Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery.The result of this study showed that there is no significant difference between the three irrigating solution used insurgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.

Accumulation of mixed oral microflora appears to be one of the contributing factors to pericoronitis, an inflammation of the oral soft tissues surrounding the crown of a partially erupted, or impacted mandibular third molars.This study was aimed to identify the predominant infectious bacteria related to pericoronitis and their coexistence with other bacterial species at the infection site.Plaque from pericoronal pockets of lower wisdom teeth of 25 patients that have been diagnosed with pericoronitis were sampled and subjected to a standard microbiological procedure for identification of bacterial species including cultivation on enriched agar plates, biochemical profiling and 16s rRNA PCR analysis. A total of 97 microorganisms were isolated and identified from the cultured samples and 94.73% were Gram-positive bacteria; with the highest incidence of Streptococcus gordonii, Streptococcus mitis, and Streptococcus anginosus. This study also revealed that facultative anaerobes were the predominant group causing pericoronitis (89%). The high occurence of multi-strain bacteria ranging from facultative anaerobic to aerobic bacteria display the importance of their infection networks in pericoronitis.Knowledge gained from this study increases our understanding on the role of different pathogens in pericoronitis and provides new insight into the clinical management of patients and in the prevention of its recurrence. Keywords:Pericoronitis, Oral bacteria, Mandibular third molar.

A 57-year-old gentleman with history of angioplasty currently on Ezetimibe/Atorvastatin, Rabeprazole sodium and Clopidogrel attended the Oral and Maxillofacial Surgery Specialist Clinic at Universiti Sains Islam Malaysia. He was referred for removal of iatrogenic displacement of mesiobuccal root of maxillary right first permanent molar (16) into the right maxillary sinus. This case report highlights the necessity of early referral to Oral and Maxillofacial surgeons for proper investigation and surgical planning to retrieve the displaced root from the maxillary sinus.

This clinical case describes using a milled crown on a cracked tooth as the abutment for a removable partial denture. A 63-year-old male patient diagnosed with lipoma undergoing chemotherapy and radiotherapy presented with symptomatic crack tooth syndrome on tooth 36 and partial edentulism. Conservative treatment using a molar band to extracoronally splint the tooth was conducted to determine the prognosis of the crack line. A lower partial cobalt-chromium denture was constructed by incorporating the milled crown of tooth 36 as the abutment. After six months of follow-up, there were no crack tooth symptoms, and regular review was adopted to monitor the tooth. The construction of a milled crown of a cracked tooth presented good and promising clinical outcomes in preserving tooth vitality and preventing crack propagation in partially dentate dentition for the long term.

Salvadora persica or Miswak is known for its antibacterial activities towards various bacteria species, including several oral pathogens. Although Miswak has many therapeutic potentials, the delivery medium is vital to ensure that the desired effects can be delivered to the target site. Ideally, starch is a biopolymer that exhibits muco-adhesive property, suitable as topical delivery material. Hence, this study was done to develop starch-based gel for Miswak antibacterial compound delivery system. In this study, Miswak hexane extract was incorporated into starch-based gels and stored at 4◦C and room temperature. Miswak gel was tested for its antibacterial activity, and its stability was monitored by visual observation. As a result, the mean inhibitory zones of Miswak gels were found to be 22.67 ± 3.79 mm (4◦C) and 20.67 ± 2.08 mm (room temperature) at day-1. The inhibitory zone decreased after 30 days with 13.00 ± 2.52 mm (4◦C), and 12.00 ± 1.00 mm (room temperature). It was observed that the gels were stable where there were no colour changes, no phase separation and degradation, visualised up to day-60. In conclusion, the starch-based gel is a suitable delivery system for Miswak extract, thus as potential management for infective ulceration. Keywords: Miswak,starch,Staphylococcus aureus,topical gel,antibacterial activity

This study aims to evaluate the optimum duration of flushing dental unit waterlines (DUWLs) in Universiti Sains Islam Malaysia (USIM) dental polyclinics for removal of heterotrophic bacteria. Water samples were obtained from triple air syringes at each dental chair from oral surgery clinic, outpatient clinic and polyclinic 17 at Faculty of Dentistry, USIM after 16 and 64 hours of not operating the dental units as baseline samples. This is followed by sampling after continuous flushing at 30 seconds, 1 minute, 2 minutes and 3 minutes of flushing duration. The levels of heterotrophic plate count (HPC) for each flushing duration were determined by quantification of colony forming units (CFUs) after cultivation of samples on plate count agar (PCA), R2A agar and 5% sheep blood agar (SBA). Statistically, there was no significant reduction in CFUs of HPC for all flushing duration compared to baseline (P>0.05) with the most notable HPC reducing level after 1 minute and 3 minutes of flushing DUWLs. However, HPC level at USIM dental clinics is still exceeding the recommendation by Centers for Disease Control and Prevention (CDC) which should be less than 500 CFU/mL. The existing method of controlling DUWLs contamination in USIM dental clinics is only by flushing DUWLs 1 minute every morning prior to dental treatment as recommended by Malaysian Dental Council (MDC) without the use of chemical germicides. Thus, the flushing method alone is not reliable to reduce the number of microorganisms in the DUWLs.

Surgical extraction of the mandibular third molar is the most common surgical procedure in oral surgery clinic. Adequate postoperative instructions and good patient compliance are important to achieve positive clinical results and minimize complications. The objectives of the study were to determine the percentage of patient compliance towards postoperative care (POC) given by dental clinicians at USIM polyclinic and to identify the association between factors influencing patient compliance towards POC following the surgical extraction of mandibular third molar at USIM polyclinic and patient’s demographic characteristics. A set of questionnaires was disseminated to 16 patients which assessed the patients’ perception on swelling, bleeding, pain, diet, oral hygiene care, medication compliance, clinician’s factors, and patient’s level of understanding and their attitude towards POC. The percentages of patient compliance were represented by descriptive statistics, while the identification of possible factors influencing patient compliance were obtained by performing a Fisher Exact test. All factors give a high percentage of compliance which is more than 60% for all demographic characteristics. There is no association between all factors and demographic characteristics (p-value>0.05). Patient’s compliance is good and demographic characteristics do not appear to be key factors that ensure patient compliance towards POC following surgical extraction of the mandibular third molar.

A 45-year-old female with Class III incisor relationship on Class I skeletal pattern came to orthodontic specialist clinic after referral from prosthodontic department. She requested to have lower dentition spaces to be closed before dental implant to be fitted. She had upper and lower dentures previously but not quite happy with the aesthetic. She is fit and healthy with diabetes mellitus type 2. Fixed appliance was done on the lower arch as the upper teeth were nicely aligned. Lower retainer was fitted after fixed appliance was removed (debonded). Several week later, she came with the complain of exposed bone on her lingual oral mucosa. The aetiology of sequestration, oral osteonecrosis and the association to diabetes mellitus is discussed in this case report.

The aim of this systematic review is to determine the effectiveness of arthroscopic lysis and lavage as a diagnostic and therapeutic tool for management of internal derangement of temporomandibular joint. Method: A systematic review will be conducted according to the guidance of Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Search strategy will be tailored according to Population, Intervention, Comparison, Outcome and Study design (PICOS) approach. Ovid Medline, CINAHL Complete, ScienceDirect, Web of Science, Cochrane centre register for clinical trials and Pub-med data bases will be searched from1975 to 2020. Truncation, Boolean and Proximity operators will be applied as appropriate. Cochrane’s tool for risk of bias assessment will be used for randomised trials and for non-randomised studies, Newcastle Ottawa Scale will be used. Narrative synthesis will be conducted for all the included studies and if an adequate data were available, a meta-analysis will be conducted. Significance: The study will systematically assess the therapeutic potential of arthroscopic lysis and lavage and define its position in the ladder of management of internal derangement of temporomandibular joint in comparison to other lines of treatment. It will also investigate the diagnostic limit of temporomandibular joint arthroscopy in assessment of disc status and its ability to detect adhesions and perforations in comparison to magnetic resonance imaging. Keywords: Temporomandibular Joint, Arthroscopy, Magnetic Resonance Imaging.