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.

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.

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.

Gastroesophageal reflux disease (GERD) is a common digestive disorder that affects millions of people worldwide. Reflux of gastric acid may cause oral acidification that can induce teeth demineralization. Destruction of dental hard tissue by acid reflux necessitates a combine approach involving medical and dental profession. This pilot study aims to assess associationbetween enamel erosion and GERD, and estimate prevalence of enamel erosion among GERD patients. A total of 22 patients (GERD and control) were involved in this case-control study. Dental charting was done using five-point ordinal scales of modified Tooth Wear Evaluation System (TWES 2.0). Cohen’s Kappa Coefficient was used for assessment of intra-rater and inter-rater reliability. Fisher’s Exact Test was used to determine association between enamel erosion and GERD, reflecting prevalence. Out of 11 GERD patients, 63.6% exhibit enamel erosion, whereas only 9.1% ofcontrol patient presented with enamel erosion. Fisher’s Exact Test showed a significant prevalence of enamel erosion in GERD patients (p=0.024).This study showeda clear association between enamelerosion and GERD, and it can be considered as an oral manifestation in patient with GERD. Future study involving large sample size is recommended to show clear statistical evidence ofassociation betweenenamel erosion and GERD.

The effects of food-simulating liquids (FSLs) on the microhardness and surface roughness: Luna (LN, conventional nanohybrid), Aura Bulk Fill (AB, bulk-fill composite), and Stela Automix (SA, self-cured composite) were evaluated. The materials were exposed to air as control, artificial saliva and three FSLs: 50% ethanol-water solution, 0.02N citric acid, and heptane-over different time intervals to compare their performance. Microhardness and surface roughness were measured at baseline, seven days, and 30 days after immersion. Two-way ANOVA revealed significant interactions between FSLs and materials for both microhardness and surface roughness (p<0.001). All materials showed a decrease in microhardness and an increase in surface roughness over time, except when exposed to air. LN exhibited the highest microhardness and lowest surface roughness, while SA demonstrated the lowest microhardness and the highest surface roughness in all FSLs. SA's surface roughness decreased in citric acid, potentially due to its lower filler content, which may result in a less durable surface. Ethanol and citric acid had the most detrimental effects on the microhardness of all materials, while heptane caused the most significant surface roughness changes in SA. These results highlight the material-specific responses to FSLs, with important implications for material selection and restoration longevity in clinical practice.

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.