1.Validity of the Third Molar Age Estimation from Different Dental Age Estimation Surveys for Malays and Chinese in Malaysia- A Pilot Study
Mohd Zefri AA ; Nukman A ; Nambiar P
Annals of Dentistry 2017;24(1):33-40
This study aims to determine which age assessment data using the third molar development values (local or international) is suitable for estimating the age of Malays or Chinese in Malaysia. A sample of 60 panoramic images of Malays and Chinese aged between 13.58 to 21.25 years were selected. Different assessment surveys which included the studies by Yusof et al. (2015), Wilson (2005), Johan et al. (2012), Mincer et al. (1993), AlQahtani et al. (2010) and Gunst et al. (2003) were employed to estimate the age from the developing third molar on the panoramic images studied. The estimated ages were compared to the chronological age of the selected Malaysians. All the datas were then recorded on Microsoft Excel sheet. The two observers were then subjected to the Intraclass Correlation Coeffecient (ICC) inter-observer reliability test.The highest number of correspondence (65%) between the chronological and estimated age (within one year) was for the survey conducted by Wilson. With regards to ethnicities, 70% of Chinese matched the mean estimated age by Wilson while Malays showed a high correspondence for the study by Mincer et al. (63.3%). Furthermore the ICC reliability test showed strong agreement between the two observers. There were similarities between the Malay and Chinese population in the correspondence of the estimated age to the chronological age employing the different dental estimation surveys; in addition the study by Wilson and Mincer et al. yielded best matching for these Malaysians.
2.Validity Of The Parallax Method With A Combination Of Imaging Receptors ' A Revisit
P. NAMBIAR ; J. JOHN ; N. SHUKOR ; N.R.A. TARMIDZI
Annals of Dentistry 2012;19(1):11-18
To determine the amount of displacement of a structurenoticed on an image when the tube of a dental X-raymachine was shifted vertically and horizontally. Inaddition, various intraoral images were combined withdental panoramic images to determine the location ofstructures. Our research is based on the parallaxtechnique which requires manipulation of horizontaland vertical angulations of the X-ray tube. A metalobject is positioned on the buccal and palatal side ofthe maxilla on the canine area of a skull. The X-raytube is shifted incrementally to obtain images onphosphor plates. Subsequently, panaromic and occlusalimages were taken to assist in localization of the metalobject. To obtain a clear image shift of 2-3mm usingthe parallax method, there must be an adequatehorizontal tube shift of approximately 30-35 degrees.When images were used in combination of dentalpanoramic images, it was found that the buccallyplaced structures can be accurately located with theperiapical or occlusal images. However, thedisplacement of images in the palatally placedstructures in panoramic imaging is not fullyappreciated with the principle of parallax method. Tubemovement of 30-35 degrees horizontally is needed fora 2-3 mm image shift. To successfully localize a buccalstructure, a combination of either periapical or occlusalimages with a dental panoramic imaging can beemployed. However, this combination with panoramicimaging is limited when looking at palatally placedstructures.
3.Evaluation Of Glove Integrity After Multiple Washes With Disinfectant
W.L. CHAI ; Z.Y.M. YUSOF ; J. MARHAZLINDA ; C.N. SHIM ; M.Y. LEE ; P. NAMBIAR
Annals of Dentistry 2012;19(2):51-55
Background: In an academic setting due to financialconstrain, it is not uncommon during non-surgicalprocedures dental students and clinical supervisorswash their gloved hands with disinfectants in betweenpatients or when touching on non-contaminatedobjects. Whether this practice could cause anydeterioration of the glove and expose clinicians andpatients to infectious micro-organisms was a concern.Aim: The aim of this study was to investigate the effectof multiple washes of gloved hands with a disinfectanton the integrity of the gloves. Methods: Three brandsof commonly used gloves in a dental school weretested for leaks after multiple washes with adisinfectant. Thirty pairs of each type of gloves weresubjected to 0, 1, 5, 10, 20 and 30 washes with adisinfectant solution at a 5-minute interval betweeneach wash. After each washing cycle, the gloves werefilled with 1L of water and hanged for 2 minutes toobserve any signs of water leaks. Results: The resultsshowed that the type of gloves and number of washeswere significantly associated with the leakage rates(p<0.001). Washing of gloves for more than 5 timeswere at least 6 times higher to suffer from leakage(OR=6.23, 95% CI=2.14–18.08). Powdered gloves werealmost 13 times higher to leak in all washes(OR=12.78, 95% CI= 4.40–37.14) and were almost 25times more likely to leak when washed for more than5 times (OR = 24.92, 95% CI = 5.79 – 107.21) whencompared to the non-powdered gloves. Conclusion:The practice of washing gloved hands with adisinfectant deteriorates the integrity of the gloves.
4.Effectiveness of vacuum-assisted closure (VAC) therapy in the healing of chronic diabetic foot ulcers.
Aziz NATHER ; Siok Bee CHIONH ; Audrey Y Y HAN ; Pauline P L CHAN ; Ajay NAMBIAR
Annals of the Academy of Medicine, Singapore 2010;39(5):353-358
<p>INTRODUCTIONThis is the fi rst prospective study done locally to determine the effectiveness of vacuum-assisted closure (VAC) therapy in the healing of chronic diabetic foot ulcers.p><p>MATERIALS AND METHODSAn electronic vacuum pump was used to apply controlled negative pressure evenly across the wound surface. Changes in wound dimension, presence of wound granulation and infection status of diabetic foot ulcers in 11 consecutive patients with diabetes were followed over the course of VAC therapy.p><p>RESULTSHealing was achieved in all wounds. Nine wounds were closed by split-skin grafting and 2 by secondary closure. The average length of treatment with VAC therapy was 23.3 days. Ten wounds showed reduction in wound size. All wounds were satisfactorily granulated and cleared of bacterial infection at the end of VAC therapy.p><p>CONCLUSIONSVAC therapy was useful in the treatment of diabetic foot infection and ulcers, which after debridement, may present with exposed tendon, fascia and/or bone. These included ray amputation wounds, wounds post-debridement for necrotising fasciitis, wounds post-drainage for abscess, a heel ulcer and a sole ulcer. It was able to prepare ulcers well for closure via split-skin grafting or secondary closure in good time. This reduced cost of VAC therapy, as therapy was not prolonged to attain greater reduction in wound area. VAC therapy also provides a sterile, more controlled resting environment to large, exudating wound surfaces. Large diabetic foot ulcers were thus made more manageable.p>
Adult
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Debridement
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Diabetic Foot
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classification
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surgery
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therapy
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Female
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Humans
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Male
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Middle Aged
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Negative-Pressure Wound Therapy
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Prospective Studies
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Wound Healing