Effect of Dietary Challenges on the Flexural Properties of Resin-based Composites

This study aims to compare flexural strength and flexural modulus of different resin-based composites (RBCs) and to determine the impact of dietary solvents on flexural properties. Forty specimens (12x2x2mm) for each of two conventional (Aura Easy [AE]; Harmonize [HN]) and one bulk fill (Sonic Fill 2 [SF2]) were fabricated using customised plastic moulds. Specimens were light-cured, measured and randomly divided into four groups. The groups (n=10) were conditioned for 7 days at 37°C: in one of media: air (control), artificial saliva (SAGF), 0.02N citric acid and 50% ethanol–water solution. After conditioning, the specimens subjected to flexural testing. Two-way ANOVA and one-way ANOVA (post hoc: Tukey’s or Dunnett T3 tests) were used at a=0.05. Significant differences in flexural properties were observed between materials and conditioning media. Flexural strength and modulus values ranged from 124.85MPa to 51.25MPa; and 6.76GPa to 4.03GPa, respectively. The highest flexural properties were obtained with conditioning in air. Exposure to aqueous solutions generally reduced flexural properties. In conclusion, the effect of dietary solvents on flexural properties were material and medium dependent. For functional longevity of restorations, patients’ alcohol intake should be considered during material selection. Dietary advice (reduce alcohol consumption) should be given to patients post operatively.

Superoxide Dismutase Expression in the Ovaries of Periodontitis Animal Models Induced by Porphyromonas gingivalis and Treated with Cassava Leaves Extract

The ovaries represent the female reproductive organs that determine the women's fertility status and their systemic and oral health, correlating to sex steroid hormone alteration. This study aimed to investigate the effect of cassava leaves extract treatment to SOD expression in the animal model-ovaries after Porphyromonas gingivalis injection. 15 female Sprague Dawley rats were used and divided into five groups: (1) control without cassava leaves extract treatment (C); (2) P. gingivalis without cassava leaves extract treatment (T1); (3) P. gingivalis and cassava leaves extract (T2); (4) P. gingivalis and vitamin C (T3); and (5) P. gingivalis and metronidazole (T4). Animal were euthanised at day seven after the initial treatment to collect ovaries. The ovaries sections were immunohistochemically stained to quantify SOD expression using light microscope while the Image J software was used to quantify the SOD expression. The results showed that all of the follicle types had the same intensity of SOD expression. Most of the follicles exhibited low intensity of SOD expression, except for atretic follicles. In conclusion, P. gingivalis and cassava leaves extract influenced SOD expression in the ovaries of animal models, which increased the SOD expression.

The Challenges of Treating Lipoblastoma in the Sublingual Space – A Case Report

The presence of lobulated tumour arising from immature adipose tissue is called lipoblastoma when occurring as localised or discrete lesion, and lipoblastomatosis when spread diffusely. The purpose of this case study is to report a case of an 18 – year old man who presented with lipoblastoma in the left sublingual space which was found to be in close proximity with the left sublingual gland. Magnetic resonance imaging (MRI) was taken and showed the tumour was confined within the sublingual space and no penetration was noted inferiorly through the mylohyoid muscle. Tumour dimension measured clinically was 3 cm x 2 cm x 2 cm and the anterior margin of the tumour crossed the midline and entered into the right sublingual space. Complete excision with sparing of neurovascular bundle was performed under general anaesthesia. Follow-up of 2 months showed complete remission of the lesion without any complications.

The Trends of Endodontic and Prosthodontic Treatment by Postgraduate Students in University of Malaya

This study is aimed to provide an insight into the types of treatment carried out by postgraduate students in the past 10 years. A retrospective study was carried out between November 2019 and February 2020 by deriving data from postgraduate students’ clinical logbooks of three different cohorts of Master of Clinical Dentistry (Restorative Dentistry in Conservative Dentistry) in 2010, 2013 and 2016. This retrospective data was systematically extracted from the records and tabulated categorically using an Excel spreadsheet (Microsoft Office Excel 2019). A descriptive analysis was carried out to further evaluate the results. Overall, the types of treatment carried out in the field of endodontics and fixed prosthodontics has changed in the past 10 years. An increasing trend is seen in the placement of all ceramic crowns and primary root canal treatment procedures, while a decreasing pattern is evident for secondary root canal procedures and placement of dental bridges.

Evaluation of internal adaptation of flowable and bulk-fill resin-based composites

This study aimed to evaluate and compare the internal adaptation of bulk-fill resin-based composite restorative materials with flowable composites as lining materials using self-etch adhesive system. Class I cavities (2mmx4mm) were prepared on flattened occlusal surfaces of fifty extracted human premolars and randomly assigned into five groups (n=10) according to the materials used: Beautifil Bulk-fill Restorative (BR); Beautifil Bulk-fill Flowable (BF); Beautifil Flow Flowable F10 (BF10); and Self-etch adhesive (SEA). Group A: SEA+BR; Group B: SEA+BF10+BR; Group C: SEA+BF+BR; Group D: SEA+BF10+SEA+BR and Group E: SEA+BF+SEA+BR. The samples were thermocycled for 500 cycles, then sectioned mesiodistally, polished and pre-treated prior to scanning electron microscopy (SEM) evaluation. From SEM images, measurement of adhesive and cohesive adaptation failures was recorded at multiple sites of the pulpal floor and in between materials. Data were analysed using one-way ANOVA and post-hoc Tukey tests (p<0.05). Cohesive failure in SEA was observed at the pulpal floor with the lowest percentage in Group A (5.14%), and highest in Group C and E (>16%). However, there were no significant difference among all groups. Adhesive failure was seen at the pulpal floor between SEA+BF/BF10/BR and between SEA+dentine with the highest percentage of gaps formed in Group A between SEA+dentine (6.62%) and SEA+BR (5.30%). Nonetheless, no significant differences were observed among all groups with p=0.89 and p=0.70, respectively. With the use of BF/BF10 at the pulpal floor, adhesive failure was reduced but resulted in increased of cohesive failure. However, both adaptation failures were absent between materials (BF/BF10 and BR) regardless with or without application of SEA.

Conduct responsible research to escape from predatory journals

Academics and researchers, willingly or unwillingly, continue to fall a “victim” to predatory journals. The entire cascade of moving forward in academia depends on one’s ability to publish papers - as many as possible and in the shortest possible time. Such a requirement for a “number” persuades an academician or a researcher to race for an increased number of papers rather than to ensure the quality of the papers they want to publish. Thanks, but no thanks to the predatory journals - for providing a comfortable avenue for those papers to get published. An effective way out could be to train the academics and create awareness among them to conduct research following the codes of responsible research. Policymakers may also need to consider adopting policies that will not force their academic and research staff to race against time and compromise the codes of responsible research.

Lower incisor changes following non-extraction orthodontic decompensation in Class III surgical cases

The amount of incisor decompensation during pre-surgical orthodontics may affect the outcome of Class III orthognathic cases. The purpose of this study was to assess the lower incisor changes post-orthodontic decompensation in Class III surgical cases and to investigate the amount of crowding as a predictive factor. This was a retrospective study reporting on 22 Class III orthognathic cases. The lower incisor angulation (LIA) and distance of the lower incisor edge to the A-Pogonion line (Li-APo) were measured on pre-treatment and pre-surgical lateral cephalograms whereas crowding was measured on digitised pre-treatment study models. Pearson’s correlation (p <0.05) was used to assess the correlation of crowding with LIA and Li-APo changes, and prediction of the lower incisor decompensation was conducted using linear regression analysis. Results showed lower incisors were retroclined at 79.84° ± 7.08° and positioned ahead of APo line by 6.52 mm ± 2.97 mm at the start of treatment. Pre-surgical LIA and Li-APo were found to increase following orthodontic decompensation to 90.43° ± 5.96° and 10.34 mm ± 3.25 mm, respectively. There was a moderate positive correlation (r = 0.592) between crowding and Li-APo changes which was statistically significant, p value = 0.004, and had a strong predictor with 31.8% predictability. However, LIA showed a weak correlation (r = 0.329) with crowding and was not statistically significant (p = 0.135). Li-APo changes during orthodontic decompensation can be predicted with 31.8% predictability using the formula; Li-APo change = 2.064 + 0.503 (crowding).

A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants

Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.

Prevalence of erosive wear lesions in Gastro-Esophageal Reflux Disease patients – A case series

Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.

Rare Morphology of The Third Maxillary Molar and Potential Complications in its Extraction

There is a wide variation in the morphology of third maxillary molar which can be difficult to be identified radiographically. We present a case of a 26 year-old Yemeni female patient presented with difficult extraction of her left maxillary third molar. The extracted tooth showed a rare variation of root morphology, having four roots with three roots curving palatally at the apices. This report emphasized the potential complex morphological variation of maxillary third molar which may lead to the difficulty of a routine straight forward procedure thus needing careful extraction maneuvering to prevent any complications.