IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
An Experiment Of Using X-Ray Microtomography (XMT) To Study The Depth Of Bonding Agent Penetration Into Dentinal Tubules
Get PDFIntroduction: This is a novel study of the depth of penetration of bonding agents (BA) by using a miniaturised CT-scan, XMT.The Linear Attenuation Coefficient describes the fraction of a beam of x-rays or gamma rays that is absorbed or scattered per unit thickness of the absorber. The higher the LAC, the more opaque the image is. Materials and Methods: The primer and sealer of bonding agent (BA) were added with contrast, iodine and tin methacrylate respectively. Each drop of the mixture were scanned for 1 hour with Mu Cat2 XMT. Linear Attenuation co-efficient (LAC) of the BA must be optimized to appear more than the enamel & dentine. 3 extracted molar teeth were sectioned up to the dentine layer and the dentine were acid etched, dried and applied with the BA. The teeth were scanned by using the same machine for 24 hours and the penetration depth of the BA was studied by using in house (Queen Mary University of London) software. Results: The LAC of dentine was 1.6 cm-1, enamel 2.6 cm-1 and the primer was 3.2 cm-1. Penetration depth of BA was about 30-300um. However, the penetration depth of the BA were not homogenous throughout the dentine. Conclusion(s): We have demonstrated that XMT gives a clear picture of penetration depth of the contrast added primer with iodine that warrants further studies in this field
Determination Of RUNX2 Single Nucleotide Polymorphism rs6930053 In Class I, II And III Malocclusions
Get PDFIntroduction: Runt-related transcription factor 2 (RUNX2) plays important roles in osteoblast differentiation, tooth development and chondrocyte maturation; hence its involvement in craniofacial development is paramount. Mutation in RUNX2 is implicated with cleidocranial dysplasia; a bone development disorder, while single nucleotide polymorphism (SNP) in RUNX2 is associated with Class II/2 malocclusion. This study aimed to determine RUNX2 SNP of DNA marker (rs6930053) in malocclusion patients from local population. Materials and Methods: Genomic DNA were extracted from unstimulated saliva of 31 Class I (control samples), 30 Class II and 30 Class III malocclusion patients. Cephalometric measurements were performed prior to saliva samples collection. The DNA was amplified using the specific primers for marker rs6930053 and the genotyping was done by sequencing. Chi-square test was used to determine differences in allele and genotype frequencies (p<0.05). Results: No significant differences were observed in RUNX2 SNP (rs8004560) in Class I and Class III malocclusion. However, there were significant differences between allele (p=0.000) and genotype (p=0.000) frequency within Class II alone; while significant differences was detected only in allele frequency between control and Class II malocclusion (p=0.019). Conclusion(s): There is genetic association between RUNX2 (rs6930053) in Class II malocclusion in our population. Further studies involving larger number of samples and other DNA markers of RUNX2 gene should be developed in order to understand the exact role and mechanism of RUNX2 in different classes of malocclusions. 
Comparing Two Views Of Video Demonstration For Access Cavity Preparation: A QuasiRandomized Controlled Trial
Get PDFIntroduction: Demonstration of the access cavity preparation procedures to dental students is challenging due to the limited operating field and detailed nature of the procedures. It is especially difficult to visualize how instruments are functioning inside the pulp space. The aim of this study was to develop and compare two different views of video demonstration in teaching access cavity preparation. Materials and Methods: Two videos of access cavity preparation were filmed, showing occlusal view of a whole tooth (WT) and sagittal view of a sectioned tooth (ST). Using quasirandomization, third year dental students (n=57) were divided into two groups to watch either one of the videos. The perception and performance of both groups were compared using Mann-Whitney U test and Fisher exact test. Results: At baseline, group WT (n=29) and group ST (n=28) were not significantly different in terms of operative scores (p=0.330). After watching the videos, the basic understanding of the theories were similar between both groups. However, ST responded more positively towards the helpfulness of the video in visualizing the inner anatomy of the tooth and in implementing the procedures (p<0.05). ST also completed the exercise within a shorter time (p<0.001). Nevertheless, the quality of the prepared access cavities was not significantly different between groups. Conclusion(s): Using sagittal view of sectioned tooth in video demonstration of access cavity preparation can improve students learning and performance speed. We highly recommend showing the sagittal view of sectioned tooth in video demonstration of access cavity preparation. 
Erosive Tooth Wear: Knowledge Of Diagnosis And Treatment Strategies Among Private Dental Practitioners In Kuantan, Pahang
Get PDFIntroduction: Awareness of erosive tooth wear (ETW) by the public is still low and most dental practitioners overlooked the very early stages dismissing minor tooth surface loss of erosive tooth wear. Therefore, this study aimed to assess knowledge of diagnosis and treatment strategies of ETW among private dental practitioners (PDP) in Kuantan. Materials and Methods: A crosssectional study was conducted in Kuantan private clinics involving PDP and general dental practitioners who performed locum by using convenience sampling. A self-administered validated questionnaire was distributed and descriptive analysis was performed. Results: Overall response rate was 75%. Results indicated that majority of participants (79.2%) received formal education about ETW. About half of participants further learned through continuous dental education. All participants agreed that carbonated drink was the cause of ETW and majority of them reported that gastro-esophageal reflux diseases and pickles also contributed to ETW. Regarding ETW documentation, majority of participants (79%) preferred case notes. Nevertheless, 40.9% and 36.4% record at tooth surface level and individual level respectively. In term of specific scoring in assessing ETW, 79% of them did not know about it. Most of participants prefer giving oral hygiene instruction and diet counseling as preventive measures; however usage of fluorides was not prioritized. 77% of participants never referred case to dental specialist and prefer to treat patient by themselves. Conclusion(s): Knowledge of ETW among recruited PDP is adequate however they did not use any specific indices for ETW scoring and treatment strategies were insufficient
Expression Of Gamma Glutamyl Hydrolase And Carbonic Anhydrase 9 In Oral Squamous Cell Carcinoma And Their Association With Extracapsular Spread
Get PDFIntroduction: Extracapsular spread (ECS) is one of the most important prognostic factors in oral squamous cell carcinoma (OSCC). Gamma Glutamyl Hydrolase (GGH) is a lysosomal enzyme which is involved in folate homeostasis. It is overexpressed in several human malignancies but its role in OSCC has never been reported. Carbonic Anhydrase 9 (CA9) is a transmembrane glycoprotein and is related to hypoxia. High expression of CA9 has been associated with poor prognosis in several tumours including OSCC. This study was aimed to investigate the expression of GGH and CA9 in OSCC and their potential use as biomarkers to predict ECS. Materials and Methods: Immunohistochemical staining with GGH and CA9 markers were performed in 35 cases of OSCC (19 with ECS and 16 without ECS) and 5 cases of normal mucosa. A semi-quantative index was used for immunoscoring. Association between the expression of these markers and ECS status were analyzed using chi-square test. Results: Immunohistochemical results indicated that GGH and CA9 were upregulated in OSCC. High GGH and CA9 expression were significantly associated with ECS (p<0.05). Combination of GGH and CA9 showed greater prognostic accuracy as compared to the individual markers. Conclusion(s): Both separately and in combination GGH and CA9 offer potential as prognostic biomarkers in OSCC and was thus reliable in segregating the OSCC cases based on ECS status
Facial Profile Of Bataknese Based On Nose, Lips And Chin Proportions
Get PDFIntroduction: The success of orthodontic treatment is often associated with the improvement of facial appearance. Soft tissues of the nose, lips and chin are important factors in determining the beauty of the face. The aim of this study was to determine the facial profile of the Bataknese based on the proportion of soft tissue facial components such as nose, lips and chin. Materials and Methods: This research was an observational study with a cross-sectional design. The samples of this research consists of 48 Batak tribe students in FKG USU Medan. This research was carried out by using 48 lateral cephalometry obtained from Batak tribe students who fit the inclusion criteria.Determination of soft tissue facial profile was carried out with Skinazi method. Results: The mean proportion results obtained from the soft tissue facial components of the nose was 64.41%, upper lip 13.79%, lower lip 14.80% and chin 6.86%. The results showed soft tissue facial profile obtained descriptively from the Bataknese were highest in nose proportion followed by lower lip, upper lip and the smallest were chin proportion. Large proportion of the nose and small proportion of chin showed that facial profile of the Bataknese were convex. The results of t- test and Mann Whitney analysis of nose, upper lip, lower lip and chin proportion showed there were no difference between male and female (p>0.05). Conclusion(s): The findings of this research showed that the soft tissue facial profile based on nose, lips and chin propotions in male and female from Batak tribe were convex
Parents' Satisfaction On The Quality Of Dental Care Provided By Dental Students At IIUM Paediatric Dental Clinic
Get PDFIntroduction: In dental schools, the clinical students are closely supervised to ensure a good quality of care delivery. However, little is known about the relation between the patients' satisfaction and the quality of care they received, therefore the aim of this study was to assess the relation between parents' satisfaction and the quality of dental care provided by dental students at IIUM students' polyclinic during paediatric clinical session. Materials and Methods: A self-administered questionnaire on service quality, interpersonal communication, and efficacy and treatment outcome dimensions were distributed to parents who attended their children dental treatment from September 2016 until December 2016. Meanwhile, the students' performances were assessed for their clinical and soft skills by the allocated paediatric dentistry lecturer. Data collected were analysed by using X² test. Results: 42 questionnaires and assessment forms were completed and analysed. The result showed 71.1% of the parents were satisfied with the quality of dental care provided despite the students' performance outcomes were moderate (84.2%). There is no significant difference between parents' satisfaction and the quality of dental care provided by the dental students (p>0.05). Mother showed higher percentage of satisfaction (60%) compared to father (36.4%). However, there is no significant relation between parents' satisfaction and the gender of the parents (p=0.076). Conclusion(s): Generally, parents are satisfied with the dental care provided by the dental students at IIUM Paediatric Dental Clinic regardless of the quality. Hence, parents' satisfaction could not be the best tool to assess the quality of care provided by the operators
Comparison of Higher-Order Aberration Values between Different Aberrometry Technologies in Preoperative Laser Refractive Surgery Patients
Get PDFIntroduction: Purpose of this study was to evaluate the inter-device agreement of ocular and corneal higher-order aberration measurements using various aberrometers. Materials and method: Ocular and corneal higher-order aberrations were measured from 57 eyes. For ocular aberration, the measurements were obtained from WASCA Analyzer (Carl Zeiss Meditec, Jena, Germany), i-Profiler Plus (Carl Zeiss Meditec, Jena, Germany) and OPD-Scan III (NIDEK Co. Ltd., Tokyo, Japan). Whereas for corneal aberration, an additional measurement was obtained from Atlas Corneal Topographer 9000 (Carl Zeiss Meditec, Jena, Germany). All the measurements were displayed by the Zernike algorithm. Root mean squares of total, 3rd and 4th order of higher-order aberrations were compared between any three devices using repeated measured analysis of variance. The Bland-Altman analysis and Pearson's correlation were employed to assess agreement and strength of relationship between measurements. Results: For ocular aberrations, there were no significant difference (P > 0.05) in all comparisons except for total higher-order aberration, oblique and horizontal trefoil. Whereas for corneal aberrations, vertical coma, spherical aberration and with-therule/against-the-rule secondary astigmatism between devices were found to be significantly different (P < 0.05). The most agreeable device pairs for ocular and corneal aberrations were demonstrated by i-Profiler Plus - OPD Scan III (95% limit of agreement: -0.340 to 0.730) and Atlas Corneal Topographer 9000 - i-Profiler Plus (limit of agreement: 0.196 to 0.520) respectively. The r-values are stronger than 0.70. Conclusion: There were differences in the value of higher-order aberrations between different aberrometry technologies. Clinical impact due to the differences in wavefront measurement between skiascopy, Placido-based and laser technologies need to be investigated further
Factors Influencing Functional Outcome of Philos Plate Fixation for Proximal Humerus Fractures
Get PDFIntroduction: Displaced and unstable proximal humerus fractures are difficult to treat and they have high morbidity. The main goal is to achieve painless shoulder with full recovery of the shoulder joint motion. Impingement syndrome is one of the commonest postoperative complication. This study aim is to appreciate the functional outcomes of Philos-plate fixation for proximal humerus fractures and to establish association with high plate positioning with impingement syndrome of the shoulder after Philos-plate fixation. Materials and method: This is a retrospective study, reviewing 26 patients who had proximal humeral fractures and underwent open reduction and Philos-plate fixation between December 2010 and January 2015 in Hospital Tengku Ampuan Afzan, Kuantan. Preoperative X-rays or CT scans were inspected, follow-up visits and X-ray images were obtained at every follow-up to evaluate the plate position and bone union. Assessments of impingement syndrome and other complications were done and also functional outcome measured with Constant shoulder scoring system during final follow-up. Results: Almost 70% of patients achieved good (Constant score: 71-85) to excellence (Constant score: 86-100) outcome, with 77.54 mean Constant score. All cases achieved union. None of the cases developed complications like malunion, infection, AVN, and loosening of implant while 2 cases complicated with shoulder impingement post operatively. Among all the factors, age more than 60 years, and high plate position found to be a significant factor in the outcome of the surgery where both factors yielded significantly less mean Constant scores. Neer 3 parts fractures have higher mean of Constant score compare to Neer 4 parts fractures and high plate position is significantly associated with impingement syndrome postoperatively. Conclusion: This study showed that age, fracture type and plate position were key factors affecting shoulder function after Philos locking plate fixation surgery. We recommend that plate should be position at most 10mm from the greater tubercle to prevent impingement syndrome postoperatively and for better functional outcome
Optimization of Droplet Digital Polymerase Chain Reaction (Ddpcr) For Dna Copy Number Variation Analysis of Cnv Esv27061 in Young Adults with Higher Blood Pressure
Get PDFIntroduction: Copy number variation (CNV) caused by changes in DNA sequences of 1000 or more bases is implicated with susceptibility to common diseases. A study on CNV esv27061 among hypertensive Australian adults reported association with high blood pressure (BP). In Malaysia, no study on CNV among hypertensive young adults is available. Thus, this investigation aimed to assess the CNV esv27061 of young Malaysian adults with high blood pressure using optimized ddPCR. Materials and method: Ten samples each from hypertensive and healthy controls were randomly selected from samples collected for an on-going comparative cross-sectional research project among young adults living in Kuantan. The DNAs were purified using Maxwell RSC Buffy Coat DNA Kit and the concentration was measured using SimpliNano spectrophotometer. Subsequently, restriction digestion of DNAs by EcoRV was performed prior to ddPCR. The products were later subjected to droplet generation (QX100 Droplet Generator), PCR amplification and finally CNV was read by QX100 Droplet reader. Unfortunately, the above method did not yield any result. Thus, an alternative method in which purified DNA concentration was determined by QuantiFluor ONE dsDNA System (Quantus fluorometer). The DNAs (60 ng) and Alu1 were added in master mix during ddPCR and CNV esv27061 analysis was performed as stated above. Results: Optimization of method in this study showed that the detection of CNV esv27061 was possible by the use of more sensitive measurement of DNA concentration, Alu1 restriction enzyme instead of EcoRV and digestion in ddPCR reaction method rather than prior digestion. The finalized protocol run on selected hypertensive and healthy controls has shown to be reproducible and easily interpretable discrimination of gene's copy numbers. Conclusion: This optimized protocol for CNV esv27061 analysis proved useful in identifying CNV and will allow a reproducible assay evaluation and the application of this method to a bigger sample size