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Introduction: Choristoma is the proliferation of histologically normal tissue in the ectopic position. Oral choristoma infrequently occurs in soft tissue, with most cases developing on the tongue and displaying osseous histological findings. It is mostly encountered in the fifth decade of life, but the age ranges from 12-to-64 years old, with a female predilection. Observations: An 81-year-old man presented with an asymptomatic, firm, mobile and pedunculated nodule on the right dorsum of the tongue, just anterior to the circumvallate papillae, for more than ten years duration. Microscopically, the lesion was covered by a parakeratinised stratified squamous epithelium and central to the lamina propia, large, calcified material that resembles normal bone and cartilage was observed. The osseous basophilic mass appears rounded with the characteristic rim of reversal lines and contains numerous lacunae with osteocytes. Peripherally, chondroid metaplasia was also seen with evidence of mature hyaline cartilage containing chondrocytes. The whole osseous-chondroid mass was surrounded by adipose tissue. Conclusion: Oral choristoma is a rare entity, and a mixture of cartilage, bone and adipose tissue is considered an exquisite histological finding. Generally, it has benign behaviour, and surgical excision is the treatment of choice. No recurrence has been reported.

Eagle's syndrome (ES) refers to a group of various types and patterns of pain which spans over the head-and-neck region owing to an elongated styloid process or calcified stylohyoid ligament. These symptoms are often confused with those attributed to a wide variety of facial neuralgias. The diagnosis of ES is usually made through clinical exclusion which is then confirmed radiographically. Patients with ES are initially managed with nonsurgical therapy, but surgical resection seems to be the treatment of choice. The styloid process shortening can be achieved through an intraoral or extraoral approach. This clinical case report describes such a case of ES after sustaining neck trauma. [ABSTRACT FROM AUTHOR]

Managing a patient with a huge intraoral mass is always challenging. Manipulation or even a simple biopsy of the mass may lead to hemorrhage and further compromise the airway. An examination under anesthesia is not without risk. The method of securing the airway itself may become an issue if the mass is fully occupying the airway before intubation. Usually a tracheostomy is indicated. We share a gentleman presented with a huge intraoral mass occupying the oropharynx, which initially necessitates tracheostomy. We utilized the ultrasonic scalpel-assisted instrument to biopsy by debulking the tumour, thus avoiding the tracheostomy while waiting for the definitive treatment. [ABSTRACT FROM AUTHOR]

Purpose: To record the density of the alveolar bone formed as a result of osteoconduction by bovine bone graft around functional endosseous implants in the region of augmented maxillary sinus and to study the role of age and gender on the formation of this newly formed alveolar bone, using cone beam computed tomography scans. Methods: Sterile freeze dried bovine bone graft produced by National Tissue Bank, Universiti Sains Malaysia was used for l-stage implant placement with maxillary sinus augmentation in a total of 19 subjects with 19 implant sites. The age of all subjects ranged between 40-60 years with a mean age 51 ± 4.70. The collected data was analyzed to evaluate bone density in Hounsfield Units using Planmeca Promax 3D ®Cone beam CT scanner and Planmeca Romexi™ Imaging Software 2.2 ®. Results: There was bone formation at the site of the augmented sinus. Statistically bone formation at the augmented site was independent of age and gender. In the existing alveolar bone males showed a statistically significant (p < 0.005) higher density than female subjects. Conclusion: Bone formation by bovine bone graft is independent of age and gender. Cone beam CT is a useful medium to study bone quality in a non-invasive manner. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to evaluate the cephalometric linear and angular measurements of lip morphology among Malaysian Chinese population. Study design: A retrospective study involving the collection and analysis of lateral cephalometric radiographs of Malaysian Chinese. Materials and Methods: Standardized cephalometric radiographs of 70 Malaysian Chinese adults were analyzed. Among them are 37 females and 33 males aged from 18 to 25 years who did not undergo any orthodontic treatment. Total 9 linear and 5 angular measurements were carried out on cephalometric radiographs using Winceph 8.0 software. Descriptive statistics and sexual dimorphism were analyzed using IBM SPSS Statistics Version 20.0. The reliability of the method was analyzed using Dahlberg's formula. Results: Statistically significant disparities were found in the lower lip to s-line, upper lip thickness and Z-angle. Other measurements showed some similarities and variations but no significant differences were observed. Conclusion: This study is an attempt to establish the description of cephalometric lip morphology for the Malaysian Chinese adults. Cephalometric lip morphology is precise for the ethnic group, but these values should not be interpreted as treatment aim. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to evaluate the cephalometric linear and angular measurements of lip morphology of Malaysian Malay population. Study Design: A retrospective study of linear and angular cephalometric measurement of lip morphology among Malay population in Malaysia. Materials and Methods: Standardized cephalometric radiographs of 70 Malaysian Malay adults were analyzed. The samples comprised of 46 females and 24 males. Total 9 linear and 5 angular measurements were carried out on cephalometric radiographs using Winceph 8.0 software. Descriptive statistics and sexual dimorphism were analyzed using IBM SPSS Statistics Version 20.0. The reliability of the method was analyzed using Dahlberg's formula. Results: Statistically significant disparities were found in the Malay population between males and female of lower lip to E line, upper lip thickness, lower lip thickness and nasolabial angle. Other measurements showed some similarities and variations but no significant differences were observed. Conclusion: We have established cephalometric lip morphology for the Malay adults and sexual demorphism but these values should not be interpreted as treatment aim. [ABSTRACT FROM AUTHOR]

Background: This is a retrospective study to compare the difference in selected linear measurements of facial skeleton for three adult ethnic groups namely Malay, Chinese and Indian in Malaysia. Materials and Methods: The study group consisted of samples in the database at Department of Oral & Maxillofacial Radiology, Faculty of Dentistry, University of Malaya. The samples were divided into ethnic groups and gender. Each ethnic group consisted of 10 males and 10 females with total samples of 60 equal of number males and females. Twenty-three (23) linear anthropometric measurements were obtained for midface and mandible. Measurements were made at vertical and horizontal plane. Data collected were entered into SPSS software (version 16.0) and analyzed using One -Way ANOVA for ethnic group and Independent-Samples T test for gender comparison. Nonparametric analysis was used for non homogenous data. Results: It shows that nine (9) out of 23 linear measurements of facial skeleton were significantly differences for ethnic groups (p < 0.05). Sixteen (16) linear measurements showed significantly difference for gender. Conclusion: The measurements in Chinese were generally largest as compared with Malay and Indian. This was shown that Chinese have biggest facial skeleton. When comparing gender, male mean values were consistently larger than female ones. [ABSTRACT FROM AUTHOR]

Background: Sialolithiasis is one of the most common diseases of the salivary gland. The submandibular gland and its duct appear to be the most susceptible. However, giant sialolith have rarely been reported in the literature. Clinical notes: This clinical report described management of 58-year-old and 25-years-old, female patient of sialoliths and giant sialoliths in the submandibular duct. A transoral removal of the stone was done under local anesthesia. Results: The giant stone was 24 mm long in later case. Follow-up showed asymptomatic and normal functioning glands. The etiology, pathogenesis and management of such giant sialoliths are discussed. Conclusion: It is interesting to note that both patients remained relatively asymptomatic in spite of such long-standing sialoliths. The glands also recovered normal function quickly following removal of stones, which is interesting as such longstanding stones usually produce irreversible functional damage to the gland. A conservative approach to the gland will spare the patient the morbidity associated with gland removal. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the prevalence and the contributing factors of infected socket in post-surgical removal of mandibular wisdom tooth. Materials and Methods: The dental records of patients who attended Hospital Universiti Sains Malaysia (HUSM) for surgical removal of mandibular third molars were reviewed. Patients' identification data, medical problem, oral hygiene, smoking status and occurrence of post-operative complication were recorded. From the total of the 342 surgical removals, 256 patients were found to have complete dental record, where 149 were female and the remaining 107 were male the average age of 24.4 years. Results: Out of the 256 patients, postoperative infected socket occurred in 27 patients (10.5%). Other complications were ulcer (n = 8, 3.1%), swelling more than 1 week (n = 11, 4.3%), sensory dysfunction of the inferior alveolar nerve (n = 6, 2.3%), and trismus (n = 10, 3.9%). The risk of infected socket was greater among the patients who had poor hygiene (p = 0.001). There was no significant relationship between the medical problems, age, gender, smoker status and infected socket. Conclusion: Postoperative infection is the most common type of complication and oral hygiene is one of the contribution factors for development of infected socket. [ABSTRACT FROM AUTHOR]

Background: The removal of impacted mandibular third molars is a common procedure; however, it can be difficult in some cases. The angulation of impacted third molar demonstrated a statistically significant relation to the surgical intervention. To determine the various angulation of impacted mandibular third molars amongst the patients has been undergone extraction of impacted mandibular third molar in Hospital Universiti Sains Malaysia (HUSM). Materials and methods: Fifty four orthopantomagrams (OPGs) of patients seen in HUSM were examined. Where impacted third molars were present, the angulations of the impacted third molar were recorded for three times. Results were analyzed using the Fisher's Exact and 95% confidence interval. Result: Mesioangular impaction (50.0%) is most common angulation of impacted mandibular third molars amongst the patient has been undergone extraction of impacted mandibular third molar in HUSM. It was followed by vertical impaction (24.0%), distoangular impaction (16.7%) and horizontal impaction (9.3%) of the mandibular third molar. There is no significant association of the angulation impacted third molar with the age and gender. (Fisher's Exact P value = 0.318 and P value = 0.901). Conclusion: Mesioangular impaction is the most common angulation. The angulation is not associated with the age and gender. However, further study with a bigger sample size should be done in the future to look for the correlation of the angulation with the age and gender. [ABSTRACT FROM AUTHOR]

Background: The timing of surgical procedure and post-surgery complication are related to the degree of difficulty of impacted mandibular third molar surgery. This study aims to determine the degree of difficulty of impacted mandibular third molar preoperatively among patients who have undergone surgical removal in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic by using PELL and GREGORY classification. Materials and Methods: A record review study was carried out on 54 orthopantomograms (OPGs) of patients who have undergone surgical removal of impacted mandibular third molar in HUSM Dental Clinic. The depth of impaction of mandibular third molar was assessed based on PELL and GREGORY classification. A simple random sampling was performed by using Random Number Generator of Microsoft Excel. Results: Cass IIA level of impaction was found in most OPGs of patients undergone surgical removal in HUSM Dental Clinic. Conclusion: Finding from this study suggest that through the radiological assessment, the degree of difficulty of impacted mandibular third molar surgery can be assessed and proper management can be planned preoperatively. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to determine the prevalence, size, shape, and location of torus palatinus (TP), torus mandibularis (TM), and to investigate their sex- and age-related differences in a Malaysian population. Methods: Nine hundred and ninety six (996) study model were assessment for the presence of both tori at Orthodontic Clinic, Hospital University Science Malaysia (HUSM). Results: Out of the 996 study model examined, 379 had TP, 3 had TM. The prevalence of TP and TM in the subjects was 38.05% and 0.3%, respectively. TP was significantly more common in females than in males (39.64% versus 33.94%). TP were frequently found in small sizes and majorities were flat type. The prevalence of TM was higher in females than in males (0.2% versus 0.1%). TM occurred most commonly in small size, bilateral forms, and was often located at the premolar area. Females have both tori occurring concurrently more than male (Ratio 1.5-1.2 to 1). Conclusion: The prevalence of both tori in this Malaysian population was comparable to the Mongoloids and other Asian populations. Statistically significant differences in the prevalence and size of tori in regard to sex and age were also found. [ABSTRACT FROM AUTHOR]

Background: A case of unilateral condylar hyperplasia is presented. Clinical presentation: A 33 year old lady referred from Klang. Clinical, radiographie and scintigraphy finding were consistent with an active unilateral hyperplasia. The stereolithography model was used to assist in the pre-surgical planning. Model surgery was done to produce the desired effect. Hence it reduces the duration of surgery. The condylectomy was performed through the modified pre-auricular approach. The presurgical planning and simulated surgery can be performed before the real operation. Result: The post surgery result was satisfactory. Condylar hyperplasia presents as a challenge because of its progressiveness and the resulting dentofacial deformity. Conclusion: The stereolithography model is advantageous for surgery planning to facilitate condylectomy. [ABSTRACT FROM AUTHOR]

Introduction: Radiographic estimation of working length is crucial for good treatment outcome in endodontic and implant. Objectives: The purpose of this experimental study is to assess the possibility of clinical significant distortion caused by a radiographie images processing software, known as Romexis and its performance in radiographie estimation of working length compared to conventional radiograph. Methods: This study was conducted using 5 sound lower incisors. Actual length of the teeth were first measured and recorded. Conventional radiograph and digital radiograph of the teeth were then taken. The radiographie images of the teeth were measured with digital caliper for conventional radiograph; while with Romexis software for digital radiograph of the teeth. Every measurement was then repeated twice and the mean was obtained. The discrepancies between the radiographie estimated length and actual length of teeth were calculated. Data was analyzed using descriptive statistic and Wilcoxon Signed Rank test. Result: The result shows that Romexis tends to underestimate the working length compared to actual length and conventional radiograph. This underestimation of working length is clinically not significant (less than 0.5 mm) despite statistically significant; as the working length is generally measured to the nearest 0.5 mm in dentistry. Conclusion: Distortion of radiographie images processed by Romexis is clinically not significant, despite statistically significant. Therefore, Romexis software can be used as an alternative for radiographie estimation of working length in clinical setting. [ABSTRACT FROM AUTHOR]

Introduction: Pierre Robin Sequence (PRS) is a condition consists of set of anomalies, which are cleft palate, micrognathia and glossoptopsis. Management of patients with PRS addresses two main problems, namely airway obstruction and feeding difficulties. Airway obstruction may lead to obstructive sleep apnea (OSA). Treatment modalities for OSA are based on the causes. There are surgical and non-surgical methods. Non-surgical methods such as diet, medication, oral appliances and continuous positive airway pressure (CPAP) can only be employed in moderate cases. Surgical method such as maxillo-mandibular advancement or expansion can be achieved by orthognathic surgery or distraction osteogenesis. We present a case report of successful management of airway in a 23-year old lady who has a PRS features with severe OSA. In our case, the respiratory obstruction that was caused by retrognathic and hypoplastic mandible has been corrected successfully with distraction osteogenesis and the OSA was found to be improved tremendously. [ABSTRACT FROM AUTHOR]

Background: Nasoethmoidal encephaloceles are herniations of intracranial contents through the foramen cecum between nasal bone and nasal cartilage, and involve the ethmoid complex. Incidence of encephalocele is 1:5000 to 1:10000 live births, more common in females. Case presentation: We presented 2 cases, a baby girl born with congenital nasoethmoidal encephalocele and another with midline enchepalocele. The encephaloceles are classified according to the location and content. The most important is to return the cerebral components in to the cranial cavity along with amputation of dysplastic tissue and closured of bony defect. Conclusion: Consequently helping in planning the prompt surgical approach may prevent a range of complications such as developmental delay, cognitive deficits, and meningitis. The survival rate is good in anterior encephalocele as compared to the posterior encephalocele. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings.