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Non-Syndromic Familial Supernumerary Teeth: Case Report And Review Of Their Phenotypic Characteristic

Annals of Dentistry.2012;19(1):28-35.

Supernumerary teeth have a genetic predispositionwith a predilection for males. This article reports anuncommon radiological finding in a non-syndromicsibling pair who presented with supernumerary teethof different morphologies on opposite and differentregions of the dental arches. A 14-year-old Chinesemale presented with a conical supernumerary palatallyplaced between the upper right central and lateralincisors. His older brother had unerupted bilateralsupplemental supernumerary teeth between the rootsof the lower second premolars and first permanentmolars. Trends of the phenotypic presentation offamilial non-syndromic supernumerary cases arediscussed. Familial supernumerary teeth have beensuggested to be due to autosomal dominance orrecessive traits. Variation in the numeral, spatial andmorphological phenotypic expressions suggests amultifactorial model of multiple genetic, epigeneticand environmental influences. Clinicians need to bemindful of the possible phenotypic variations that maypresent when treating cases with family history ofdental anomalies.

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A Rare Case Report Of Bilateral Maxillary Canine ' First Premolar-Transposition

L.A. TELANG ; J. NERALI ; A. TELANG ; P.V.K. CHAKRAVARTHY

Annals of Dentistry.2012;19(1):24-27.

Tooth transposition is a rare developmental anomalyaffecting less than 1% of the population. Thepermanent maxillary canine and 1st premolar are themost commonly affected teeth. Bilateral maxillarycanine-1st premolar transpositions are extremely rarewith only a handful of cases being reported in theliterature. We report one such case of bilateralmaxillary canine-1st premolar transposition in a 28year old Malaysian female which was associated withother dental anomalies.

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Modified Vertical Mattress Suturing Technique For Flap Approximation After Ramping ' A Modified Resective Osseous Surgical Procedure

L.P. Gopu CHANDRAN ; S. SUBASHINI

Annals of Dentistry.2012;19(1):19-23.

Purpose of this study is to evaluate the efficacy ofmodified vertical mattress suturing technique for flapapproximation after ramping – a modification ofresective osseous surgical procedure. Eighteen patientsrequiring periodontal surgery for pocket therapy wereincluded in the study. The preoperative gingival andperiodontal conditions were evaluated and intraoralradiographs were taken to identify the osseous defect.Shallow Craters present in the interdental regionstowards the palatal surface were treated by ramping.On completion of the procedure, flaps wereapproximated for the final suturing. Suturing is doneby a modification of vertical mattress suturing methodusing 4-0 silk sutures. The surgical sites wereevaluated at the conclusion of the surgery, duringsuture removal and one month post-operative. Theoutcomes were evaluated in terms of patient’s comfort,surgical flap approximation, complications and post–operativerecessions. Complete closure of wound andgood flap approximation was achieved in all casesimmediately after the surgery. Except for three patientswith delayed wound healing at suture removal, allother patients displayed rapid healing without anydiscomfort. No noticeable defect was seen in thehealing of the interdental papilla on the buccal aspect.Embrasure spaces on the buccal surface werecompletely filled by interdental papilla during the onemonth review period. In patients undergoing resectiveosseous surgery by ramping that result in two differentplanes for flap approximation, the modified verticalmattress suturing technique proves to be a reliable andan effective method of suturing.surgery

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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.

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Orthodontic Treatment Need And Outcome At University

Y.Y. KONG ; H. GHAZALI ; W.N. Wan HASSAN

Annals of Dentistry.2012;19(1):1-10.

The study aimed to assess patient satisfaction withtheir orthodontic treatment outcome and type of casesaccepted for orthodontic treatment at the Faculty ofDentistry, University of Malaya (UM) and to audit thequality of treatment outcome. The standard set were100% patient should be satisfied with their treatmentoutcome and less than 5% of the proportion of casesshould fall in the “worse/no different’ category with amean reduction of Peer Assessment Rating (PAR) scorebeing greater than 70%. Records of cases that hadcompleted orthodontic treatment were traced. Surveyforms were sent to 150 patients that had met theinclusion and exclusion criteria. Their intact studymodels were assessed for the Index of OrthodonticTreatment Need (IOTN) and PAR. 21.3% responded tothe survey, of which 59.4% had treatment involvingfixed appliances and 37.6% had either removable orfunctional appliances or retainers. 93.8% respondentswere satisfied with their dental alignment and 87.5%with the overall treatment results. For the dental healthcomponent of the IOTN, 63.3% had ‘definite need’ and21.1% had ‘borderline need’ for treatment. For theaesthetic component of the IOTN, 24.2% had ‘definiteneed’ and 32.0% had‘borderline need’ for treatment.For the PAR, 8.0% had an outcome of “worst/nodifferent”. The mean PAR reduction score was 75.3%.In conclusion, although majority were satisfied withtheir treatment results, there is still a need to improveon the standard of care to address the issues of theminority who were not satisfied with the treatmentoutcome.

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Hot Towel Massage Relieved A 7 Years Orofacial Pain ' A Case Report

M.S. MA.

Annals of Dentistry.2012;19(2):66-69.

Introduction: Diagnosis and management of orofacialpain of non-odontogenic origin has always been achallenge to dentists. Inaccurate diagnosis wouldresult in delay of treatment and in cases of orofacialpain, affects patient’s quality of life. Temporomandibularpain dysfunction syndrome is the mostcommon temporomandibular disorder that presents todental clinics. Trigeminal neuralgia, also known as ticdouloureux is a relatively rare condition that causeselectric shock-like pain when the trigger zone isstimulated by triggering factor. Case report: A caseof temporomandibular pain dysfunction syndromein a 52 years old Indian lady that was managed astrigeminal neuralgia for 7 years is presented.Conclusion: The aim of this case report is to makedentists aware of the signs and symptoms of differentorofacial pain, so that early and accurate diagnosis canbe made and appropriate treatment instituted.Key words: orofacial pain; temporomandibular paindysfunction syndrome; trigeminal neuralgia

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Determinants Of Dna Yield And Quality From Different Non-Invasive Sampling Methods

Y.F. CHOON ; L.P. KAREN-NG ; S. HASSAN ; J. MARHAZLINDA ; R.B. ZAIN

Annals of Dentistry.2012;19(2):62-65-65.

Aim: The purpose of this study was to determine theDNA yield and quality from different non-invasivesampling methods and to identify the method whichgave the highest DNA yield. Method: Thirty-eightvolunteers had been recruited in this study whereblood, buccal cells and saliva were collected usingvarious collection techniques. Buccal cells werecollected by 1) cytobrush and 2) saline mouth rinsingor “swish”. Meanwhile saliva was collected by passivedrooling method. Upon processing the white bloodcell (WBC), buccal cells and saliva samples, DNAextraction was performed according to themanufacturer’s protocol. Quantification and quality(DNA ratio at A260/A280) of the extracted DNA weredetermined using NanoDropND-1000®. T-test wasperformed to compare means between DNA obtainedfrom various collection methods. Results: DNA yieldsfrom buccal cells collected with cytobrush, “swish”,saliva and WBC (mean ± SD) were (8.2 ± 5.9)ng/μl,(28.2 ± 14.9)ng/μl, (5.9 ± 9.5)ng/μl and (105.3 ±75.0)ng/μl respectively. Meanwhile the mean DNAratio at A260/A280 for cytobrush, “swish”, saliva andWBC were 2.3, 2.0, 1.7 and 1.8 respectively. Post hoctest with Bonferroni correction suggested that DNAyield from “swish” technique exhibited the least meandifferent as compared to the DNA extracted from WBC(p<0.05). There was no significant difference in themean quality of the DNA extracted from WBC, salivaand buccal cells collected in these non-invasivemethods (p=0.323). Conclusion: The “swish”technique of obtaining buccal cells yielded thehighest amount of DNA and was of the quality of DNAextracted from blood sample.Key words: buccal cells; non-invasive methods;cytobrush; “swish”; saliva; DNA yield; DNA quality

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Malaysian Senior Dental Officers' Perceptions Of The Employability Of Male Dental Nurses And Possible Policy Implications

N.A.M. NOR ; N. MURAT ; A. MOHAMED ; A. GAMBOA

Annals of Dentistry.2012;19(2):56-61.

Background: In Malaysia, training to enter dentalnursing profession is only open to women. Ironically,there are no such gender restrictions on training forany other health related professions in Malaysia.Aim: Therefore this study aims to assess theperceptions of Malaysian Senior Dental Officers(SDOs) towards the employability of male workers inthe dental nursing profession and to compare findingsfrom male and female SDOs. Methods: This crosssectional study was carried out on all SDOs inMinistry of Health, Malaysia, using a self-administeredquestionnaire. Descriptive statistics and a chi squaretest were used to address the study objectives. Results:Of the 112 participants, 78 SDOs returned thequestionnaire, yielding a response rate of 70%. Themajority of SDOs had positive perceptions of theemployment of male dental nurses. It was indicated thatgender is an important indicator for workforcedevelopment, and that the employment of both maleand female dental nurses would enhance productivity.Almost 70% of SDOs perceived that the productivityof oral health service would be enhanced by havingmale and female dental nurses but 84.6% disagreedthat male dental nurses would be more productive thanfemale. Two thirds of SDOs disagreed that male dentalnurses would increase satisfaction among malepatients. About 64% of male SDOs disagreed thatdental nursing profession is associated with femaletraits. There was no significant difference betweenperceptions by male and female SDOs for anystatements. Conclusion: The majority of MalaysianSDOs have positive perceptions towards theemployability of male dental nurses, and perceiveddental nursing as a suitable profession for bothgenders. Training for the dental nursing professionshould therefore be made available for men.

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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.

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Microtomes And Microtome Knives ' A Review And Proposed Classification

F. MOHAMMED ; T.F. ARISHIYA ; S. MOHAMED

Annals of Dentistry.2012;19(2):43-50.

Microtome is a mechanical instrument used to cutbiological specimens into very thin segments formicroscopic examination. Biological specimens can bepresented in many ways. But more often, thesespecimens are embedded in paraffin wax blocks andthe commonest way of sectioning these specimens canbe achieved by the microtome. The earliest form of themicrotome enabled free hand sectioning of fresh orfixed material using a sharp razor. Modern microtomesare precision instruments designed to cut uniformlythin sections of a variety of materials for detailedmicroscopic examination. Central to the production ofgood sections is the microtome knife. Microtomyvirtually begins and ends with a sharp, blemish-freecutting edge. The introduction of disposable blades hasmade easier the production of good quality, thinsections, but they are often unsatisfactory forsectioning harder tissues, especially bone. A sharp knifeedge free from imperfections is essential for theproduction of good sections. Since many types ofmicrotomes are commercially available in the market,choosing the right microtome is essential forproducing the best result as required. A classificationis proposed that unifies and organizes the variousmicrotomes based on the mode of operation.

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