Nik Madihah Nik Azis

Periodontal and alveolar bone regeneration requires coordinated angiogenic and osteogenic responses supported by biomimetic scaffolds. This study compared three-dimensional bioprinted hydroxyapatite–acrylated palm olein (3D-HA–APO) scaffold formulations containing 5%, 7% and 10% (w/v) hydroxyapatite (HA), designated F1, F2 and F3, respectively. Human umbilical vein endothelial cells were cultured on the scaffolds, and background-corrected soluble vascular endothelial growth factor (VEGF) concentrations in culture supernatants were quantified by enzyme-linked immunosorbent assay (ELISA). Angiogenic-related responses of human periodontal ligament stem cells were assessed by VEGF and cluster of differentiation 31 (CD31) immunofluorescence after endothelial induction, while alkaline phosphatase (ALP) activity in construct lysates was used as an indicator of early osteogenic activity. Soluble VEGF concentrations increased from F1 to F3, with significant differences between all formulations. VEGF-associated signal proportions differed among formulations, with F3 significantly higher than F1. CD31-associated signal proportions increased progressively from F1 to F3, with significant differences between all formulation pairs. ALP activity increased over time in all scaffold groups, and F3 generally showed the highest activity from Day 4 onwards. Overall, F3 showed the most favourable formulation-level profile across the selected angiogenic-related and early osteogenic outcomes.

Radiomics has emerged as a promising approach for quantifying bone regeneration by extracting high-dimensional features from routine imaging data. This scoping review aimed to map the current evidence on the application of radiomics in bone remodeling, identify methodological trends, and explore its clinical applicability in regenerative procedures. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Elsevier, and Google Scholar up to July 2025. Eligible studies were original investigations applying radiomics features, such as texture analysis, fractal dimension, and histogram-based metrics, derived from CT or cone-beam CT (CBCT) images to assess bone healing or regenerative outcomes. Nine studies met the inclusion criteria, comprising seven retrospective and two prospective designs, with sample sizes ranging from 25 to 450 patients. All studies utilized CBCT imaging and evaluated bone healing following tooth extraction ( n = 3), socket preservation ( n = 2), or grafting procedures ( n = 3). The most frequently extracted features were gray-level co-occurrence matrix (GLCM) parameters ( n = 7), histogram of oriented gradients (HOG) ( n = 3), and fractal dimensions ( n = 4). Feature selection methods included least absolute shrinkage and selection operator (LASSO) regression and statistical filtering techniques. Four studies incorporated machine learning models, including 3D U-Net architectures; however, validation strategies and performance metrics were inconsistently reported. Overall, radiomics demonstrates potential for characterizing bone regeneration patterns, particularly through GLCM-based texture features. Nevertheless, validation was limited, reporting was heterogeneous, and clinical integration remains minimal. Future research should prioritize well-designed prospective studies, standardized radiomics workflows, and integration of multimodal biomarkers to facilitate reliable clinical translation.

Introduction: Dental photography serves as a valuable adjunct in dental examination and diagnosis, patient communication and dentolegal documentation. Despite its growing importance, the effectiveness of educational approaches and challenges in achieving competency in clinical photography remain underexplored. This study aims to evaluate the self‐perceived competency of postgraduate dental students and alumni following structured clinical photography training and to assess its relevance in clinical practice. Materials and Methods: A cross‐sectional study was conducted at the Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), involving postgraduate students and alumni who had completed a faculty‐developed clinical photography course within the past 5 years. A questionnaire consisting of 25 skills across five competency domains was distributed to current students and alumni from the 2019 to 2024 cohorts. Additionally, three open‐ended questions explored participants' perceptions regarding course strengths, barriers to learning and areas for improvement. Results: The course contributed to self‐perceived competency across multiple domains. A majority of respondents reported high proficiency in theoretical knowledge (88.2%–92.1%), chairside photography skills (73.7%–89.5%), practical application (82.9%–94.7%) and overall satisfaction with the curriculum design (77.6%–96.1%). Significant associations were observed between the place of practice and digital single‐lens reflex camera handling ( p = 0.050), as well as the role of practical sessions in developing competency ( p = 0.048). Hands‐on training and expert supervision were frequently cited as key strengths. Conclusion: The study highlights the value of structured clinical photography education in enhancing self‐perceived competency. Tailored workshops, practical sessions, and mentorship can improve technical skills, confidence, and ethical application across specialities.

Background and Objectives: Periodontal disease, characterized by progressive destruction of tooth-supporting tissues, often results in substantial alveolar bone loss, necessitating regenerative interventions such as guided bone regeneration (GBR). Insulin-like growth factor 2 (IGF-2) has emerged as a promising biomolecule for periodontal regeneration because of its osteogenic and immunomodulatory properties. Materials and Methods: A comprehensive literature search was conducted across five electronic databases (Scopus, ScienceDirect, PubMed, Wiley, and EBSCO). Studies examining the use of IGF-2 in periodontal or alveolar bone regeneration, including randomized controlled trials, animal studies, and in vitro experiments, were included. Results: Three studies met the inclusion criteria. In vitro, IGF-2 was associated with enhanced osteogenic differentiation and mineralization of mesenchymal stem cells, along with upregulation of key osteogenic markers. In animal models, IGF-2 treatment was associated with increased osteogenesis, greater bone volume, and a shift in macrophage polarization toward a less inflammatory phenotype. However, heterogeneity in study designs, protocols, and outcome measures limited direct comparisons. Conclusions: In vitro, IGF-2 was associated with enhanced osteogenic differentiation and mineralization of mesenchymal stem cells, accompanied by upregulation of key osteogenic markers. In animal models, IGF-2 treatment was associated with increased osteogenesis, greater bone volume, and a shift in macrophage polarization toward a less inflammatory phenotype.

This systematic review aims to evaluate the nature of postoperative pain and donor site morbidity following palatal soft tissue harvesting procedures, util

Background: The benefits of Salvadora persica L. chewing stick as an oral hygiene tool have been extensively demonstrated in clinical studies worldwide. Nonetheless, there are wide variations in knowledge, awareness, and practice of these chewing sticks across different populations. This scoping review aims to synthesize current knowledge gaps and practice patterns to inform potential standardization of S. persica use. Methods: Following PRISMA-ScR guidelines, a systematic literature search was conducted by using the Web of Science, Medline, and Scopus databases, covering studies published up to June 2025. Results: Twenty-seven studies were included, involving diverse populations from Africa, the Middle East, and Asia. Knowledge, awareness, and practice of S. persica chewing sticks varied significantly by region, demographic group, and mode of use. Most studies evaluating awareness and knowledge reported that a lack of information on proper use leads to reduced practice. There was no standardized method of use reported. Behaviors varied in terms of preparation of the stick before use, frequency and duration of use, angle or technique during brushing, and storage methods after use. Conclusions: The findings emphasize the need for culturally sensitive clinical guidelines and community health education programs to inform both the public and healthcare professionals about the use of S. persica chewing sticks–particularly in populations with limited access to other oral hygiene tools.

The oral health of military personnel is critical in ensuring their operational readiness and overall health. This cross-sectional study aimed to assess the oral health parameters, behaviours and impact profile among naval personnel stationed at a Malaysian naval base. Participants first underwent oral health examinations to evaluate their plaque scores, bleeding scores, Community Periodontal Index of Treatment Needs (CPITN), and Decayed, Missing, and Filled Teeth (DMFT) index. Additionally, the oral health behaviours and oral health impact profiles of the participants were assessed through a structured questionnaire. A total of 176 naval personnel participated in the study. Overall, the findings indicate high levels of plaque (30.7%) and bleeding scores (39.6%) while the CPITN results showed a significant proportion of participants (52.1%) requiring advanced periodontal treatment (CPITN 3 or 4). The DMFT index highlighted a substantial burden of dental caries with a mean score of 4.59 ± 4.24, including untreated decay (1.15 ± 1.63). The assessment of oral health-related quality of life using the OHIP-14 revealed low scores among some participants, with a mean of 13.47 and a maximum score of 42. Additionally, oral health behaviours were generally inadequate, with 12% of participants reporting infrequent brushing and 68.2% indicating limited use of interdental aids. Oral diseases were highly prevalent among the selected population, with notable deficiencies in oral health behaviours such as toothbrushing frequency, the use of interdental cleaning aids, and tongue cleaning. Oral health issues also significantly impacted daily life, as evidenced by the OHIP-14 scores. These findings highlight the need for tailored oral health interventions within the naval setting to enhance deployment readiness, improve oral health outcomes, and elevate the quality of life for naval personnel. Not applicable.

This study aimed to classify the crowns of maxillary central incisors into distinct categories and to examine the associations between these crown forms and morphometric characteristics in an ethnically diverse Asian population. This is significant for the treatment planning and management of cases, especially for the anterior teeth, from the restorative and aesthetic points of view. Clinical measurements and photographic data were collected from 160 participants, comprising students, staff, and patients of the Faculty of Dentistry, Universiti Kebangsaan Malaysia. The crown length, crown width, contact surface, papilla height, papilla fill, keratinized mucosa width, and gingival tissue thickness were measured. Cluster analyses were performed to identify the different crown form categories and corresponding characteristics. The mean crown width measured 7.093 ± 0.637 mm, while the mean crown length was 10.209 ± 0.966 mm. Three crown-form clusters were identified: triangular (50 %), square/tapered (23.1 %), and square (26.9 %) shapes. The triangular cluster had a significantly higher mean papilla height (4.64 mm ± 0.818) and the highest incidence of incomplete papilla fill (17.5 %). The chi-squared test showed a significant difference in crown forms between the different ethnicities, χ2 (2, 160) = 0.033. Within this diverse Asian population, the crown form demonstrates three clusters: triangular, square/tapered, and square, characterized by a notably small average crown width and crown length. Most participants predominantly exhibited triangular crown forms with reduced crown width, crown length, and crown width/ crown length ratio. Furthermore, noticeable variations in crown forms and their morphometric attributes were observed among the three ethnic groups: Malays, Chinese, and Indians.

Background and Objective: Digital computerized assessment can provide objective values for the measurement of gingival pigmentation. This study aims to compare the Commission Internationale de l’Eclairage Lab color space (CIELAB) values and the computerized intensity values (CIVs) from digital imaging with clinical evaluations using the Dummett–Gupta Oral Pigmentation Index (DOPI) for assessing gingival pigmentation in a multi-ethnic population. Methodology: Digital photographs of 188 participants were taken using standardized parameters. The buccal gingival pigmentation was evaluated using three methods (a) a clinical evaluation by two independent assessors using the DOPI, (b) the CIELAB values using the Adobe Photoshop® software (Version 23.1.1) and (c) the CIV calculated using the ImageJ software (Version 1.53k). A hierarchical clustering analysis was used to identify colour groups that clustered together. Agreement between the clinical and digital categorization of the pigmentation was carried out using weighted kappa analysis. Agreements between CIELAB and CIV were compared using intra-class correlation coefficient. Results: There was a statistically significant difference in the DOPI, the L*, a*, and b* coordinates, and the CIV between the different ethnic groups of the participants. Cluster analysis for the CIELAB and CIV both identified four clusters. The gingival pigmentation categorization using the L*, a*, and b* values moderately agreed with the clinical evaluation using the DOPI index while the categorization with the CIV was in slight agreement with the clinical evaluations. Conclusion: This study identified four clusters of gingival pigmentation in 188 multi-ethnic participants. The clusters, determined by CIELAB values, align with the clinical assessment of gingival pigmentation. Digital measurements derived from clinical photographs can serve as an effective means of pigmentation measurement in dental clinics.

Osteoarthritis (OA) patients have decreased functional ability and restricted access to healthcare facilities and are on a spectrum of medications. These can impact their oral health. This study aims to investigate the association between periodontal disease and OA disease parameters, specifically the functional disability and the medications taken. This was a cross-sectional study on OA participants recruited from the Hospital Canselor Tuanku Mukhriz. Periodontal health parameters were obtained from an oral examination of the participants. A Health Assessment Questionnaire (HAQ) was administered to ascertain the functional status of the participants. Out of the 130 participants recruited, 71 (54.6%) had periodontitis. There was a correlation between the teeth count with OA severity, where participants with a greater Kellgren–Lawrence score had less teeth (rs = 0.204, p = 0.025). Participants with a greater degree of functional limitation also had less teeth (rs = −0.181, p = 0.039) and a higher clinical attachment loss (rs = 0.239, p = 0.006). There were no associations found between the symptomatic slow-acting drugs in OA and periodontal health parameters. In conclusion, there was a high proportion of periodontitis in patients with OA. Functional disability was associated with measures of periodontal health. It is suggested that clinicians treating OA patients consider the need for a referral for dental care when managing this group of patients.