Oral lichen planus is a disorder that affects the oral mucosal. Desquamative gingivitis (DG) is usually a manifestation of oral lichen planus (OLP) and may be the only clinical presentation of these disorders. There is erosion of the superficial epithelium layer. Such lesions impede proper oral hygiene indirectly increase the long-term risk for plaque-induced periodontal disease via plaque accumulation. This case report presents a multidisciplinary management of an Indian male, who suffer from OLP related desquamative gingivitis with the diagnosis of generalized chronic periodontitis. The patient was jointly managed by oral medicine specialist, periodontist and prosthodontist. Proper mangement and long term maintenance can significantly reduce the morbidity in patients associated with these conditions.

This study's purpose is to evaluate the clinical performance of Class V restorations in non-carious cervical lesions (NCCL's) using conventional glass ionomer Riva Self Cure (SDI) materials in a teaching institute for one-year follow-up. Participants with Class V restorations were recruited from the e-clinical database and reviewed after one-year. Two independent calibrated examiners were assigned to the clinical assessment with high inter-examiner reliability (? =0.82). Modified Ryge / USPHS criteria was used for direct evaluation of the clinical performance of restorations. The criteria assessed were anatomical form, the presence of secondary caries, retention, marginal adaptation, surface staining, soft tissue health and post-operative sensitivity. Class V restoration restored with glass ionomer showed 80.9% retention rate. Secondary caries, retention, surface staining and soft tissue health showed high scoring of A (clinically excellent restoration) (>90%). The highest acceptable restoration percentage (A- clinically excellent restoration + B-clinically acceptable) was surface staining while the lowest scoring categories was post-operative sensitivity. There was significant difference between gender and post-operative sensitivity (p<0.05). Spearman Correlation test showed that the gender was significantly correlated with post-operative sensitivity (r=0.48) while marginal adaptation was significantly associated with anatomical form (r=0.36) and secondary caries (r=0.39). In summary, after one-year follow, conventional glass ionomers are still clinically acceptable material to restore Class V and come with minimal complications. Clinical Significance: Class V restorations restored with conventional glass ionomer is still relevant as a material of choice to restore NCCL's despite the advancement of resin based materials.

There is a current trend to restore posterior teeth with composite resin due to increasing demands on natural tooth colour restoration and increased concern about the safety of amalgam restorations. The objective was to evaluate the current teaching of posterior direct restoration among restorative dental lecturers in Malaysia compared to available international literature. An online questionnaire, which sought information on the teaching of posterior restoration was developed and distributed to 13 dental schools in Malaysia. The response rate for the questionnaire was 53.8%. The most popular posterior restoration teaching methods among the respondents were lecture (95.7%), demonstration (87.0%) and problem-based learning (PBL) (73.9%), while continuous assessment and a practical competency test (82.6%) were the most popular assessment methods. Placing a hard setting calcium hydroxide and GIC base for deep cavity restored by composite restoration was taught in 79.2% of cases. The standard protocols for posterior composite restoration were incremental filling in deep cavity (87.5%), using circumferential metal bands with wooden wedge (91.7%), with a total etch system (95.8%), using a light emitting diode (LED) light curing unit (91.7%), finishing using water cooling (80%) and finishing with a disc (87.5%). Graduates from dental schools in Malaysia received similar theoretical, preclinical and clinical teaching on posterior restoration techniques, although there were variations in the delivery methods, techniques and assessments, pointing to a need for uniformity and consensus.

Objective: Our aim is to propose a method for determining a more convenient artificial ageing (AA) protocol, which may be used to compare the optical / mechanical properties of universal to conventional composite. Methods: Artificial ageing (AA) protocol was adapted from (Alp et al., 2018) for thermocycling and (Jasin et al., 2018) for static immersion, which arbitrarily simulating 6 and 7 months of oral environment, respectively. In phase 1, Filtek Z350XT® will be used to be immersed in coffee solution (test group) with distilled (control group) water. Colour changes will be measured and calculated using the CIEDE2000 formula and data will be statistically analysed to determine a meeting time point of colour change occurrence. Measurement will be repeated thrice to validate the new static emersion method. In phase 2, this new static immersion AA protocol will be used to compare Omnichroma's® colour stability with translucency to the Filtek Z350XT®. In phase 3, SEM EDS will be used to measure quantitative and qualitatively the occurrence of subsurface properties changes in Omnichroma® and Filtek Z350XT®. Finally, the discs’ microhardness will be evaluated. Significance: Presently, it is very difficult to precisely simulate the oral environment. In comparison to thermocycling, static immersion is a more convenient AA method. Establishing an evidence-based protocol may well potentially serve as a guide for researchers to assuredly select the more simplified AA protocol for future dental material development and clinical usage scenarios.

Root canal treatment (RCT) is a procedure to eliminate pulpal diseases with the aim to promote healing of the periradicular tissue. The RCT conducted must be of high technical standard and achieve a good quality endodontic work (GQEW) to ensure successful outcome and prolonged retention of the teeth in oral cavity. Previous studies reported poor outcome of RCT conducted by the undergraduate dental students. There is limited report documented on the quality of RCT performed by the dental students in Malaysia. The aim of this study was to identify the technical standards of the RCT and types of post-endodontic restoration placed by USIM undergraduate dental students. The radiographic obturation quality from 274 root filled teeth were evaluated against several indices. The data was analyzed using SPSS version 21. Post treatment radiographs indicated that 84.62% of the RCT have adequate density indicating good apical seal. Meanwhile, for obturation level, the root canal filling that ends 0-2mm (optimal), >2mm away (inadequate), and beyond apex (extrusion) were 84.59%, 5%, and 10.77%, respectively. Teeth with GQEW, having both adequate root filling length and complete obturation were found in 194 (74.6%) teeth. McNemar's test revealed significant reduction in post-treatment periapical index (p<0.001) indicating good periapical healing. Permanent restoration was only placed in 48% of the teeth. In conclusion, the RCT conducted by USIM undergraduate dental students have a good technical standard. Placements of post-endodontic permanent restoration need to be emphasized in the curriculam to ensure long-term success of the endodontically treated teeth.

Introduction: There is an uprising calls on restoring posterior teeth with composite resin due to increasing demands on natural tooth colour restoration and increased concerns about the safety of amalgam restorations. Previous studies had indicated that the teaching of the posterior composites in dental schools were still developing although at the slower pace compared to the recent development of the contemporary dental materials and techniques. Purpose: To evaluate the current teaching of posterior composite restorations among restorative dental lecturers in Malaysia. Methodology: An online questionnaire which sought information on teaching of the composite resin restoration on posterior teeth was developed and had been distributed to 13 dental schools in Malaysia. Findings: The most popular posterior restoration teaching methods among the respondents were lecture (95.7%), demonstration (87.0 %) and PBL (73.9%) while continuous assessment and practical competency test (82.6%) were the most popular assessment methods. For preclinical training, composite resin (95.7%), amalgam (87%), glass ionomer cement (GIC) (34.8%) and resin modified GIC (13%) were the posterior materials taught in the preclinical year. The standard protocol for posterior composite restoration were incremental filling (87.5%) in deep cavity and using circumferential metal bands with wooden wedge (91.7%), with total etch system (95.8%) Significance: Graduates from Malaysia dental school received preclinical, thereotical and clinical teaching on posterior composites although there were variations on the delivery methods, techniques and assessments.

Objectives The aim of this study was to investigate the current knowledge and attitude of deep caries removal method among dental students in Malaysia. Materials and Methods A total of 303 students (n = 303) responded to the online questionnaire. The first part of questionnaire was to evaluate the demographic data of the respondents and focused on the technique and management approach used for deep caries lesion. The second part investigated the preferred treatment used for deep caries based on the designated clinical case, while the third part assessed the factors that affected the decision on deep caries management. Statistical Analysis Independent t -test was used to compare difference between the two groups. Results Seventy four percent of the students have the knowledge of the different methods of caries removal, while 25.8% were only familiar with complete caries removal. The preferred method for deep caries removal in permanent teeth was partial caries removal (53%). For primary dentition, 45.6% of the students prefer to perform pulpotomy as compared with other techniques. There was no significant difference in caries removal method for permanent teeth between undergraduate year of study (p > 0.05), which was partial caries removal at 52.7 and 53.5%, respectively. For primary dentition, the preferred caries removal method was pulpotomy for year 4 (39.8%) and year 5 (52%) students. The popular material to restore deep caries was resin composite (42%) followed by glass ionomer cement (23.3%). Conclusions This study showed that partial caries removal was the preferred method despite partial understanding on the identification of the clinical indicators of the technique. © 2020. European Journal of Dentistry.

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.

This study was conducted to assess the changes of salivary pH level, salivary buffering capacity and salivary flow rate after consumption of tualang honey (TH). Fourty-four USIM dental students who fulfilled the inclusion criteria participated in this experimental blinded crossover study. Criteria for subject selection were: subjects with no active caries, no history of antibiotic usage for the past 6 months, no history of antimicrobial mouthwash usage for the past 6 months, no orthodontic appliance worn, and healthy. In phase 1, Group A did not consumed honey whereas Group B consumed honey. After 1 month washout period, subjects in Group A consumed honey and Group B stopped consuming honey. The mean salivary flow rate at baseline before honey consumption was 1.5 ± 0.52mL/min. There was a significant decreased in salivary flow rate at Day 7 and baseline. At Day 14, the salivary flow rate increased significantly when compared to Day 7. After consumption of tualang honey, there was a significant increased in salivary flow rate at Day 14 when compared to Day 3 and Day 7. There was no significant changes in salivary pH level at control phase and after consumption of tualang honey. After 2 weeks of honey consumption, the percentage of subjects who had normal salivary buffering capacity slightly reduced (38.6%).It can be concluded that 2 weeks consumption of tualang honey did not give any obvious negative effects on the salivary flow rate, saliva pH level and its buffering capacity. However, further studies will berequired to support these preliminary result. Keywords:Buffering capacity, pH level, Salivary flow rate, Tualang honey.

This study was conducted to compare the changes of salivary microorganisms after consumption of tualang honey (TH). A total of 44 USIM dental students (male = 9, female = 35) who fulfilled the inclusion criteria participated in this experimental blinded crossover study. Criteria for subject selection were: subjects with no active caries, no history of antibiotic usage for the past 6 months, no history of antimicrobial mouthwash usage for the past 6 months, no orthodontic appliance worn, and healthy. In phase 1, participants in Group A were not given TH to consume whereas Group B consumed honey. After one month washout period, participants in Group A were given TH to consume and Group B had excluded TH from consumption. The mean differences in the salivary bacterial count (CFU/mL) were analysed using repeated measure ANOVA at p value of 0.05. There was not a significant difference in the salivary bacterial count (CFU/mL) at baseline, Day 3, Day 7 and Day 14 during control phase. However, after consumption of tualang honey, the bacterial count was slightly decreased at Day 7, however, the difference was not statistically significant. The increase in CFU count on Day 3 and Day 14 was also not statistically significant. It can be concluded that two weeks consumption of tualang honey did not give any obvious negative effects on the bacterial count. However, further studies will be required to support these preliminary result.

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.

The trends of material selection for posterior restoration have changed and shifted from silver amalgam to composite restoration due to various reasons. It maybe expected that the dental curriculum in Malaysia would be following the same pattern. Thus, the aim of this study was to identify the types of posterior restorative material selection and factors that contribute to its selection. A total of 177 final year dental students from six Malaysian public dental schools responded to the questionnaire distributed online. Majority of the respondent acquired an equal knowledge and training on amalgam and composite restoration. However, they preferred composite to amalgam for posterior restoration (49.27% vs 35% respectively; p value<0.05). The major factor influencing choices of material are moisture control (92.1%). 77.4% agree that composite is a good substitutes for amalgam restoration but amalgam is still relevant and should not be totally replaced.