RELIABILITY OF THE DENTAL PANORAMIC TOMOGRAPHY (DPT) VERSUS CONE-BEAM COMPUTERISED TOMOGRAPHY (CBCT) IN DETERMINING THE CLOSE RELATIONSHIP OF THE IMPACTED MANDIBULAR THIRD MOLAR ROOT TO THE INFERIOR ALVEOLAR CANAL (IAC) PRIOR TO SURGICAL REMOVAL
1MOHAMED AZAHAR FA, 1AUNG LW, 2NAMBIAR P (1Department of Oro- Maxillofacial Surgical and Medical Sciences Faculty of Dentistry University of Malaya, 2Oral and Maxillofacial Imaging Division Faculty of Dentistry University Malaya)
Introduction: The incidence of damage to inferior alveolar nerve when in close relationship existed between the impacted mandibular third molar root and the inferior alveolar canal increased the demand for proper pre surgical planning to avoid any complications. Objectives: To evaluate the diagnostic accuracy of dental panoramic tomography (DPT) compared to cone-beam computed tomography (CBCT) in predicting inferior alveolar nerve (IAN) exposure during the removal of impacted mandibular third molar tooth (MTMT). Materials and Methods: This is a prospective interventional study of consecutive patients who consulted for removal of mandibular third molar under local anaesthesia. Thirty-two patients have been selected for the study at Department of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry University Malaya. All these patients who showed the close relationship of mandibular third molar tooth to inferior alveolar nerve from the panoramic radiographs were selected for CBCT for further assessment before undergoing the surgery. Thirty-five impacted MTMT were removed from thirty-two patients in this study. Results: With respect to the inter-observer reliability, no significant difference was observed (P=0.2) for the prediction on nerve exposure and injury from the DPT but showed significant difference for the CBCT (P=0.001). The prevalence of contact between MTMT to IAC was found to be 96.8% with a significant finding P= 0.002 (p< 0.05). There was a significant different for the loss of cortex in predicting nerve exposure with P= 0.04 (p<0.05). Clinically three patients had nerve exposure and two patients had neurosensory disturbances. Conclusion: Dental panoramic radiography is still a useful guideline for predicting the close relationship of the mandibular third molar root to the inferior alveolar canal, but with some limitations. However CBCT has the best precision in localising the close contact between the mandibular third molar roots to the mandibular canal. CBCT proves to benefit patients who show loss of cortex, darkening of the root and narrowing of the canal diagnosed from the dental panoramic radiography.
DETERMINATION OF PALATAL MUCOSAL GRAFT DONOR SITE BASED ON HISTOLOGICAL STUDY OF HUMAN CADAVERS
1SN RAMASAMY , 1WC NGEOW, 2M NAIDU
1Department of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur
2Department of Anatomy, Faculty of Medicine, University of Malaya, Kuala Lumpur
Purpose: The palatal masticatory mucosa is the main donor site of soft tissue grafts in the field of periodontal plastic surgery. The purpose of this study was to determine palatal mucosal graft donor site based on a histology study of human cadavers. Exercise was undertaken to determine the spatial relationship of the neurovascular bundle, adipose tissue and salivary glands within the palatal mucosa of cadavers. The thicknesses of the palatal mucosa and each of their layers namely the epithelium, the lamina propria and the submucosa were measured. Methods: Eight hemimaxilla of cadavers were examined (6 male and 2 female). A piece of specimen was taken from each maxilla, processed for histological sectioning and scanned for histomorphometric analysis. The thicknesses of the palatal mucosa and their layers were measured at 10 intervals of 1.5 mm width over 3 locations termed Location I, II and III(obtained at 10 mm, 20 mm and 30 mm anterior to the Greater Palatine Foramen respectively), with the aid of 3D HISTECH PANORAMIC software. A total of 20 life patients were used in this study to identify percentage of soft tissue shrinkage following embalmment. Results: The average palatal mucosal thickness was 3.66 mm. It was the thinnest at location III (2.98 mm) and thickest at Location I (4.49 mm). Histologically, Location III has the thickest epithelium and lamina propria while Location I has the thinnest epithelium but the thickest submucosa. At these locations, the epithelial thickness was discovered to decrease from the tooth side to the median palatal side of the specimens. The lamina propria also showed a similar feature. However, the submucosa showed a gradual increase of thickness till the middle of the specimen, after which it decreased in thickness toward the medial site. Most of the arterial blood vessels, adipose tissue and minor salivary glands were located within the submucosal layer. Nerve bundles were scattered across the lamina propria and the submucosal layer. Conclusions: Considering a large portion of the thickness of the palatal mucosa at the location I consist of submucosa with major arterial blood vessel and salivary glands and presence of thinner palatal mucosa at first molar, the best site to harvest palatal mucosa graft is at location III with approximately 3mm can be harvested safely.
Keywords: Donor site, soft tissue graft, histomorphometric analysis, palatal mucosa, spatial relationship
EFFECTIVENESS OF LASER ACTIVATED IRRIGATION IN REMOVING THE SMEAR LAYER
Dr Noor Hayati Azami, Dr Okba Mahmoud
Faculty of Dentistry, University Malaya, Kuala Lumpur
Aim: To compare the efficacy of laser activated irrigation (LAI) with that of passive ultrasonic irrigation (PUI) and conventional syringe irrigation protocols in removing smear layers from the coronal, middle and apical thirds of the root canal. Methodology: Forty maxillary central incisors were selected. They were prepared using ProTaper ® rotary files up to size F4. All canals were irrigated using a 31G needle with 5.25% sodium hypochlorite (NaOCl). They were randomly divided into four groups. Group A (n=10) was the control group. Groups B, C and D (n=10 each) were further irrigated with EDTA for one minute, and rinsed with NaOCl again. In group B, no activated irrigation was employed. In group C (n=10), PUI was employed using IrriSafeTM (#20) with 5.25%, NaOCl for three times and each for 20 seconds. In group D (n=10), LAI was employed with an Er,Cr:YSGG laser for four times, each for five seconds. Teeth were dried and split in a bucco-lingual direction. Smear layers at coronal, middle and apical segments of the root canals were analysed and scored from SEM and compared both intra-group and inter-groups at each level. Each image was scored by two individual assessors. The data were analysed using Friedman, Kruskal-Wallis and Dunn’s tests. Results: Intra-group comparisons showed there were significant differences between Group B, C and D in the coronal and middle thirds, and the coronal and apical thirds respectively (p<0.05). Inter-group comparisons showed there were significant differences in efficacy of the different irrigation protocols between Groups A to B, C and D in the apical, middle and coronal third segments (all p<0.05). In all segments, there were no significant differences in smear layer removal efficacies between groups B, C and D (all p>0.05). Conclusions: The LAI was not effective in removing the smear layers from the root canals. The coronal thirds showed better smear layer removal in all groups.
BIOCOMPATIBILITY AND STABILITY OF NOVEL (LOCALLY MANUFACTURED) TITANIUM BONE PLATING SYSTEM: AN ANIMAL STUDY IN SHEEP
1RIPEN ZM, 1RAHMAN ZAA, 2ABU KASIM NH, RAMANATHAN A1 (1Department of Oro-Maxillofacial Surgical & Medical Sciences, Faculty of Dentistry, University of Malaya, 2Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya)
Objectives: To compare the biocompatibility and stability of a novel (locally manufactured) titanium alloy bone plating system prototype with a commercially available bone plating system in sheep. Materials and Methods: Five sheep each were used in the control (commercially available titanium bone plating system) group and in test (locally manufactured bone plating system) group. A vertical osteotomy cut was made at the body of mandible via extra-oral incision. The fractured fragments were reduced and fixed with titanium bone plating systems from either group. All sheep were sacrificed eight-week post-operatively and the bone plating systems were removed en-block together with the mandibular bone. Histomorphometric study of the undecalcified, unstained slides was used to analyse bone formation into the osteotomy gap. Results: Loose screws presented in three sheep and were considered failed osteosynthesis. Seven sheep proceeded for analysis. Both groups showed bone formation into the osteotomy gap. Using the statistical analysis of proportion, the z= 31.43 > 1.65 the ratio of bone formation into the osteotomy gap was statistical significantly higher in the locally made titanium plates and screws. Conclusion: The biocompatibility of the locally made titanium bone plates and screws is comparable to the commercially available titanium bone plates and screws. This study shows locally made titanium plates and screws are more stable compared to the commercially available titanium plates and screws.
SHAPING ABILITY OF REPEATEDLY USED ROTARY & REROCATING NI-TI FILES
Nora Sakina Mohd Noor
Faculty of Dentistry, University of Malaya
Objectives: To compare the shaping ability of repeatedly used Ni-Ti files, ProTaper® Universal, Wave•One™ and RECIPROC® in preparing curved root canals (between 20° to 30°) in mesial roots of first mandibular molars. Methods: Seventy five mesial roots of first mandibular molars with 150 canals were numbered and divided into 3 groups (ProTaper® Universal, Wave•One™ and RECIPROC®). The groups were later divided into 5 more groups consisting of 10 canals in each group. Five new sets of each mentioned files were used successively 10 times each to shape the canals and time was recorded during the procedure. Post-operative radiographs were taken after each instrumentation and surfaces were calculated (in thirds) using AutoCAD 2010 software. The files were analysed under stereo microscope. Results: There is a significant difference in the true mean of the coronal, middle and apical thirds surface area of preparation for the three experimented files from T1 to T10. Coronally, there is a significant difference when all three files were compared at T1, T3, T6 and T10. Meanwhile in the middle third, significant differences were only noted at T1 and T3 whereas, apically, significant difference was noted at T3 and T10. Further analyses using Mann Whitney test with Bonforreni correction was done. The test revealed when ProTaper® Universal was compared to Wave•One™ and then compared to RECIPROC® coronally, there was a significant difference in all the time chosen. In the middle third, comparison between ProTaper® Universal and Wave•One™ revealed significant difference only at T1 and T3, which was the same when ProTaper® Universal was compared to RECIPROC®. Apically, comparison between ProTaper® Universal and Wave•One™ revealed significant difference only at T10 while between ProTaper® Universal and RECIPROC® revealed significant difference at T3 and T10. Under the stereomicroscope, all the files remained intact except for Wave•One™ which had deformation in all the experimented files. RECIPROC® recorded 36.6% (at T10) faster in preparation compared to ProTaper® Universal and 28.5% (at T10) faster than Wave•One™. Conclusions: The surface areas of root canal preparation are significantly reduced statistically after the tenth use of ProTaper® Universal, Wave•One™ and RECIPROC®. Wave•One™ is the only file that showed deformation while RECIPROC® yields the least working time compared to the other two files.
PERCEIVED NEED VS TREATMENT NEED IN CLEFT LIP AND PALATE PATIENTS AGED 12 YEARS AND ABOVE
Dr Khairul Bariah bt Chi Adam
Introduction: Residual deformities are considered as stigma, therefore, many anthropometry researches have been conducted, attempting to classify the stigmata and the effects on patients’ psychology and psychosocial well being. With the increasing availability of medical and dental treatments, it would be useful to ascertain how assessment of cleft-related facial deformity could help to plan for further treatment and identify the stigmata of residual deformity. Recent studies showed that parents and patients were “very involved” in making treatment decisions. Perceived need of treatment among the parents is an important role in determining the success of healthcare delivery in cleft lip and palate patients. Therefore, this indicates the needs to compare the actual treatment need with the parents’ perceived need. Purpose of study: Identify the treatment need and perceived need in cleft lip and palate individuals aged 12 years old and above. Materials and method: Questionnaire guided interview was done on 47 parents of cleft lip and palate patients to obtain demographic data, treatment history, effect of cleft on the social behaviour of the child and perceived need of treatment. Clinical examinations were done on cleft lip and palate patients according to GOSLON yardstick to evaluate malocclusion, dmft were recorded to evaluate need for dental treatment, assessment of sublabial and palatal fistula were done to evaluate need for further surgical treatment. Gross speech assessment was done to evaluate the need for further speech therapy. 3D photographs were taken for all cleft patients and deformity was evaluated by consultant oral surgeon to assess on further treatment need. Results: 91.5% of the subjects were found to have malocclusion, 53.5% need dental treatment, 38.3% & 34% presented with palatal fistula and nasoalveolar fistula respectively, 40.4% have problem with speech. Unilateral cleft lip and palate showed highest group in perceived need in further treatment for ABG, teeth, nose and others as compared to other types of cleft. Highest perceived need for treatment was shown in descending order is perceived need for further treatment of teeth, followed by nose and alveolus in all types of cleft.We also found that there were poor to slight agreement between parents’ perceived need of treatment and professional’s assessment on treatment need (Kappa= -0.114 to 0.313). Conclusion: From this study, it can be concluded that there is a difference between perceived need and the treatment need.
A QUALITATIVE STUDY ON THE EXPERIENCE OF MOTOR VEHICLE ACCIDENT RELATED MAXILLOFACIAL TRAUMA PATIENT
A. S. Hoe1, W. L. Chai2 & W. C. Ngeow1
1Department of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya.
2Department of Diagnostic and Integrated Dental Practice, Faculty of Dentistry, University of Malaya
Background: Patients are usually left in a vulnerable state after an accident. Because of this, they long for a good encounter when they are brought to hospital. It is thus important for health care staffs to understand how the patients feel and what they experience during the period right after an accident to the end of definitive treatment in order to improve the quality of care. Aims: This study aim to understand the experience of oral and maxillofacial trauma patient due to motor vehicle accident right from immediate after the accident till the end of the definitive treatment. Data collection and analysis: The study was conducted in University of Malaya Medical Center (UMMC), Malaysia. Phenomenological approach of qualitative study was used to explore these patients’ experience. Twenty subjects involved in motor vehicle accidents without any cognitive impairment aged 18 and above were recruited. Purposive sampling was used to include maximal variation sample in term of age, gender, race, types of injury and types of treatment received. Semi-structured open ended interview approach was used in order to obtain in-depth information. All recorded data was transcribed into textual data and imported into Nvivo 10 software before being analyzed. Results: Seven themes were identified to describe the patients’ response and experience after meeting with a motor vehicle accident; they are unreal experiences, emotional responses, need to inform and need for being informed, need for assistance, their perception towards the maxillofacial injury, their experience on treatment and staff patient interaction. Even though some patients reported negative psychological impact such as emotional distress and anxiety disorders, most patients reported of gaining a different perspective on their life after trauma. Conclusions: This qualitative study has provided an in-depth understanding of patients experience during maxillofacial trauma and treatment, which otherwise cannot be obtained by the use of surveys and test questions.
OUTCOME OF PRIMARY ROOT CANAL TREATMENT BY UNDERGRADUATE STUDENTS
Md Idris A. N. & Ahmad N. A.; Faculty of Dentistry, University of Malaya
Introduction: This study intends to provide an insight into the quality of primary root canal treatment (RCT) provided by the undergraduate students of the Faculty of Dentistry, University of Malaya, by means of assessing the long-term health of the periapical tissue. From a clinician’s point of view, the periapical tissue status at follow-up is important because it reflects the success or failure of the endodontic treatment in achieving its goal. Objectives: The aim of this study was to investigate the outcome of RCT provided by the undergraduate students of the Faculty of Dentistry, University of Malaya. The objectives were: (i) To determine the success rate of primary RCT by undergraduate students, and (ii) to assess various prognostic factors that might influence the outcome of treatment. Methodology: A list of 144 patients (204 teeth) who had received primary RCT was extracted from the 2006 to 2007 undergraduate waiting list. Patient’s particulars, pre-operative status and treatment details were extracted from the treatment records. Patients were invited to a follow-up where clinical and radiographic examinations were carried out to determine the periapical status of the root-treated tooth. Treatment outcomes were categorised as either favourable or unfavourable. Data were tabulated and subjected to univariate, bivariate and multivariate analysis using SPSS version 12.0. Forward stepwise logistic regression analysis was conducted to determine the prognostic factor which best predicted the treatment outcome. Result: With a recall rate of 23%, a total of 33 patients (38 teeth) came for the follow-up. The success rate of RCT was found to be 71.1%. Age, location of tooth and quality of root filling were found to have a significant association with the treatment outcome at a bivariate level (p < 0.25). However, at a multivariate level, only the quality of root filling was revealed to have the strongest effect on the treatment outcome (p < 0.05). Conclusion: The success rate of RCT delivered by the undergraduates of University of Malaya was 71.1%, and the quality of the root filling, i.e. the apical extent and the density of the root filling was an important predictor of the outcome of RCT.
NON SURGICAL PERIODONTAL THERAPY (NSPT) VERSUS ORAL HYGIENE INSTRUCTIONS (OHI) IN CHRONIC PERIODONTITIS PATIENTS
Maaz Asad1, Wan Himratul Aznita Wan Harun2, Rathna Devi Vaithilingam1
1Department of Restorative dentistry, 2 Department of Oral Biology & Biomedical Sciences
Faculty of Dentistry, University of Malaya,
Objective: To compare microbiological changes in A. actinomycetemcomitans, T. forsythia, P. gingivalis and P. intermedia after 3-months of non surgical periodontal therapy (NSPT) versus oral hygiene instructions (OHI) in chronic periodontitis subjects and also to evaluate if clinical parameters have any effect on the prevalence and counts of these microbiota. Material and methods: 56 subjects with moderate to advanced chronic periodontitis were randomly assigned to OHI (28 subjects) and NSPT groups (28 subjects). Periodontal parameters were assessed and subgingival plaque samples obtained from deep pockets (≥ 5 mm) at baseline and 3-months post-therapy. Following DNA extraction, quantification of A. actinomycetemcomitans, T. forsythia, P. gingivalis and P. intermedia was carried out using qPCR. Results: At baseline, high prevalence for all the periodontal pathogens was observed which remained almost similar at 3-months. Significant reductions for microbial counts were observed for A. actinomycetemcomitans and T. forsythia (p ≤ 0.05) in NSPT group. None of the clinical parameters showed any signs of association with microbiological profiles (p>0.05). Conclusion: At 3-months post-therapy, NSPT demonstrated significant reduction for A. actinomycetemcomitans and T. forsythia as compared to OHI.
THE HEALTH-RELATED QUALITY OF LIFE IN MAXILLECTOMY PATIENTS
M.S.F SAPARI, S.M ISMAIL
Department of Oro-Maxillofacial Surgical and Medical Sciences, Faculty OF Dentistry, University of Malaya, Kuala Lumpur
Objectives: This study was conducted to look into patients’ Health-Related Quality of Life (HRQOL) following maxillectomy, using the University of Washington Quality of Life for Head & Neck Cancer version 4 (UW-QOL) and the Obturator Functioning Scale (OFS) questionnaires. The objectives are to determine the patients’ postoperative HRQOL, to identify variables that may have significant relationships with the UW-QOL and OFS scores, and to find a correlation between the patients with obturators’ UW-QOL scores and the OFS scores. Methods: This was a prospective and cross-sectional study of maxillectomy patients from the University of Malaya Medical Centre who were interviewed using the UW-QOL and the OFS questionnaires. Non-parametric Kruskal-Wallis, Mann Whitney U and Spearman’s Correlation of Coefficient tests were used in the analysis. Results: Thirteen patients (9 of them with obturators) were interviewed. Based on the scale of 0 (the worse) to 100 (the best), the mean overall UW-QOL-based QOL score was 61.54 with SE of 4.78 (rated as Good according to scoring guidelines). Based on the scale of 15 (the best) to 75 (the worse), the mean OFS score for 9 patients with obturators was 28.11 (SD 6.509). All 13 patients were more concern on their Appearance, which was the most chosen domain issue in the UW-QOL (sharing the first place with Chewing issue), evidenced by a strong correlation between the UW-QOL and OFS scores with p = 0.001. Patients also had chosen Chewing, Swallowing and Speech among the top-most concerned issues, but they were statistically not significant. Conclusions: Our 13 maxillectomy patients had Good-rated quality of life. They were more concern to have good facial appearance, followed by good oral functions. An integrated multidisciplinary approach is needed to meet the aesthetic and functional expectations of the patients.
PATTERN OF CRANIOMAXILLOFACIAL (CMF) INJURIES AMONG CHILDREN INVOLVED IN ROAD TRAFFIC ACCIDENTS (RTA).
Siti Salmiah bt Mohd Yunus, Ngeow Wei Cheong, Roszalina Ramli
Faculty of Dentistry, National University of Malaysia
Objectives: To determine the pattern of injuries among children who were involved in road traffic accident (RTA) in the Klang Valley region, to investigate the association between the type of injuries with general crash characteristic, and in particular specific for motorcycle and car crashes ,to determine the parents’ basic knowledge and attitude in relation to the use of restraints and protective devices for car passengers and motorcycle riders, respectively. Methods: A unicenter cross sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children (particularly as car passengers and motorcycle pillion riders) involved in road traffic accidents and were treated at the University Malaya Medical Centre (UMMC).Clinical records of 71 patients were retrieved from 1st January 2008 until 31 December 2012 and a questionnaire was formed to interview the parents for more insight about the accidents. The outcome of interest was the pattern of injuries and was defined as the type and severity of injury from motorcycles and passenger cars accidents. Results: 52 children involved in motorcycles accidents while the rest were involved in passenger cars crash. CMF injuries and bodily injuries were observed to occur in both type of transports with more severe injury in motorcycle accidents. CMF injuries were significantly associated with children who rode on motorcycles. However, it was not observed among travelled in passenger cars. Nevertheless, gender, age, ethnicity, education level as well as parents’ knowledge and attitude did not seem to contribute to the absence and presence of CMF injuries. Conclusions: Wearing helmet reduced significantly the number of CMF injuries. This finding provide proof of the usefulness of a helmet and shall be used as evidence to educated parents who think that wearing helmet is a nuisance, and is not necessary for journeys of short distance.
EFFECT OF NON-SURGICAL PERIODONTAL THERAPY ON CLINICAL RESPONSE, MICROBIOLOGICAL PROFILE AND GLYCEMIC CONTROL IN TYPE 1 DIABETIC PATIENTS
M. BUZININ, A. M. ALABSI, A. T. TAN, D. SWAMINATHAN. FACULTY OF DENTISTRY, UM
Objectives: The aim of this study was to compare the effect of non-surgical periodontal therapy (NSPT) between patients with type 1 diabetes (T1D) and non-diabetic patients and to investigate the effect of NSPT on glycemic control on patients with T1D and its effect on the quantity of bacteria in both groups. Methods: Forty-one patients consisting of 20 T1D (test group) and 21 non-diabetics (control group) with chronic periodontitis were enrolled in to this study. Periodontal clinical parameters, namely VPI, GBI, PPD and PAL, were evaluated at baseline, 2 months and 3 months. Plaque samples were collected from all patients in both groups to assess quantity of Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans. Blood samples were collected from test group only to assess the levels of HbA1c. Plaque and blood samples were evaluated before and 3 months after NSPT. Results: A statistically significant effect was demonstrated for VPI, GBI, PAL and PPD for both groups at 3 months follow up except for PPD of > 6 mm in test group. There were no statistical significant differences between test and control group at any point of time (p > 0.05). The level of HbA1c for test group decreased from 9.24 ± 2.34 before treatment to 8.935 ± 2.35 after treatment which was not significant statistically (p > 0.111). Microbiological evaluation indicated that, there were significant reduction in the level of P. gingivalis, and T. forsythia in both groups following NSPT except for the level of A. actinomycetemcomitans. Conclusion: Our results showed that there was no significant difference between subjects with T1D and non-diabetic subjects in response to NSPT and there is no improvement in glycemic control in T1D after NSPT, and non-surgical periodontal therapy does not always succeed in eliminating periodontal pathogens completely.
ASSOCIATION BETWEEN TNF-Α G308A POLYMORPHISM AND RISK TO ORAL SQUAMOUS CELL CARCINOMA
Logesvari Thangavalu1, Ismadi Ishak1, Cheong Sok Ching2
1Department of Oro-Maxillofacial Surgical & Medical Sciences, Faculty of Dentistry, University of Malaya, Malaysia. 2Cancer Research Initiatives Foundation (CARIF), 2nd Floor Outpatient Centre, Subang Jaya Medical Centre, 47500 Subang Jaya, Selangor, Malaysia.
Purpose: To determine the prevalence of TNF-α G308A polymorphism in a selected Malaysian population and to examine the association between TNF-α G308A polymorphism and the risk to oral squamous cell carcinoma (OSCC). The correlation between TNF-α G308A polymorphism and the clinico-pathological characteristics of OSCC patients were also investigated. Materials and methods: Deoxyribonucleic acid (DNA) from 59 subjects diagnosed with OSCC and 50 healthy unmatched control subjects were obtained from Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Socio-demographic and clinico-pathological information of the subjects were also obtained from MOCDTBS. Genotyping of TNF-α 308 gene was carried out using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) techniques. For validation of results obtained from PCR-RFLP, 6 randomly chosen samples representing both groups and 36 samples with questionable genotype were sent for direct sequencing. The association between TNF-α G308A polymorphism and risk of OSCC and clinico-pathological parameters were determined using chi-square and simple logistic regression test. Result: Frequency of the polymorphic GA/AA genotypes and A allele in the case subjects were found to be 20.3% and 10.9% respectively; slightly higher than the control subjects (14.0% and 7.9% respectively). An absent of association was noted between TNF-α G308A polymorphism and the risk to OSCC (p= 0.385, OR=1.568, CI=0.566-4.349). TNF-α G308A polymorphism also did not exhibit a significant correlation with the clinico-pathological characteristics of case subjects namely, tumour size (p=0.464), lymph nodes involvement (p= .526), distant metastasis (p=0.997) and histologic grade (p=0.092). Conclusion: This study demonstrated an absent of association between TNF-α G308A polymorphism and the risk of OSCC in the selected population. Correlation between TNF-α G308A polymorphism and the clinico-pathological parameters also could not be established. A study with a larger sample size is strongly suggested in the future to confirm this finding.
IMPACT OF CHRONIC PERIODONTITIS ON ORAL HEALTH RELATED QUALITY OF LIFE AMONG OBESE PATIENTS
KHAN, R. SAUB, R.D. VAITHILINGAM, S.H. SAFII, and N.A. BAHARUDDIN,
Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
Objective: Evidences showed association of obesity and chronic periodontitis (CIPD). It is expected that obese individuals have high risk of developing CIPD, with compromised oral health related quality of life (OHRQoL). The study aims to assess impact of CIPD on OHRQoL among obese population. Method: A cross sectional study was carried among obese population. Ethical approval was obtained (MEC96223). Convenience sampling method was used. Obesity was defined: BMI ≥ 27.5 kg/m2 (WHO 2004). Full mouth periodontal examination and OHIP-14 questionnaire were used. CIPD was defined using case definition based on probing depth and clinical attachment loss defined by Eke et al 2012. OHIP-14 was analyzed computing two parameters; (1) prevalence of impact i.e. percentage of participants reporting ≥ 1 impacts “very often/often” and (2) severity of impact i.e. sum of responses for 14 items; ranging 14-70. Lower values indicate higher impact. Univariate analysis and Ancova were used to analyse OHRQoL in relation to CIPD. SPSS version 20 was used. Results: There were 165 obese participants, mean age 43.9(±8.90). Prevalence of CIPD was 73.9%. Overall prevalence of OHRQoL was 64.8%, mean severity of impact 55.3(±9.03). Univariate analysis suggested CIPD was significantly linked to OHRQoL, in terms of physical pain (p<0.05) and psychological disability (p<0.05). CIPD had an impact on ≥1 domain of OHRQoL after controlling for age, gender, smoking and alcohol intake. Conclusion: Periodontal disease has a negative impact on the OHRQoL of the obese population. The most affected domains were physical pain and psychological disability.