IIUM Journal of Orofacial and Health Sciences (IJOHS)
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Tuberculous encephalopathy mimicking limbic encephalitis and large intraparenchymal mass: A case report
Full text linkWe report a 17-year-old gentleman presented with acute encephalopathy and neuropsychiatric disturbances. Contrast-enhanced CT and MRI brain revealed bilateral enhancing grey matter lesions involving both basal ganglia with perilesional oedema. The peculiarity of the lesions raising confusions whereby limbic encephalitis and intracranial masses were initially given consideration hence causing a delay in treatment. Tuberculous encephalopathy has different imaging appearances depending on the stage of maturity which will be further discussed here. Definitive treatment for this patient comprises of daily 10-months dose of anti-tuberculous drugs with prompt neurosurgical intervention if required. However, these should be delivered at a timely fashion to improve the outcome for both survival and neurological sequelae
Comparison of the perceived image quality of intraoral orthodontic photographs taken with DSLR camera and mobile phone camera: A double-blinded prospective study
Full text linkClinical orthodontic photography is a vital skill that every orthodontist should master to record the patients’ details and to permit the orthodontist to carefully plan, monitor and execute the treatment. With the advancement of technology, some clinicians opt to take intraoral photographs with their mobile phone rather than DSLR camera. Hence, this study aimed to answer one main question: whether there was any significant difference in the perceived quality image between intraoral photos taken with a mobile phone and a standard DSLR camera. The cameras used were a DSLR (Nikon D300s with AF-S Micro NIKKOR 105mm lens and NIKON R1C1 Twin Flash) and Mobile Phone (Apple I-Phone 11 with Selfie Ring Light). Assessment of 20 sets of intraoral photographs (100 individual images) by five IIUM orthodontists using a perceived quality Likert scale of Zero (0) to Ten (10). The assessors and the lead investigator were blinded to the source of the photographs. Reliability was evaluated using a test-retest method on 4 sets of intraoral photographs (20 individual images), a few weeks after their initial assessment. There was no significant difference (p=0.35) in perceived quality of intraoral photographs taken between DSLR and mobile phone, with the mean value of 7.34 and 7.12 respectively. Reliability was good (ICC=0.549). This prospective study showed that there was no statistical difference between the perceived quality of intraoral orthodontic photographs taken with a DSLR camera and a Mobile Phone camera
Cultivating dental excellence: Advancing dental education in Malaysian higher institutions
Full text linkA randomised controlled trial comparing online versus face-to-face smoking cessation course for Malaysian dental officer
Full text linkOral health professionals play a vital role in tobacco cessation efforts, but there is a notable gap in their training and skills in this area. Online Smoking Cessation Course was developed by UiTM to benefit the oral health professionals however it has not been evaluated yet. Thus, the aim of this study is to evaluate the effectiveness of online smoking cessation module in comparison with the face-to-face method, in term of the level knowledge. This randomized controlled trial involved 185 new dental officers from four states in Peninsular Malaysia, divided into online and face-to-face (F2F) delivery groups. They were assessed using validated questionnaire, both pre- and post-intervention. The results showed that both the control (F2F) and intervention (online) groups demonstrated significant improvements in knowledge post-training. The control group's average score increased from 6.05 to 7.99, while the intervention group saw an increase from 6.22 to 8.20, with both groups showing statistically significant improvements (p< 0.001). This indicates the effectiveness of the smoking cessation course in enhancing knowledge. The study concluded that the online module is suitable for new dental officers, equipping them with knowledge and skills for smoking cessation counselling as it found that online delivery is as effective as F2F training. This suggests that online training could provide a more cost-effective and accessible method for future smoking cessation training, reaching a broader audience
Association of temporomandibular joint space and condylar head position with different skeletal patterns among the Malaysian population
Full text linkDuring growth and development of the head and neck, some degree of interaction and interdependence between skeletal pattern with temporomandibular joint (TMJ) space and condylar head position occurs. Results from previous studies are varied; some reporting significant difference of TMJ space or condylar head position among the skeletal patterns, whilst others have shown that no such association is present. Considering that previous studies have been conducted in populations outside of Malaysia and the importance of determining the correlation between skeletal and TMJ morphology, this retrospective study was done to evaluate the TMJ space and condylar head position in different skeletal patterns among the Malaysian population using computed tomography (CT) images. A total of 90 CT images of the head and neck were included. Skeletal pattern (class I, II, III) was determined from each CT image based on the ANB angles obtained from reconstruction of these images. The TMJ space measurement and condylar head position were determined from sagittal images based on established landmarks from the reconstructed CT images. Statistical analysis was used to compare the TMJ space and condylar head position across the three skeletal classes and assess its significance. The results of this study demonstrated that there was no significant association between TMJ space or condylar head position in the different skeletal patterns among the Malaysian population. It is recommended that a prospective study with large sample size and standardized measurement techniques be implemented in the future to determine the precise association between TMJ morphology and different skeletal patterns
A prosthetic-surgical approach for aesthetic treatment of peri-implant soft tissue defects: A case report
Full text linkPeri-implant soft tissue defects (PSTD) in the esthetic zone affect approximately 54% cases of post-implant insertion, leading to aesthetic concerns and increasing the risk of peri-implantitis. Various surgical techniques are aimed at addressing these issues, but the outcomes can be unpredictable, especially for severely mispositioned implants. This report details a combined prosthetic and surgical approach to treat a severely angulated single central maxillary implant with mid-labial mucosal recession. A 38-year-old female expressed dissatisfaction with the implant at 21 area, which appeared elongated due to peri-implant mucosal recession of almost 4 mm. Treatment involved two phases: 1) prosthetic phase involves replacing the original crown of implant at 21 area with a temporary crown to promote mucosal growth and 2) surgical phase that involves soft tissue surgery three months later using an envelope flap technique at the recipient site and a connective tissue graft harvested from the palate. Upon three months after the surgery, full coverage with thick mucosal tissue was achieved, and a new zirconia crown was placed. The outcome remained stable throughout the nine-month follow-up. This case demonstrates that PSTD in angulated implants in the esthetic zone can be effectively treated through a combination of prosthetic and surgical modalities
Upper tract transitional cell carcinoma: An array of imaging conundrum
Full text linkWe report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathologies especially the benign ones hence imaging plays a pivotal role in ascertaining the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high-risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory
Endodontic management and outcome of non-surgical root canal treatment for radix entomolaris associated mandibular molar teeth: A scoping review of case reports
Full text linkRadix entomolaris (RE) is an anatomical variant of the permanent mandibular molar (MM) with various complex anatomy. However, there is limited literature on the guideline on endodontic management of RE, resulting in unclear understanding on the endodontic treatment outcomes. Hence, this study aimed to map current case reports on endodontic treatment modalities, occurrence of endodontic mishaps, and outcome of MM associated with RE. A systematic search was performed in PubMed, Google Scholar, Scopus, Science Direct, PLOS, and Lilac databases for English articles published between 2000 and 2022 that met the inclusion criteria. The search yielded 1435 results; after screening was completed, only 58 articles were included in the study and critically appraised using JBI critical appraisal tool. Amongst the modifications made in endodontic management of RE were utilising angulated periapical radiograph supplemented with cone-beam computed tomography, extending the access cavity distolingually, and maintaining a small apical size of #25. There were 12% incidence of endodontic mishaps (separated instrument, ledge, missed canal, and extruded sealer) on RE. The success and survival rate of MM associated with RE were 58.7% and 40% respectively, at an average of 8.4 months. The basic management of MM with RE is similar to that of other MM. However, emphasis should be made on RE identification to prevent endodontic mishaps that can influence the endodontic treatment outcome
Distribution of cases encountered in Oral Medicine Undergraduate Clinic: A retrospective analysis
Full text linkOral medicine (OM) is a dental specialty concerning the diagnosis and non-surgical management of oral conditions closely related to medical disorders. This study aims to evaluate the distribution of OM cases at the International Islamic University Malaysia (IIUM) undergraduate dental polyclinic and to determine its relationship with sociodemographic background via disease category. Students’ OM logbooks across four academic years were used for convenient sampling. Disease categories were based on previously published studies. Total cases were classified into 22 diagnosis codes and analysed using SPSS version 23. A total of 1917 cases were recorded at the undergraduate dental polyclinic across four academic batches, from year 2010 until 2018. OM case with highest frequency was oral ulcer (31%), followed by temporomandibular disorder (23%), and pericoronitis (10%). In contrast, the least common cases were lichen planus (0.4%), oral potentially malignant disease (0.3%), and tumour (0.2%). With regards to age group, second decade age group was reported the most across the observation period. OM cases were higher in females across most disease categories and Malays were the highest ethnicity reported. The current study identified the most common OM cases encountered in IIUM undergraduate dental polyclinic. The findings may portray the disease burden in the Kuantan population in general. Knowledge of common cases is crucial to prepare clinicians with safe and competent management required in clinical practice
The awareness and perception of teledentistry among Malaysian dental professionals in universities and private practices
Full text linkThe unexpected outbreak of COVID-19 has caused the temporary collapse and suspension of dental practices around the world. With the emergence of teledentistry, this incident unwittingly pushes for a revolutionary modification in the usual provision of dental care. The purpose of the study was to determine the level of awareness and perception of teledentistry among university and private-sector dental practitioners. This descriptive cross-sectional study used a pre-validated 27-item questionnaire with a 5-point Likert scale to assess the perceptions of university-based and private dental practitioners regarding teledentistry in four domains: the usefulness of teledentistry for patients, its benefits to dental practices, the potential improvements it can bring to dental practices, and concerns about the adverse effects of teledentistry. 150 dental practitioners participated in the research (30% overall response rate). More than 70% of respondents agreed that teledentistry can benefit both dentists and patients by improving communication and treatment monitoring. However, 45–80% of dentists had doubts regarding the technology's dependability, diagnostic accuracy, and patient data privacy. In conclusion, the results of this study suggest that Malaysian dentists are well-informed and prepared to implement teledentistry in their practices. However, additional research is necessary to determine the viability of commercial usage of teledentistry, both in Malaysia and internationally