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  1. Chong BS, Abdullah D, Liew AKC, Khazin SM
    Br Dent J, 2021 03;230(5):273.
    PMID: 33712761 DOI: 10.1038/s41415-021-2797-2
  2. Liew AKC, Yeh YC, Abdullah D, Tu YK
    Restor Dent Endod, 2021 Aug;46(3):e41.
    PMID: 34513647 DOI: 10.5395/rde.2021.46.e41
    Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth.

    Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application.

    Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates.

    Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

  3. Teh LA, Abdullah D, Liew AKC, Soo E
    J Endod, 2020 Jun;46(6):748-755.
    PMID: 32279884 DOI: 10.1016/j.joen.2020.02.007
    INTRODUCTION: The pulpal involvement, ulceration, fistula, and abscess (PUFA) index was developed to screen for the clinical consequences of untreated dental caries. The aim of this study was to compare the diagnostic accuracy of the PUFA index and the periapical index (PAI) in identifying pulpal and periapical diseases.

    METHODS: A cross-sectional study was conducted using consecutive sampling. Each participant went through screening using the PUFA index, orthopantomography assessment using PAI, and comprehensive clinical examination to derive pulpal and apical diagnoses. The outcomes were dichotomized. Reliability was estimated using the Cohen kappa coefficient. Sensitivity, specificity, and predictive values were calculated. The area under the receiver operating characteristic curve was compared using the chi-square test.

    RESULTS: A total of 165 participants were examined, 98.2% of whom had a decayed, missing, or filled tooth index >0. Of 4115 teeth assessed, 16.2% (n = 666) were diagnosed with pulpal disease and 7.9% (n = 325) with periapical disease. Interexaminer reliability for the PUFA index and PAI was 0.87 and 0.80, respectively. Intraexaminer reliability was 0.83 and 0.76 for the PUFA index and 0.75 and 0.72 for PAI. For pulpal diagnosis, the sensitivity of the PUFA index and PAI was 67.6% and 41.7%, respectively; the specificity of the PUFA index and PAI was 99.8% and 99.2%, respectively. For apical diagnosis, the sensitivity of the PUFA index and PAI was 87.7% and 75.4%, respectively; the specificity of the PUFA index and PAI was 95.4% and 98.4%, respectively. The PUFA index is statistically more accurate than PAI for pulpal diagnosis and apical diagnosis (P < .05).

    CONCLUSIONS: The PUFA index can be used in screening for pulpal and periapical diseases with some limitations.

  4. Dabbour H, Liew AKC, Soo E, Abdullah D
    Iran Endod J, 2018;13(4):474-480.
    PMID: 36883030 DOI: 10.22037/iej.v13i4.20275
    INTRODUCTION: Demonstration of the access cavity preparation procedures to dental students is challenging due to the limited operating field and the detailed nature of the procedures. The aim of this study was to develop and evaluate two different views in video demonstrations used to teach access cavity preparation.

    METHODS AND MATERIALS: Two videos of access cavity preparation were filmed, one showing the occlusal view (OV) and one showing the sectional view (SV). Third-year dental students (n=57) who consented to participate in the study were divided into two groups to watch one of the videos. The perception and performance of both groups were compared using the Mann-Whitney U test and Fisher's exact test.

    RESULTS: At baseline, group OV (n=29) and group SV (n=28) were not significantly different in terms of operative scores (P=0.330). After watching the videos, the basic understanding of the theories was similar in both groups. However, the SV group responded more positively towards the helpfulness of the video in visualizing the inner anatomy of the tooth and in implementing the procedures (P<0.05). The SV group also completed the exercise within a shorter time (P<0.001). Nevertheless, the quality of the prepared access cavities was not significantly different between groups.

    CONCLUSION: Within the limitations of this study, the additional step in sectioning a tooth before demonstration of access cavity preparation seems well worth the effort, offering the novice students advantages in visualizing certain anatomical landmarks and implementing access cavity preparation procedure within a shorter timeframe. Nevertheless, it did not improve the final quality of the preparations.

  5. Mat Zainal MK, Liew AKC, Abdullah D, Soo E, Abdul Hamid B, Ramlee RAM
    Dent Traumatol, 2024 Aug;40(4):460-469.
    PMID: 38459669 DOI: 10.1111/edt.12939
    BACKGROUND/AIM: Mouthguards are crucial for protecting athletes against orofacial injuries, yet concerns persist regarding their potential impact on oral functions. This study aimed to investigate the effects of sports mouthguards on oral functions and speech over time.

    MATERIAL AND METHODS: Thirty national rugby players received custom-fitted mouthguards. Questionnaire responses and speech recordings were collected before mouthguard use and at various intervals after using mouthguards: immediately, 1 week, 2 month, and 6 months. Spectrographic analysis was performed to measure voice onset time (VOT) for /p, b, t, d/ phonemes. Questionnaire responses were assessed with Friedman's test, while VOT changes were examined using one-way repeated measure analysis of variance.

    RESULTS: Compliance with mouthguard use improved during training and competitions, with consistent wear reported during matches. Over time, speaking difficulties and lisping decreased significantly (p 

  6. Mohamed Khazin S, Abdullah D, Liew AKC, Soo E, Ahmad Tarib N
    Aust Endod J, 2022 Apr;48(1):8-19.
    PMID: 34609035 DOI: 10.1111/aej.12567
    This study aimed to determine the incidence and contributing factors to pulpal and periapical disease in crowned vital teeth. Seventy-three pairs of healthy teeth were included and divided into two groups; 'crowned' and 'untreated' groups. The crowned group was prepared for full coverage crown and no treatment was carried out on the untreated group. Both groups were subjected to clinical and radiographic examination to detect endodontic signs and symptoms pre-operatively and one-week after crown cementation. Electric pulp test was also subjected to both groups, pre-operatively, after tooth preparation and before crown cementation. The incidence of pulpal and periapical disease was 6.8% and 1.4%, respectively, after tooth preparation. Factors associated with pulpal and periapical disease were exposed pulp during tooth preparation and pre-operative bone level <35%. Despite the low incidence, the occurrence of pulpal and periapical disease within a short period is noteworthy.
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