DISSERTATIONS/THESES UNDERTAKEN AT THE FACULTY OF
DENTISTRY, UNIVERSITY OF MALAYA FOR THE YEAR 2009
The Effect of some Denture Cleansers on
the Properties of Three Auto Polymerized
Silicone Den.ture Liners
Omar. Tarik Alirhayim
Department of Prosthetic Dentistry
A study was carried out to assess weight changes and
surface quality in three auto polymerized silicone soft
denture liners; GC(Soft and extra soft, GC, Japan) and
Mollosil plus (Detax, Germany) after immersion in·
different denture cleansers; Polident (GlaxoSmithKline,
Ireland), Steradent (Reckitt & Colman., UK), Protefix
(Queisser Pharma, Germany) and one disinfectant;
Perform (Schulke & Mayr. Asia Ltd.).
The soft lining materials were mounted on the
prepared acrylic resin disc of 14 mm diameter and 2
mm thickness (Meliodent, Heraeus Kulzer, Germany),
n ~ seventy five. Five specimens from each of soft
liners were immersed in each denture cleanser and one
, disinfectant for 8 hours; this represented the normal
overnight cleansing regime. Fresh solutions of-denture
cleanser and disinfectant were prepared each day and
following the immersion period, the specimens were
stored in tap water at 37°C for the remainder of 24-
hour period (24 -8 = 16 hours). This procedure was
repeated 'for 60 days with the interval of 3, 7, 14, 28
and 60 days. The control specimens were stored in tap
water at 37"C. Sorption was expressed as a percent of
weight loss or gain compared with the weight of the
initial sample by using digital electronic balance :.
(Sartorius, Germany).
Repeated measu~s_ analysis of variance (ANOVA)
procedure, Post Hoc Tukey's test, paired sample t test
and Bonferroni correction were conducted to test the
null hypotheses about the effects of both the subjeCts
factors and the within factors. The results of the
analysis indicated that there was a significant effect (P
< 0.04) in terms of weight gain for immersion period
and there is a significant interaction effect for
immersion period by-material and immersion period
by-denture cleanser:
The sorption in the soft liners was significant after
60 days (P < 0.04) of immersion in the denture
cleansers and disinfectant, which is time dependent.
The correct combination of soft liner and denture
cleanser is critical to ensure optimum life span of the
lining.
Attitudes and Experience of General
Dentists in Providing Oral Healthcare for
Children with Special Needs
Dr. Norliza Ismail
Department of Community Dentistry
Qral healthcare is the most prevalent unmet health care
need for children with special needs (CSN). The lack
of health care professionals who are trained,
experienced, and willing to provide treatment are some
of the barriers in the provision of a comprehensive care
for this group of children.
The aim of this study is to determine the attitudes
and experience of general dentists in providing oral
healthcare for C~N. A descriptive cross-sectional study
was carried out among all general dentists in Selangor
and Kuala Lumpur. Self-administered questionnaire
was used for data collection. The final sample
comprised of385 particip~nts, with a response Tate of
82.1 % (n= 165) for public dentists and 34.1 % (n=220),' .
for p'rivate dentists.
The results showed that the majority)'90%)
reporteCl experience and willingness in pr9viding. care
for CSN with a'significantly higher pro'portion among
the public dentists, younger age groups (40 and below)
and those with less than 10 years of practice (p<0.05).
The most frequent care provided was extraction
(77.7%), examination only (76.8%) and restorative
(74.8%). Perceived barriers to providing care were
mainly patient factors; lack of cooperation (92.7%),
difficult communication (90.1 %) and time factor
(81.3%) as well as dentist factors; lack of experience
(77.9%) and lack of knowledge (63.4%) ..
The undergraduate training (79%) 'and knowledge
(40%) were perceived to be inadequate. A bout half
(51 %) reported not confident in the management of
CSN. The majority (93%) perceived the need for after-
graduate training. However, only a few (35.3 %)
received additional training.
Willingness to provide care for CSN were
significantly higher among those with prior experience,
those with after-graduate training, those whO rated their
knowledge as adequate ahd those who claimed to be
confident (p<0.05).
Therefore the dental undergraduate'training as well
as on the job training for general dentists need to
emphasize on soft skills as well as technical
competency in the management and preventive care for
CSN to improve the knowledge-' and 'confidence of
general dentists in the provision of a comprehensive
care for children with special needs.
44 Annals af Dentistry, University af Malaya, Val. 16 2009

Smoking Habits among Dental Personnel in if proper programme is implemented. Creating a

Pahang supportive environment would give a bigger impact to
the current Smoking Cessation Programme.
Dr. Maryana Musa
Departli1fnt of Community Dentistry
Estimating Orthodontic Treatment Need: A
Smoking is a worldwide problem. Being dental Comparison between Dental Aesthetic
personnel do not exclude them from engaging into this Index and Index of Orthodontic Treatment
habit. The aim of this study was to investigate the
Need
smoking habits among de~tal personnel in the state of
Pahang using a self-administered questionnaire
Hasni Md. Zain
followed by a Nominal Group Technique discussion.
Department' of Community ~entistry
The objectives of this stu'dy were to investigate the
prevalence of smoking habits among dental personnel
Cu;rently, there are two indices which have
and its association with socio-demographic factors, to
incorporated the dental component and the aesthetic
investigate the association between knowledge, attitude
component namely the Index of Orthodontic Treatment
and smoking habits and to evaluate the impact of the
Need (IOTN) and the Dental Aesthetic Index (DAI).
"Smoking Cessation Programme".
The objectives.of this study are to assess the prevalence
A total of 728 out of 780 dental personnel
and severity of malocclusion using the DAI and the
respopded to- the questionnaire giving a response rate
IOTN and to determine the relationship in assessing the
of 93.3%. The prevalence of current smokers was
prevalence" of malocclusion a~d"orthodontic treatment
13.8% (n=100) and was significant,ly associated with
need in the study population.
ethnicity, location (p=O.O 18), gender, occupati'on,
A cross sectional study was carried out using a
education level and income (p<O.OOI). Malays and
multistage and clustered random sampling procedure.
those working in the rural clinics' had the highest
The sample involved 723 participants age9 13-14 years,
proportion of smokers with 14.6% (n=97) and 16.8%
attending 4 government schools in urban and rural area
(n=62) respectively. Males (41.5%, n= 100), those in
in Muar district. A self-administered qu~stionnaire
the lower education level (24.7%, n=92), the lower
survey and a clinical examination for occlusal status
income group (20.2°/~, n=94) and the Support 11
using IOTN and DAI was performed for each
occupatiop group (21.6%, n=94) were more likely to
participant to assess for their orthodontic treatment
s~oke. Mean initiation age was 17.1 years old (CI
need.
16.5~ 17.7) and 97% of them smok>ed cigarettes.' A
The results revealed that the prevalence of
majority of the current smokers were moderate and
malocclusion according to OAI was 44.4%. About
light smokers (98.9%, n=.99) with the average number
17.0% had definite malocclusion, 15.5% had severe
of cigarettes smoked per day was 10 (CI 8.9-11.1).
malocclusion and only 11.8% had handicapping
Passive smokers accounted for 18.8% (n=137) of the
malocclusion. The mean OAI score for all participants
population. A significant association was found
in this study was 26.6 (95%CI: 26.08, 27.13). The
between knowledge, attitude and smoking habits
prevalen~e of malocclusion was 36.2% according to the
(p<O.OOI). More than 'three. quarters of the current
Aesthetic Component of IOTN. About 12.0% had
smokers (88.7%, n=86) had ever attempted to qUIt
moderate malocclusion and about 24.0% had severe
smoking. Almost one third (33.1 %, n=46) ~f the
malocclusion. The prevalence of malocclusion was
current smokers had attende'd the Quit Smoking Clinic
38.7% according to the Dental Health Component of
and 15.2% (n=7) had successfl:llly quit smoking ..
IOTN. About 12.0% had moderate malocclusion and
Following the NGT diSCUSSions,environmental and
about 26.0% had severe malocclusion. There was a
personal factors were the most important reasons to
positive relationship between OAI and IOTN. The
determine success in quitting smoking. Education,
Spearman correlation coefficient were r = 0.71
Administrative and Technical Incompetency factors
between DAI and the AC ofIOTN and r = 0.72 between
were associated with the perceived proo1"ems and
the DAI and DHC of IOTN (p < 0.01). The Kappa
barriers of the existing Smoking Cessation Programme.
value for both Aesthetic Coinp.qnent of IOTN and
-Administrative, Technical Competency, Enforc.ement
Dental Aesthetic Index in agreement of assessing
and Education were the most important factors'
treatment need was 0.61 (p<' 0.05). Similarly, the
suggested to improve the Smoking Cessation
Kappa value for Dental Health Com"ponent of IOTN
Programme.
and Dental Aesthetic Index was also 0.61 (p<0.05).
It is concluded that the prevalence of smokers
The findings of this study indicate that the DAI
among dental personnel was quite low. Since the
record a higher prevalence of malocclusion than either
majority of the smokers were light and moderate
the Aesthetic Component or the Dental Health
smokers and had a low nicotine dependence score, they
Component of IOTN. Hence it is recommended that the
were more likely to be successful in quitting smoking

DAI be used as a screening tool by dental nurses in the
school dental service as it can act as a safety net and
ensure that students in need of orthodontic treatment
are not left out. Dental officers can be trained to use
the IOTN as the next level of referral to re-check the
students using the DHC of the IOTN before referring
them to the' orthqdontists. This would ensure a more
objective system referral and tho.se in great need fo~
treatment are ploi9ritized accordingly and given timely
intervention ..
Dental status and combat readiness
assessment of Malaysian Armed Forces
infantry soldiers
Dr. Amrizan Abdul Wahid
Department of Community Dentistry
The aims of this study were to assess the dental status,
dental combat readiness and related oral health
.behaviours of the infantry soldiers after five years of
active military service. The objectives were to evaluate
the progression of dental caries using the DMFT and
DMFS index, their current oral health practices and
behaviours, and the dental aspect of combat readiness
in five infantry battalions of the Malaysian Armed
Forces. This study was a combination of cross-sectional
and retrospective studies using a self-administered
quest(onnaire followed by an oral examination
involving 173 soldiers who had completed five years
of activ~ service. The soldiers were taken from five
infantry battalions by using the total sampling method.
The response rate was 67.3%.
The pi"evalence of caries (DMFT 2:. 1) ha'd
increased by 3.8% within 5 years (2008 = 79.8%, 2002/
03 = 76.9%). Th~r§ was a decrease in mean DT (4003
= 1.7,.2008 =1.3), an increase in mean MT (2003 =
0.5,2008 =1.1) and mean.:FT (2003 =1.3; 2008 =1.6).
The prevalence of active caries (DT) was slightly
higher at recruitment (59%) than in 2008 (54.9%)
indicating that treatment was done to treat the active
caries. DMFS .had increased by 63.6% since
recruitment with the biggest changes seen in the MS
component where it had increased by 129.2%.
According toCDENTAP~2008 system, only 40.5%
of the total subjects were dentally fit. The prevalence
of dental pain was 34.1 % and toothache was cited as
the main cause (91.5%). The impacts of dental pain
were feeling worried (91.5%), sleep disturbance
(62.7%), work disturbance (59.3%), chewing
disturbance (66%) and social disturbance (37.3%).
However, on the examination day, the majority of
respondents (91.9%) did not experience any dental.
pam.
All subjects (100%) reported brushing their teeth
daily. The majority (62.4%) used fluoride toothpaste.
However, only 1.7% flossed their teeth. About 42% of
the total sample attended a dental clinic in the past one
Dissertations/Theses 45
year prior to the study. Out of these, 53.4% went
because of dental problems. More than one-half
(54.3%) went to military dental clinics on their last
visit. Smoking prevalence was very high (85%), with
mean number of cigarettes/day of 10.0( (SD= 4.8).
Only 7% of subjects consumed alcoholic drinks.
It was concluded that the current dental status of
the infantry soldiers was better than during recruitment
in 2002/03 in terms of decreased mean DT. However,
the mean number offilled teeth (FT) and missing teeth
(MT:)-had also increased. The dental combat readiness
according to DENTAP 2008 classification was low
with more than one-half of the subjects who needed
dental treatment prior to deployment.
It was recommended that MAF make policy
. changes to promote the oral health of the infantry
solCliers such as improving the dental attendance,
providing a dental kit as part of Full Service Marching
Order (FSMO) and organizing oral health promotion
programmes to reduce oral diseases and improve oral
health related quality of life of the infantry soldiers.
Epidemiology of Tt:aumatic Dental Injuries
a~ong Adolescents
Dr. Sofiah Mat Ripen
De,Partment of Community D,ent;istry
The aim of the study wa's to measure the prevalence
of traumatic dental injuries (TDI) to permanent anterior
teeth in adolescents, to determine the causes of TDI,
to identify r~asons for the untreated injured teeth and
the impact of untreated injured teeth on Quality of Life
among 13 and 16-year-old schoolchildren in Klang
district.
A cross-sectional study was carried out in a sample
of4602 schoolchildren. The children were, clinically
examined and children with TDI ~ere given a self-
administered questionnaire.
The prevalence of traumatic dental injury was
5.0%. Males (6.8%) had TDI levels approximately
twice as high as females (3.0%). Indians experienced
a higher TDl levels than other ethnicity. Maxillary
central incisors were the most common teeth with TDI.
Most of the affected children (77.2%) had trauma to 1
tooth. Enamel fracture (42.4%) was the major type of
TDI. The main cause of injury reported was fall
. (62.7%). Most of the TDl occurred at home (52.2%).
A total of 288 teeth were traumatis'ed with 84.4% of
the traumatised teeth not treated. About half of the
participants "do not care" about the appearance of their
untreated traumatised teeth. The impact of untreated
. traumatise teeth on Quality of:Life among adolescents
in Klang was found to be between low to moderate.
In conclusion, the prevalence of TDI among
adolescents in Klang is low and the impact of
traumatised teeth 0!1 the Quality of Life among
adolescents is found to be low to moderate.
 46 Annals of Dentistry, University of Malaya, Vol. 162009
Tooth Brushing Practices and Oral Health
Impacts among Bangladeshi Urban
Adolescents
. ,I Dr. Md. Tafazzul Islam
Department of Community Dentistry
The aim, of this study was to investigate tooth brushing
practices and oral health related quality. of life
(OHRQoL) of adolescents aged 14-15 years old
attending schools in Sylhet city.
A cross sectionfll study design was used. A
convenient sample of 751 respondents aged 14-15 year
old from 6 secondary schools in Sylhet city were
recruited for the study.
S-OHIP (M) was used to determine Oral Health
Related Quality of Life of children. Data collection was
conducted by distributing self administered
questionnaires among the children.
Almost all respondents (95%) brushed their teeth
using toothbrush and toothpaste and they owned a
toothbrush (98%). Majority (7Q%) of the respondents
brushed their teeth twice d,aily and used fluoridated
tooth paste (53%). However, about half (42%) of the
respondents were unaware whether their toothpaste
contained fluoride. Most respondents (95%) learned
how to clean their mouth and teeth from family
members. Comm(.lilly reported oral impacts were
"toothache" (71%), "felt uncomfortable due"to food
, getti.ng'stuck in between teeth or dentures" (66%),
)'discomfort during eating any f9od'; '(48%), "d.ifficulty
in chewing" (42%) and "concentration bee,n disturbed"
(38%). The number of respondents who "very" or
."quite often" experienced oral impacts was very small
for all types of impacts. However, about 11%
frequently (very or quite often) experienced toothache
while 18% were sometimes affected. The associations
between frequency of tooth brushing and the following
5 oral impacts were' found to be statistically significant:
halitosis (p=0.005), sleep disturbed due to problems in
theirmouth (p=O.O18)Jeel uncomfortable due to food
impacted in between their teeth (p=0.025); ulc~rs in the
mouth (p=0.039), and feeCshy due t~ problems in th.eir
mouth (p= 0.047).
Most adolescents in Sylhet City clean their teeth
with tooth brush and toothpaste. However, many do
not know about fluoride toothpaste. Fa!llilies play an
important role in the maintenance of oral hygiene.
Tooth ache and oral discomfort were more common
impacts. Those who brushed at least twice daily were
less likely to have oral impacts compared to those who
brush only once daily.
Oral Health Status and impacts among
First Year Cadets of National Defence
University Malaysia
Dr. Mohd. Rosli Majid
Department of Community Denstistry
..
~
The aim of the study was to-determine the oral healthl ~
status and oral health impacts among UPNM first year.
cadets. The objectives of this study were; (1) to assessl
the perceived oral health status, satisfaction with oral
health and perceived need., for treatment among first.
year cadets in UPNM, (2) to assess their level of caries'
(DMFS), (3) to assess thei~ level of periodontal disease
(CPI) and (4) to assess the oral health impact of oral
diseases in the group by using the Oral Health Impact
Profile (OHIP). This is a cross-sectional survey of the
UPNM first yea~. cadets where data was obtained
through oral examination (DMFS and CPI) and self
administered questionnair~ survey (about demographic,
perceived oral health, satisfaction with oral health,
perceived treatment need and Oral Health Impact).
Three hundred and thirty UPNM first year cadets in
Sg Besi campus were involved in this study.
The prevalence of caries free ,and periodontally
healthy subjects were 40.6% and 5.8% respectively. The
mean DMFS was 3.07 of which 16.3% is accounted for
by decayed surfaces. Females had higher DMFS than
males. Nine out of ten cadets had calculus present and
16.7% required complex periodontal treatment.
Overall, 36.7% of the subjects had often or very often
experienced at least one oral health impact due to teeth,
mouth, and denture problem. The three OHRQoL
domains most commonly affected were functional
limitation, physical pain and psychological di.scomfort.
Social disability had the lowest domain impact among
the cadets. The impacts which were very often or quite
often experienced by the subjects were discomfort due
to food getting stuck (24.8%), had ulcer (9.7%) and
bad breath (5.8%). Cadets who were free from oral
di~eases (caries and periodontal diseases) had lesser
oral health impact. 75.5 % of them perceived they
needed dental treatment and it significantly related with
caries status and OHRQoL.
It is concluded that there is low level of caries, high
level of periodontal diseases and moderate oral health
impacts among the cadets. It is recommended that
hygienist be stationed in UPNM to assist dentist to
manage the high level oi.periodontal problems
encountered.
..

The effect of abutment angulation on
stresses in bone: A 3-dimensional finite
element study
Dr. Muraja Afif Uthman
Department of Oral and Maxillofacial Surgery
Aims: To evaluate the effect of variations in implant
abutment angulation on the intensity and distribution
of von Mises, tensile and compressive stresses in the
bone surrounding an implant using three-dimensional
(3-D) Finite Element Method.
Methods: 3-D FE models were constructed using
FE software (Pro/Engineer, Wildfire 2.0 parametric
technology Corporation). The implant fixture was·
modeled following Ankylos® system (Dentsply'
Friadent, Germany); 3.5 mm in diameter and 11 mm
in length, restored with an all-ceramic crown
representing the mandibular second premolar. The bone
segment was modeled to approximate the bone
dimensions in the region of mandibular second
premolar. Two situations of implant placement were
investigated. Group A represented distal tilting of the
implant in various angulations: 15°, 22.5°, 30° and
37.5° and the abutments angled correspondingly so that
the crown was in similar axial direction. To
accommodate the abutment, the distal crestal bone was'
beveled to level the implant head with the crestal bone.
Group B represented a-nother clinical situation, in.
which the implant was placed along the long axis of
the bone while the bone segment was inclined buccally
at various angulations: 15°,22.5°,30° and 37.5°. As in
previous models, corresponding angulated abutments
were used so that the crown was always loaded in
similar axial position.
The control gro~p of this study was a straight
implant and str2:~ght,abutment placed vertically in the
ce~tre of the hone segment. A 3-D tetrahedral mesh
was generated for alt.models constructed. Occlusal
loads of 150 N were applied aXIally to the buccal cusp
and distal fossa, giving a total load of 300 N for all
models, to simulate occlusal loading during function.
ANSYS versiop 11.0 (ANSYS/Workbench, Ansys Inc,
USA) was used to provide the loading simulation and
stress pro.file analyses. Results: For the co"ntrol group,
stresses (comptessive, tens-ile) were seen concentrated
around the implant collar at the cortical bone. Stresses
were more homogenous in nature surrounding the
implant body and apical area.
There was an increase in all types of stresses
around the implant collar in the cortical bone when
increasing the abutment angulation for both groups.
The highest compressive and tensile stresses for the
Group A models were -96 MPa and 60 MJ;>a"
respectively, which were observed on the cortical bone
around the implant collar. A high level of compressive
stress (-40 MPa) was observed. For the 37S model
where the distal cortical bone was cOffi.pletely removed
Dissertations/Theses 47
to accommodate the abutment, the Group B models
showed -80 MPa and 64.5 MPa for the highest
compressive and tensile stresses respectively.
Conclusions: Within the limitations of the present
study, the following conclusions were drawn: 1)
Stresses appeared to concentrate at the cortical bone
around implant collar for single implant that was
loaded at buccal cusp and distal fossa. The stresses
around the implant body and apical area were relatively
low and homogenous. 2) Stresses increased with
-increased abutment angulation for both groups. When
37.5° model was used, the stresses increased nearly
three folds. 3) Removal of cortical bone at distal aspect
for 22.5°, 30° and 37.5° models of group A, resulted
in high levels of compressive stress at the cancellous
bone which may predispose the bone to micro fracture
ana resorption when they exceed the elastic limit of
bone. 4) Group B, particularly 37.5° model, showed
tensile stress higher than the elastic limit of bone,
which may undergo microfracture and resorption.
Condylar sagittal path angle in selected
Malay females .
Ammar Jasim Ali Musawi
• Department of Prothetic Dentistry
I
-' .
PURPOSE: To investigate the condylar path angle
(CPA) in Malay females, compare the measurements
obtained with the average values (25°-35° Campers)
and compare the right condylar path angle with the left
con-dylar path angle.
MATERIALS AND METHODS: A total of thirty
subjects were chosen according to a selected criteria,
impressions of arches were made using a wash
technique with silicone regular body over silicone putty
type. Casts were poured into type IV diestone and
facebow transfer was taken for each subject. Casts were
mounted to their centric position on Ka Vo Protar evo
9 semi-adjustable articulator. Protrusive guides were
constructed on the anterior teeth of the casts to allow
the mandible to be protruded for 5 mm, then the angles
measured using protrusive record method with silicone
bite registration material.
RESULTS: Within the limitation of this current
study, for the right angle it was found that 13 subjects
(43.33%) were witltin the range of the average value
(25°-35° Campers) and 17 subjects (56.66%) were out
of range of the average value. Furthermore, the
measurements for the left angle 10 subjects (33.33%)
were found to be in the range of the average value and
20 subjects (66.66%) were .out of range. There was no
statistically significant diff~rence 'between the left and
right condylar path angles. There was a strong linear
relationship between left and right condylar path angles
among the Malay females.
 48 Annals af Dentistry, University af Malaya, Val. 16 2009
SUMMARY: The Malay females are not
considered as an ethnic variation in regards to CPA,
they can be treated the same way as the Caucasian~ in
regards to that angle. CPA should be considered in
constructing fiX:~d and/or removable pro~theses
combined with the use of semi-adjustable articulators;
this would enhance and improve the quality of the
treatment given to the patient. Clinicians should not
depend on the average values to which the simple
articulators are set. . value for test of significance was set at p=0.05.
Protrusive record method for programming the
semi-adjustable articulators can be reliable if modified
by using efficient bite registration material and making
it reproducible by making use of the protrusive guide.
Prevalence of Risk Factors for the
Development of Oral Mucosal Lesions
among Or,ang AsH in Malaysia
Intan Suraiya Merican Aljunid Merican
Department of Oral Pathelogy,
Oral Medicine and ~eri~dontology
Risk habits such as smoking, alcohol'consumption and
betel quid chewing have long been identified as
primary risk factors in causing many'severe diseases
and cancers, Glutathiony S-transferase (GST), a Phase
II enzyme, is important in the detoxification and
ex~retion,ofmany carcinogens. Amorig the major GSTs
family, GST - mul (GSTMl) had attracted r~searchers
to conduct studies to establish the f~le of GSTMI in
, the detoxification of carcinogens especiapy, from
cigarette smoke. There are contradictory reports on the
association between the oral cancer related risk habits
(smoking, betel quid chewing and alcohol drinking)
with GSTMI polymorphism (null genotype). There are
currently no studies on the prevalence of oral cancer
related risk habits and oral mucosal lesions/conditions
available on the indigenous people of Peninsula
Malaysia namely the Orang Asli. There is, also little or
lack of information on 'the prey'alence of' gene
polymorphisms or its influence on the associatio~ of
diseases and risk habits among"this populations,
Aim: To determine the prevalence and describe the
commonly used preparation/ingredients of oral caneer
related risk habits (smoking, betel quid chewing and
alcohol drinking); to determine the pre~alence ef
related oral mucosal lesions and prevalence of GSTMI
'polymorphism (null genotype); and to investigate the,
association between risk habits and oral mucosal lesion'
among those with and without GSTMI polymorphism
in a selected group of Orang Asli of Peninsula Malaysia
Methods: This is a cross-sectional descriptive
study with convenience sampling of Orang Asli
villagers from southern Peninsula Malaysia. The
sociodemographic information was collected using a
structured questionnaire and a face to face interview.
Subjects had their mouth examined and cells of buccal
mucosa for DNA extraction were collected using
cervical cytobrush. Multiplex PCR was used to
determine GSTMI polymorphism (null genotype).
Where relevant, the chi-square test of associations was
carried out using the SPSS version 14.0. The alpha
ReSults: A total of 242 Orang Ash were
interviewed and the, prevalence of smoking in this
population was 55.0% (133/242)'; alcohol drinking was
4.1 % (10/242); and betel quid chewing was 19.8% (48/
242). Males were more likely -to indulge in smoking
and alcohol drinking compared to their female
counterparts (p=O.OOOand p=0.005 respectively). The
subjects commonly smoked commercially made
cigarettes and' the 'rokok daun'. The most common
betel quid-ingredients used by the bet~l-quid chewers
were dried ripe areca nut, betel-leaf and lime with few
adding 'gambir' to the quid which are commonly
placed in the buccal sulcus. Only 159 subjects allowed
examination of their mouth and the prevalence of oral
mucosal lesion/conditions (namely leukoplakia, oral
submucous fibrosis, chewer's mucosa, lichen planus
and other lesions) was 8.8% (14/159). Out of 159
subjects with buccal cells collected, DNA from only 98
subjects was of good quality for laboratory analysis.
The overall prevalence of GSTMI polymorphism (null
genotype) was 32.7% (32/98). Among subjects with
lesions and GSTMI polymorphism (null genotype),
33.3% smoked 1-10 cigarettes per day with 66.7%
having smoked for >20 years; while among subjects
with lesions and without GSTMI polymorphism (non-
null genotype), 83.3% smoked 1 to 10 cigarettes per
day with 50% have been smoking for >20 years. For
the betel-quid chewers, among those with lesions and
GSTMI polymorphism, 33.3% each were chewing 1-
5,6-10 and >10 quids/day with 100% having chewed
for a duration of 1-20 years; while among those with
lesions and without GSTMI polymorphism, 50% were
non-chewers and 50% chewed 1-5 quids per day with
33.3% and 16.7% have been chewing for 1-20 and >30
years respectively. All the alcohol drinkers had no oral
mucosal lesions.
Conclusion: Smoking was the most common risk
habit in this Orang Asli population.' The prevalenc,e of
oral mucosal lesion in this population was 8.8% and
of GSTMI polymorphism (null genotype) was 32.7%,
No trend was observed betw~en risk habits and oral
mucosal lesions in those with' and without GSTMI
polymorphisms. In view of the small sample size, this
finding cannot be generalized until a larger study is
conducted.
 Dissertations/Theses 49

Effect of Porosity and Thermocycling on number of the porosity in the specimens of

Compressive Strength of Selected Luting encapsulated cements were greater than those of hand-
mixed cements. 3. Mixing method has no effect on the
Cements
compressive strength. 4. The porosity (1-100) 11m in
diameter and the compressive strength bore no linear
Dr. Aws Hashim Ali AI-Kadhim
relationship to each other. 5. The effect of
Department of Conservative Dentistry
thermocycling on the compressive strength of luting
cements differed considerably with respect to their
The purpose of this in vitro study was to evaluate the
chemical compositions.
effect o(por.osity of diameter (1-100) 11m, and
thermocycling on the compressive strength of selected _
luting cements.
Materials and methods: A total of thirty cylindrical Porphyromonas gingivalis FimA type I and
specimens 6mm height and 4mm in diameter were II genotypes in Malay periodontitis patients':
prepared for each type of cement which are RelyXTM
ARC (3M ESPE, USA), Fuji 1 (GC Corp, Tokyo, Abdulr3,hman Rashad Mohamed AI-Alimi
Japan), Fuji I CAPSULE (GC Corp, Tokyo, Japan), Department of Oral Pathology, Oral Medicine
Fuji CEM (GC Corp, Tokyo, Japan) and Fuji PLUS' :. and Periodontology
CAPSULE (GC Corp, Tokyo, Japan) and were divided
into two subgroups. Both groups were stored in Introduction: P gingiva lis (Pg) is a gram-negative
distilled water at 37°C for 24 hours, but one group were anaerobe ,associated' with periodontal diseases including
then subjected to 500 cycles in baths of 5°C and 55°C adult periodontitis, generalized juvenile periodontitis,
with 20 seconds of dwell time for each bath. The periodontal abscesses, and progressive periodontitis. A
compressive strength for each cement type was number of investigations studied -the association of the
determined using the universal testing machine genotypes of fimA ,of Pg with periodontal conditions
SHIMADZU (SHIMADZU Corp, Tokyo, Japan). The " in many ethnic groups. The present study is a' c'ross-
fractured surfaces of 10 randomly selected specimens sectional study conducted on a Malay ethnic population
for each group of cement type were examined usi~g with periodontitis, who were matched by ethnicity and
Scanning Electron Microscopy (SEM) at 250 times corilpar~d,to healthy participant~. 'i
magnification, and five photomicrographs were taken Objectives: The objective of this study was to
at. five random places for each fractured surface. All determine the prevalence Pg fimA type I and II
the photomicrographs were analyzed using an image genotypes in a Malay ethnic group and to relate this
analyzer software to determine the amount and size of presen'ce to chronic periodontitis.
porosity present. The data were analyzed by Kruskal- , Materials and Methods: A total of 30 Malay
Wallis and Mann-Whitney tests for compressive subjects (15 periodontitis and 15 periodontal healthy
strength and percentage of porosity, Spearman?s rho subjects) aged 25 years and above were selected for the
test was used to examine the correlation between the current study. All consented subjects received detailed
compressive ,strength and the percentage of porosity (I- information sheets concerning the nature and the
IQO) 11min diameter and Mann-Whitney test was used procedures involved in the study. Periodontitis subjects
to determine the :,:effect of thermocycling on were selected if they possessed pockets depth of 2.5 mm
compressive strength of these selected luting cements at 2.4 sites. Healthy subjects had probing pocket depths
Results: Resin adhesive cement has the highest :::;:3mm and no evidence of attachment loss. Clinical
compressive strength, followed by conventional GIC parameters such as plaque (PI), bleeding (BI) and
and resin mpdified GIC has the least. Mechanical gingival (GI), indices, probing pocket depth (PPD), and
mixing method had no effect on the ,compressive probing attachment loss measurements were scored for
strength. Bu~ it had a significant effect by increasing each subject. The number of missing teeth were also
the percentage of porosity of diameter (1-100) 11m in noted. Subgingiva:l plaque samples were taken from the
diameter of GIC and Resin modified GIe. There was deep pocket 2.5 mm in periodontitis subjects and from
no linear relationship between compressive strength areas without bleeding upon probing in healthy
and porosity (1-100) 11m in diameter for all luting subjects. Pg fimA types I and II was identified by
cements which were used in this study (P>0.05). polymerase chain reactiorl followed by gel
Thermocycling had no significant effect on electrophoresis.
compressive strength of RelyXTM ARC and Fuji I Results: Pg was more prevalent in subjects with
(P>0.05), but a significant effect on Fuji I CAPSULE, periodontitis (26.7%) a~ compared to the healthy
Fuji CEM, Fuji Plus CAPSLUE (P<0.05). subj ects (6.7%). In periodontitis subj ects, both
Conclusion: 1. Resin adhesive cement (RelyXTM genotypes of Pg fimA were detected in of 20% and
ARC) has the highest compressive strength followed by 33.33% of patients (type I and II) respectively. On the
conventional glass ionomer cement (Fuji I, Fuji I other hand, fimA type I genotype Pg was detected in
CAPSULE), and resin modified gla~s ionomer cement 6.67% of healthy individuals while fimA type II
(Fuji CEM, Fuji Plus CAPSULE). 2. The size and genotype was not observed in this group. Pg positive
 50 Annals of Dentistry, University of Malaya, Vol. 16 2009
individuals were shown to harbor fimA type I and II
bacteria almost equally in each category of probing
pocket depth and attachment loss measurements.
However, type 11detection was higher than type 1 in .
both these ·measurements. Both genotypes of bacteria
were found only in pocket depths of more than 3 mm.
For the GI, BI and PI categories, both genotypes of Pg
were associated with these indices. The frequency of
genotype fimA type 11 was greater where plaque
accumulation was greater (> 1)..
Conclusions: Pg was detected in periodontally
diseased and healthy subjects. However it was more
predominant in the diseased subjects. PgfimA genotype
1 was prevalent in both groups. Pg fimA genotype 11
was identified in diseased subjects only. Pg was
associated significantly with all clinical parameters,
except for plaque index and missing teeth. Pg positive
fimA genotypes 1 and 11had no significant relationship
to all clinical parameters.
Immunolocalization of WNT-l ..in different
clinicopathologic subtypes ~fAnieloblastoma
. 'primary (n = 517; 71.43%) and all recurrent (n = 5/5;
Chuah Kee Seng
Department Oral Pathology, Oral Medicine
and Periodontology
Background: Ameloblastoma is a histological benign,
but 10callya,ggTessive non-encapsulated tumor arising
from' the odontogenic ectoderm and its derivatives.
Despite it being classified as a benign odontogenic
tumor, the ameloblastoma shows a high tendency of
. 'iecurrence and occasional.1y produces metastases.
Ameloblastoma is classified into four ciinical types:
unicystic, conventional or multi cystic, peripheral and
malignant. Histologically, there are two basic growth
patterns, follicular and plexiform. Wnt-l (Wingless
type protein), belongs to a 'large ~family of 19 secreted
glycoprotein that act as signaling transducers that
promotes cell proliferation and devefopment. Wnt
protein signaling pathway plays an important key role
in carcinogenesis and embrYGgenesis. Previou·s.
experimental data has shown over<-expression of Wnt-
1 in human cancers like oral squamous cell carcinoma,
colorectal tumors, basal cell carcinoma, non-small ceIL
lung cancer, mammary cancer, mesothelioma and
sarcoma.
Objective: The aim of this study was to determine
the· immunolocalization of Wnt-l in ameloblastoma in
terms of its distribution and staining intensity in its
various neoplastic cellular components and to relate it
to the different clinicopathologic subtypes of this
neoplasm ..
Materials and methods: Thirty-seven cases
comprising 24 conventional, 12 unicystic and I
peripheral ameloblastomas (totaling 23 primary and 14
recurrent cases) were retrieved from the archives of the
Department of Oral Pathology, Oral Medicine &
Periodontology, Faculty of Dentistry, University of
Malaya. For all the selected cases, 5m thick sections
were prepared for staining with haematoxylin and
eosin, and for immunohistochemistry with rabbit anti-
Wnt-l polyc1onal antibody (Genetex Inc., USA). Three
microscopic fields were chosen randomly from the
lesional area and data were collected by using the
quantitative histological technique.
Results: The study sample was from 24 male and
13 female patients with an overall mean age of 27.95
years (age'range: 11-57 years). Theirracial composition
was 48.6% Chinese, 32.1% Malays, q.5% Indians and
5.5% other races. Thirty-four cases were from the
mandible and the remaining three cases were from the
maxilla. Histologically, there were 24 conventional
(solid/multicystic), 12 unicystic and 1 peripheral
ameloblastoma. Wnt-l expression was detected in 34
(91.89%) out of 37 cases of ameloblastoma. Staining
intensity for W n( 1 was moderate to strong in all cases
of primary conventional ameloblastoma (n = 15/15;
100%) compared to their recurrent· counterpart (n = 51
7; 71.43%). I~ the unicystic ~meloblastoma, moderate
..to strong Wnt-l expression was obse!ved in both
100%) tumors. Wnt-l showed preferential expression
in pre-ameloblasts more than in stellate reti'culum-like
cells. Keratinizing cells in areas of squamous
metaplasia stained more strongly for Wnt-l compared
to their surrounding polyhedral stellate reticulum-like
cells.
Conclusion: Present findings suggest that Wnt-l
may play differential roles in the cytodifferentiation and
proliferation of the various neoplastic cellular
components in the primary conventional and unicystic
ameloblastoma, and their recurrent tumors.
Determination of root and canal morphology
of first permanent molars amongst Kenyan
adults
Dienya Tomjoseph Mboya
Department of General Dental Practice and
Oral and Maxillofacial Imaging
Introduction: A study aimed at getting a detailed
understanding of the root canal system of Kenyans 1st
permanent molars was done using Cone Beam
Computerized Tomography. _
Objectives: .To determine 'r~ot and canal
morphology of 1st permanent molars amongst Kenyan
adults employing CBCT (i -CAT). -
Materials and methods: 267 extracted human 1st
permanent molars were examined visually for external
root morphology. Access cavities were prepared and
pulp tissue removed using 5.25% sodium hypochlorite.
The teeth were then scanned using CBCT. The resultant
images were observed using Xoran software (version
3.1.59) and the collected data analysed using SPSS

(version 11). For better visualization of minute canal
details such as apical deltas, data was transferred to
another computer with Simplant software.
Results: Most of the mandibular 1st molars had
two separate roots (99.4%). Fusion of roots in
mandibular 1st molars occurred in 5.8% of the sample.
In maxillaJ;'y molars, all the teeth were three rooted.
Fusion occurred mainly b.etween DB and MB roots
(8.9%). ''[-~e prevalence of root curvature was high in
both type~ of t~eth. In mandibular mo.lars, tYl2e IV _
canal c<;.>nflguratlOnwas the commonest III M roots. In -.
maxillary molars, type I was the domiqant
configurations in all the three roots. Lateral canals were
commonly found in M roots in mandibular molars and
MB roots in maxillary molars. Centrally plac'ed apical
foramen was the most prevalent position in all the roots . ,Keratcrcystic Odontogenic Tumour (KCOT) is formerly
studied.
Conclusion: CBCT proved a very reliable and non-
invasive means of getting information on canal
anatomy on extracted teeth. Root and canal
morphology of Kenyans 1st permanent molars showed
some variations and complexities as compared to those
of other races. These should be considered when one
is treating Kenyan patients especially during might play in the high recurrence rate 'in KCOTs.
endodontic procedures.
Association of KI-67 and P53 expression
with cervical lymph node metastasis in oral
~quamous cell carcinoma
Ghassan Mutaher Abdullah AI-Iryani
Department of Oral and Maxillofacial Surgery
Introduction: TNM staging has been consider.ed,
regardless of its limitations, the most reliable
prognostic,Jactot for oral squamous cell carcinoma
(OSCC). The cervical lymph nodes status (N) implies
a significant prognqstic value. The aim of this study
was to correlate the incident of cervical lymph node
metastasis with P53 and Ki-67 expression.
Materials and Methods: The sample consisted of
23 (11 tongue and 12 buccal mucosa) SCCs. Two
specimens representing the Tumour tissue and a clear
margin of each case were selected to undergo
immunohistochemical~ staining. Expression pf P53 and
Ki-67, represented as a percentage of cells showing
immunoreactivity, was assessed· using an image
analyser. The values obtained were statistically
analysed for any association with lymph node status.
Results: Depending on the normality of the data,
parametric or nonparametric test were used to test for
the association of P53 and Ki-67 expression with
lymph node status. No association between P53 and ki-
67 expression in both tumour and margin with lymph
node status was found.
Dissertations/Theses 51
Conclusion: P53 and Ki-67 expression can not
provide a prognostic value in regard to the prediction
of lymph node metastasis in OSCe. Never the less, the
size of this sample does not allow a confident exclusion
of other variants that might have come to participate,
specifically heterogeneity of SCe.
Basement membrane profile of keratocystic
odontogenic tumour
Hartinie Muhammad
Department of Oral Pathology, Oral Medicine
and Periodontology
known as odoi1togenic keratocyst (OKC).The high
recurrence rate is a unique characteristic of KCOT. The
pre'sent study. was aimed at determining the presence
of Collagen IV, Laminin.5, Mcttrix Metalloproteinase-
2 (MMP-2) and Matrix Metalloproteinase;, 9 (MMP-
9) in the basement membrane (BM) zone of KCOT in
order to gain a better understan~ing of the role they
Materials and methods: Haematoxylin and' eosin-
stained .sections of 26 KCOT cases were group into I.
Twelve primary KCOT cases which had not recurred
(KCO/o.R) (n=12), II. Seven primary'KCOT cases
which had recurred (KCOTwR) (n=7) and III. Seven
recurrence KCOT (ReKCOT) (n=7). They were
prep'ared for immunohistochemical staining for
Collagen IV, Laminin 5, MMP-2 and MMP-9 with
suitable positive and negative controls.
Results: Primary KCOTnR showed Collagen IV
expression in high percentage (75.0% cases) followed
by tho'se found in KCOTwR (28.6% cases). The
expressions of Collagen IV, Laminin 5, MMP-2 and
MMP-9 at the BM zone were not significantly different
between the primary KCOTnR and primary KCOTwR
but a decrease in the number of immunopositive cases
of the Collagen IV in the primary KCOTnR to the
primary KCOTwR and the ReKCOT was seen.
Immunopositivity Tor Laminin 5, MMP-2 and MMP-9
were also found in the basal and suprabasal epithelial
cells. MMP-2 and MMP-9 immunoreactivity were also
detected in the' fibroblasts of the connective tissue
stroma.
Conclusion: There was no statistically significance
difference in the expressions of Collagen IV, Laminin
5, MMP2 and MMP9 at the' BM zone between the
primary KCOTnR and primary KCOTwR. Collagen IV,
Laminin 5, MMP-2 and MMP-9 may be involved in the
modulation of KCOTs' basement membrane integrity
a
but may not be used as' predictable marker for the
recurrence of KCOT.
 52 Annals of Dentistry, University of Malaya, Vol. 16 2009
Cephalometric of unilateral cleft lip and
palate patients
Lqybia Emily Ebin
Department of Children's Dentistry and Orthodontics
The aim of this cross-sectional study was to establish
a descriptive s~mmary of the craniofacial morphology
for the Malay unilateral cleft lip and palate (UCLP)
patients and also to documfint the possible craniofacial
morphology differences between the Malay UCLP
children and normal Malay children (control). In
addition, Malay UCLP was also compared to the
Caucasian UCLP for possible differences in their
craniofacial morphology. Twenty UCLP children (12
boys, 8 girls) with a mean age of 10.5 years (SD ±
1.79) were compared with 20 control children (12 girls,
8 boys) who were matched for age (mean = 9.72 years,
SD ± 1.70) and sex. The Malay UCLP was also
compared with the Caucasian UCLP of matched age
from the study of Semb (1991). Thirty one linear and
angular variables were measured from lateral
cephalometric radiographs where. the landmarks were
directly digitised with Dolphin Imaging Software
Version 10.0 (Dolphin Imaging, Chatsworth, CA). The
data were analysed with Mann-Whitney and the level
of significance was set at p < 0.05. Compared with the
control group, the Malay, UCLP demonstrated a more
retrognathic and shorter maxilla but with normal
maRdible. ffhe cranial base angulation was smaner and
more- acute in Malay UCLP. There ~ere also a
bimaxillary retroclination of the ~pper and)o~er
. / incisors which lead to the increased angulation 'of the
interil).cisa~ angle. The soft'tissue was less convex with
obtuse nasolabial angle and thinner upper lip. There
was no significant findings in the vertical measurement
of the 'facial height and the maxillomandibular planes
angle. The Malay UCLP showed a tendency for a Class
III skeletal pattern compared to Caucasian UCLP due
to a smaller and acute cranial base angulation and more
forward position of the mandible. In conclusion ' the
..
most significant difference was found in th'e maxilla
morphology, where the maxilla Of the Malay UCLP was
more retrusive and shorter than the contr~l group but
was set more forward when compared to the Caucasian
UCLP.
The effect of shortening post length on the
fracture resistance of endodontically:
treated teeth
Naji Ziad Naji Arandi
Department of Conservative Dentistry
Objective: This study evaluated the effect of the post
length and type on the fracture resistance and failure
mode of endodontically treated teeth.
Methods: A total of 90 single-rooted maxillary
central incisors were endodontically treated with their
crowns removed 15.0 mm above the root apex. The
teeth were then randomly divided into 3 groups of 30
specimens. Each group was restored using a different
post system: Rely:xrM fiber post (3M/ESPE, USA),
Radix™ Fiber post (Dentsply/Maillefer, USA) and
ParaPost® XH (Coltene/Whaledent,. USA). Each group
was further divided into 3 subgroups of 10 specimens;
each wit.h a different post length (10.0, 7.5, 5.0 mm
respectively). All posts were luted using a self adhesive
resin cement (RelyX ,Unicem, 3M/ESPE, USA) and
restored with a composite core (Fl1tek Z350, 3M/ESPE,
USA). The specimens were thermocycled and then
placed in a custom jig, fixed in an Instron testing
machine and loaded with a mono static compressive
force at a crosshead speed of 0.5 mm/min 135° to the
long axis of the root until failure occurred. The load
at failure and m:ode of failure were recorded. The data
were analyied with One-way ANOVA test and the Post
Hoc (Bonfferoni) test ,was-:used for pairwise
comparisons where applicable.
Results: The first part of the ,study showed
significant differences in the mean failure loads
between the 3 subgroups restored with ParaPost system
(p=0.025). No significant difference was found within
the fiber post groups (Radix, p=0.550 and RelyX,
p=O.27 1). Post Hoc test revealed that the roots restored
with 7.5 mm ParaPost group had significantly higher
failure loads than the 5'.0 mm group (p=0.021). Within
the systems, the subgroups with 5.0 mm post length
displayed the highest percentage of unfavourable
failure patterns (ParaPost = 80%, Radix = 50%, RelyX
= 50%). The second part of the study showed'
significant differences in the failure loads between the
3 subgroups restored with 7.5 mm posts (p=0.016}.
No significant difference was found within the
10.0 mm and 5.0 mm groups (p=0.320, p=0.189
respectively). Post Hoc test revealed that at 7.5 mm,
Parapost XH showed significantly higher fracture
resistance than Radix fiber post (p=0.016). Regardless
of the length group, the ParaPost had the highest
percentage of unfavourable failure loads (10 mm =
50%,7.5 mm= 60%,5.0 mm = 80%).
Conclusions: (I) Shortening the post length had no
significant effect on the failure load of an
endodontically treated teeth restor~d with either the
Radix or RelyX fiber post systems. (II) Teeth restored
with the short fiber posts (1/3 the_canal length) had the
highest percentage of unfavourable'root fractures. (III)
The differences in the mean faill1re loads recorded for
the prefabricated titanium posts were 'only significant
when the post was shortened from 1/2 to 1/3 the canal
length. (IV) Similar to fiber posts, teeth restored with
the short titanium posts (1/3 the canal length) had the
highest percentage of unfavourable root fractures. (V)
Fiber posts displayed lower percentages of
unfavourable failures compared with metal posts at all
lengths.

Acoustic pharyngometry in subjects with
different jaw relationship
Ng Hon Wei
Department of Oral and Maxillofacial Surgery
Purpose of the -study: A descriptive cross sectional
study using acoustic pharyngometry to obtain the upper
airway tract"<a'imension of healthy subjects with
different gender, race, jaw position and relationship
anteroposteri0rly, Material and Method: Seventy-two
healthy orthodontic and orthognathic patients; 49
female and 23 male with average age of25,9 years old
and BMI 21.09kg/m2 of were selected to have their
upper airway tract measured using acous"tic
pharyngometry, Their lateral cephalograms were trace
and analyzed to obtain the maxilla position, mandible
position and jaw relationship in relation to the anterior
cranial base. The subjects' upper airway parameters
would be compared according to gender, race, jaw
position and jaw relationship anteroposteriorly.
Results: Average oral and pharyngeal lengths were
9cm and 8.89cm, hence total upper tract volume was
17.89cm3, The mean cross-section area for the oral was
4.14cm2 and pharyngeal was 2.70cm2, The average'
oral volume was 38,18cm3 while pharyngeal volume
was 26.43 cm3. Males had a longer oral and pharyngeal
tract compared with female. Their oral and pharyngeal
cross sectional area and volume were significantly
larger ,than the female value. When comparing among
the races, Chinese have the largest oral mean cross
sectional area, oral volume and pharyngeal volume
while Indians have the smallest. There were no
statistically different in the upper airway parameters
with different maxilla position, mandible position and
maxillomandibular relationship anteropostriorly.
Conclusion:)n t'his study, the upper airway
dimen~ion is different for different gender and race.
There is no direct relationship between the jaw position
and the relationship anteroposteriorly when compared
with the upper airway dimension. Hence, the risk of
airway narrowing may not be depended on the type of
the jaw discrepan~ies in healthy subjects,
Expression' of cyclin III and p27 in oral
squamous 'cell carcinoma
. depth> 8 mm (p = 0.043), non cohesive pattern of
Nor Nazaliza Basri
Department of Oral Pathology, Oral Medicine
and Periodontology
Introduction: Cyclin D 1 regulates cell cycle
progression by forming a complex with different
cyclin-dependant kinases. p27 is an inhibitor of cyclin
dependant kinase and acts as negative regulators of the
cell cycle. Deregulation of cyclin D 1 and p27 can result
in loss of normal cell growth and tumour development.
Dissertations/Theses 53
Increased expression of cyc1in D 1 and underexpression
of p27 have also been correlated with poor prognosis
in a variety of human tumours, The aim of the present
study was to describe the expression of cyclin D 1 and
p27 in OSCC of buccal and alveolar mucosa and also
to investigate whether there is any association between
the expressions of cyclin D 1 and p27 with selected
clinicopathological parameters (habit, Broders' t~mour
grading, tumour size, tumour depth, pattern of
in:rasion, lymph node metastasis and pTNM staging),
-Materials and Methods: The samples of the study
were taken from surgical specimens of 31 patients who
had been diagnosed with OSCC of buccal and alveolar
mucosa. The surgical specimens were obtained from
the archives of~ the Oral Pathology Diagnostic
. La~oTatory.-The sociodemographic and clinical data
were obtained from the Malaysian Oral Cancer Tumour
and Database System at the Oral Cancer Research and
Coordinating Centre (O~RCC). Of the 31 patients, 25
(81 %) were female and 6 (19%) were male, Overall age
ranged from 41 to 86 years with a mean age of 62 ±
9.93 years. The OSCC patients consisted of 24 (78%)
Indians, 6 (19%) Malays and 1(3%) Chinese. The
expressions of cyclin D 1 and p27 wer~ demonstrated
with immunohistochemistry using the Envision systeirl,
Immunoreactivity evaluation of cyclin D 1 and p27 was
performed using the image analyzer. For analysis of
cyclin D 1 and p27 expressions, positive staining was
considered when there is more than 5% and 10% of
nuclear reactivity in th'e selected cell population
observed respectively. Statistical correlations between
cyclin D 1 or p27 expression and certain
c1inicopatho!ogical parameters of OSCC were analyzed
using chi square or Fisher's exact test.
Results: Cyclin D 1 positivity and reduced
expression ofp27 was detected in 74% and 87% of the
cases respectively. The distribution of cyclin D 1
immunoreactivity was observed mainJy at the-periphery
of the tumour islands at the invasive front with
decreasing immunoreactivity towards the centre. No
immunoreactivity was seen within the keratin pearls,
The distribution of p27 expression appeared to be
opposite to the cyciin D 1 expression where absent and
low immunoreactivity was observed mainly at the
periphery of the tumour islands at the invasive front.
The present study found significant correlation
between cyclin D 1 positivity with larger tumour
greatest dimension (T3t and T4) (p = 0,012), tumour
invasion (p = 0.001) and advanced pathological tumour
stage (III-IV) (p = 0.003). Reduced p27 expression was
significantly associated with non cohesive pattern of
invasion (p = 0.043).
Conclusion: The pres~nt findings showed
overexpression of cyclin D 1 and underexpression of
p27 in OSCC of the buccal and alveolar mucosa. These
findings supports other findings that cyclin D 1 and p27
are involved in ora! carcinogenesis. There is a
 54 Annals af Dentistry, University af Malaya, Val, 16 2009
significant correlation between overexpression of
cyclin D I and underexpression of p27 with some,
clinicopathological parameters which are known
independent prognostic indicators. Thus, these results
suggests that' over~xpression of cyclin D I and
underexpression of p27 may be used as prognostic
markers for OSCC of buccal and alveolar mucosa.
Recommendation: The findings of the present
study are considered preliminary as the samples used
were small. A larger sample size with adequate data of
loco-recurrence and survival would give more
definitive prognostic potential of cyclin D I and p27.
Association between Mutans Streptococci,
Lactobacilli and other risk factors with
severe early childhood caries
Or. Norita Abdul Rahim
Department of Children's Dentistry and Orthodontics
Early childhood caries is a multifactorial disease' which
is most prevalent among childhood that warrants much
attention. The aim of this study was. to assess the
association between mutans streptococci (MS),
lactobacilli (LB) and other risk factors with severe
early childhood caries (S-ECC) in 5-year-old healthy
Malay children. The objectives were (i) to investigate
the relationship between S-ECC with salivary MS and
LB levei; (ii) to' investigate the relation;hip pet"'{een S-
ECC with other risk factors such as .socioeconomic
status, oral hygiene practices of child, feeding h~bits
.. Of child and dietary habit of child and (iii) to
understand·. the factors OT predicting S-ECC by
assessing interrelationships between all the independent
variables and developing a logistic regression model.
A convenient sample of 72 subjects, whereby, 35
subjects were with S-ECC.(dmfs = 6) and 37 caries
free, (dmfs = 0) as a control, were selected from 4
preschools under Federal Islamic ne.p,artment, Kuala
Lumpur. The study was cros~: sectional, case-c<"mtrol
type by comparing the children with S-ECC and caries-
free children .•
Results showed that both mutans streptococci (MS)
and lactobacilli (LB) levels were strongly associated
with S-ECC. Other risk factors significantly associated'
with S-ECC were on demand breastfeeding, no,£;t~rnal
bottle feeding and use of sweetened drinks in feeding -
bo.ttle. Significant interrelationships between
independent variables were: MS and LB, MS and on
demand breastfeeding, LB and on demand
breastfeeding, LB and daily frequency of sweet foods
and drinks intake, LB and daily frequency of
toothbrushing, on demand breastfeeding and
breastfeeding after the age of one year, nocturnal bottle
feeding and use of sweetened drinks in feeding bottle,
and total income of the family and mother's educational
level. The logistic regression model includes 6
variables. These were lactobacilli level, use of
sweetened drinks in feeding bottle, mutans streptococci
level, use of fluoride toothpaste, breastfeeding after the
age of one year and total income of family.
The predictive probability of the model was good
at 88.9% with sensitivity of 88.6% and specificity of
89.2%. The study has highlight~d th~ complex
aetiology of S-ECC which involved MS, LB,and other
significan,t risk factors, particularly among Malay
preschool children. Therefore, in futur;e, it was
suggested that the study"should be carried out on other
various ethnic groups in Malaysia sbch as Chinese and
Indian population due to different culture or norm. This
will be valuable in identifying cafies risk factors and
facilitating understanding of caries occurrence or
aetiology among different ethnics of preschool children
in Malaysia. The information might be useful as a
guideline to fonnulate dental health promotion and
preventive measures of ECC specifically for all
preschool children in Malaysja .. -,
Tensile bond strengths of silicon-based soft
liners to two chemically different. denture
base polymers
Omar Hilal Abbod AI- Bayati
Department of· Prosthetic Dentistry
Objectives: To evaluate and compare the tensile bond
strength' of four silicone-based soft liners to two
denture base polymers; polymethyl methacrylate I
(PMMA) and urethane dimethacrylate (UDMA) and to
describe the mode of failure and relating it to tJ:le
tensile bond strength values.
Methods: The 24 hours' tensile bond strength of
4 silicone based soft lining materials (GC soft, GC
Extra soft, Silagum Comfort and Mollosil Plus) to two
chemically different denture base polymers (Eclipse,
UDMA based resin and Impact, PMMA based resin)
were evaluated with a modified method. 10 specimens
were prepared for each denture base-soft liner
combination group (Total=80 specimens). Each
specimen composed of two denture base of dimension
(20 x 20 x 4 mm) with an interposing cylindrical soft
lining material of (10 mm diameter and 3mm
thickness), The denture base specimens were stored in
water for 30 days before relin'ing.and the relined
specimens were stored in water for 24 hours prior to
testing. The tensile bond st.cength 'test v.:as carried out
using Shimadzu universal testing machine (Shimadzu,
Japan) at cross head speed of 5mm/min. After testing,
the mode of failure was determined using a stereo
microscope (Kyowa SD-2PL) at magnification of XI 0,
Two-way ANaYA, Kruskal-Wallis and Mann-Whitney
test was used for statistical analysis (p=0.05).

Results: Significant differences in tensile bond
strength amongst different soft lining materials within
each denture base polymer group (p<0.05) was found.
In PMMA group, tensile bond strength of GC soft
(1.94 MPa) and GC extra soft (2.04 MPa) was not
significantly different (p>0.04) but significantly higher
than that of Silagur.n Comfort (1.5 MPa) and Mollosil
Plus (1.07 MPa) (p<0.04). Whilejn UDMA group,
Silagum Comfo'rt. showed the highest tensile bond
strength (1.37 MPa); however, it was not significantly
different than that of GC soft (1.21 MPa) and GC extra
soft (1.04 MP~) (p>0.04), all soft lining materials
showed a significantly higher tensile bond strength than
Mollosil Plus (0.8 MPa) (p< 0.04).
All soft lining materials showed a significantly
higher tensile bond strength to PMMA than to UDMA
(p<0.05), except for Silagum Comfort, although it was
higher it was not significantly different (p>0.05). The
mixed mode of failure was the most common type of
failure found in PMMA group (GC soft 70%, GC Extra
soft 60% and Mollosil Plus 70%). While, adhesive type
of failure was the most common type in UDMA group
(GC soft 80%, GC Extra soft 60% and Mollosil Plus
70%) , except for Silagum Comfort which was mostly
adhesive in both groups (PMMA 100% and UDMA
90%).
Conclusion: Different brand of chemically similar
silicone-based soft lining materials showed different
bond strength to denture base polymer. The silicone-
based soft lining materials showed different order in
regards to the tensile bond strength, when used to reline
PMMA denture base polymer compared to when they
were used' to reline the UDMA denture base polymer.
Silicone-based soft lining materials showed lower
bond strength to UDMA denture base polymer:
compared to PMMA denture base polymer.
For PMMA denture jJase polymer, the mixed mode
of failure was the-most common indicated t~a~the
tensile bond strength of the soft lining material is close"
to the tensile strength of the' soft lining materials itself.
This indicated that the bond strength of the soft lining
material to the denture base polymer is more related
to the physical properties of the soft lining materials
itself. While, for UDMA denture base polymer, the
adhesive mode of failure was the most common,
indicated tha:t the. tensile bond strength of the soft
lining material "to denture b;se polymer is lower than
the tensile strength of the soft lining material itself.
This indicated that the bond strength of the soft lining
material to dentl\re base polymer is more related to the
adhesion at the interface between the two materials.
Dissertations/Theses 55
Craniofacial anthropometry: A comparison
between the Malay and Orang AsH Kuala
Dr. Rosliza Parumo
Department of Oral and Maxillofacial Surgery
Direct craniofacial anthropometry is a simple and
noninvasive method that is useful to gather informat!on
on the facial profile of various ethnics for the purpose
_ of physical anthropology study, ergonomic study and
the planning of craniofacial reconstructive surgery. The
_.aim of this cross-sectional study was to determine the
differences in craniofacial morphology between the
Malay and Orang Asli Kuala in Peninsular Malaysia.
A series -of 21 dir~ct anthropometric craniofacial
measurements'were performed on 120 healthy subjects
of b~th ethnics. There :were 30 females and 30 males
between 18 to 45 years of age who were recruited into
each group. Subjects of mixed parentage were
excluded. Standard anthropometry method as outlined
by Farkas (1994) was used. Seventeen proportion
indices were derived from the measurements obtained.
The data were compared using independent t-test with
the significant value set at 95% (p<0.05). 'Comparisons
between both groups showed several similarities and -
differences in their craniofacial features. Almost all the
significant differences were found in the -vertical
measurements (y-n, v-gn, n-gn, n-sto, ,sto~gn, ps~pi, n-
.sn) while the horizontal measurements (eu-eu, g-op, zy-
zy, go-go, en-en, en-ex, ch~ch) remained almost equal.
Our findings showed that both ethnics shared the same
mesocephalic head (medium wide-long type), long
leptoprosop face (long-narrow face type), similar
intercanthal distance and eye fissure length, similar
nasal tip protru"sion height and almost identical
orolabial dimensions. However, because of the
differences in vertical dimensions, some distinguished
feat1,lfes wt:re obvious in 4 regions, namely the head,
fac~:'orbit and nose. The Orang Asli Kuala had longer
head, shorter midface but longer mandible height and
smaller eye fissure height. They also presented with a
chamerrhin nose type (broad; wide alar and short nose)
while the Malay presented with a mesorrhine (medium
width) nose type. This typical Negroid nose type is
their most striking distinguishing feature for the Orang
Asli Kuala. This study suggests that the Orang Asli
Kuala manifests facial features that are mixture
between the African (Negroid) and the Malay and
"Chinese, both of whom are of Mongoloid stock.
However, the finding of this small scale study needs
to be confirmed by a larger scale, randomised and
preferably stratified study" A multi-researchers
calibrated re-collection of data with standard
ins.trument and methodology or even by using more
-sophisticated technology of measurement may be
. helpful to ensure more accurate and reliable outcome
in the future.
56 Annals of Dentistry, University of Malaya, Vol. 16 2009
Effect of light tip angulation on shear bond
strength of an orthodontic adhesive
, Ummu Aiman Yusoff
Department Child,en's Dentistry and Orthodontics
A number of studies have been done in relation to the
effect of different factors affecting the shear bond
strength of orthodontic adhesives, At present there are
no studies that have evaluated the effect of light tip
angulations while curing the lorthodontic adhesives on
the shear bond strength, The purpose of this study was
to investigate the effect of light curing tip angulations
on the shear bond strength of an orthodontic adhesive,
Ninety human premolars with brackets bonded in
a standardized manner using the light-cure orthodontic
adhesive, Transbond XT, were polymerized using a blue
LED light curing unit for 40 seconds at three different
angulations of 0 degree, 45 degrees and 90 degrees at
a standardized 3 mm distance, The Instron Universal
if!
"
Testing Machine was used to measure the maximum
force for debonding, The Adhesive Remnant Index
(ARI) and evaluation under Scanning Electron
Microscope (SEM) were done to evaluate the site of
bond failure on tooth and bracket surface, respectively,
SPSS version 12,0 was used to analyze the data,
The Kruskal-Wallis test was employed to compare the
shear bond strength of all groups, Frqm the results, the
mean shear bond strength values for Group A (0
degree), ~roup B (45 degrees) and Group C (90
degrees) were 4.15, 4,56 and 6,66 MPa, respectively,
The highest mean rank,. was 46,98 for group C. The
statistical analysis of the study sh6wed'no significant
difference (p = 0.286) of the shear bond strengths of
orthodontic adhesives when cured at three different
angulations of the light curing tip, However, the highest
shear bond strength was at 90 degrees angulations of
the light curing tip and its value was within the optimal
orthodontic force,
.. ...
~-
 Conferences, Seminars, Lectures & Workshops 57

Conferences, Seminars, Lectures and 9. Lectures by Dr. Glenn T. Clark (Division of

Workshops organized by the Faculty of Diagnostic Sciences-Oro facial Pain & Oral
Medicine) and Dr. Roseann Mulligan (Special care
Dentistry, University of Malaya
Dentistry, Gerodontology, General pentistry,
Community Health & Dental Education-AIDS
1. Colloquium 'PROTEOMICS' & 'Salivary Education & Training), Department of Oral
Proteome Analysis Of Cigarette Smokers And pathology, Oral Medicine and Periodontology,
Non-Smoker; By Two "Qimensional Gel • Faculty of Dentistry, University of Malaya, II-12th
Electrophoresis'; Balai Ungku Aziz, Faculty of May 2009.
Dentistry, Uni~ersity of Malaya, 6th January 2009.
10. -Lecture by Assoc. Prof. Chaiwat Maneenut (Dept
2. Lectures by Prof. Dr. Roger Ellwood (Director, of Operative Dentistry, Chulalongkorn
Colgate Palmolive Dental Health Unit, Manchester University): 'Bleaching-Facts & Fiction',
Science Park, England), Prof. Dr. Ian Pretty Department of Conservative Dentistry, Faculty of
(University of Manchester, England) and Dr, Dentistry, Univ:rsity of Malaya, 13th May 2009.
Chew Hooi Pin (Senior Lecturer, University of
Manchester); Faculty of Dentistry, University of 11, Le-cture by Prof. Dr. Hugh Devlin (University of
Malaya, 15th and 16th January 2009. Manchester): 'Osteoporosis Assessment by
Dentist: Osteoporosis and the Jaws', Department
3. Lecture by Prof. Finbarr Allen Dean (Cork of Prosthetic D·entistry, Faculty of Dentistry,
University Dental School and Hospital, Ireland): University -of Malaya, 14th May 2009.
"Health-Related (And Oral Health) Qol
Assessment in Prosthodontic Rehabilitation of 12. Simposium 'Millenium Oral Health Goals 2020.
Elderly Patients", Faculty of Dentistry, University Revisiting the Road Map', Department of
of Malaya, 20th January 2009 . Community Dentistry, Balai Ungku Aziz, Faculty'
. of Dentistry, University of Malaya, 2yh May 2009.
4. Lecture by Prof. Laskman Samaranayake (Dean
Faculty of Dentistry, University of Hong Kong): 13. "Fish Workshop", Oral cancer ,Research &
"Can Biofilm Kill You", Faculty of Dentistry, Coordinati"ng Centre (OCRCe), Faculty of
University of Malaya, 20th January 2009. Dentistry, University of Malaya, 25th May 2009.

5. UK-Malaysia symposium on Oral & 14. Lecture by Prof. Dr. Yip Hak Kong (University of
Nasopharyngeal Cancer, Oral cancer Research & Hong Kong): 'A New Paradigm Shifts in the
Coordinating Centre (OCRCC), Faculty of Management of Worn Dentition', Department of
Dentistry, University of Malaya, 23rd March 2009 .. Conservative Dentistry, Faculty of Dentistry,
University. of Malaya, 18th June 2009.
6. '2nd MSP Seminar §<- Workshop 2009: Sinus Lift
Procedure using Piezosurgery' by Prof. Dr. G. 15. Prof. Takashi Ohyama (President Tokyo ,Medical
Conrad Hornbuckle, Department of Oral & Dental University Grad·uate School):
pathology, Oral Medicine and Periodontology, "Removable Partial Denture Design" and "Sports
Faculty of Dentistry, University of Malaya, 28-29th Dentistry", Department of Prosthetic Dentistry,
March 2009. Faculty of Dentistry, University of Malaya, 19th
June 2009.
7. Seminar on 'tJnderstanding Oral Malignancies',
CARIF-UMOCRCC-Ministry of Health, Balai 16. 2nd Postgraduate Students' Seminar, Balai Ungku
Ungku Aziz, ,faculty of Dentistry, University of Aziz, Faculty of Dentistry, University of Malaya,
Malaya, 4th May 2009. ' 30th June - 1st July 2009.

8. Lecture by Prof Mike Morgan (School of Dental '17. Seminar by Professor Dr David Beam (University
Science, The University of Melbourne): of Dundee, Scotland): "Current Review on
'Prevention at the community level: Mixing the Functional Orthodontics and Self-ligation
old with the new', Department of Community Treatment", Department of Children's Dentistry
Dentistry, Faculty of Dentistry, University of and Orthodontic, Faculty of Dentistry, University
Malaya, 11th May 2009 . . of Malaya, 2 pt July 2009.
58 Annals of Dentistry, University of Malaya, Vol. 16 2009
18. Workshop on 'Statistical techniques in molecular
epidemiology II-continuous to categorical', Assoc.
Prof. Dr. Yang Yi Hsin (Kaohsiung Medical
University,Taiwan), Balai Ungku Aziz, Faculty of'
Dentistry: Univ,ersity of Malaya, 30th July - 31 5t
July 2009.
19. Workshop on 'Introduction to Implantology',
Universiti Malaya, University of Frankfurt,
Dentsply Friadent TraiJ;l.ing Centre, Balai UngKu
Aziz, Faculty of Denti~try, University of Malaya,
17-l9th August 2009.
20. Conference on 'Head & Neck Tumours and
Reconstructive Surgery of the Mouth and Jaws',
Balai Ungku Aziz, Faculty of Dentistry, University
of Malaya, 20th _23rd August 2009.
21. Seminar by Prof. Dr. David B. Ferguson (visiting
professor): "What Drives Knowledge: Science or
Machines?", Department of Oral Biology, Faculty
of Dentistry, University of Malay,a, yd September
2009.
22. Seminar by Dr. Nutthanom Wattanaroonwong
(Prince Songkla University ,Thailand): "Effect of
C02 Laser and Fluoride Varnish On Permanent
and Primary Tooth Enamel", Department of Oral
Biology, Faculty of Dentistry, University of
,MalaYfl, 23rd October 2009.
-.
23. Workshop on 'Human Molecular Cytogenetics:
Research, Applications and Recent Develop-
ments'; Oral Cancer Research Coordinating
Centre (OCRCC), Faculty of Dentistry, UM and
Oxford Gene Technology (OGT), Balai Ungku
Aziz, Faculty of Dentistry, University of Malaya,
9th November 2009.
24. Seminar on: 'Standardization of Oral Surgeons as
Trail}ers for Primary Health Care Workers for the
Diagnosis Of Oral Cancer, Potentially Malignant
Disorders and Related Lesions', Grand Seasons
Hotel, Kuala Lumpur, 18-20th November 2009.
25. Seminar by Prof. Dr. Ward t. Massey (Prof. and
Head of the School of Dentistry and Health
Sciences Charles Sturt University), Faculty of
Dentistry, .University of Malaya, 25 & 30th
November 2009.
26. 11 th Dental Students; Scientific Conference
University of Malaya 2009. 'Nurturing Scientists,
Enhancing Research, Balai Ungku, Aziz, Faculty
of Dentistry, University of Malaya, 16-l7th
December 2009.
- --....
INSTRUCTIONS TO CONTRIBUTORS
GENERAL INFORMATION
The Annals of Dentistry University of Malaya is
published annually as the official journal of the Faculty
of Dentistry, University of Malaya, Kuala Lumpur,
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60 Annals of Dentistry, University of Malaya, Vol. 16 2009

.or madified methads and give reasans far using them
and evaluate their limitatians. Identify all drugs and.
chemicals used including generic names, dase anq
route .of administratian ..
. ,
<
3) Kata Y, Okawa A, Hayashi S, et al. Studies an
marginal leakage .of campasite resin restaratians.
Part 2: On the leakage praperties .of variaus
campasite resin restaratians. Jpn J Canserv Dent
1976; 19: 281-9 .

RESULTS
4) Klineberg IJ, Murray GM. Design .of
Present results in a lagical sequence in the text, tables superstructures far asseaintegrate,d fixtures. Swed
and illustratians. 'Da nat repeat in the text all the data Dent J 1985; 28(Suppl): 63-9.
in the tables and illustratians. Emphasise .or summarise'
.only impartant abservatiails. Specify statistical 5) Lincks J, Bayan BD, Cachran DL, Liu Y, Blanchard
methads used ta analyse results and describe them with C, Dean DD, Schwartz Z. MG63 cells discriminate
sufficient detail ta enable a knowledgeable reader with between surface raughness and material
access ta .original data ta analyse results. campasitian. J Dent Res (Abstract na: 1123) 1998;
77 (Special issue A): 246.
DISCUSSION

Emphasise the new and impartant aspects .of the study Books, Monographs and Agency Publications:
and the canclusian that fallaw from them. Da nat
repeat in detail, data .or ather materials, given in Baak - Chaptt:)r in a baak: .
Intraduc'tion .or Results sechan. Include in the 1) Zinner ID. Esthetic cansider.a,!ions in restarative
Discussian sectian the implicatian .of the findings and dentistry. In Seide LJ, e~.-A dynamic approach to
their limitatians, including implicati'ons far future' restorative dentistry. 1st edn. Chicaga, W.B.
research. Relate the abservatians ta ather relevant Saunders Campany 1980; pp. 520-58:
studies.
Baak - persanal authar/s:
2) Gutmann J, Harrisan Jw. Surgical Endodontics, 1st
CONCLUSIONS edn. Bastan, Blackwell Scientific Publicatians
Link the canclusians ta the gaal .of the study but avaid _ 1991.
unqualifi~d state,ments and canclusian~ nat supparted
by yaur data. ' Managraph - Baak Proceeding:
3) DuPant B. Bane marrow transplantatian in severe

ACKNOWLEDGEMENTS
-. cambined immunadeficiency with an unrelated
MLC campatible danar. In: White HJ, Smith R,
Acknawledgements where applicable' shauld be eds. Proceedings of the third Annual Meeting of the
included at the end .of the text. This shauld be kept ta International Society for Experimental Hematology'
a mmlmum. 1974; pp. 44-6.

Managraph - thesis/dissertatian:
REFERENCES
4) Tay WM. Physica-chemical praperties .of
References shauld be carefully checked, as their aluminasilicate based dental cements. University .of
accuracy is the respansibility .of the authar(s) . .In. the Landan, 1988. PhD. thesis.
text, references shauld be numbered sequentially in·
.order .of citatian by bracketed nu~erals, eg .. (1,3-6) .. A,gency publicatian:
The reference list must be attached at the end .of the 5) Parkin DM, Whelan SL, Ferlay J, Raymand L,
paper using the fallawing farm at: Yaung 1. Cancer Incidence in five continents.
Valume VII, Internatianal Agency far Research an
Cancer: Lyan. IARC Scientific Publicatian Na 143.
Journals:
1997.
1) ,Master M, Barber TK. Actian .of amalgam an
dentin. J Am Dent Assac 1980; 47: 415-22.
'Tables:

2) Murray AJ, Nanas JA, Fantenat RE. Campressive
strength .of glass ianamer with and withaut silver
allay. J Dent Res (Abstract na: 215) 1986; 65: 193.
Each table shauld be typed an a separate sheet,
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Instructions To Contributors 61
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