Roszalina Ramli

A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia

INTRODUCTION Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia. MATERIALS AND METHODS A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed. RESULTS Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital. CONCLUSION Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods.

Facial trauma in geriatric patients in a selected Malaysian hospital

Background:  Road traffic accidents are the main cause of trauma in Malaysia. It has been shown that there was an increase in admissions for trauma patients older than 60 years in the last decade. The purpose of this study was to determine the pattern of maxillofacial injuries in the geriatric patients referred to Seremban Hospital, Malaysia.

Duplication of lower lip and mandible—A rare diprosopus

Diprosopus or duplication of the lower lip and mandible is a very rare congenital anomaly. We report this unusual case occurring in a girl who presented to our hospital at the age of 4 months. Surgery and problems related to this anomaly are discussed.

The effect of motorcycle helmet type, components and fixation status on facial injury in Klang Valley, Malaysia: a case control study.

BackgroundThe effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.Method755 injured motorcyclists were recruited over a 12-month period in 2010–2011 in southern Klang Valley, Malaysia in this case control study. Of the 755 injured motorcyclists, 391participants (51.8%) sustained facial injuries (cases) while 364 (48.2%) participants were without facial injury (control). The outcomes of interest were facial injury and location of facial injury (i.e. upper, middle and lower face injuries). A binary logistic regression was conducted to examine the association between helmet characteristics and the outcomes, taking into account potential confounders such as age, riding position, alcohol and illicit substance use, type of colliding vehicle and type of collision. Helmet fixation was defined as the position of the helmet during the crash whether it was still secured on the head or had been dislodged.ResultsHelmet fixation was shown to have a greater effect on facial injury outcome than helmet type. Increased odds of adverse outcome was observed for the non-fixed helmet compared to the fixed helmet with adjusted odds ratio (AOR) = 2.10 (95% CI 1.41- 3.13) for facial injury; AOR = 6.64 (95% CI 3.71-11.91) for upper face injury; AOR = 5.36 (95% CI 3.05-9.44) for middle face injury; and AOR = 2.00 (95% CI 1.22-3.26) for lower face injury. Motorcyclists with visor damage were shown with AOR = 5.48 (95% CI 1.46-20.57) to have facial injuries compared to those with an undamaged visor.ConclusionsA helmet of any type that is properly worn and remains fixed on the head throughout a crash will provide some form of protection against facial injury. Visor damage is a significant contributing factor for facial injury. These findings are discussed with reference to implications for policy and initiatives addressing helmet use and wearing behaviors.

The use of buccal fat pad flap in the treatment of osteoradionecrosis

The use of buccal fat pad in the management of osteoradionecrosis has not been described previously. A series of 10 consecutive cases of osteoradionecrosis treated with a combination of sequestrectomy and buccal fat pad is presented. The data were obtained by reviewing operative and medical records. The combination of sequestrectomy and buccal fat pad flap was successful in 86% of cases of stage II osteoradionecrosis and in 0% of cases of stage III. The overall success rate was 60%. Based on the result of this series, this treatment regime appeared to be beneficial in stage II osteoradionecrosis.

A retrospective study of ranula in two centres in Malaysia

IntroductionRanula is a mucous extravasation cyst which occurs as a result of trauma or obstruction of the sublingual or minor salivary gland or the duct itself.Patients and results14 patients were seen at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur and Hospital Tunku Ampuan Afzan, Kuantan, Malaysia between 2000 to 2006. There were six cases of intra-oral ranula and eight plunging ranula. Twelve patients underwent surgical intervention while two refused surgery. Four patients (33.3%) from those who had surgical intervention returned with recurrence; two (16.7%) had marsupialization and the other two (16.7%) had excision of the pseudocyst intraorally.ConclusionExcision and marsupialization remain as the treatment of choice in our centres.

Pediatric craniomaxillofacial injuries after road traffic crashes: characteristics of injuries and protective equipment use

OBJECTIVE A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated. METHODS Retrospective records of children treated in the University Malaya Medical Centre, Kuala Lumpur, Malaysia, after road traffic crashes between January 1, 2008 and December 31, 2012 were reviewed, and, after that, telephone interviews were made. RESULTS Seventy-one children were included in this study. Fifty-two (73.6%) were involved in a motorcycle injury and 19 (23.4%) in a car crash. Their mean age was 6.02 years; SD, 3.46 (range between 0 to 13 years old). More male children were observed (52.1%) compared with females (47.9%). Thirty-nine point four percent of the children sustained CMF injuries, 33.8% body injuries, and 23.9% had both CMF and other body parts injuries. The highest injury severity score was 26, whereas the lowest was 0. Many children did not use protective equipment during traveling, 44.2% of children among motorcycle pillion riders, and 78.9% among car passengers. The association between helmet use and CMF injuries was shown to be statistically significant (P < .001). CONCLUSION Craniomaxillofacial injuries could be prevented with the use of motorcycle helmet and seat belt.

Atlas of craniomaxillofacial trauma

Introduction - Aetiology and Epidemiology Maxillofacial Examination Dentoalveolar Injuries Mandibular Fractures Fractures of the Mandibular Condyle Fractures of the Edentulous Mandible Middle Third Injuries Ophthalmic Injuries Orbital Fractures Zygomatic (Malar) Fractures Nasal Fractures Nasorbitoethmoid (NOE) Fractures Panfacial Fractures Craniofacial Fractures Intensive Care/Therapy for Maxillofacial Patients Paediatric Trauma.

The Clinical Features and Expression of bcl-2, Cyclin D1, p53, and Proliferating Cell Nuclear Antigen in Syndromic and Nonsyndromic Keratocystic Odontogenic Tumor.

AbstractThe aim of this study was to describe the clinical features and expression of bcl-2, cyclin D1, p53, and proliferating cell nuclear antigen (PCNA) antibodies in syndromic (nevoid basal cell carcinoma syndrome [NBCCS]) and nonsyndromic patients diagnosed with keratocystic odontogenic tumor (KCOT).Methods: This descriptive study comprised 5 patients of KCOT associated with NBCCS and 8 patients of nonsyndromic type treated in the Department of Oral Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre between years 1998 and 2011. The clinical features (site, size, treatment, and recurrence), demographic characteristics, and immunohistochemistry results using antibodies of bcl-2, cyclin D1, p53, and PCNA were examined. The association of the antibody expression and the type of KCOT was analyzed using Fisher exact test.Results: Altogether there were 13 patients, 5 with syndromic KCOT (1 patient met 3 major criteria of NBCCS) and 8 with sporadic KCOT. The age range for syndromic KCT was 11 to 21 years (mean 16.00 years, SD 4.36) and 10 to 54 years (median 24.50 years, interquartile range 19.00) for the nonsyndromic KCOT. Tumor recurrence occurred in 3 patients (7.7%); 1 patient from the syndromic and 2 patients from the nonsyndromic. The most positive expression was observed in PCNA for both the syndromic and nonsyndromic samples and the least positive expression involved the p53.Conclusion: PCNA, bcl-2 protein, and cyclin D1 expressions could be useful in evaluating the proliferative activity of the tumor and the aggressiveness of the clinical presentation; however, the authors would propose for larger sample size research for more definitive results.

Oral cavity squamous cell carcinomas in young patients in a selected Malaysian centre

Aim:  This study aims to evaluate the demographics, to analyze the clinical and pathological findings, treatment and the outcome of oral cavity squamous cell carcinomas (OSCC) in patients aged 40‐years old and below in our centre.