-old man. BCAC shares overlapping histopathological features with the other oral basaloid cell neoplasms which carries different prognosis and treatment modality. We emphasised on the histomorphologic features and the role of immunohistochemistry panel in the differential diagnosis of BCAC in incisional biopsies.