Introduction: The purpose of the current case is to give a detail description on an incidence of a traumatized upper left central incisor with symptomatic periapical periodontitis which was root treated. Descriptions: The apical portion of the tooth had a large apical lesion with external root resorption that end up with an open apex due to the loss of tooth cementum, dentine and adjacent hard tissue. The tooth was endodontically retreated, and the apical region was treated surgically with apical curettage and retrograde Mineral Trioxide Aggregate filling (MTA). Results: The affected tooth was considered successful both functionally and aesthetically during a 12-month follow-up. Conclusion: Apicoectomy and retrograde filling with MTA is a viable option in case of treating traumatized tooth with large peri-apical lesion and open apex

Objective This study aims to compare the antimicrobial activity of calcium hydroxide (CaOH) and zinc oxide (ZnO) when incorporated with other solutions such as 2% chlorhexidine (CHX), 2.5% sodium hypochlorite (NaOCl), 1% povidone-iodine (PVP-I), and sterilized distilled water (ddH2O) against Enterococcus faecalis. Materials and Methods The materials were prepared by mixing CaOH and ZnO with other solutions (CHX, PVP-I, NaOCl, and ddH2O) separately. The antibacterial activity of CaOH and ZnO mixtures against E. faecalis was done by using disk diffusion assay (DDA). Twofold serial dilutions of the mixtures were used against E. faecalis to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values. Biofilm inhibition of E. faecalis had been measured by using crystal violet assay. Statistical Analysis The quantitative data of this study had been analyzed by using two-way analysis of variance with software SPSS version 27. The result is considered as significant if the value of analysis is p-value less than 0.05. Results From the DDA results, the lowest zone of inhibition toward E. faecalis was CaOH-PVP-I (6.00 0.00 mm), while the highest zone of inhibition toward E. faecalis was CaOH-CHX (22.73 0.02 mm). Besides that, ZnO-PVP-I showed the lowest zone of inhibition (16.50 0.06 mm), while ZnO-CHX showed the highest zone of inhibition (18.30 0.08 mm) against E. faecalis. The MIC and MBC values of CaOH-CHX and ZnOCHX were 0.78 and 6.25 mg/mL, respectively. In biofilm assay, CaOH-CHX and ZnOCHX were reduced biofilm formation of E. Faecalis. Conclusion Both CaOH-CHX and ZnO-CHX showed the highest antimicrobial activities toward E. faecalis. CaOH and ZnO alone showed no antimicrobial activities against E. faecalis.

Introduction: According to the Ministry of Health Statistics, there have been 87,710 confirmed HIV infected cases in Malaysia. The objective of this study is to determine how well MAHSA University medical students knew about HIV/AIDS. Methods:This was a cross-sectional questionnaire-based study conducted at MAHSA University's School of Medicine. The surveys focused on different mechanisms of transmission, high-risk behaviours, and prevention strategies. Results :A total of 360 medical students participate in this study. Medical students in pre-clinical years had substantially higher knowledge ratings than those in clinical years (p=0.045). Comfortableness dealing with HIV/AIDS patients had the highest stigmatizing score (3.78 ± 0.86). Attitudes toward imposed measures had the lowest stigmatization score (mean 2.60 ± 0.62), knowledge score is significantly correlate with stigmatizing attitude (P=0.004). In addition, higher knowledge scores were shown among medical students who reported to have previous encounters with patients living with HIV/AIDS (PLWHA) (p<0.001). Knowledge scores were significantly low among the patients living with HIV (PEWHIV) (4.2 ± 1.67) (P=0.019). Concerning mother to child transmission of HIV/AIDS infection, clinical medical students showed higher degree of knowledge as compare with preclinical years medical students with P value<0.05.Conclusion:The knowledge of medical students in MAHSA University is generally high, awareness of HIV transmission from mother to child through breast milk is still lacking, indicating that this is the most significant feature that has to be stressed and improved in future medical curriculum for better health care services and public education.

Introduction: Dental officers could be the first medical personal to diagnose HIV/AIDS and cross–contamination may happen. More efforts should be taken to improve knowledge and the behaviour of dental students towards HIV/AIDS patients. The objective of this study is to assess and compare knowledge and the attitude of USIM dental students towards HIV patients. Methods: A total of 136 dental students from Year 2 to Year 5 of academic year 2017/2018 participated in this study. Students were consented and briefed about the purpose of the current project prior to answering self-administered questionnaires that have been previously validated. Results: The mean total knowledge and attitude score were 69.65% (good) and 68.54(%) (passive), respectively. Both clinical and pre-clinical students have passive attitude towards HIV patients and showed good level of knowledge with 70.81% and 66.39% respectively. There were significant association between sex and knowledge of HIV/AIDS among USIM dental students (p=0.001). There is also a statistically positive weak correlation between knowledge and attitude towards HIV/AIDS patients. Conclusion: USIM dental undergraduates have good knowledge and passive attitude towards HIV/AIDS patients. Improvement of dental curriculum regarding HIV/AIDS knowledge and attitude towards HIV/AIDS patients is recommended through conducting activities such as seminar, workshop and small-group discussion among dental students.

Success in root canal treatment is dependent on thorough cleaning, shaping and complete obturation of root canal system. It fundamental that such a procedure be performed in root canal systems that do not comply with the normal anatomical features described in standard textbooks. This article describes the conventional root canal treatment on an unusual mandibular second molar with four root-canals.

Teeth spacing is commonly seen in the upper anterior teeth, which affect patient’s confidence due to disagreeable appearance. Teeth spacing may be due to low frenal attachment, which causes median diastema, small teeth with large maxilla, and bi-maxillary procline anterior teeth. Some patients will seek for options to close the space in order to get better aesthetic appearance. We reported this case of a 25-year-old woman who requested to close her median diastema between the teeth 11 and 21 as she felt that her smile was not nice and attractive. She also presented with mild spacing between her upper anterior teeth apart from the diastema. The treatment given to her was direct composite resin build-up, a minimal invasive treatment to close the spacing of between 1 to 2mm. The treatment has provided satisfaction to the patient. Being a conservative treatment, it can be reversible and repairable.

Oral health literacy is the ability of an individual in making an appropriate decision to achieve optimum oral health. This study aimed to assess the oral health literacy and oral health status of undergraduate university students. This is a cross sectional study conducted among students from various faculties in USIM. A written consent was obtained before the administration of OHLIM questionnaire via Google form. Oral examination was conducted after completing the questionnaire. A descriptive data analysis was performed to determine the adequacy of oral health literacy and oral health status among the students. A total of 280 students participated in this study. The mean age was 22 years old (SD=1.17) with the majority of them being female (82.1%) and coming from urban residences (57.1%). The prevalence of dental caries and periodontal disease was 58.9% (95% CI= 53.2 to 64.6) and 13.2% (95% CI= 9.6 to 17.1) respectively. Students with adequate

Nonsurgical retreatment involves removing mechanical barriers such as gutta-percha to achieve proper cleaning and disinfection. The complexity of the anatomy of molar tooth gives challenge in retreatment procedure. Thus, this study evaluates the amount of residual gutta-percha after retreatment with rotary files (Reciproc Blue®) from each maxillary first molar canal using cone-beam computed tomography (CBCT) and the time required to accomplish it. Nine freshly extracted maxillary molars were instrumented and obturated. Preoperative CBCT was taken, and retreatment was done using Reciproc Blue®. CBCT was taken post retreatment, and the residual volume percentage of gutta-percha from each canal was calculated. The total retreatment time was recorded, and the data were statistically analyzed. The result shows no statistically significant difference in the amount of residual filling material in mesiobuccal, distobuccal, and palatal canal for maxillary first molar and total time used for retreatment with Reciproc Blue® system.

Endodontics procedures are difficult and complicated that most of the practitioners would encounter. Therefore, dental students should gain their confidence and competent during their training. This research aimed to study the perception of final year students on confidence level regarding endodontic treatments from all public universities and their opinions on the quality of endodontic education. A Google Form was used to disseminate an online questionnaire to all dental students from public universities across Malaysia. The survey included both scaled answer and open-ended questions. 184 responses out of 235 students, were obtained (response rate = 78%). Perception of competence and confidence were significantly greater amongst the students from research-based universities group (P < 0.05). 93.5% (n=179) of participants agree that they were confident to do endodontic procedure on anterior tooth, whilst on posterior tooth, only 75.5% (n=139) were confident. Only 6.5 percent of participants (n = 12) did not feel confident doing root canal treatment on single-rooted teeth, but 76.1 percent (n = 140) did not feel competent performing root canal treatment on multirooted teeth. Over 90% of the students rated the quality and the amount of time spent on endodontic education were adequate at their respective university as ?5 on a Likert scale (1 = inadequate to 10 = adequate). In addition, when they were asked to give the suggestion on how to improve the quality of endodontic education, 10.9% of the students suggested to increase the number of practical session and to do regular discussion regarding endodontic cases. It is vital to improve undergraduate endodontic education in order to raise students' perceptions of their confidence and competence when doing root canal therapy.

Introduction: Root canal treatment (RCT) and its coronal restoration should be regularly assessed to ensure a successful treatment outcome. The aim of the current study is to evaluate the relationship between the obturation technical quality and coronal restoration in the clinical and radiographic outcome of RCT provided by Malaysian undergraduate students. Materials and Methods: A total of 143 root-treated teeth from 136 patients were evaluated through clinical examinations and periapical radiographs with a mean follow-up period of 2.4 (standard deviation = 1.59) years. The quality of the coronal restoration was classified according to modified United States Public Health Service criteria and the technical quality of the obturation was assessed based on two variables: length and density. Periapical status was evaluated according to periapical index scores. Results: About 64% of the teeth were classified as healthy with a significant reduction of apical periodontitis from 70.3% preoperatively to 36% at reassessment (P < 0.001). About 92.1% of obturation was of acceptable length, whereas 5% underfilled and 2.9% overfilled. Teeth with acceptable obturation length were five times less likely associated with apical periodontitis than the inadequately filled ones. 90% of canals had adequate obturation density with no significant association to apical periodontitis. Teeth restored with intracoronal restorations had 50% more chance of developing apical periodontitis. Inadequately restored teeth and teeth with poor obturation quality were associated with three times more likely apical periodontitis occurrence. The quality of endodontic treatment and the coronal restoration significantly influenced the periapical status (P < 0.001). Conclusion: The radiographic obturation quality and coronal restorations of the RCTs performed by the undergraduate students in a Malaysian public dental school were acceptable in 63.8% of cases with a 64% favorable outcome.

Introduction: A few studies investigated the numerous potential endodontic uses of CBCT, including the examination of root canal morphology and presumed that CBCT was effective for the initial identification of such morphology; moreover CBCT is a reliable method for the detection of the MB2 canal when compared with the gold standard of physical sectioning of the specimen. The aim of this study was to identify the root and canal morphology of the maxillary first molars among Malaysians analysed by cone-beam computed tomography (CBCT) images. Materials and Methods: Maxillary first (n = 421) molars from Malaysian patients (n = 241) of Malay, Chinese and Indians inceptions were examined by two Endodontists using in vivo CBCT methods. The number and configuration of roots, the number of root canals, and the canal configuration according to Vertucci’s classification were determined. Results: Single roots were not found in maxillary first molars. The incidence of fused roots was 1.995% in the first molars between mesiobuccal and distobuccal roots. In (421) 3-rooted maxillary first molars, additional canals were found in 45.6% of the mesiobuccal (MB) roots and 0% of the distobuccal (DB) roots. Bilateral symmetry of the MB roots was found in 82.36% of the first molar. Only one tooth was found to have pulp stone inside the pulp chamber. Conclusions: The root and canal configuration of a Malaysian population showed different features from those of other populations. CBCT scans can enhance the understanding of root canal anatomy, with the potential of improving the outcome of endodontic treatment.

Dental education around the world were being affected by the pandemic COVID-19. Patients could not come to received treatment and students could not performed dental clinical practical due to lockdown implementation. To overcome this, an online orthodontic screening for examination and diagnosis was developed to help dental students to practice and perform assessment on patients. The objective of this study was to assess the possibility of using online orthodontics screening as an alternative way to physical classes and orthodontic clinics. This cross-sectional study was conducted on clinical years dental students. A total of seventy subjects participated in this study. All subjects were required to assess orthodontic patient extra-oral and intra-oral attributes base on the online orthodontic screening. The result shows that all subjects could identify correctly extra-oral features such as assessment of the skeletal pattern and soft tissue. While mixed result was noted on intra-oral characteristics such as teeth condition, teeth in occlusion and lower upper arches. As a conclusion, the implementation of orthodontic screening thru online method can be utilized as a feasible alternative in comparison to the traditional clinical setting.

Dental education around the world were being affected by the pandemic COVID-19. Patients could not come to received treatment and students could not performed dental clinical practical due to lockdown implementation. To overcome this, an online orthodontic screening for examination and diagnosis was developed to help dental students to practice and perform assessment on patients. The objective of this study was to assess the possibility of using online orthodontics screening as an alternative way to physical classes and orthodontic clinics. This cross-sectional study was conducted on clinical years dental students. A total of seventy subjects participated in this study. All subjects were required to assess orthodontic patient extra-oral and intra-oral attributes base on the online orthodontic screening. The result shows that all subjects could identify correctly extra-oral features such as assessment of the skeletal pattern and soft tissue. While mixed result was noted on intra-oral characteristics such as teeth condition, teeth in occlusion and lower upper arches. As a conclusion, the implementation of orthodontic screening thru online method can be utilized as a feasible alternative in comparison to the traditional clinical setting.

Introduction: Tooth restoration is a common, routine procedure among dentists but still has its own difficulties especially for posterior teeth. As it is a straightforward procedure, some dentists are not aware of the difficulties that may contribute in reducing the longevity of the filling. The aim of the study is to determine the difficulties encountered during and after placement of restorative materials in deep cavities. Materials and methods: Standardized questionnaires were divided randomly among general private dental practitioners in Kuala Lumpur. Chi-square test was used to determine any significant factors associated with difficulties of material placement. Results: This study showed that the most frequent difficulties encountered among practitioners were to obtain good moisture control (39.0%). No significant association was found between obtaining good moisture control and year of clinical experience (p= 0.286) and also place of graduation with the manipulation of the materials (p= 0.542). Conclusion: Dental practitioners claimed that it was difficult to obtain good moisture control in placement of posterior restoration. Thus, it is an obligation of dental practitioners to practice proper isolation and good manipulation of materials on posterior restoration.

Missed dental appointments drastically affect treatment proficiency and productivity of dental care facility. This study aimed to determine the prevalence and reasons for missed dental appointments among patients treated by clinical dental students of Universiti Sains Islam Malaysia (USIM). A total of 202 folders from year 2018 to 2020 treated by year 3 to year 5 dental students were retrieved from a pool of patient’s record files using simple random sampling methods. Information on missed appointments was recorded. Other patients’ information was kept confidential. The percentage of missed dental appointments among patients under clinical dental students’ care was 37.1% (95% CI=30.7, 44.0). The majority of patients who missed dental appointments were male (37.6%), adults (38.7%) and employee (40.2%) patients. The most reported reason for the missed dental appointment was due to personal matters (36%) and the least was forgetfulness (0.6%) and miscommunication (0.6%). In conclusion, missed dental appointment commonly occurs among patients and frequently it was due to personal matters. A proper explanation by the students before scheduling an appointment is crucial to avoid any future missed dental appointments.

The maxillary first molar has the highest failure rate of root canal treatment, with missing canals being one of the most common causes of failure. This case illustrates the wide range of root canal anatomy in the maxillary first molar. Therefore, during endodontic care, anatomical variation should be taken into account by radiographic and clinical evaluations.

Objective: The primary objective of this study is to identify common ethical dilemmas encountered by Universiti Sains Islam Malaysia’s (USIM) clinical dental student. The other objective is to correlate between gender/experience with theory of ethics that is commonly applied. Methods: The participants for this study were all USIM’s 4th and 5th year clinical dental students and dentists with more than 5 years’ experience. The total number of participants involve are 53 students and 19 experienced dentists. This survey consists of two parts of questionnaire. The students will answer both parts while the dentists will answer only the second part. The first part is regarding the common ethical dilemma that commonly encountered in the clinic. The students were asked to tick 3 most common items that they had faced during their practice in USIM’s polyclinic. For the second part the dentists and the students were asked several questions on decision-making strategies based on ethical theories, which are Teleology, Deontology and Virtue. Result: The result suggested that the most common Ethical Dilemma encountered by USIM’s clinical students is difficult patient (83%). The second most common is Conflict between clinician (43%) and followed closely by Treatment option (41%). For the decision making strategies it shows that there were no much differences between USIM clinical dental students and the experienced dentists. Conclusion: The result of the survey showed that the ethical dilemmas commonly encountered by USIM’s clinical dental students were the items that related with communication process such as difficult patient and the treatment option.