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  1. Sulaiman, E., Yeo, Y.M., Chong, Y.T.
    Ann Dent, 2007;14(1):39-45.
    MyJurnal
    Purpose of the study: The objective of this study was to investigate the flexural strengths of five commercially available tooth-coloured restorative materials – Alpha-Dent (composite resin, Dental Technologies Inc.), Solare Anterior (composite resin, GC), F2000 (polyacid-modified composite resin, 3M), Beautifil (giomer, Shofu) and Fuji II LC (resin- modified glass ionomer cement, GC] using the ISO 4049 specifications. Materials and Method: Ten specimens of (25±0.2)mm x (2±0.1)mm x (2±0.1)mm from each material were prepared at 22-23ºC using a customized metal mould. After light polymerization, the specimens were stored in distilled water at 37ºC for 24 hours. The specimens were subsequently blotted dry, measured and subjected to flexural testing using an Instron Universal Testing Machine with a crosshead speed of 0.5mm/min. The flexural strengths were calculated from the maximum load exerted on the specimens. Data were analysed using one way ANOVA and scheffe’s post-hoc multiple comparison tests at a significance level of 0.05.Results: The results showed that the mean flexural strengths of Beautifil, Solare Anterior and Alpha-Dent were above 80 MPa and those of F2000 and Fuji II LC were below 80 MPa. The results of one-way ANOVA and Scheffe’s post-host tests demonstrated that Beautifil had significantly higher mean flexural strength compared to Fuji II LC, F2000 and Alpha-Dent (P
  2. Sulaiman, E., Yaakub, M.S., Zulkifli, N.A., Abdullah, M., Gonzalez, M.A.G.
    Ann Dent, 2010;17(1):9-14.
    MyJurnal
    Purpose of the study: The objective of this study was to investigate the existence of the golden proportion between the width of the maxillary anterior teeth of undergraduate dental students at University of Malaya. Materials and method: Standardised photographs of 100 dental students’ smiles displaying only the lips and the teeth were captured. The images were transferred to a personal computer and the width of the maxillary anterior teeth was measured using an Image
    Analyzer (Leiqa QWin). Calculations were made according to the Theory of Golden Proportion. The
    data were statistically analysed using paired student T-test (α
  3. Abdullah, M., Che Ab Aziz, Z.A., Roslan Saub, Murat, N., Sulaiman, E., Hashim, N., et al.
    Ann Dent, 2009;16(1):9-14.
    MyJurnal
    The objectives of this study were to assess the practice of molar root canal treatment (RCT) among general dental practitioners (GDPs), confidence level of GDPs in performing molar RCT and to identify factors that influence their confidence in managing molar RCI. One hundred questionnaires were distributed to GDPs in Kuala Lumpur and Selangor. Fifty questionnaires were delivered by mail and the remaining fifty were hand-delivered. All data was coded and verified. Fiftysix OOPs rcsponded to the questionnaires. Only fortyfive questionnaires were accepted (n=45) as eleven OOPs had never performed molar RCI. Most of the OOPs followed the standard quality guidelines while performing molar RCT except for vitality testing (36.4%) and rubber dam usage (27.3%). In this study, 100% of the GDPs were confident in making diagnosis of perinidicular diseases and 95.4% were confident in performing molar RCT from history taking until obturation. Patients' tolerance and availability of instruments and materials (97.7%) were two factors that most influence the GDPs' confidence level. The. least influcncing factor was undergraduate training (78.1 %). Attending seminars and lectures on endodontic, large number of molar teeth treated for ReT, patLents' affordability to pay for RCT and postgraduate training also influencc GDPs' confidence to a certain degree. From this study, it can be concluded that majority of OOPs complied standard quality guidelines except for vitality testing and rubber dam usage. Most of them were confident in performing molar RCT and were greatly influenced by the availability or"instruments and materials in their clinic and patients' tolerance in receiving molar RCI.
  4. Khuder T, Yunus N, Sulaiman E, Dabbagh A
    J Mech Behav Biomed Mater, 2017 11;75:97-104.
    PMID: 28709037 DOI: 10.1016/j.jmbbm.2017.06.039
    Denture fracture is a common clinical complication caused by improper material selection, design, or fabrication technique. This study aimed to investigate the effect of two attachment systems on fracture risk of the implant-overdentures (IOD) via finite element analysis (FEA), using the force distributions obtained from patients' occlusal analyses and to compare the obtained results with the clinical complications associated with these attachments. A three-dimensional jaw model comprised of the edentulous bones was constructed. Three types of mandibular prostheses including complete denture (CD) (model LCD), IOD with Locator attachment (model LID-L), and IOD with telescopic attachment (model LID-T), as well as a maxillary CD (model UCD) were assembled. The vertical occlusal forces at anterior and posterior quadrants were obtained from the patients wearing mandibular CDs or IODs. The FEA results were further compared with the mechanical failures of different prostheses observed at patient recalls. In overall, the fracture risk of mandibular prostheses was lower than the maxillary compartments. The UCD opposing LCD underwent higher strains than that opposing LID-L and LID-T, which was mostly concentrated at the anterior mid-palatal polished surface. On the other hand, LID-L showed the lowest strain, followed by LID-T, and LCD. The obtained results were consistent with the clinical complications observed in the patient recalls.
  5. Khuder T, Yunus N, Sulaiman E, Ibrahim N, Khalid T, Masood M
    J Oral Rehabil, 2017 May;44(5):398-404.
    PMID: 28295492 DOI: 10.1111/joor.12504
    This study aimed to investigate residual ridge resorption (RRR) of anterior and posterior maxillary and mandibular edentulous ridges, in patients treated with mandibular implant overdentures (IOD) and compare with conventional complete denture (CD) wearers, and to determine at each location, the association of RRR with the occlusal forces distribution and other patients' variables. The anterior and posterior RRR of IOD (six males, 17 females) and CD (12 males, 11 females) groups were determined using baseline and follow-up dental panaromic radiographs (DPT) (mean intervals 4 ± 1·8 years). The bone ratios were calculated using proportional area: anatomic to fixed reference areas and mean difference of ratios between the intervals determined RRR. The ridge locations included anterior and posterior maxillary and posterior mandibular arches. The T-Scan III digital occlusal system was used to record anterior and posterior percentage occlusal force (%OF) distributions. There were significant differences in anterior and posterior %OF between treatment groups. Two-way anova showed RRR was significant for arch locations (P = 0·005), treatment group (IOD versus CD) (P = 0·001), however, no significant interaction (P = 0·799). Multivariate regression analyses showed significant association between RRR and %OF at anterior maxilla (P = 0·000) and posterior mandible (P = 0·023) and for treatment groups at posterior maxilla (P = 0·033) and mandibular areas (P = 0·021). Resorption was observed in IOD compared to CD groups, with 8·5% chance of less resorption in former and 7·8% in the latter location. Depending on arch location, ridge resorption at various locations was associated with occlusal force distribution and/or treatment groups (implant prostheses or conventional complete dentures).
  6. Alarami N, Sulaiman E, Al-Haddad A
    Am J Dent, 2017 Aug;30(4):197-200.
    PMID: 29178701
    PURPOSE: To evaluate fracture resistance and failure mode of endodontically-treated mandibular molars restored with different intra-radicular techniques.

    METHODS: 75 human mandibular molars were randomly divided into five equal groups. Teeth were standardized, endodontically-treated and restored according the assigned group as follows: amalgam core only, prefabricated titanium post in the distal canal and amalgam core, composite core only; fiber post in the distal canal and composite core. One group of untreated sound teeth was used as a control. Non-precious metal crowns were fabricated and cemented on the prepared specimens with Rely X U200 resin cement. All specimens were subjected to a compressive load at crosshead speed 0.5 mm/minute, 25° to the long axis of the tooth. Failure loads and modes were recorded.

    RESULTS: Mean failure loads among the groups were significantly different (P= 0.035). Post-hoc multiple pair-wise comparisons revealed the amalgam core and composite core groups produced significantly lower fracture resistance than the control group (P= 0.041 and P= 0.025, respectively) and no significant differences among the different intra-radicular techniques (P> 0.05). The composite core with fiber post and amalgam core with titanium posts showed the highest percentage of favorable failures (67%) and non-favorable failures (87%) respectively.

    CLINICAL SIGNIFICANCE: The composite core with fiber post is the most appropriate intraradicular restoration in cases of severely compromised molars.

  7. Abdulrazzak SS, Sulaiman E, Atiya BK, Jamaludin M
    Aust Endod J, 2014 Aug;40(2):81-6.
    PMID: 24118334 DOI: 10.1111/aej.12042
    The purpose of this study was to evaluate the combined effect of ferrule height and post length on fracture resistance and failure mode of endodontically treated teeth restored with glass fibre posts, composite resin cores and crowns. Ninety human maxillary central incisors were endodontically treated and divided into three groups (n = 30) according to the ferrule heights: 4, 2 and 0 mm, respectively. Post spaces in each group were prepared at 2/3, 1/2 and 1/3 of the root length (n = 10). The specimens were received fibre posts, composite resin core build up and cast metal crowns. After thermocycling, compressive static load was applied at an angle of 135° to the crowns. Two-way analysis of variance showed significant differences in the failure load in the ferrule height groups, no significant differences in post length groups and no significant interaction between ferrule heights and post lengths. More restorable failure modes were observed.
  8. Ishak MI, Kadir MR, Sulaiman E, Kasim NH
    Int J Oral Maxillofac Implants, 2013 May-Jun;28(3):e151-60.
    PMID: 23748334 DOI: 10.11607/jomi.2304
    To compare the extramaxillary approach with the widely used intrasinus approach via finite element method.
  9. Saidin S, Abdul Kadir MR, Sulaiman E, Abu Kasim NH
    J Dent, 2012 Jun;40(6):467-74.
    PMID: 22366313 DOI: 10.1016/j.jdent.2012.02.009
    The aim of this study was to analyse micromotion and stress distribution at the connections of implants and four types of abutments: internal hexagonal, internal octagonal, internal conical and trilobe.
  10. Ishak MI, Abdul Kadir MR, Sulaiman E, Abu Kasim NH
    Int J Oral Maxillofac Surg, 2012 Sep;41(9):1077-89.
    PMID: 22575179 DOI: 10.1016/j.ijom.2012.04.010
    The aim of this study was to compare two different types of surgical approaches, intrasinus and extramaxillary, for the placement of zygomatic implants to treat atrophic maxillae. A computational finite element simulation was used to analyze the strength of implant anchorage for both approaches in various occlusal loading locations. Three-dimensional models of the craniofacial structures surrounding a region of interest, soft tissue and framework were developed using computed tomography image datasets. The implants were modelled using computer-aided design software. The bone was assumed to be linear isotropic with a stiffness of 13.4 GPa, and the implants were assumed to be made of titanium with a stiffness of 110 GPa. Masseter forces of 300 N were applied at the zygomatic arch, and occlusal loads of 150 N were applied vertically onto the framework surface at different locations. The intrasinus approach demonstrated more satisfactory results and could be a viable treatment option. The extramaxillary approach could also be recommended as a reasonable treatment option, provided some improvements are made to address the cantilever effects seen with that approach.
  11. Abdelrehim A, Sulaiman E, Sofian H, Salleh NM
    J Prosthet Dent, 2023 Nov 16.
    PMID: 37980225 DOI: 10.1016/j.prosdent.2023.10.014
    STATEMENT OF PROBLEM: Intraoral scanning of implants supporting complete arch prostheses is limited because of the lack of geometric heterogeneity and unique reference points, creating inherent errors in the image stitching process by the scanner software program.

    PURPOSE: The purpose of this in vitro study was to evaluate the significance of geometric heterogeneity on complete arch implant scanning by using a novel auxiliary geometric device. Three different clinical simulations were tested to assess its significance. The study also assessed whether scans produced using the auxiliary device would meet a clinically acceptable threshold.

    MATERIAL AND METHODS: A total of 60 scans (n=20) were performed using an intraoral scanner in 3 different clinical simulations: 2 parallel implants, 4 parallel implants, and 4 implants with a 30-degree posterior angulation of the distal implants. Scanning alternated between using the auxiliary geometric scanning device (test groups; 4IP+, 4IA+, 2IP+) and not using the device (control groups; 4IP-, 4IA-, 2IP-). A reference scan for each model was prepared from a high precision laboratory scanner. The scans were analyzed for accuracy in 3-dimensional deviation, interimplant distance deviation, and angular deviation by using an inspection software program. The effect of the auxiliary device was statistically analyzed by comparing scans of the same group using the paired t test for normally distributed data and the Wilcoxon Signed Rank test when data were not normally distributed (α=.05).

    RESULTS: Significant effects of the auxiliary geometric device were found in 3-dimensional, distance and angular deviations (P

  12. Abdelrehim A, Salleh NM, Sofian H, Sulaiman E
    J Oral Implantol, 2024 Apr 01;50(2):104-110.
    PMID: 38353347 DOI: 10.1563/aaid-joi-D-23-00063
    Accuracy is a necessity in implant impressions to fabricate accurately fitting implant-supported prostheses. This in vitro study aimed to explore the impact of the number of scan bodies on scanning quality by comparing scans of 2 vs 4 implants, and to determine if their accuracy and precision meets acceptable clinical threshold. Two mandibular edentulous models were used: one with 4-parallel implants (4-IM) and the other with 2-parallel implants (2-IM). Each model was scanned 10 times with an intraoral scanner, while reference scans were obtained with a high-precision laboratory scanner. The accuracy of test scans was evaluated by superimposing them onto reference scans and measuring 3D and angular deviations of the scan bodies. To assess the precision, the repeatability of the scans was analyzed by measuring the 3D SDs. Independent t test was used to compare angular deviations, the Mann-Whitney U test was used for 3D deviations and 3D SDs, and 1 sample t test was used for comparing means to the clinical threshold. Angular and 3D deviations were statistically not significant between the 2 groups (P = .054 and 0.143). 3D deviation values were higher than the 150-µm threshold for 2-IM (201 µm) and 4-IM (290 µm); angular deviation in 2-IM was 0.600 degrees and 0.885 degrees for 4-IM. There was no statistically significant difference in the precision of scans between the 2 groups. (P = .161). Although scanning quality improved when 2 scan bodies were used, the difference was not statistically significant. Moreover, full-arch implant scanning did not meet acceptable levels of accuracy and precision.
  13. Abdelrehim A, Etajuri EA, Sulaiman E, Sofian H, Salleh NM
    J Prosthet Dent, 2024 Sep;132(3):528-535.
    PMID: 36357194 DOI: 10.1016/j.prosdent.2022.09.010
    STATEMENT OF PROBLEM: Attaining a passive fit in implant restorations is desirable but clinically difficult to achieve, especially in screw-retained prostheses. At a certain magnitude, this misfit will not cause mechanical and biological complications, but the exact level has yet to be determined.

    PURPOSE: The purpose of this systematic review was to gather, compare, and appraise studies that attempted to determine the biological and mechanical tolerance of misfits.

    MATERIAL AND METHODS: The review protocol was published in the Prospective Register for Systematic Reviews (PROSPERO; registration no. CRD42021268399) and follows the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was conducted through PubMed, Ebscohost, and Web of Science followed by a manual search up to December 2021.

    RESULTS: A total of 413 manuscripts were identified by electronic and manual search. After removing duplicates, nonrelevant titles, and abstract screening, 62 manuscripts were eligible for full-text assessment. Finally, a total of 13 articles (1 cross-sectional study, 1 retrospective and prospective, 7 in vitro studies, and 4 animal studies) met the eligibility criteria and were included in this review. A wide range of tolerable misfits were reported. Vertical misfit up to 1 mm and horizontal misfit up to 345 μm were associated with no adverse outcomes.

    CONCLUSIONS: The current literature provides inadequate data to determine a clinical threshold of an acceptable misfit. However, this review demonstrated that the mechanical response to misfit is more critical than the biological response.

  14. Sulaiman E, Alarami N, Wong YI, Lee WH, Al-Haddad A
    Dent Med Probl, 2018 10 18;55(3):275-279.
    PMID: 30328305 DOI: 10.17219/dmp/94656
    BACKGROUND: There is no sufficient literature on the effect of post location on endodontically treated premolar teeth with 2 roots.

    OBJECTIVES: The aim of the study was to evaluate the effect of fiber post location on fracture resistance and failure mode of endodontically treated premolars with 2 roots.

    MATERIAL AND METHODS: Fifty extracted maxillary first premolars with 2 roots were divided randomly into 5 groups. Group 1 was comprised of sound teeth, which received only metal crowns (control). Teeth from groups 2, 3, 4, and 5 were decoronated 2 mm above the cementoenamel junction (CEJ) and were endodontically treated. No post was placed in group 2 teeth. Teeth from groups 3, 4 and 5 were given a fiber post placed in the buccal canal, palatal canal, and both buccal and palatal canals, respectively. All teeth in groups 2, 3, 4, and 5 were built up with composite and full coverage metal crowns. A compressive static load was applied at an angle of 25° to the crowns with a crosshead speed of 0.5 mm/min, until fracture.

    RESULTS: One-way analysis of variance (ANOVA) showed significant differences among the groups (p = 0.002). A post hoc test showed significantly lower fracture resistance of group 4 compared to group 5 (p = 0.011). Furthermore, group 2 had significantly less fracture resistance compared to group 1 (p = 0.021) and group 5 (p = 0.002). According to Fisher's exact test, different post locations are non-significantly associated with fracture mode (p = 0.256).

    CONCLUSIONS: Fiber post location has a significant effect on fracture resistance of severely damaged, endodontically treated maxillary premolars with 2 roots. However, post placement in the palatal root is preferred, as it maintains the restorability of the tooth.

  15. Sarraf M, Razak BA, Nasiri-Tabrizi B, Dabbagh A, Kasim NHA, Basirun WJ, et al.
    J Mech Behav Biomed Mater, 2017 02;66:159-171.
    PMID: 27886563 DOI: 10.1016/j.jmbbm.2016.11.012
    Tantalum pentoxide nanotubes (Ta2O5NTs) can dramatically raise the biological functions of different kinds of cells, thus have promising applications in biomedical fields. In this study, Ta2O5NTs were prepared on biomedical grade Ti-6Al-4V alloy (Ti64) via physical vapor deposition (PVD) and a successive two-step anodization in H2SO4: HF (99:1)+5% EG electrolyte at a constant potential of 15V. To improve the adhesion of nanotubular array coating on Ti64, heat treatment was carried out at 450°C for 1h under atmospheric pressure with a heating/cooling rate of 1°Cmin-1. The surface topography and composition of the nanostructured coatings were examined by atomic force microscopy (AFM) and X-ray electron spectroscopy (XPS), to gather information about the corrosion behavior, wear resistance and bioactivity in simulated body fluids (SBF). From the nanoindentation experiments, the Young's modulus and hardness of the 5min anodized sample were ~ 135 and 6GPa, but increased to ~ 160 and 7.5GPa, respectively, after annealing at 450°C. It was shown that the corrosion resistance of Ti64 plates with nanotubular surface modification was higher than that of the bare substrate, where the 450°C annealed specimen revealed the highest corrosion protection efficiency (99%). Results from the SBF tests showed that a bone-like apatite layer was formed on nanotubular array coating, as early as the first day of immersion in simulated body fluid (SBF), indicating the importance of nanotubular configuration on the in-vitro bioactivity.
  16. Madfa AA, Kadir MR, Kashani J, Saidin S, Sulaiman E, Marhazlinda J, et al.
    Med Eng Phys, 2014 Jul;36(7):962-7.
    PMID: 24834856 DOI: 10.1016/j.medengphy.2014.03.018
    Different dental post designs and materials affect the stability of restoration of a tooth. This study aimed to analyse and compare the stability of two shapes of dental posts (parallel-sided and tapered) made of five different materials (titanium, zirconia, carbon fibre and glass fibre) by investigating their stress transfer through the finite element (FE) method. Ten three-dimensional (3D) FE models of a maxillary central incisor restored with two different designs and five different materials were constructed. An oblique loading of 100 N was applied to each 3D model. Analyses along the centre of the post, the crown-cement/core and the post-cement/dentine interfaces were computed, and the means were calculated. One-way ANOVAs followed by post hoc tests were used to evaluate the effectiveness of the post materials and designs (p=0.05). For post designs, the tapered posts introduced significantly higher stress compared with the parallel-sided post (p<0.05), especially along the centre of the post. Of the materials, the highest level of stress was found for stainless steel, followed by zirconia, titanium, glass fibre and carbon fibre posts (p<0.05). The carbon and glass fibre posts reduced the stress distribution at the middle and apical part of the posts compared with the stainless steel, zirconia and titanium posts. The opposite results were observed at the crown-cement/core interface.
  17. Abu Kasim NH, Abu Kassim NL, Razak AA, Abdullah H, Bindal P, Che' Abdul Aziz ZA, et al.
    Eur J Dent Educ, 2014 Feb;18(1):51-7.
    PMID: 24423176 DOI: 10.1111/eje.12058
    Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.
  18. Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.
    J Dent Educ, 2012 Oct;76(10):1377-83.
    PMID: 23066138
    This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.
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