Age estimation from developing third molars.

We investigated the development of third molars among Malaysians (including variations between jaws and genders) using Demirjian's method. Dental panoramic radiographs of 1224 subjects aged 8 to 24 years were examined, and the molars were assigned Demirjian et al.'s development grades (A-H). Results indicated that 18.8% had congenitally missing or extracted third molars. Development of molars begins earlier in females (also in the mandible), but by age 9, male children's molar development speeds up with more advanced grades in their middle teens than females. Grade C indicates the subject is a juvenile, while initiation of root development (Grade E), was observed from 13 years on. Grade H can occur in a child aged 18 years who technically is still a juvenile. We compared the development and growth patterns of the third molar from both the maxilla and the mandible.

Potential effects of Psidium sp., Mangifera sp., Mentha sp. and its mixture (PEM) in reducing bacterial populations in biofilms, adherence and acid production of S. sanguinis and S. mutans.

OBJECTIVE: Psidium sp., Mangifera sp. and Mentha sp. and its mixture (PEM) are known to have antimicrobial and anti-adherence effects. DESIGN: Here, we have investigated these individual plant extracts and its synergistic mixture (PEM) for its anti-cariogenic effect to reduce populations of single and mixed-species of Streptococcus sanguinis and Streptococcus mutans in a planktonic or/and biofilm and their others reduced virulence. Bacterial populations in the biofilm after 24 h, hydrophobic cell surface activity to n-hexadecane and pH changes at 5 min' intervals until 90 min of incubation were recorded. Total phenolic content and bioactive compounds in the crude aqueous plant extracts were analysed. Regulatory gene expressions of S. mutans adhesins genes (gtfB, gtfC, gbpB and spaP) upon treatment with PEM were investigated in planktonic and biofilm conditions. RESULTS: All plant extracts strongly reduced S. mutans in the biofilm compared to S. sanguinis in single and mixed-species. PEM reduced S. mutans by 84% with S. sanguinis 87% in the mixed population. Psidium sp. and PEM highly reduced cell-surface hydrophobicity of the two bacteria thus reducing adherence and biofilm formation. PEM and Mangifera sp. lowered initial pH change in the mixed populations of S. sanguinis and S. mutans. PEM downregulated the S. mutans gtfB gene expression in the single species planktonic and mixed-species biofilms. CONCLUSIONS: The effectiveness of PEM in reducing S. mutans within the biofilm, cell-surface hydrophobicity, acid production and adhesin gene (gtfB) expression in mixed-species with S. sanguinis indicates its potential as an antibacterial agent against dental caries. This is attributed to the phenolic content in the PEM.

Non-aqueous extracts of Curcuma mangga rhizomes induced cell death in human colorectal adenocarcinoma cell line (HT29) via induction of apoptosis and cell cycle arrest at G0/G1 phase.

OBJECTIVE: To investigate the cytotoxic activity of the hexane and ethyl acetate extracts of Curcuma mangga rhizomes against human colorectal adenocarcinoma cell lines (HT29). METHODS: The cytotoxic activity of the hexane and ethyl acetate extracts of Curcuma mangga rhizomes against human colorectal adenocarcinoma cell lines (HT29) was determined by using the SRB assay. RESULTS: The ethyl acetate extract showed a higher cytotoxic effect compared to the hexane extract. Morphological changes of the HT29 cells such as cell shrinkage, membrane blebbling and formation of apoptotic bodies while changes in nuclear morphology like chromatin condensation and nuclear fragmentation were observed. Further evidence of apoptosis in HT29 cells was further supported by the externalization of phosphatidylserine which indicate early sign of apoptosis. CONCLUSIONS: The early sign of apoptosis is consistent with the cell cycle arrest at the G0/G1 checkpoint which suggests that the changes on the cell cycle lead to the induction of apoptosis in HT29.

Phytochemical and cytotoxic investigations of Curcuma mangga rhizomes.

Investigations on the cytotoxic effects of the crude methanol and fractionated extracts (hexane, ethyl acetate) C. mangga against six human cancer cell lines, namely the hormone-dependent breast cell line (MCF-7), nasopharyngeal epidermoid cell line (KB), lung cell line (A549), cervical cell line (Ca Ski), colon cell lines (HCT 116 and HT-29), and one non-cancer human fibroblast cell line (MRC-5) were conducted using an in-vitro neutral red cytotoxicity assay. The crude methanol and fractionated extracts (hexane and ethyl acetate) displayed good cytotoxic effects against MCF-7, KB, A549, Ca Ski and HT-29 cell lines, but exerted no damage on the MRC-5 line. Chemical investigation from the hexane and ethyl acetate fractions resulted in the isolation of seven pure compounds, namely (E)-labda-8(17),12-dien-15,16-dial (1), (E)-15,16-bisnor-labda-8(17),11-dien-13-on (2), zerumin A (3), ß-sitosterol, curcumin, demethoxycurcumin and bis-demethoxycurcumin. Compounds 1 and 3 exhibited high cytotoxic effects against all six selected cancer cell lines, while compounds 2 showed no anti-proliferative activity on the tested cell lines. Compound 1 also demonstrated strong cytotoxicity against the normal cell line MRC-5. This paper reports for the first time the cytotoxic activities of C. mangga extracts on KB, A549, Ca Ski, HT-29 and MRC-5, and the occurrence of compound 2 and 3 in C. mangga.

Lamotrigine for trigeminal neuralgia: efficacy and safety in comparison with carbamazepine.

BACKGROUND: Anticonvulsants are regarded as useful for the treatment of neuropathic pain. In this study, we evaluated the efficacy and occurrence of side effects of lamotrigine (LTG) in comparison with carbamazepine (CBZ), in trigeminal neuralgia (TN) patients. METHODS: The study was an interventional and crossover comparison. Twenty-one patients with TN were administered with LTG in comparison to CBZ. The clinical trials comprised two phases of 40 days each, with an intervening three-day washout period. The final titration in dose for LTG was 400 mg and 1,200 mg for CBZ. Efficacy of the medications involved was determined by visual analog scale (VAS) and verbal rating scale (VRS). Side effects were recorded through marking of the profiles of side effects encountered on administration of LTG and CBZ, together with baseline haematological, hepatic and renal investigations. RESULTS: Both on VAS and VRS assessments, in terms of proportion of patients, CBZ benefitted 90.5% (19/21) of the patients with pain relief (p < 0.05), in contrast to 62% (13/21) from LTG. On VAS assessment, of the 13 patients who gained pain relief from LTG and 19 from CBZ, 77% (10/13) obtained a "complete" degree of pain relief from LTG, as compared with 21% (4/19) from CBZ. On VRS assessment, with LTG, 84% (11/13) of the patients accomplished "much better" degree of pain relief, as compared with 26% (5/19) with CBZ. On LTG, 67% (14/21) of patients endured general pharmacological side effects, as compared with 57% (12/21) of patients on CBZ (p > 0.05). Meanwhile, LTG inflicted 14% (3/21) of the patients with haematological, hepatic and renal derangements, as compared with 48% (10/21) on CBZ. CONCLUSION: LTG is generally an effective and safe treatment for management of TN, compared to CBZ.

Metastatic follicular thyroid carcinoma to the mandible: a case report.

INTRODUCTION: Metastatic lesions to the oro-facial region may be the first evidence of dissemination of an unknown tumour from its primary site. CASE PRESENTATION: We described a case of metastatic follicular thyroid carcinoma to the mandible presenting with pain and loosening of teeth in a 70 years old female patient leading to extraction of the loose teeth. CONCLUSION: The present case emphasizes the importance of considering metastasis in the differential diagnosis of swelling related to loosening of teeth, even though the patient had no history of any malignant disease.

Cytotoxic components of Pereskia bleo (Kunth) DC. (Cactaceae) leaves.

Dihydroactinidiolide (1) and a mixture of sterols [campesterol (2), stigmasterol (3) and beta-sitosterol (4)], together with the previously isolated individual compounds beta-sitosterol (4), 2,4-di-tert-butylphenol (5), alpha-tocopherol (6), phytol (7) were isolated from the active ethyl acetate fraction of Pereskia bleo (Kunth) DC. (Cactaceae) leaves. Cytotoxic activities of the above mentioned compounds against five human carcinoma cell lines, namely the human nasopharyngeal epidermoid carcinoma cell line (KB), human cervical carcinoma cell line (CasKi), human colon carcinoma cell line (HCT 116), human hormone-dependent breast carcinoma cell line (MCF7) and human lung carcinoma cell line (A549); and non-cancer human fibroblast cell line (MRC-5) were investigated. Compound 5 possessed very remarkable cytotoxic activity against KB cells, with an IC(50 )value of 0.81microg/mL. This is the first report on the cytotoxic activities of the compounds isolated from Pereskia bleo.

Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report.

The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.

Peri-implant soft tissue integration of immediately loaded implants in the posterior macaque mandible: a histomorphometric study.

BACKGROUND: Today, one critical goal in implant placement is the achievement of optimal soft tissue integration. Reports thus far have demonstrated successful soft tissue preservation in delayed loaded implants placed in anterior jaws. The aim of this study was to histomorphometrically examine the soft tissues around immediately loaded implants placed in the macaque posterior mandible. METHODS: Splinted crowns on screw-shaped titanium implants (8 mm length, 3.5 mm diameter) were utilized. Three implants each were placed in the premolar-molar edentulous mandibular segments of 6 adult monkeys (Macaca fascicularis); one side served as the control (delayed loading) and the other as the test sites (immediate loading). The animals were sacrificed after 3 months of loading. Histomorphometry of 6 soft tissue indices including the sulcus depth (SD), junctional epithelium (JE), connective tissue contact (CTC), biologic width (BW = SD + JE + CTC), DIM (distance between the implant top and coronal gingiva), and DIB (distance between the implant top and first implant-to-bone contact) was performed on non-decalcified sections. RESULTS: No significant differences in the mean soft tissue scores (mm) between the test (SD = 0.68 +/- 0.63; JE = 1.71 +/- 1.04; CTC = 1.51 +/- 1.14; DIM = 2.27 +/- 1.18; DIB = 1.32 +/- 1.21; BW = 3.9) and control (SD = 0.88 + 0.57; JE = 1.66 + 0.77; CTC = 1.24 +/- 0.92; DIM = 2.38 +/- 0.81; DIB = 1.19 +/- 0.91; BW = 3.78) groups were observed (P > 0.01). CONCLUSION: These findings suggest that the dimensions of the peri-implant soft tissues were within the biologic range and were not influenced by immediate functional loading or posterior location of the implants in the macaque mandible.

Malignancy in oral lichen planus: a review of a group from the Malaysian population.

The objective of this study was to determine the socio-demography (age, race and gender) of a group of Malaysian patients who were diagnosed as suffering from oral lichen planus (OLP). The occurrence of malignancy was also investigated. A total of 77 clinical and biopsy records of patients with OLP were studied. Females were affected more than males, with the female to male ratio being 2:1. Middle-aged Indian and Chinese females tend to be affected by OLP when compared with the rest of the population. Only 19 patients returned for further follow-up. One adult Indian female with a six-year history of lichenoid reaction showed the presence of malignancy.