ABSTRACT This study aims to explore experiences of Malaysian undergraduate dental students on the appropriate use of systemic antibiotics for pulp and periapical pathology. Final-year students from thirteen Malaysian dental schools were invited to participate in an online survey on the use of systemic antibiotics for treatment of pulp and periapical infections. The questionnaire was divided into i) respondents’ demographic data; ii) experiences and practices related to antibiotic use in managing endodontic pathology. Two open-ended questions were included to assess awareness on i) existing guidelines for prescribing antibiotics for endodontic pathology; ii) consequences of overprescribing antibiotics. Response rate was 100%. Amoxicillin (with or without clavulanic acid) (85.0%) was the most used antibiotic while clindamycin (53.7%) was chosen for penicillin-allergic patients. Antibiotic treatment was carried out for five-day duration. Cases of acute apical abscess with systemic involvement received the most antibiotic prescriptions (88.5%). A considerable number of students inappropriately prescribe antibiotics for asymptomatic apical periodontitis with or without sinus tract (29.0%) and reversible pulpitis (5.6%). 87.0% of respondents were aware of detrimental effects of antibiotics overuse. Despite high awareness on antibiotics’ side effects, some students still prescribe antibiotics unnecessarily. Enhancement of undergraduate endodontic education is highly recommended to avoid unnecessary antibiotic prescriptions.

ABSTRACT A case report of 24 years old male with Class III malocclusion on a Class III skeletal base with missing upper lateral incisors is presented to describe the mechanics to distalise mandibular molars using mini implants in a borderline orthognathic surgery case. Mini implants were placed buccally between the lower second molars and lower first molars bilaterally. Mandibular molars were distalised and intruded using elastics power chains from the mini implant to the long hook placed distal to the lower canines on a 0.019x0.025-inch stainless steel archwire. Extrusion of the lower anterior segment was prevented with the use of the stiff archwire and lowered retraction by the long hook. Labial root torque was expressed on the lower incisor from the use of MBT brackets with -6 degrees torque. Treatment was completed within 21 months. In conclusion, accurate planning and understanding of biomechanical teeth movement may facilitate the correction of borderline Class III orthognathic surgery cases.

Hypertension is one of the most common comorbidities in Malaysia mandating the need for screening prior to dental treatment to identify undiagnosed cases and ensure safe delivery of care. A standard protocol is imperative to guide dental practitioners to manage their patients based on the blood pressure readings. This study identifies the prevalence of known and unknown cases of hypertension in patients attending Universiti Sains Islam Malaysia (USIM) Dental Clinic and proposed a working clinical algorithm to be used for dental patients with abnormal blood pressure. It involves a retrospective study of 386 patients from the year 2017 until 2021. All data were analysed using Statistical Program for Social Science (SPSS) version 28.0. A literature review was also done to construct a clinical algorithm. The prevalence of patients with known hypertension in our study is 33.2% and 29.8% of them presented with unknown elevated blood pressure reading. Only 9.3% of uncontrolled and unknown cases were actually given referral for medical assessment. The presence of patients unaware of their possible hypertensive condition warrants the need for screening prior to dental treatment, hence the need for a standard protocol for all dental practitioners.

For centuries, deer antler velvet (DAV) has been a staple in traditional medicine due to its numerous health benefits, including immune stimulation, anti-ageing, wound healing, and anti-osteoporosis properties. Researchers attribute the therapeutic advantages of DAV to various compounds in its extract, ranging from growth hormones to minerals and amino acids. Recently, there has been renewed interest in these natural products for their potential use in treating chronic diseases such as bone health and development, bacterial infections, and sports supplementation to increase athletic performance. The available literature supports that DAV significantly affects bone development, chondrogenesis, and antimicrobial properties, making it a valuable resource in medical and dental settings. This review aims to provide an in-depth overview of the potential applications of DAV in modern medicine and dentistry.

A perfect smile always relates to well-aligned teeth. Factors such as fracture, malocclusion, and tooth migration challenge a clinician to restore a patient’s appearance and functionality. This case report presented a 32-year-old Malay male patient concerns on his appearance because of a fractured maxillary canine due to motor vehicle accident. There has been no restoration on the tooth since three years ago. After obtaining the patient’s agreement, a full ceramic crown was constructed despite being complicated by Class III malocclusion. It is challenging to improve aesthetics and longevity for this patient with a midline shift and diastema of the lower arch, anterior cross bite of tooth 12, and an open bite between teeth 14 and 44. After discussion, the patient agreed and decided on a full ceramic crown of tooth 23 despite being challenged to achieve an ideal occlusion. The patient was satisfied with the crown’s quality and aesthetic.

Electrolyzed water (EW) has been introduced as a surface disinfectant due to its antimicrobial properties without cytotoxic effects to oral tissues contrary to sodium hypochlorite (NaOCl), which is cytotoxic and can be detrimental if extruded beyond the root canal. This scoping review aimed to compare antimicrobial efficacy of EW with NaOCl on root canal pathogens and to assess effect of concentration and exposure time on antimicrobial efficacy. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol guidelines. Electronic databases were searched for eligible articles published between 2011-2021 in PubMed, PLOS, Science Direct, and Google Scholar. Joanna Briggs Institute Critical Appraisal Tool was used for quality assessment. Of the 784 articles recovered, only 8 were eligible based on inclusion criteria. The included studies assessed several types of EW, which showed antimicrobial potential against E. faecalis in vitro in suspension and biofilm forms. EW demonstrated antimicrobial efficacy comparable with NaOCl in 5 of 8 studies. Only one study found that higher concentration and exposure time increased antimicrobial efficacy of EW; other studies showed otherwise. It can be concluded that EW can be a potential alternative solution for NaOCl as an endodontic irrigant.

This study was undertaken to assess knowledge regarding furcation defects among dental fraternity. This is an open-ended, randomized, web-based cross-sectional multinational online survey. A total of 904 responses were gathered by sending 13 questions through a google form. Data were expressed in frequency and percentages. Chi-square test was performed to determine significant difference between gender, education level and variation between dentists of India and other countries. P value <0.05 was considered to be statistically significant. Present study had 650 dentists from India and 254 dentists from other countries. For overall knowledge regarding furcation, 90.7% (average of first and second question) of dentists had knowledge regarding furcation. There was no significant difference between males (range 54%-93%) and females (range 46%- 95%) (p>0.05) in terms of knowledge. Majority (88.7%) of post-graduates knew about the use of Nabers probe for furcation measurements and values were significant (p<0.05). Present study also revealed 65%-67% of undergraduates and post-graduates knew that Degree II furcation defects showed predictable periodontal regeneration, however values were non-significant (p>0.05). There was no statistical significance (p>0.05) between dentists of India and other countries. Dental fraternity in general had adequate knowledge regarding the furcation defects, their treatment modalities and expected complications.

Zygomycosis is a rare opportunistic fungal infection caused by fungi in the phylum Mucoromycota, subphylum Mucoromycotina and order Mucorales. Immunocompromised patients may harbour the disease by inhalation of the spores from the environment into the paranasal sinuses. Rhino-orbital-cerebral is the most common form which extends into the oral cavity, especially to the palate. We present twelve cases of zygomycosis diagnosed in the Stomatology Unit, Institute for Medical Research (IMR), Malaysia. Most of the patients are immunocompromised and presented as the rhino-orbital-cerebral form. Routine haematoxylin and eosin (H&E) staining were used for all cases while selected cases required additional special staining. The characteristic histological features of broad, non-septate, branched, amphophilic fungal hyphae are seen. We aim to report this rare occurrence to contribute to the literature and raise awareness about this condition among clinicians. To date, this is the first compilation of oral zygomycosis cases known to be reported in Malaysia.

Accessory cusps are occasional variations in tooth morphology that can be detected clinically. Third molars have a wide range of eruption patterns and shapes but are commonly impacted. Unlike root morphology, variations in the crown morphology of the third molar have rarely been reported. Variations in crown morphology are important because they can affect clinical outcomes. Here, we present a rare case of fully erupted mandibular third molar (MTM) with multiple accessory cusps. This case report describes a case of a 31-year-old female Kenyah with a unique crown morphology of her fully erupted, vital, and functional mandibular third molar (MTM) which has multiple accessory cusps seen on the buccal surface, giving the appearance of a double tooth. Her MTM presented with an incipient caries lesion, which was managed conservatively. Documenting variations in tooth morphology is crucial for individual identification. While most people opt to have their MTMs extracted, early management of well-erupted and functional teeth should be undertaken to prevent disease progression.

This study aims to determine the prevalence of dental anomalies and MSX1 gene 799G>T polymorphism and its association with non-syndromic cleft lip with or without palate (NSCLP) attending Hospital Universiti Sains Malaysia. Clinical and radiological assessments on 37 NSCL±P patients and 80 non-cleft children were done to detect dental anomalies. The buccal cells were collected and polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was used to identify polymorphism. NSCL±P was higher among males (54%) and mostly unilateral cleft lip and palate (51.3%). The prevalence of dental anomalies in morphology in NSCL±P was 18.9% (95% CI: 5.7%, 32.2%) and non-cleft was 6.3% (95% CI: 0.8%, 11.7%). Hypodontia in NSCLP was 75% (95% CI: 61.2%, 90.2%) and non-cleft was 7.5% (95% CI: 1.6%, 13.4%). There was a significant association between NSCLP and anomalies in morphology (P= 0.04; OR=3.5)) and number (P< 0.01; OR= 40). There was an absence of rare 799G>T polymorphism in all NSCL±P and non-cleft children indicating that all samples contain common 799G polymorphism. In conclusion, the prevalence of dental anomalies in morphology and number was significantly higher in NSCL±P compared to non-cleft children. However, it was not significantly associated with MSX1 799G>T polymorphism.