V I Y M: Dissertations/Theses Undertaken at The Faculty of Dentistry UNI ERS T OF Alaya For The Year 2009
V I Y M: Dissertations/Theses Undertaken at The Faculty of Dentistry UNI ERS T OF Alaya For The Year 2009
V I Y M: Dissertations/Theses Undertaken at The Faculty of Dentistry UNI ERS T OF Alaya For The Year 2009
A study was carried out to assess weight changes and Qral healthcare is the most prevalent unmet health care
surface quality in three auto polymerized silicone soft need for children with special needs (CSN). The lack
denture liners; GC(Soft and extra soft, GC, Japan) and of health care professionals who are trained,
Mollosil plus (Detax, Germany) after immersion in· experienced, and willing to provide treatment are some
different denture cleansers; Polident (GlaxoSmithKline, of the barriers in the provision of a comprehensive care
Ireland), Steradent (Reckitt & Colman., UK), Protefix for this group of children.
(Queisser Pharma, Germany) and one disinfectant; The aim of this study is to determine the attitudes
Perform (Schulke & Mayr. Asia Ltd.). and experience of general dentists in providing oral
The soft lining materials were mounted on the healthcare for C~N. A descriptive cross-sectional study
prepared acrylic resin disc of 14 mm diameter and 2 was carried out among all general dentists in Selangor
mm thickness (Meliodent, Heraeus Kulzer, Germany), and Kuala Lumpur. Self-administered questionnaire
n ~ seventy five. Five specimens from each of soft was used for data collection. The final sample
liners were immersed in each denture cleanser and one comprised of385 particip~nts, with a response Tate of
, disinfectant for 8 hours; this represented the normal 82.1 % (n= 165) for public dentists and 34.1 % (n=220),' .
overnight cleansing regime. Fresh solutions of-denture for p'rivate dentists.
cleanser and disinfectant were prepared each day and The results showed that the majority)'90%)
following the immersion period, the specimens were reporteCl experience and willingness in pr9viding. care
stored in tap water at 37°C for the remainder of 24- for CSN with a'significantly higher pro'portion among
hour period (24 -8 = 16 hours). This procedure was the public dentists, younger age groups (40 and below)
repeated 'for 60 days with the interval of 3, 7, 14, 28 and those with less than 10 years of practice (p<0.05).
and 60 days. The control specimens were stored in tap The most frequent care provided was extraction
water at 37"C. Sorption was expressed as a percent of (77.7%), examination only (76.8%) and restorative
weight loss or gain compared with the weight of the (74.8%). Perceived barriers to providing care were
initial sample by using digital electronic balance :. mainly patient factors; lack of cooperation (92.7%),
(Sartorius, Germany). difficult communication (90.1 %) and time factor
Repeated measu~s_ analysis of variance (ANOVA) (81.3%) as well as dentist factors; lack of experience
procedure, Post Hoc Tukey's test, paired sample t test (77.9%) and lack of knowledge (63.4%) ..
and Bonferroni correction were conducted to test the The undergraduate training (79%) 'and knowledge
null hypotheses about the effects of both the subjeCts (40%) were perceived to be inadequate. A bout half
factors and the within factors. The results of the (51 %) reported not confident in the management of
analysis indicated that there was a significant effect (P CSN. The majority (93%) perceived the need for after-
< 0.04) in terms of weight gain for immersion period graduate training. However, only a few (35.3 %)
and there is a significant interaction effect for received additional training.
immersion period by-material and immersion period Willingness to provide care for CSN were
by-denture cleanser: significantly higher among those with prior experience,
The sorption in the soft liners was significant after those with after-graduate training, those whO rated their
60 days (P < 0.04) of immersion in the denture knowledge as adequate ahd those who claimed to be
cleansers and disinfectant, which is time dependent. confident (p<0.05).
The correct combination of soft liner and denture Therefore the dental undergraduate'training as well
cleanser is critical to ensure optimum life span of the as on the job training for general dentists need to
lining. emphasize on soft skills as well as technical
competency in the management and preventive care for
CSN to improve the knowledge-' and 'confidence of
general dentists in the provision of a comprehensive
care for children with special needs.
44 Annals af Dentistry, University af Malaya, Val. 16 2009
DAI be used as a screening tool by dental nurses in the year prior to the study. Out of these, 53.4% went
school dental service as it can act as a safety net and because of dental problems. More than one-half
ensure that students in need of orthodontic treatment (54.3%) went to military dental clinics on their last
are not left out. Dental officers can be trained to use visit. Smoking prevalence was very high (85%), with
the IOTN as the next level of referral to re-check the mean number of cigarettes/day of 10.0( (SD= 4.8).
students using the DHC of the IOTN before referring Only 7% of subjects consumed alcoholic drinks.
them to the' orthqdontists. This would ensure a more It was concluded that the current dental status of
objective system referral and tho.se in great need fo~ the infantry soldiers was better than during recruitment
treatment are ploi9ritized accordingly and given timely in 2002/03 in terms of decreased mean DT. However,
intervention .. the mean number offilled teeth (FT) and missing teeth
(MT:)-had also increased. The dental combat readiness
according to DENTAP 2008 classification was low
Dental status and combat readiness with more than one-half of the subjects who needed
assessment of Malaysian Armed Forces dental treatment prior to deployment.
It was recommended that MAF make policy
infantry soldiers
. changes to promote the oral health of the infantry
solCliers such as improving the dental attendance,
Dr. Amrizan Abdul Wahid
providing a dental kit as part of Full Service Marching
Department of Community Dentistry
Order (FSMO) and organizing oral health promotion
programmes to reduce oral diseases and improve oral
The aims of this study were to assess the dental status,
health related quality of life of the infantry soldiers.
dental combat readiness and related oral health
.behaviours of the infantry soldiers after five years of
active military service. The objectives were to evaluate
the progression of dental caries using the DMFT and Epidemiology of Tt:aumatic Dental Injuries
DMFS index, their current oral health practices and a~ong Adolescents
behaviours, and the dental aspect of combat readiness
in five infantry battalions of the Malaysian Armed Dr. Sofiah Mat Ripen
Forces. This study was a combination of cross-sectional De,Partment of Community D,ent;istry
and retrospective studies using a self-administered
quest(onnaire followed by an oral examination The aim of the study wa's to measure the prevalence
involving 173 soldiers who had completed five years of traumatic dental injuries (TDI) to permanent anterior
of activ~ service. The soldiers were taken from five teeth in adolescents, to determine the causes of TDI,
infantry battalions by using the total sampling method. to identify r~asons for the untreated injured teeth and
The response rate was 67.3%. the impact of untreated injured teeth on Quality of Life
The pi"evalence of caries (DMFT 2:. 1) ha'd among 13 and 16-year-old schoolchildren in Klang
increased by 3.8% within 5 years (2008 = 79.8%, 2002/ district.
03 = 76.9%). Th~r§ was a decrease in mean DT (4003 A cross-sectional study was carried out in a sample
= 1.7,.2008 =1.3), an increase in mean MT (2003 = of4602 schoolchildren. The children were, clinically
0.5,2008 =1.1) and mean.:FT (2003 =1.3; 2008 =1.6). examined and children with TDI ~ere given a self-
The prevalence of active caries (DT) was slightly administered questionnaire.
higher at recruitment (59%) than in 2008 (54.9%) The prevalence of traumatic dental injury was
indicating that treatment was done to treat the active 5.0%. Males (6.8%) had TDI levels approximately
caries. DMFS .had increased by 63.6% since twice as high as females (3.0%). Indians experienced
recruitment with the biggest changes seen in the MS a higher TDl levels than other ethnicity. Maxillary
component where it had increased by 129.2%. central incisors were the most common teeth with TDI.
According toCDENTAP~2008 system, only 40.5% Most of the affected children (77.2%) had trauma to 1
of the total subjects were dentally fit. The prevalence tooth. Enamel fracture (42.4%) was the major type of
of dental pain was 34.1 % and toothache was cited as TDI. The main cause of injury reported was fall
the main cause (91.5%). The impacts of dental pain . (62.7%). Most of the TDl occurred at home (52.2%).
were feeling worried (91.5%), sleep disturbance A total of 288 teeth were traumatis'ed with 84.4% of
(62.7%), work disturbance (59.3%), chewing the traumatised teeth not treated. About half of the
disturbance (66%) and social disturbance (37.3%). participants "do not care" about the appearance of their
However, on the examination day, the majority of untreated traumatised teeth. The impact of untreated
respondents (91.9%) did not experience any dental. . traumatise teeth on Quality of:Life among adolescents
pam. in Klang was found to be between low to moderate.
All subjects (100%) reported brushing their teeth In conclusion, the prevalence of TDI among
daily. The majority (62.4%) used fluoride toothpaste. adolescents in Klang is low and the impact of
However, only 1.7% flossed their teeth. About 42% of traumatised teeth 0!1 the Quality of Life among
the total sample attended a dental clinic in the past one adolescents is found to be low to moderate.
46 Annals of Dentistry, University of Malaya, Vol. 162009
Tooth Brushing Practices and Oral Health Oral Health Status and impacts among
Impacts among Bangladeshi Urban First Year Cadets of National Defence
Adolescents University Malaysia
The effect of abutment angulation on to accommodate the abutment, the Group B models
stresses in bone: A 3-dimensional finite showed -80 MPa and 64.5 MPa for the highest
compressive and tensile stresses respectively.
element study
Conclusions: Within the limitations of the present
study, the following conclusions were drawn: 1)
Dr. Muraja Afif Uthman
Stresses appeared to concentrate at the cortical bone
Department of Oral and Maxillofacial Surgery
around implant collar for single implant that was
loaded at buccal cusp and distal fossa. The stresses
Aims: To evaluate the effect of variations in implant
around the implant body and apical area were relatively
abutment angulation on the intensity and distribution
low and homogenous. 2) Stresses increased with
of von Mises, tensile and compressive stresses in the
-increased abutment angulation for both groups. When
bone surrounding an implant using three-dimensional
37.5° model was used, the stresses increased nearly
(3-D) Finite Element Method.
three folds. 3) Removal of cortical bone at distal aspect
Methods: 3-D FE models were constructed using
for 22.5°, 30° and 37.5° models of group A, resulted
FE software (Pro/Engineer, Wildfire 2.0 parametric
in high levels of compressive stress at the cancellous
technology Corporation). The implant fixture was·
bone which may predispose the bone to micro fracture
modeled following Ankylos® system (Dentsply'
ana resorption when they exceed the elastic limit of
Friadent, Germany); 3.5 mm in diameter and 11 mm
bone. 4) Group B, particularly 37.5° model, showed
in length, restored with an all-ceramic crown
tensile stress higher than the elastic limit of bone,
representing the mandibular second premolar. The bone
which may undergo microfracture and resorption.
segment was modeled to approximate the bone
dimensions in the region of mandibular second
premolar. Two situations of implant placement were
investigated. Group A represented distal tilting of the Condylar sagittal path angle in selected
implant in various angulations: 15°, 22.5°, 30° and Malay females .
37.5° and the abutments angled correspondingly so that
the crown was in similar axial direction. To Ammar Jasim Ali Musawi
accommodate the abutment, the distal crestal bone was' • Department of Prothetic Dentistry
beveled to level the implant head with the crestal bone. I
-' .
Group B represented a-nother clinical situation, in. PURPOSE: To investigate the condylar path angle
which the implant was placed along the long axis of (CPA) in Malay females, compare the measurements
the bone while the bone segment was inclined buccally obtained with the average values (25°-35° Campers)
at various angulations: 15°,22.5°,30° and 37.5°. As in and compare the right condylar path angle with the left
previous models, corresponding angulated abutments con-dylar path angle.
were used so that the crown was always loaded in MATERIALS AND METHODS: A total of thirty
similar axial position. subjects were chosen according to a selected criteria,
The control gro~p of this study was a straight impressions of arches were made using a wash
implant and str2:~ght,abutment placed vertically in the technique with silicone regular body over silicone putty
ce~tre of the hone segment. A 3-D tetrahedral mesh type. Casts were poured into type IV diestone and
was generated for alt.models constructed. Occlusal facebow transfer was taken for each subject. Casts were
loads of 150 N were applied aXIally to the buccal cusp mounted to their centric position on Ka Vo Protar evo
and distal fossa, giving a total load of 300 N for all 9 semi-adjustable articulator. Protrusive guides were
models, to simulate occlusal loading during function. constructed on the anterior teeth of the casts to allow
ANSYS versiop 11.0 (ANSYS/Workbench, Ansys Inc, the mandible to be protruded for 5 mm, then the angles
USA) was used to provide the loading simulation and measured using protrusive record method with silicone
stress pro.file analyses. Results: For the co"ntrol group, bite registration material.
stresses (comptessive, tens-ile) were seen concentrated RESULTS: Within the limitation of this current
around the implant collar at the cortical bone. Stresses study, for the right angle it was found that 13 subjects
were more homogenous in nature surrounding the (43.33%) were witltin the range of the average value
implant body and apical area. (25°-35° Campers) and 17 subjects (56.66%) were out
There was an increase in all types of stresses of range of the average value. Furthermore, the
around the implant collar in the cortical bone when measurements for the left angle 10 subjects (33.33%)
increasing the abutment angulation for both groups. were found to be in the range of the average value and
The highest compressive and tensile stresses for the 20 subjects (66.66%) were .out of range. There was no
Group A models were -96 MPa and 60 MJ;>a" statistically significant diff~rence 'between the left and
respectively, which were observed on the cortical bone right condylar path angles. There was a strong linear
around the implant collar. A high level of compressive relationship between left and right condylar path angles
stress (-40 MPa) was observed. For the 37S model among the Malay females.
where the distal cortical bone was cOffi.pletely removed
48 Annals af Dentistry, University af Malaya, Val. 16 2009
SUMMARY: The Malay females are not villagers from southern Peninsula Malaysia. The
considered as an ethnic variation in regards to CPA, sociodemographic information was collected using a
they can be treated the same way as the Caucasian~ in structured questionnaire and a face to face interview.
regards to that angle. CPA should be considered in Subjects had their mouth examined and cells of buccal
constructing fiX:~d and/or removable pro~theses mucosa for DNA extraction were collected using
combined with the use of semi-adjustable articulators; cervical cytobrush. Multiplex PCR was used to
this would enhance and improve the quality of the determine GSTMI polymorphism (null genotype).
treatment given to the patient. Clinicians should not Where relevant, the chi-square test of associations was
depend on the average values to which the simple carried out using the SPSS version 14.0. The alpha
articulators are set. . value for test of significance was set at p=0.05.
Protrusive record method for programming the ReSults: A total of 242 Orang Ash were
semi-adjustable articulators can be reliable if modified interviewed and the, prevalence of smoking in this
by using efficient bite registration material and making population was 55.0% (133/242)'; alcohol drinking was
it reproducible by making use of the protrusive guide. 4.1 % (10/242); and betel quid chewing was 19.8% (48/
242). Males were more likely -to indulge in smoking
and alcohol drinking compared to their female
Prevalence of Risk Factors for the counterparts (p=O.OOOand p=0.005 respectively). The
Development of Oral Mucosal Lesions subjects commonly smoked commercially made
cigarettes and' the 'rokok daun'. The most common
among Or,ang AsH in Malaysia
betel quid-ingredients used by the bet~l-quid chewers
were dried ripe areca nut, betel-leaf and lime with few
Intan Suraiya Merican Aljunid Merican
adding 'gambir' to the quid which are commonly
Department of Oral Pathelogy,
placed in the buccal sulcus. Only 159 subjects allowed
Oral Medicine and ~eri~dontology
examination of their mouth and the prevalence of oral
Risk habits such as smoking, alcohol'consumption and mucosal lesion/conditions (namely leukoplakia, oral
betel quid chewing have long been identified as submucous fibrosis, chewer's mucosa, lichen planus
primary risk factors in causing many'severe diseases and other lesions) was 8.8% (14/159). Out of 159
and cancers, Glutathiony S-transferase (GST), a Phase subjects with buccal cells collected, DNA from only 98
II enzyme, is important in the detoxification and subjects was of good quality for laboratory analysis.
ex~retion,ofmany carcinogens. Amorig the major GSTs The overall prevalence of GSTMI polymorphism (null
family, GST - mul (GSTMl) had attracted r~searchers genotype) was 32.7% (32/98). Among subjects with
to conduct studies to establish the f~le of GSTMI in lesions and GSTMI polymorphism (null genotype),
, the detoxification of carcinogens especiapy, from 33.3% smoked 1-10 cigarettes per day with 66.7%
cigarette smoke. There are contradictory reports on the having smoked for >20 years; while among subjects
association between the oral cancer related risk habits with lesions and without GSTMI polymorphism (non-
(smoking, betel quid chewing and alcohol drinking) null genotype), 83.3% smoked 1 to 10 cigarettes per
with GSTMI polymorphism (null genotype). There are day with 50% have been smoking for >20 years. For
currently no studies on the prevalence of oral cancer the betel-quid chewers, among those with lesions and
related risk habits and oral mucosal lesions/conditions GSTMI polymorphism, 33.3% each were chewing 1-
available on the indigenous people of Peninsula 5,6-10 and >10 quids/day with 100% having chewed
Malaysia namely the Orang Asli. There is, also little or for a duration of 1-20 years; while among those with
lack of information on 'the prey'alence of' gene lesions and without GSTMI polymorphism, 50% were
polymorphisms or its influence on the associatio~ of non-chewers and 50% chewed 1-5 quids per day with
diseases and risk habits among"this populations, 33.3% and 16.7% have been chewing for 1-20 and >30
Aim: To determine the prevalence and describe the years respectively. All the alcohol drinkers had no oral
commonly used preparation/ingredients of oral caneer mucosal lesions.
related risk habits (smoking, betel quid chewing and Conclusion: Smoking was the most common risk
alcohol drinking); to determine the pre~alence ef habit in this Orang Asli population.' The prevalenc,e of
related oral mucosal lesions and prevalence of GSTMI oral mucosal lesion in this population was 8.8% and
'polymorphism (null genotype); and to investigate the, of GSTMI polymorphism (null genotype) was 32.7%,
association between risk habits and oral mucosal lesion' No trend was observed betw~en risk habits and oral
among those with and without GSTMI polymorphism mucosal lesions in those with' and without GSTMI
in a selected group of Orang Asli of Peninsula Malaysia polymorphisms. In view of the small sample size, this
Methods: This is a cross-sectional descriptive finding cannot be generalized until a larger study is
study with convenience sampling of Orang Asli conducted.
Dissertations/Theses 49
individuals were shown to harbor fimA type I and II Periodontology, Faculty of Dentistry, University of
bacteria almost equally in each category of probing Malaya. For all the selected cases, 5m thick sections
pocket depth and attachment loss measurements. were prepared for staining with haematoxylin and
However, type 11detection was higher than type 1 in . eosin, and for immunohistochemistry with rabbit anti-
both these ·measurements. Both genotypes of bacteria Wnt-l polyc1onal antibody (Genetex Inc., USA). Three
were found only in pocket depths of more than 3 mm. microscopic fields were chosen randomly from the
For the GI, BI and PI categories, both genotypes of Pg lesional area and data were collected by using the
were associated with these indices. The frequency of quantitative histological technique.
genotype fimA type 11 was greater where plaque Results: The study sample was from 24 male and
accumulation was greater (> 1).. 13 female patients with an overall mean age of 27.95
Conclusions: Pg was detected in periodontally years (age'range: 11-57 years). Theirracial composition
diseased and healthy subjects. However it was more was 48.6% Chinese, 32.1% Malays, q.5% Indians and
predominant in the diseased subjects. PgfimA genotype 5.5% other races. Thirty-four cases were from the
1 was prevalent in both groups. Pg fimA genotype 11 mandible and the remaining three cases were from the
was identified in diseased subjects only. Pg was maxilla. Histologically, there were 24 conventional
associated significantly with all clinical parameters, (solid/multicystic), 12 unicystic and 1 peripheral
except for plaque index and missing teeth. Pg positive ameloblastoma. Wnt-l expression was detected in 34
fimA genotypes 1 and 11had no significant relationship (91.89%) out of 37 cases of ameloblastoma. Staining
to all clinical parameters. intensity for W n( 1 was moderate to strong in all cases
of primary conventional ameloblastoma (n = 15/15;
100%) compared to their recurrent· counterpart (n = 51
Immunolocalization of WNT-l ..in different 7; 71.43%). I~ the unicystic ~meloblastoma, moderate
clinicopathologic subtypes ~fAnieloblastoma ..to strong Wnt-l expression was obse!ved in both
. 'primary (n = 517; 71.43%) and all recurrent (n = 5/5;
Chuah Kee Seng 100%) tumors. Wnt-l showed preferential expression
Department Oral Pathology, Oral Medicine in pre-ameloblasts more than in stellate reti'culum-like
and Periodontology cells. Keratinizing cells in areas of squamous
metaplasia stained more strongly for Wnt-l compared
Background: Ameloblastoma is a histological benign, to their surrounding polyhedral stellate reticulum-like
but 10callya,ggTessive non-encapsulated tumor arising cells.
from' the odontogenic ectoderm and its derivatives. Conclusion: Present findings suggest that Wnt-l
Despite it being classified as a benign odontogenic may play differential roles in the cytodifferentiation and
tumor, the ameloblastoma shows a high tendency of proliferation of the various neoplastic cellular
. 'iecurrence and occasional.1y produces metastases. components in the primary conventional and unicystic
Ameloblastoma is classified into four ciinical types: ameloblastoma, and their recurrent tumors.
unicystic, conventional or multi cystic, peripheral and
malignant. Histologically, there are two basic growth
patterns, follicular and plexiform. Wnt-l (Wingless Determination of root and canal morphology
type protein), belongs to a 'large ~family of 19 secreted of first permanent molars amongst Kenyan
glycoprotein that act as signaling transducers that
adults
promotes cell proliferation and devefopment. Wnt
protein signaling pathway plays an important key role
Dienya Tomjoseph Mboya
in carcinogenesis and embrYGgenesis. Previou·s.
Department of General Dental Practice and
experimental data has shown over<-expression of Wnt-
Oral and Maxillofacial Imaging
1 in human cancers like oral squamous cell carcinoma,
colorectal tumors, basal cell carcinoma, non-small ceIL
Introduction: A study aimed at getting a detailed
lung cancer, mammary cancer, mesothelioma and
understanding of the root canal system of Kenyans 1st
sarcoma.
permanent molars was done using Cone Beam
Objective: The aim of this study was to determine Computerized Tomography. _
the· immunolocalization of Wnt-l in ameloblastoma in
Objectives: .To determine 'r~ot and canal
terms of its distribution and staining intensity in its
morphology of 1st permanent molars amongst Kenyan
various neoplastic cellular components and to relate it adults employing CBCT (i -CAT). -
to the different clinicopathologic subtypes of this
Materials and methods: 267 extracted human 1st
neoplasm ..
permanent molars were examined visually for external
Materials and methods: Thirty-seven cases root morphology. Access cavities were prepared and
comprising 24 conventional, 12 unicystic and I
pulp tissue removed using 5.25% sodium hypochlorite.
peripheral ameloblastomas (totaling 23 primary and 14
The teeth were then scanned using CBCT. The resultant
recurrent cases) were retrieved from the archives of the
images were observed using Xoran software (version
Department of Oral Pathology, Oral Medicine &
3.1.59) and the collected data analysed using SPSS
Dissertations/Theses 51
(version 11). For better visualization of minute canal Conclusion: P53 and Ki-67 expression can not
details such as apical deltas, data was transferred to provide a prognostic value in regard to the prediction
another computer with Simplant software. of lymph node metastasis in OSCe. Never the less, the
Results: Most of the mandibular 1st molars had size of this sample does not allow a confident exclusion
two separate roots (99.4%). Fusion of roots in of other variants that might have come to participate,
mandibular 1st molars occurred in 5.8% of the sample. specifically heterogeneity of SCe.
In maxillaJ;'y molars, all the teeth were three rooted.
Fusion occurred mainly b.etween DB and MB roots
(8.9%). ''[-~e prevalence of root curvature was high in Basement membrane profile of keratocystic
both type~ of t~eth. In mandibular mo.lars, tYl2e IV _ odontogenic tumour
canal c<;.>nflguratlOnwas the commonest III M roots. In -.
maxillary molars, type I was the domiqant
Hartinie Muhammad
configurations in all the three roots. Lateral canals were
Department of Oral Pathology, Oral Medicine
commonly found in M roots in mandibular molars and
and Periodontology
MB roots in maxillary molars. Centrally plac'ed apical
foramen was the most prevalent position in all the roots . ,Keratcrcystic Odontogenic Tumour (KCOT) is formerly
studied.
known as odoi1togenic keratocyst (OKC).The high
Conclusion: CBCT proved a very reliable and non- recurrence rate is a unique characteristic of KCOT. The
invasive means of getting information on canal pre'sent study. was aimed at determining the presence
anatomy on extracted teeth. Root and canal of Collagen IV, Laminin.5, Mcttrix Metalloproteinase-
morphology of Kenyans 1st permanent molars showed 2 (MMP-2) and Matrix Metalloproteinase;, 9 (MMP-
some variations and complexities as compared to those 9) in the basement membrane (BM) zone of KCOT in
of other races. These should be considered when one order to gain a better understan~ing of the role they
is treating Kenyan patients especially during might play in the high recurrence rate 'in KCOTs.
endodontic procedures.
Materials and methods: Haematoxylin and' eosin-
stained .sections of 26 KCOT cases were group into I.
Twelve primary KCOT cases which had not recurred
Association of KI-67 and P53 expression (KCO/o.R) (n=12), II. Seven primary'KCOT cases
with cervical lymph node metastasis in oral which had recurred (KCOTwR) (n=7) and III. Seven
~quamous cell carcinoma recurrence KCOT (ReKCOT) (n=7). They were
prep'ared for immunohistochemical staining for
Ghassan Mutaher Abdullah AI-Iryani Collagen IV, Laminin 5, MMP-2 and MMP-9 with
Department of Oral and Maxillofacial Surgery suitable positive and negative controls.
Results: Primary KCOTnR showed Collagen IV
Introduction: TNM staging has been consider.ed, expression in high percentage (75.0% cases) followed
regardless of its limitations, the most reliable by tho'se found in KCOTwR (28.6% cases). The
prognostic,Jactot for oral squamous cell carcinoma expressions of Collagen IV, Laminin 5, MMP-2 and
(OSCC). The cervical lymph nodes status (N) implies MMP-9 at the BM zone were not significantly different
a significant prognqstic value. The aim of this study between the primary KCOTnR and primary KCOTwR
was to correlate the incident of cervical lymph node but a decrease in the number of immunopositive cases
metastasis with P53 and Ki-67 expression. of the Collagen IV in the primary KCOTnR to the
Materials and Methods: The sample consisted of primary KCOTwR and the ReKCOT was seen.
23 (11 tongue and 12 buccal mucosa) SCCs. Two Immunopositivity Tor Laminin 5, MMP-2 and MMP-9
specimens representing the Tumour tissue and a clear were also found in the basal and suprabasal epithelial
margin of each case were selected to undergo cells. MMP-2 and MMP-9 immunoreactivity were also
immunohistochemical~ staining. Expression pf P53 and detected in the' fibroblasts of the connective tissue
Ki-67, represented as a percentage of cells showing stroma.
immunoreactivity, was assessed· using an image Conclusion: There was no statistically significance
analyser. The values obtained were statistically difference in the expressions of Collagen IV, Laminin
analysed for any association with lymph node status. 5, MMP2 and MMP9 at the' BM zone between the
Results: Depending on the normality of the data, primary KCOTnR and primary KCOTwR. Collagen IV,
parametric or nonparametric test were used to test for Laminin 5, MMP-2 and MMP-9 may be involved in the
the association of P53 and Ki-67 expression with modulation of KCOTs' basement membrane integrity
lymph node status. No association between P53 and ki- a
but may not be used as' predictable marker for the
67 expression in both tumour and margin with lymph recurrence of KCOT.
node status was found.
52 Annals of Dentistry, University of Malaya, Vol. 16 2009
significant correlation between overexpression of level. The logistic regression model includes 6
cyclin D I and underexpression of p27 with some, variables. These were lactobacilli level, use of
clinicopathological parameters which are known sweetened drinks in feeding bottle, mutans streptococci
independent prognostic indicators. Thus, these results level, use of fluoride toothpaste, breastfeeding after the
suggests that' over~xpression of cyclin D I and age of one year and total income of family.
underexpression of p27 may be used as prognostic The predictive probability of the model was good
markers for OSCC of buccal and alveolar mucosa. at 88.9% with sensitivity of 88.6% and specificity of
Recommendation: The findings of the present 89.2%. The study has highlight~d th~ complex
study are considered preliminary as the samples used aetiology of S-ECC which involved MS, LB,and other
were small. A larger sample size with adequate data of significan,t risk factors, particularly among Malay
loco-recurrence and survival would give more preschool children. Therefore, in futur;e, it was
definitive prognostic potential of cyclin D I and p27. suggested that the study"should be carried out on other
various ethnic groups in Malaysia sbch as Chinese and
Indian population due to different culture or norm. This
Association between Mutans Streptococci, will be valuable in identifying cafies risk factors and
Lactobacilli and other risk factors with facilitating understanding of caries occurrence or
aetiology among different ethnics of preschool children
severe early childhood caries
in Malaysia. The information might be useful as a
guideline to fonnulate dental health promotion and
Or. Norita Abdul Rahim
preventive measures of ECC specifically for all
Department of Children's Dentistry and Orthodontics
preschool children in Malaysja .. -,
Early childhood caries is a multifactorial disease' which
is most prevalent among childhood that warrants much
attention. The aim of this study was. to assess the Tensile bond strengths of silicon-based soft
association between mutans streptococci (MS), liners to two chemically different. denture
lactobacilli (LB) and other risk factors with severe base polymers
early childhood caries (S-ECC) in 5-year-old healthy
Malay children. The objectives were (i) to investigate Omar Hilal Abbod AI- Bayati
the relationship between S-ECC with salivary MS and Department of· Prosthetic Dentistry
LB levei; (ii) to' investigate the relation;hip pet"'{een S-
ECC with other risk factors such as .socioeconomic Objectives: To evaluate and compare the tensile bond
status, oral hygiene practices of child, feeding h~bits strength' of four silicone-based soft liners to two
.. Of child and dietary habit of child and (iii) to denture base polymers; polymethyl methacrylate I
understand·. the factors OT predicting S-ECC by (PMMA) and urethane dimethacrylate (UDMA) and to
assessing interrelationships between all the independent describe the mode of failure and relating it to tJ:le
variables and developing a logistic regression model. tensile bond strength values.
A convenient sample of 72 subjects, whereby, 35 Methods: The 24 hours' tensile bond strength of
subjects were with S-ECC.(dmfs = 6) and 37 caries 4 silicone based soft lining materials (GC soft, GC
free, (dmfs = 0) as a control, were selected from 4 Extra soft, Silagum Comfort and Mollosil Plus) to two
preschools under Federal Islamic ne.p,artment, Kuala chemically different denture base polymers (Eclipse,
Lumpur. The study was cros~: sectional, case-c<"mtrol UDMA based resin and Impact, PMMA based resin)
type by comparing the children with S-ECC and caries- were evaluated with a modified method. 10 specimens
free children .• were prepared for each denture base-soft liner
Results showed that both mutans streptococci (MS) combination group (Total=80 specimens). Each
and lactobacilli (LB) levels were strongly associated specimen composed of two denture base of dimension
with S-ECC. Other risk factors significantly associated' (20 x 20 x 4 mm) with an interposing cylindrical soft
with S-ECC were on demand breastfeeding, no,£;t~rnal lining material of (10 mm diameter and 3mm
bottle feeding and use of sweetened drinks in feeding - thickness), The denture base specimens were stored in
bo.ttle. Significant interrelationships between water for 30 days before relin'ing.and the relined
independent variables were: MS and LB, MS and on specimens were stored in water for 24 hours prior to
demand breastfeeding, LB and on demand testing. The tensile bond st.cength 'test v.:as carried out
breastfeeding, LB and daily frequency of sweet foods using Shimadzu universal testing machine (Shimadzu,
and drinks intake, LB and daily frequency of Japan) at cross head speed of 5mm/min. After testing,
toothbrushing, on demand breastfeeding and the mode of failure was determined using a stereo
breastfeeding after the age of one year, nocturnal bottle microscope (Kyowa SD-2PL) at magnification of XI 0,
feeding and use of sweetened drinks in feeding bottle, Two-way ANaYA, Kruskal-Wallis and Mann-Whitney
and total income of the family and mother's educational test was used for statistical analysis (p=0.05).
Dissertations/Theses 55
Effect of light tip angulation on shear bond Testing Machine was used to measure the maximum
strength of an orthodontic adhesive force for debonding, The Adhesive Remnant Index
(ARI) and evaluation under Scanning Electron
, Ummu Aiman Yusoff Microscope (SEM) were done to evaluate the site of
Department Child,en's Dentistry and Orthodontics bond failure on tooth and bracket surface, respectively,
SPSS version 12,0 was used to analyze the data,
A number of studies have been done in relation to the The Kruskal-Wallis test was employed to compare the
effect of different factors affecting the shear bond shear bond strength of all groups, Frqm the results, the
strength of orthodontic adhesives, At present there are mean shear bond strength values for Group A (0
no studies that have evaluated the effect of light tip degree), ~roup B (45 degrees) and Group C (90
angulations while curing the lorthodontic adhesives on degrees) were 4.15, 4,56 and 6,66 MPa, respectively,
the shear bond strength, The purpose of this study was The highest mean rank,. was 46,98 for group C. The
to investigate the effect of light curing tip angulations statistical analysis of the study sh6wed'no significant
on the shear bond strength of an orthodontic adhesive, difference (p = 0.286) of the shear bond strengths of
Ninety human premolars with brackets bonded in orthodontic adhesives when cured at three different
a standardized manner using the light-cure orthodontic angulations of the light curing tip, However, the highest
adhesive, Transbond XT, were polymerized using a blue shear bond strength was at 90 degrees angulations of
LED light curing unit for 40 seconds at three different the light curing tip and its value was within the optimal
angulations of 0 degree, 45 degrees and 90 degrees at orthodontic force,
a standardized 3 mm distance, The Instron Universal
if!
"
.. ...
~-
Conferences, Seminars, Lectures & Workshops 57
5. UK-Malaysia symposium on Oral & 14. Lecture by Prof. Dr. Yip Hak Kong (University of
Nasopharyngeal Cancer, Oral cancer Research & Hong Kong): 'A New Paradigm Shifts in the
Coordinating Centre (OCRCC), Faculty of Management of Worn Dentition', Department of
Dentistry, University of Malaya, 23rd March 2009 .. Conservative Dentistry, Faculty of Dentistry,
University. of Malaya, 18th June 2009.
6. '2nd MSP Seminar §<- Workshop 2009: Sinus Lift
Procedure using Piezosurgery' by Prof. Dr. G. 15. Prof. Takashi Ohyama (President Tokyo ,Medical
Conrad Hornbuckle, Department of Oral & Dental University Grad·uate School):
pathology, Oral Medicine and Periodontology, "Removable Partial Denture Design" and "Sports
Faculty of Dentistry, University of Malaya, 28-29th Dentistry", Department of Prosthetic Dentistry,
March 2009. Faculty of Dentistry, University of Malaya, 19th
June 2009.
7. Seminar on 'tJnderstanding Oral Malignancies',
CARIF-UMOCRCC-Ministry of Health, Balai 16. 2nd Postgraduate Students' Seminar, Balai Ungku
Ungku Aziz, ,faculty of Dentistry, University of Aziz, Faculty of Dentistry, University of Malaya,
Malaya, 4th May 2009. ' 30th June - 1st July 2009.
8. Lecture by Prof Mike Morgan (School of Dental '17. Seminar by Professor Dr David Beam (University
Science, The University of Melbourne): of Dundee, Scotland): "Current Review on
'Prevention at the community level: Mixing the Functional Orthodontics and Self-ligation
old with the new', Department of Community Treatment", Department of Children's Dentistry
Dentistry, Faculty of Dentistry, University of and Orthodontic, Faculty of Dentistry, University
Malaya, 11th May 2009 . . of Malaya, 2 pt July 2009.
58 Annals of Dentistry, University of Malaya, Vol. 16 2009
18. Workshop on 'Statistical techniques in molecular 23. Workshop on 'Human Molecular Cytogenetics:
epidemiology II-continuous to categorical', Assoc. Research, Applications and Recent Develop-
Prof. Dr. Yang Yi Hsin (Kaohsiung Medical ments'; Oral Cancer Research Coordinating
University,Taiwan), Balai Ungku Aziz, Faculty of' Centre (OCRCC), Faculty of Dentistry, UM and
Dentistry: Univ,ersity of Malaya, 30th July - 31 5t Oxford Gene Technology (OGT), Balai Ungku
July 2009. Aziz, Faculty of Dentistry, University of Malaya,
9th November 2009.
19. Workshop on 'Introduction to Implantology',
Universiti Malaya, University of Frankfurt, 24. Seminar on: 'Standardization of Oral Surgeons as
Dentsply Friadent TraiJ;l.ing Centre, Balai UngKu Trail}ers for Primary Health Care Workers for the
Aziz, Faculty of Denti~try, University of Malaya, Diagnosis Of Oral Cancer, Potentially Malignant
17-l9th August 2009. Disorders and Related Lesions', Grand Seasons
Hotel, Kuala Lumpur, 18-20th November 2009.
20. Conference on 'Head & Neck Tumours and
Reconstructive Surgery of the Mouth and Jaws', 25. Seminar by Prof. Dr. Ward t. Massey (Prof. and
Balai Ungku Aziz, Faculty of Dentistry, University Head of the School of Dentistry and Health
of Malaya, 20th _23rd August 2009. Sciences Charles Sturt University), Faculty of
Dentistry, .University of Malaya, 25 & 30th
21. Seminar by Prof. Dr. David B. Ferguson (visiting November 2009.
professor): "What Drives Knowledge: Science or
Machines?", Department of Oral Biology, Faculty 26. 11 th Dental Students; Scientific Conference
of Dentistry, University of Malay,a, yd September University of Malaya 2009. 'Nurturing Scientists,
2009. Enhancing Research, Balai Ungku, Aziz, Faculty
of Dentistry, University of Malaya, 16-l7th
22. Seminar by Dr. Nutthanom Wattanaroonwong December 2009.
(Prince Songkla University ,Thailand): "Effect of
C02 Laser and Fluoride Varnish On Permanent
and Primary Tooth Enamel", Department of Oral
Biology, Faculty of Dentistry, University of
,MalaYfl, 23rd October 2009.
-.
- --....
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INTRODUCTION
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Manuscripts are refereed anonymously. Authors must Begin with a concise introduction by outlining the
keep copies of manuscripts sent. purpose of the research and making reference to
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or gap in existing knowledge related to the study in
CORRESPONDENCE
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Address all correspondence to: The Editor, Annals of . not include data or conclusion from the work reported.
Dentistry Unjversity of Malaya, Faculty of Dentistry,
University of Malaya, 50603 Kuala Lumpur, Malaysia.
MATERIALS AND METHOD
Please include your e-mail address.
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SUMMARY OF REQUIREMENT
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Type the manuscript on white bond paper, 216 by 279 . replicate the study. Give references to established
mm or ISO A4 (212mm by 279mm), with margins of methods, including· statistical methods. Provide
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60 Annals of Dentistry, University of Malaya, Vol. 16 2009
.or madified methads and give reasans far using them 3) Kata Y, Okawa A, Hayashi S, et al. Studies an
and evaluate their limitatians. Identify all drugs and. marginal leakage .of campasite resin restaratians.
chemicals used including generic names, dase anq Part 2: On the leakage praperties .of variaus
route .of administratian .. campasite resin restaratians. Jpn J Canserv Dent
. , 1976; 19: 281-9 .
<
RESULTS
4) Klineberg IJ, Murray GM. Design .of
Present results in a lagical sequence in the text, tables superstructures far asseaintegrate,d fixtures. Swed
and illustratians. 'Da nat repeat in the text all the data Dent J 1985; 28(Suppl): 63-9.
in the tables and illustratians. Emphasise .or summarise'
.only impartant abservatiails. Specify statistical 5) Lincks J, Bayan BD, Cachran DL, Liu Y, Blanchard
methads used ta analyse results and describe them with C, Dean DD, Schwartz Z. MG63 cells discriminate
sufficient detail ta enable a knowledgeable reader with between surface raughness and material
access ta .original data ta analyse results. campasitian. J Dent Res (Abstract na: 1123) 1998;
77 (Special issue A): 246.
DISCUSSION
Emphasise the new and impartant aspects .of the study Books, Monographs and Agency Publications:
and the canclusian that fallaw from them. Da nat
repeat in detail, data .or ather materials, given in Baak - Chaptt:)r in a baak: .
Intraduc'tion .or Results sechan. Include in the 1) Zinner ID. Esthetic cansider.a,!ions in restarative
Discussian sectian the implicatian .of the findings and dentistry. In Seide LJ, e~.-A dynamic approach to
their limitatians, including implicati'ons far future' restorative dentistry. 1st edn. Chicaga, W.B.
research. Relate the abservatians ta ather relevant Saunders Campany 1980; pp. 520-58:
studies.
Baak - persanal authar/s:
2) Gutmann J, Harrisan Jw. Surgical Endodontics, 1st
CONCLUSIONS edn. Bastan, Blackwell Scientific Publicatians
Link the canclusians ta the gaal .of the study but avaid _ 1991.
unqualifi~d state,ments and canclusian~ nat supparted
by yaur data. ' Managraph - Baak Proceeding:
3) DuPant B. Bane marrow transplantatian in severe
ACKNOWLEDGEMENTS
-. cambined immunadeficiency with an unrelated
MLC campatible danar. In: White HJ, Smith R,
Acknawledgements where applicable' shauld be eds. Proceedings of the third Annual Meeting of the
included at the end .of the text. This shauld be kept ta International Society for Experimental Hematology'
a mmlmum. 1974; pp. 44-6.
Managraph - thesis/dissertatian:
REFERENCES
4) Tay WM. Physica-chemical praperties .of
References shauld be carefully checked, as their aluminasilicate based dental cements. University .of
accuracy is the respansibility .of the authar(s) . .In. the Landan, 1988. PhD. thesis.
text, references shauld be numbered sequentially in·
.order .of citatian by bracketed nu~erals, eg .. (1,3-6) .. A,gency publicatian:
The reference list must be attached at the end .of the 5) Parkin DM, Whelan SL, Ferlay J, Raymand L,
paper using the fallawing farm at: Yaung 1. Cancer Incidence in five continents.
Valume VII, Internatianal Agency far Research an
Cancer: Lyan. IARC Scientific Publicatian Na 143.
Journals:
1997.
1) ,Master M, Barber TK. Actian .of amalgam an
dentin. J Am Dent Assac 1980; 47: 415-22.
'Tables:
2) Murray AJ, Nanas JA, Fantenat RE. Campressive Each table shauld be typed an a separate sheet,
strength .of glass ianamer with and withaut silver numbered cansecutively in Arabic numerals (eg. Table
allay. J Dent Res (Abstract na: 215) 1986; 65: 193. 4) and titled with a descriptive but cancise heading.
Explanatary nates if any shauld be placed belaw the
table.
Instructions To Contributors 61