Pusat Pengajian Sains Pergigian - Tesis
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- PublicationA study of temporomandibular joint morphology and positions among class i, class ii, class iii malocclusion and the effect of petit facemask in class iii malocclusion subjects(2022)Azhar, Mohammed IrfanThe temporomandibular joint (TMJ) is the most complex synovial joint in the body. TMJ morphology can be affected due to various reasons such as age, sex, increased or decreased muscle activity, the growth pattern of the face, pathological changes, occlusal forces, and changes in the dental occlusion. The effect of these changes can result in remodelling and reconfiguration of the TMJ surfaces. Therefore, careful diagnosis and treatment planning is very essential before the initiation of any orthodontic procedure. The purpose of our study was to evaluate and compare the TMJ morphology of 120 subjects with 40 subjects each in Class I, Class II and Class III malocclusion using pre-treatment lateral cephalometric radiographs (LCRs) and to evaluate and compare the TMJ morphology of 28 subjects with Class III malocclusion treated with petit-FM (Facemask) using pre-and post-treatment LCRs. TMJ evaluation included the measurements of porion location (PL), glenoid fossa, condyle position, condylar height (CH), joint spaces, maxillary base position (MX) and mandibular base position (MD). This was a retrospective cross-sectional study. LCRs were obtained using Planmeca Promax 3D machine (Planmeca Oy, Helsinki, Finland). TMJ morphology measurements were accomplished using the WinCeph cephalometric software version.11 (Rise corporation, Sendai, Japan) for both objectives. Data analysis was performed using SPSS ver.26 software (IBM, SPSS Statistics, Armonk, NY-USA). A one-way ANOVA and Bonferroni post hoc test was done for objective 1, while paired t-test was carried out for objective 2. The comparison of TMJ morphology between Class I, II and III malocclusions showed a significant difference for superior joint space (SJS), posterior joint space (PJS), and MD with (p = 0.00). Correspondingly, the comparison of TMJ morphology between pre-and post-treatment subjects of Class III malocclusion in response to petit-FM therapy revealed significant difference for horizontal positions of the glenoid fossa with (p = 0.00) and (p = 0.03) respectively. Significant difference was observed in hinge axis with (p = 0.00) and (p = 0.04) and all variables of condyle position with (p = 0.00). Lastly, all the joint spaces, MX, and MD showed statistically significant differences with (p = 0.00). In conclusion, the first objective revealed highest SJS and PJS for Class III malocclusion and lowest for Class II malocclusion respectively. There was increase in the length of mandibular base (MD) in Class III subjects which indicate forwardly placed mandible and decrease in Class II subjects which represent backwardly placed mandible. Correspondingly, the second objective demonstrated significant alterations in horizontal position of the glenoid fossa indicating posterior displacement after FM therapy. The hinge axis and condylar head (both superior and posterior condyle) were placed postero-superiorly, while the anterior condyle was placed postero-inferiorly suggesting clockwise rotation of the mandible post treatment. There was an increase in the length of maxillary base which indicate forwardly placed maxilla and decrease in the length of mandibular base which exhibit backwardly placed mandible. Among joint spaces, the anterior joint space (AJS) was found to be larger, and smaller for SJS and PJS post treatment suggesting upward and backward movement of the mandible.
- PublicationInhibition of endoplasmic reticulum stress using 4-phenyl butyrate mitigates osteoporosis in a mouse model of hindlimb suspension(2024-08)Al-Daghestani, Hiba Saad SubhiOsteoporosis (OP) characterized by micro-architectural deterioration of bone tissue is a common skeletal disease in the elderly and may lead to fragility fractures. It may also negatively affect implant rehabilitation and prosthesis fixation in the older people. Mouse hindlimb suspension (HLS) is an established model to study disuse- induced OP and its molecular pathology. The disruption of protein folding by endoplasmic reticulum (ER), called ER stress may be a prime driver of OP during disuse. 4- phenylbutyrate (4-PBA) is short chain fatty acid that functions as a chemical chaperone to reduce ER stress. We aimed to investigate the impact of ER stress on OP, and the effect of 4-PBA, as an ER stress inhibitor in the HLS mouse with OP. 21 male C57BL/6J mice were randomly divided into three groups namely: ground-based controls, untreated HLS group, and HLS treated with 4-PBA via intra-peritoneal injections at 100mg/kg/d for 21 days. HLS duration was for 21 days, thereafter, mice were euthanized by cervical dislocation. Humeri, femora, and tibiae bones were collected and cleaned from soft tissues for measurements of reactive oxygen species (ROS) levels, histomorphometry, micro-CT, Raman spectroscopy, and gene expression studies. The results obtained were analysed using GraphPad Prism version 8. High levels of ROS were generated in the hindlimbs (HLs) and forelimbs (FLs) of the untreated HLS group compared to controls. The tibiae bones of the untreated HLS group demonstrated lower osteocyte density, numerous multinucleated osteoclast-like cells, and adipocyte infiltration within the marrow, while micro-CT revealed lower bone volume fraction, reduced trabecular thickness, along with fewer trabeculae striations with increased trabecular separation. Cortical thickness and total cross-section of cortical area were also reduced. Raman spectrophotometric analysis of the femur in the untreated HLS group revealed elevated ER stress with an increase in levels of hydroxyproline, non-collagenous proteins, phenylalanine, tyrosine, and CH2Wag, and a reduction in proteoglycans and adenine. Alkaline phosphatase (ALP) and osteocalcin (OC) expressions were downregulated, while cathepsin K (Cat K), Tartrate resistant Acid Phosphatase (TRAP), and sclerostin were upregulated. Taken together, these characteristics of bone reflect poorer mineralization, less collagen crosslinking, and a pro-inflammatory effect. Treatment with 4-PBA mitigated ER stress levels, restored the normal bone histomorphometry and microarchitecture, increased collagen crosslinking and mineralization, and promoted anti-inflammatory and downregulated bone resorption markers. This study shed light on characterizing the potential contribution of ER stress to OP during bone disuse and the potential effect of 4-PBA as an innovative pharmacological approach to OP treatment.
- PublicationThe cytotoxicity and antimicrobial activity of andrographis paniculata herbal mouthwash formulation(2023-02)Alojid, Anis Amiera MuhamadOral disease is a global health problem caused by oral pathogens. To prevent the oral disease, mouthwash is commonly used. However, commercial mouthwash contained alcohol and other chemicals found to be toxic with unfavourable side effects. Besides, existence drugs seemed to be ineffective due to excessive use and multidrug resistance against the oral pathogens. Thus, there is a demand for a safer and effective alternative treatment in dental product. As the studies on cytotoxicity and antimicrobial activities of medicinal herb, Andrographis paniculata (AP) against oral pathogens are limited, this study proposed AP aqueous extract as herbal mouthwash to determine its effectiveness against selected oral pathogens; Porphyromonas gingivalis, Streptococcus mutans, S. sobrinus, Staphylococcus aureus, and Actinomyces viscosus. In this study, antibacterial effect of AP aqueous extract against the tested oral pathogens was determined by disc diffusion and well diffusion assays, followed by antibacterial effect of five concentrations of AP herbal mouthwash at 1000, 500, 250, 125 and 62.5 mg/mL using well diffusion and broth microdilution method. Assessment of toxicity was determined by brine shrimp lethality bioassay and 3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay onto L929 fibroblast cells while the analysis of heavy metal was analysed using atomic absorption spectrometry (AAS). Stability study was carried out on the final product of AP herbal mouthwash. Results revealed that AP aqueous extract significantly inhibited the growth of all oral pathogens (p<0.05) except for S. aureus with inhibition zones ranging from 2.83 ± 0.83 mm to 14.37 ± 0.83.mm. Similar to AP aqueous extract, AP herbal mouthwash exhibited significant antibacterial activities onto all tested pathogens except for S. aureus (p<0.05) with inhibition ranging from median (IQR) of 9.50 (3.80) to median (IQR) of 15.00 (3.40). All mouthwash concentrations caused bacteria inhibition from 10.56% to 261.09% with minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) at 3.90 mg/mL to 7.81 mg/mL and 7.81 mg/mL to 62.50 mg/mL respectively. However, there was no MBC detected for S. aureus at these concentrations. Formulation of mouthwash was non-toxic to brine shrimp and L929 fibroblast cell line with LC50 value 3255.06 μg/mL and IC50 value 43.55 mg/mL respectively. AP herbal mouthwash was free from heavy metal contamination and maintained its characteristics and sterility for 12 months storage. In conclusion, AP herbal mouthwash at 7.81 mg/mL was found to be the best mouthwash formulation. However, more research works need to be carried out for its clinical use for further product commercialization.
- PublicationA longitudinal qualitative study on lived experience of oral cancer patients during covid-19 pandemic in khyber pakhtunkhwa Pakistan(2023-02)Khattak, Maria IshaqOral cancer health experiences are profound and complex for patients even at the best of times. There is, however, little knowledge of how oral cancer patient’s health experiences may alter and develop in response to the COVID-19 pandemic's changing environment. This study explored the physical, social and psychological experiences of oral cancer patients at diagnosis, six months after diagnosis, and one year after diagnosis, with a particular focus on how experiences change through the different periods of time during the COVID-19 pandemic. Patients diagnosed with oral cancer at Khyber College of Dentistry, Peshawar, Pakistan were included in the study. The participants were selected using a maximum variation purposive sampling method to participate in this study. A longitudinal qualitative design was employed using the principles of phenomenological inquiry. Three semi-structured interviews were conducted as follows: at diagnosis (T1), six months after diagnosis (T2), and twelve months after diagnosis (T3). The sample at T1 and T2 comprised 17 participants. The sample at T3 comprised of a total 12 participants. The interviews were conducted in Pashto, the local language of Khyber Pakhtunkhwa. The audio-recorded interviews were transcribed ad verbatim in English and thematically analyzed. Data was organized using ATLAS.ti software version 8. Eight major broad-level themes were derived at T1: (1) pain and generalized physical weakness, (2) shock at diagnosis, (3) psychological distress of the COVID-19 pandemic, (4) faith and religion, (5) double hit loss of employment, (6) social isolation, (7) social support from caregivers, and (8) lack of support from health care professionals. At T2, five major broad-level themes were derived: (1) physical impairment and limitations, (2) psychological vulnerability, (3) reliance on God for protection, (4) availability of social support systems, and (5) financial decline. Finally, four major broad level themes were derived at T3: (1) the new normal, (2) the sum of fears, (3) belief in traditional healing practices, and (4) striving towards normalcy in social life. In conclusion, this longitudinal qualitative study provides insight into the complexities of living with oral cancer during the pandemic. The narratives in the study highlight conventional physical experiences while heightened psycho-social concerns at diagnosis. Patients social support slightly improved six months after diagnosis, but increased financial burdens, psychological distress, and physical symptoms continued. Finally, after twelve months, patients attempted to recover physically and gain social normalcy, but unwavering psychological concerns about the recurrence of oral cancer and the COVID- 19 pandemic lingered. The duality of the common oral cancer experiences and additional pandemic-inflicted experiences were evident in all three phases which affected the physical, psychological, and social well-being of oral cancer patients in Pakistan
- PublicationCharacterization of fiber reinforced nanohybrid dental composites from agricultural biowaste using kenaf fiber(2022-06)Abbas, HinaBackground: Fiber reinforced composite was introduced due to development of new biomaterials, technological advancements, and more effective treatment approaches. Aims of the study: This study aimed to determine the bonding mechanism between kenaf fibers and nanohybrid dental composite derived from agricultural biowaste. The kenaf fiber reinforced composite was investigated for flexural and compressive strength. The features of fractured surface of the flexural specimens were also assessed. Materials and method: Preparation of kenaf fiber reinforced composite was done using the treated silica from rice husk and kenaf cellulose. The kenaf cellulose was processed and treated using tetraethyl orthosilicate (TEOS) sol gel. Fourier- transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) were used to investigate the treated kenaf cellulose. Six specimens were prepared for each group; composite groups A, B, C, D, E, F, G with 0%, 1% untreated, 2% untreated, 1% treated, 2% treated kenaf cellulose, Neofil and ever-X composite respectively. For compressive and flexural strength tests, specimens were formed using stainless steel molds with dimensions of 6mm x 4mm and 25mm x 2mm x 2mm, respectively. After light curing using a light cure unit (Elipar Deep cure L, 3M, USA) for 40 seconds, the specimens were tested using an Instron Universal Testing Machine (Shimadzu, Japan). SEM was used to examine the fractured flexural strength samples. Results: SEM showed the average diameter of treated kenaf fibers was 7.4μm whereas the average length of treated kenaf fibers was 537μm. The FTIR results suggested formation of chemical bonds between the kenaf cellulose and silica from TEOS sol gel. For flexural and compressive strength tests, one way ANOVA showed there was statistically significant difference (P<0.05) between all groups. The nanohybrid composite incorporated with treated kenaf cellulose resulted in comparable compressive strength with the commercial Neofil composite and no improvement for flexural strength. SEM analysis showed smoother fiber surface with presence of lesser voids and gaps between matrix and kenaf fiber which suggested enhanced interfacial bonding. Conclusion: Surface treatment of the kenaf cellulose improved the bonding mechanism in the kenaf reinforced nanohybrid composite. Adaptation between surface treated kenaf fiber and composite matrix contributed to improvement in compressive strength of fiber reinforced composite.