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  1. Ab Rahman N, Wey MC, Othman SA
    Korean J Orthod, 2017 Jan;47(1):11-20.
    PMID: 28127535 DOI: 10.4041/kjod.2017.47.1.11
    OBJECTIVE: This randomized controlled trial aimed to compare the stability of mandibular arch orthodontic treatment outcomes between passive self-ligating and conventional systems during 6 months of retention.

    METHODS: Fortyseven orthodontic patients with mild to moderate crowding malocclusions not requiring extraction were recruited based on inclusion criteria. Patients (mean age 21.58 ± 2.94 years) were randomized into two groups to receive either passive self-ligating (Damon® 3MX, n = 23) or conventional system (Gemini MBT, n = 24) orthodontic treatment. Direct measurements of the final sample comprising 20 study models per group were performed using a digital caliper at the debonding stage, and 1 month, 3 months, and 6 months after debonding. Paired t-test, independent t-test, and non-parametric test were used for statistical analysis.

    RESULTS: A significant increase (p < 0.01) in incisor irregularity was observed in both self-ligating and conventional system groups. A significant reduction (p < 0.01) in second interpremolar width was observed in both groups. Mandibular arch length decreased significantly (p = 0.001) in the conventional system group but not in the self-ligating system group. A similar pattern of stability was observed for intercanine width, first interpremolar width, intermolar width, and arch depth throughout the 6-month retention period after debonding. Comparison of incisor irregularity and arch dimension changes between self-ligating system and conventional system groups during the 6 months were non-significant.

    CONCLUSIONS: The stability of treatment outcomes for mild to moderate crowding malocclusions was similar between the self-ligating system and conventional system during the first 6 months of retention.

  2. Sivarajan S, Ringgingon LP, Fayed MMS, Wey MC
    Am J Orthod Dentofacial Orthop, 2020 Mar;157(3):290-304.
    PMID: 32115107 DOI: 10.1016/j.ajodo.2019.10.009
    INTRODUCTION: Minimally invasive micro-osteoperforations (MOPs) look promising for a routine acceleration of orthodontic tooth movement (OTM). The objective of this research was to systematically evaluate evidence regarding the effects of MOPs on the OTM rate, treatment duration, and associated complications.

    METHODS: Electronic database and hand search of English literature in PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and clinical trial.gov, with author clarification were performed. The selection criteria were randomized controlled trial (RCT) comparing MOPs with conventional treatment involving both extraction and nonextraction. Cochrane's risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation approach were used for quality assessment. Studies were analyzed with chi-square-based Q statistic methods, I2 index, fixed-effects, and random-effects model. Quantitative analysis was done on homogenous studies using Review Manager.

    RESULTS: Eight RCTs were included for the qualitative analysis. Meta-analysis of 2 homogenous studies indicated insignificant effect with MOPs (0.01 mm less OTM; 95% CI, 0.13-0.11; P = 0.83). No difference (P >0.05) was found in anchorage loss, root resorption, gingival recession, and pain.

    CONCLUSIONS: Meta-analysis of 2 low-risk of bias studies showed no effect with single application MOPs over a short observation period; however, the overall evidence was low. The quality of evidence for MOP side effects ranged from high to low. Future studies are suggested to investigate repeated MOPs effect over the entire treatment duration for different models of OTM and its related biological changes.

    TRIAL REGISTRATION NUMBER: PROSPERO CDR42019118642.

  3. Wey MC, Salah Fayed MM, Ringgingon LP, Sivarajan S
    Am J Orthod Dentofacial Orthop, 2020 08;158(2):159-160.
    PMID: 32576428 DOI: 10.1016/j.ajodo.2020.04.010
  4. Wey MC, Shim CN, Lee MY, Jamaluddin M, Ngeow WC
    Aust Orthod J, 2012 May;28(1):17-21.
    PMID: 22866589
    This study aimed to establish a safety zone for the placement of mini-implants in the buccal surface between the second maxillary premolar (PM2) and first maxillary molar (M1) of Mongoloids.
  5. Wey MC, Loh S, Doss JG, Abu Bakar AK, Kisely S
    Aust N Z J Psychiatry, 2016 Jul;50(7):685-94.
    PMID: 26560842 DOI: 10.1177/0004867415615947
    OBJECTIVE: People with chronic schizophrenia have high rates of physical ill-health such as heart disease. However, there has been less attention to the issue of poor oral health including dental caries (tooth decay) and periodontal (gum) disease, although both have consequences for quality of life and systemic physical health. We therefore measured tooth decay and gum disease in Malaysians with schizophrenia.

    METHODS: We recruited long-stay inpatients with schizophrenia from June to October 2014. Four dental specialists assessed oral health using the decayed-missing-filled teeth index, the Community Periodontal Index of Treatment Needs and the Debris Index of the Simplified Oral Hygiene Index. Results were compared with the 2010 Oral Health survey of the general Malaysian population.

    RESULTS: A total of 543 patients participated (66.7% males, 33.3% females; mean age = 54.8 years [standard deviation = 16.0]) with a mean illness duration of 18.4 years (standard deviation = 17.1). The mean decayed-missing-filled teeth was 20.5 (standard deviation = 9.9), almost double that of the general population (11.7). Higher decayed-missing-filled teeth scores were associated with both older age (p 

  6. Sivarajan S, Mani SA, John J, Fayed MMS, Kook YA, Wey MC
    Korean J Orthod, 2021 Jan 25;51(1):55-74.
    PMID: 33446621 DOI: 10.4041/kjod.2021.51.1.55
    Objective: To systematically review studies on canine agenesis prevalence in different populations and continents, based on the jaw, sex, location, and associated dental anomalies.

    Methods: Electronic and hand searches of English literature in PubMed, Web of Science, Scopus, OpenGrey, and Science Direct were conducted, and the authors were contacted when necessary. Observational studies (population-based, hospital/clinic-based, and cross-sectional) were included. For study appraisal and synthesis, duplicate selection was performed independently by two reviewers. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology checklist, with main outcome of prevalence of canine agenesis.

    Results: The global population prevalence of canine agenesis was 0.30% (0.0-4.7%), highest in Asia (0.54%), followed by Africa (0.33%), and the least in Europe and South America (0.19% in both continents). Canine agenesis was more common in the maxilla (88.57%), followed by both maxilla and mandible (8.57%), and the least common was mandible-only presentation (2.86%). The condition was more common in females (female:male ratio = 1.23), except in Asia (female:male ratio = 0.88) and Africa (female:male ratio = 1). In Asia, unilateral agenesis was almost twice as prevalent as bilateral, but in Europe, the bilateral form was more common.

    Conclusions: The overall prevalence of canine agenesis is 0.30%, with the highest prevalence in Asia, followed by Africa, Europe, and South America. The condition is more common in the maxilla than the mandible, and in females than males (except in Asia and Africa), with unilateral agenesis being more common in Asia and the bilateral form showing a greater prevalence in Europe.

  7. Ibrahim N, Asif MK, Sivarajan S, Teh NHK, Wey MC
    Am J Orthod Dentofacial Orthop, 2021 02;159(2):e83.
    PMID: 33546837 DOI: 10.1016/j.ajodo.2020.11.009
  8. Sivarajan S, Doss JG, Papageorgiou SN, Cobourne MT, Wey MC
    Angle Orthod, 2019 09;89(5):831.
    PMID: 31430196 DOI: 10.2319/0003-3219-89.5.831
  9. Othman SA, Majawit LP, Wan Hassan WN, Wey MC, Mohd Razi R
    PLoS One, 2016;11(10):e0164180.
    PMID: 27706220 DOI: 10.1371/journal.pone.0164180
    To establish the three-dimensional (3D) facial soft tissue morphology of adult Malaysian subjects of the Malay ethnic group; and to determine the morphological differences between the genders, using a non-invasive stereo-photogrammetry 3D camera.
  10. Liu X, Yang X, Shao J, Hong Y, Gopinath SCB, Chen Y, et al.
    J Anal Methods Chem, 2020;2020:6528572.
    PMID: 32309010 DOI: 10.1155/2020/6528572
    Cervical, ovarian, and endometrial cancers are common in the female reproductive system. Cervical cancer starts from the cervix, while ovarian cancer develops when abnormal cells grow in the ovary. Endometrial or uterine cancer starts from the lining of the womb in the endometrium. Approximately 12,000 women are affected every year by cervical cancer in the United States. Squamous cell carcinoma antigen (SCC-Ag) is a well-established biomarker in serum for diagnosing gynecological cancers, and its levels were observed to be elevated in cervical, ovarian, and endometrial cancer patients. Moreover, SCC-Ag was used to identify the tumor size and progression stages. Various biosensing systems have been proposed to identify SCC-Ag; herein, enhanced interdigitated electrode sensing is presented with the use of gold nanoparticles (GNPs) to conjugate an antigen/antibody. It was proved that the limit of detection is 62.5 fM in the case of antibody-GNP, which is 2-fold higher than that by SCC-Ag-GNP. Furthermore, the antibody-GNP-modified surface displays greater current increases with concomitant dose-dependent SCC-Ag levels. High analytical performance was shown by the discrimination against α-fetoprotein and CYFRA 21-1 at 1 pM. An enhanced sensing system is established for gynecological tumors, representing an advance from the earlier detection methods.
  11. Choong WY, Teh KW, Lau MN, Wey MC, Abd Rahman ANA, Ashari A
    Cranio, 2023 Jul;41(4):340-347.
    PMID: 35254223 DOI: 10.1080/08869634.2022.2043023
    OBJECTIVE: To investigate the prevalence of adults and children seeking orthodontic treatment at high risk of obstructive sleep apnea (OSA) and pediatric OSA (POSA) and its association with demographic variables.

    METHODS: One hundred-eleven adults and 105 children were consecutively recruited from three centers. The Epworth Sleepiness Scale (ESS) and ESS for Children and Adolescents were used for Risk stratifications for OSA and POSA.

    RESULTS: The prevalence of patients seeking orthodontic treatment at high risk of OSA/POSA was 27.8%, where 26.1% were adults, and 29.5% were children. High risk for OSA/POSA was not associated with gender, ethnicity, age, Body Mass Index, or neck circumference.

    CONCLUSION: Approximately 26% of adults and 30% of children seeking orthodontic care were at high risk for OSA and POSA. Screening for OSA and POSA among adults and children seeking orthodontic treatment is imperative.

  12. Gu M, Savoldi F, Chan EYL, Tse CSK, Lau MTW, Wey MC, et al.
    Orthod Craniofac Res, 2021 Aug;24(3):360-369.
    PMID: 33217159 DOI: 10.1111/ocr.12442
    BACKGROUND: The present study compared the treatment changes in the upper airway, hyoid bone position and craniofacial morphology between two groups of children with skeletal class II malocclusion treated with the headgear activator (HGA) and Herbst appliance (Herbst).

    SETTING AND SAMPLE POPULATION: Orthodontic population from the Faculty of Dentistry of the University of Hong Kong.

    METHODS: Thirty-four skeletal class II patients treated with the HGA (17 patients, mean age 10.6 ± 1.5 years) and the Herbst (17 patients, mean age 11.0 ± 1.4 years) were matched for sex, age, overjet, skeletal class and mandibular divergence. The patients received lateral cephalometric radiographs (LCRs) at the beginning of treatment (T1 ), after treatment (T2 ) and at follow-up (T3 ). In the HGA group, patients underwent LCRs 7 months before the beginning of treatment (T0 ), which were used as growth reference for intra-group comparison. Paired Student's t tests were used for intra- and inter-group comparisons (α = .05).

    RESULTS: Treatment changes (T2 -T1 ) did not differ significantly between the groups. However, at follow-up (T3 -T1 ) the Herbst group showed a smaller increase than the HGA group in the vertical position of the hyoid bone relative to the Frankfort plane (P = .013) and mandibular plane (P = .013).

    CONCLUSIONS: There were no significant differences in the upper airway, hyoid bone position and craniofacial morphology between the groups at the end of treatment. However, the Herbst may provide better long-term control of the vertical position of the hyoid bone than the HGA in children with skeletal class II malocclusion.

  13. Lim GS, Wey MC, Azami NH, Noor NSM, Lau MN, Haque N, et al.
    Curr Stem Cell Res Ther, 2021;16(5):577-588.
    PMID: 33198618 DOI: 10.2174/1574888X15999201116162256
    The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s, even before the discovery of stem cells and regenerative medicine, it was in the 2000s that this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy, which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps, which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful, especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients, with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, the three most desirable outcomes anticipated by clinicians from this procedure include resolution of clinical signs and symptoms, root maturation and redevelopment of the neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes while favoring tissue formation that closely resembles the pulp-dentin complex.
  14. Sivarajan S, Soh EX, Zakaria NN, Kamarudin Y, Lau MN, Bahar AD, et al.
    BMC Med Educ, 2021 Jun 07;21(1):326.
    PMID: 34098931 DOI: 10.1186/s12909-021-02717-5
    BACKGROUND: Wire-bending skills is commonly taught through live demonstrations (LD) though flipped classroom (FC) method has gained popularity. Continuous formative assessment promotes personalised learning via closely monitored progress, with the identification of students' strengths and weaknesses. This study aims to evaluate the effects of LD and FC teaching methods, supplemented with continuous formative assessment, on dental students' learning of wire-bending skills for six types of removable orthodontic appliance components. A deeper understanding of the relative effectiveness between LD and FC teaching methods can help identify the most appropriate method to achieve student learning objectives, which is especially important given the current Covid-19 pandemic.

    METHODS: Forty third-year undergraduate dental students were randomly assigned into FC (n = 20) or LD (n = 20) cohort. Each student attended six teaching sessions, each to teach students' competency in fabricating one type of wire component, for a total competency in fabricating six wire components over the course of six teaching sessions. Either LD or FC teaching methods were used. After each session, wire assignments had to be submitted. Wire assignments were then evaluated using a blinded wire-bending assessment protocol. As part of their formative assessment, the assessment results were distributed to students, lecturers, and technicians before the next session. After the first session (T0) and at the end of all six sessions (T1), students completed a self-reported questionnaire.

    RESULTS: The mean wire-bending scores for FC were significantly higher than LD for two of the six assignments, namely the Adams clasp (p 

  15. Lau MN, Sivarajan S, Kamarudin Y, Othman SA, Wan Hassan WN, Soh EX, et al.
    J Dent Educ, 2022 Nov;86(11):1477-1487.
    PMID: 35650663 DOI: 10.1002/jdd.12954
    OBJECTIVE: This study aimed to explore students' perceptions of flipped classroom (FC) compared to live demonstration (LD) in transferring skills of fabricating orthodontic wire components for orthodontic removable appliances.

    METHODS: Forty third-year undergraduate dental students were randomly assigned to two groups: FC (n = 20) and LD (n = 20). Students in group FC attended FC, while students in group LD attended LD. Both groups underwent a series of standardized teaching sessions to acquire skills in fabricating six types of orthodontic wire components. Eight students (four high achievers and four low achievers) from each group were randomly selected to attend separate focus group discussion (FGD) sessions. Students' perceptions on the strengths, weaknesses, and suggestions for improvement on each teaching method were explored. Audio and video recordings of FGD were transcribed and thematically analyzed using NVivo version 12 software.

    RESULTS: Promoting personalized learning, improvement in teaching efficacy, inaccuracy of three-dimensional demonstration from online video, and lack of standardization among instructors and video demonstration were among the themes identified. Similarly, lack of standardization among instructors was one of the themes identified for LD, in addition to other themes such as enabling immediate clarification and vantage point affected by seating arrangement and class size.

    CONCLUSIONS: In conclusion, FC outperformed LD in fostering personalized learning and improving the efficacy of physical class time. LD was more advantageous than FC in allowing immediate question and answer. However, seating arrangement and class size affected LD in contrast to FC.

  16. Othman SA, Kamarudin Y, Sivarajan S, Soh EX, Lau MN, Zakaria NN, et al.
    Eur J Dent Educ, 2023 Aug;27(3):419-427.
    PMID: 35579042 DOI: 10.1111/eje.12823
    OBJECTIVE: To explore students' perception on the implementation of flipped classroom (FC) combined with formative assessment during the undergraduate teaching of orthodontic wire-bending skills.

    METHODS: Third-year undergraduate dental students were taught wire-bending skills via FC teaching method using a series of pre-recorded online video demonstrations. As part of the formative assessment, the students were given the results and assessment rubrics of their prior wire-bending assessment before every subsequent session. Purposive sampling method for focus group discussion was used to recruit eight students comprising four high achievers and four low achievers. Strengths, weaknesses and suggestions for improvement of the FC with formative assessment were explored. Data were transcribed and thematically analysed.

    RESULTS: Students perceived that FC allowed for a more convenient and flexible learning experience with personalised learning and improved in-class teaching efficiency. The pre-recorded online videos were useful to aid in teaching wire-bending skills but lacked three-dimensional representation of the wire-bending process. Students suggested better standardisation of instructions and access to the marking rubric before and after assessment.

    CONCLUSIONS: FC teaching with continuous formative assessment and constructive feedback as a form of personalised learning was viewed favourably by students. The implementation of periodic individual feedback can further enhance their learning experience.

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