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Norliwati Ibrahim

    Norliwati Ibrahim

    The rapid healing of oral ulcers is important to prevent secondary infection, especially for chronic oral ulcers. Platelet lysate (PL) is rich in growth factors for cell growth and promotes tissue regeneration. Hence, this study was... more
    The rapid healing of oral ulcers is important to prevent secondary infection, especially for chronic oral ulcers. Platelet lysate (PL) is rich in growth factors for cell growth and promotes tissue regeneration. Hence, this study was performed to compare the effects of PL originating from umbilical cord blood (CB) and peripheral blood (PB) on oral mucosal wound healing. The PLs were molded into gel form in the culture insert with the addition of calcium chloride and conditioned medium for sustained release of growth factors. The CB-PL and PB-PL gels were found to degrade slowly in culture and their degradation percentages by weight were 5.28 ± 0.72% and 9.55 ± 1.82% respectively. The results from the scratch assay and Alamar blue assay showed that the CB-PL and PB-PL gels increased the proliferation (148 ± 3% and 149 ± 3%) and wound closure (94.17 ± 1.77% and 92.75 ± 1.80%) of oral mucosal fibroblasts compared to the control with no statistical differences between the two gels, respe...
    Cord blood-platelet lysate (CB-PL), containing growth factors such as a platelet-derived growth factor, has a similar efficacy to peripheral blood-platelet lysate (PB-PL) in initiating cell growth and differentiation, which makes it a... more
    Cord blood-platelet lysate (CB-PL), containing growth factors such as a platelet-derived growth factor, has a similar efficacy to peripheral blood-platelet lysate (PB-PL) in initiating cell growth and differentiation, which makes it a unique alternative to be implemented into oral ulceration healing. This research study aimed to compare the effectiveness of CB-PL and PB-PL in promoting oral wound closure in vitro. Alamar blue assay was used to determine the optimal concentration of CB-PL and PB-PL in enhancing the proliferation of human oral mucosal fibroblasts (HOMF). The percentage of wound closure was measured using the wound-healing assay for CB-PL and PB-PL at the optimal concentration of 1.25% and 0.3125%, respectively. The gene expressions of cell phenotypic makers (Col. I, Col. III, elastin and fibronectin) were determined via qRT-PCR. The concentrations of PDGF-BB were quantified using ELISA. We found that CB-PL was as effective as PB-PL in promoting wound-healing and both ...
    Oral Pathology course has always been synonym with practical learning using microscope to identify histological features in order to diagnose. However, many students had expressed their difficulty in learning this subject when using light... more
    Oral Pathology course has always been synonym with practical learning using microscope to identify histological features in order to diagnose. However, many students had expressed their difficulty in learning this subject when using light microscope (LM). The study was to evaluate the effectiveness of digital microscope (DM) as a teaching aid in Oral Pathology. 53 students of 4 year Dentistry at Dental Faculty, Universiti Kebangsaan Malaysia (UKM) were required to view 20 pathological cases, both under LM and DM and diagnose them. Questionnaires on their preference microscope were evaluated. There were 92% response rate to the survey. 87% students preferred DM over LM. 92% students agreed that DM positively improved their learning and had sufficient resolution to allow identification and magnification of the slides viewed. 95% students agreed that DM was effective for the course purpose. For the diagnosis exercise, all participants managed to answer correctly using DM compared to LM...
    Periodontitis is an oral inflammatory process involving the periodontium, which is mainly caused by the invasion of periodontopathogenic microorganisms that results in gingival connective tissue and alveolar bone destruction. Metabolic... more
    Periodontitis is an oral inflammatory process involving the periodontium, which is mainly caused by the invasion of periodontopathogenic microorganisms that results in gingival connective tissue and alveolar bone destruction. Metabolic products of the oral pathogens and the associated host immune and inflammatory responses triggered are responsible for the local tissue destruction. Numerous studies in the past decades have demonstrated that natural polyphenols are capable of modulating the host inflammatory responses by targeting multiple inflammatory components. The proposed mechanism by which polyphenolic compounds exert their great potential is by regulating the immune cell, proinflammatory cytokines synthesis and gene expression. However, due to its low absorption and bioavailability, the beneficial effects of these substances are very limited and it hampers their use as a therapeutic agent. To address these limitations, targeted delivery systems by nanoencapsulation techniques ...
    Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are two similar bone pathologies in the jaw with different aetiologies. Actinomycosis is a relatively rare oral infection caused by the Gram-positive... more
    Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are two similar bone pathologies in the jaw with different aetiologies. Actinomycosis is a relatively rare oral infection caused by the Gram-positive anaerobe Actinomyces sp. that normally colonizes the oral cavity. Actinomycosis is associated with the pathogenesis of both the MRONJ and ORN, as evident in our cases, and not just as a superficial contaminant. The clinical and histopathological aspects of the cases treated in our centre were also reported with a review of the literature. Clinical implication on the treatment of the cases was highlighted in view of the presence of this microorganism.
    An incidental finding of a radiopaque lesion on the mandible on a routine orthopantomogram taken before orthodontic treatment had triggered an alarm to the orthodontist. The opacity of lesion showed that it was composed of a dense bone... more
    An incidental finding of a radiopaque lesion on the mandible on a routine orthopantomogram taken before orthodontic treatment had triggered an alarm to the orthodontist. The opacity of lesion showed that it was composed of a dense bone and the lesion presented in the pathway of planned orthodontic tooth movement. We report a case of an asymptomatic radiopaque, non-expansive and localized lesion which occurred as an incidental finding upon routine dental panoramic radiograph assessment prior to orthodontic treatment. The radiopaque lesion which was presented in the pathway of planned orthodontic tooth movement had triggered an alarm to the orthodontist. On the basis of dental panoramic radiograph, the lesion was classified as well defined completely opaque lesion (98mmx70mm), located at the right body of mandible between tooth 44 and tooth 45 and did not attach to these teeth in adjacent to it (with continuous periodontal space separating the roots from the lesion). Nevertheless, the...
    Oral Pathology course has always been synonym with practical learning using microscope to identify histological features in order to diagnose. However, many students had expressed their difficulty in learning this subject when using light... more
    Oral Pathology course has always been synonym with practical learning using microscope to identify histological features in order to diagnose. However, many students had expressed their difficulty in learning this subject when using light microscope (LM). The study was to evaluate the effectiveness of digital microscope (DM) as a teaching aid in Oral Pathology. 53 students of 4 year Dentistry at Dental Faculty, Universiti Kebangsaan Malaysia (UKM) were required to view 20 pathological cases, both under LM and DM and diagnose them. Questionnaires on their preference microscope were evaluated. There were 92% response rate to the survey. 87% students preferred DM over LM. 92% students agreed that DM positively improved their learning and had sufficient resolution to allow identification and magnification of the slides viewed. 95% students agreed that DM was effective for the course purpose. For the diagnosis exercise, all participants managed to answer correctly using DM compared to LM...
    Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral... more
    Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral permanent canine (13) and premolars (14 and 15) have erupted. Upon radiographic examination, a mass which was diagnosed later to be compound odontome was detected. The treatment consisted of surgical removal of the odontome, extraction of the primary canine (63) and left permanent canine (23), and transplantation of the permanent canine (23). The management of this case and the literature related to autotransplantation are discussed.
    Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of nasopharynx. Nasopharynx's obstruction,... more
    Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of nasopharynx. Nasopharynx's obstruction, recurrent infection or trauma may exacerbate mucous secretion by the potential space lining. Although rare and is usually symptomless, it is not uncommon for the patients to have some nasal, ear, cervical or oral symptoms. We report a case of Tornwaldt cyst with rare associated dental symptoms. The patient's initial presentations were dry mouth, cheek biting, post nasal drip and few nasal symptoms including frequent snoring, sleep apnoea, mouth breathing, sneezing, sore throat and itchiness. These symptoms were tremendously and immediately relieved once the cyst was surgically removed.
    Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of nasopharynx. Nasopharynx’s obstruction,... more
    Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of nasopharynx. Nasopharynx’s obstruction, recurrent infection or trauma may exacerbate mucous secretion by the potential space lining. Although rare and is usually symptomless, it is not uncommon for the patients to have some nasal, ear, cervical or oral symptoms. We report a case of Tornwaldt cyst with rare associated dental symptoms. The patient’s initial presentations were dry mouth, cheek biting, post nasal drip and few nasal symptoms including frequent snoring, sleep apnoea, mouth breathing, sneezing, sore throat and itchiness. These symptoms were tremendously and immediately relieved once the cyst was surgically removed.
    Summary. Periodontitis is an inflammatory condition of the tooth supporting structures that will lead to tooth loss. Research has proven that Gelam honey has an anti-inflammatory effect and  potential for treating inflammatory condition.... more
    Summary. Periodontitis is an inflammatory condition of the tooth supporting structures that will lead to tooth loss. Research has proven that Gelam honey has an anti-inflammatory effect and  potential for treating inflammatory condition. This study aimed to determine the effect of Gelam honey on the inflammatory mediators systemically and locally in Sprague-Dawley rats with periodontitis. Twenty-eight rats were randomly assigned into 4 groups; NLS (control treated with saline), NLH (control treated with Gelam honey, 3g/kg body weight), LS (periodontitis treated with saline), LH (periodontitis treated with Gelam honey, 3g/kg body weight). Periodontitis was induced by ligating the lower left first molar with 4/0  Black Silk Suture. On day 15, plasma and tissue samples were analysed using ELISA and histological staining. The LS group exhibited significantly higher levels of inflammatory cells and IL-1β in the tissues than other groups.  No significant difference of plasma IL-1β levels was found between all of the groups. Gelam honey was able to reduce the level of IL-1β in diseased rats with a total reduction of 21.26% in plasma, 81.27% in immunohistochemical staining. In conclusion, Gelam honey was able to reduce the level of IL-1β in periodontitis rats. Therefore, Gelam honey has potential to be included in dental products especially for treating periodontal disease. Industrial relevance. Periodontitis is one of the major dental diseases in most of the population in the world. It is an infectious disease and produced an inflammatory condition. Gelam honey ( Melaleuca Cajuputi )  is one of the fresh honeys which are easily available in Malaysia and research has proven that Gelam honey has an anti-inflammatory effect. The present study demonstrated that Gelam honey able to reduce inflammatory cells and mediators namely IL-1β in the plasma and in the tissue samples from rats induced with Periodontitis. The results of this study showed that Gelam honey has the potential to be the remedy for treating periodontal disease and this study may be the stepping stone to further the usage of honey in dentistry. Keywords. Inflammatory mediators; inflammation; honey; periodontitis
    Clinically, patients were usually young adults, but it may involve a wide age range from birth to 75 years of age. Symptoms depending on the area involved although pain or pathologic fracture are the usual clinical presentations. The... more
    Clinically, patients were usually young adults, but it may involve a wide age range from birth to 75 years of age. Symptoms depending on the area involved although pain or pathologic fracture are the usual clinical presentations. The diagnosis is established by exclusion, where patients show unremarkable biochemistry and haematology findings, radiographic evident of osteolytic lesions in association with histological proliferation of capillary and small lymphatic vessels [5].
    Introduction: Tornwaldt's (Thornwaldt's) or nasopharyngeal cyst is an uncommon developmental benign cyst located in the midline postero-superior wall of nasopharynx. Incidence reported in general population is 0.06%. It occurred... more
    Introduction: Tornwaldt's (Thornwaldt's) or nasopharyngeal cyst is an uncommon developmental benign cyst located in the midline postero-superior wall of nasopharynx. Incidence reported in general population is 0.06%. It occurred in the potential space due to outpouching of ectoderm into the pharyngobasilar fascia at the site where notochord attached to pharyngeal ectoderm. The cyst developed when the epithelial lining of the pouch secrets mucous following recurrent infection or trauma of the nasopharynx. Although majority of the cases are asymptomatic, patients may present with clinically-significant nasal, ear or cervical symptoms. Thus, most of Tornwaldt cyst cases were reported under otorhinolaryngology (ORL)-associated journals. However, patient presented with dental symptoms has never been reported before. This case is the first one as such to be reported.
    Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The... more
    Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The present study aims to determine the effectiveness of the training program “OralDETECT”, a spaced repetitive, test-enhanced learning tool with a corrective feedback mechanism for early detection of oral cancer. Thirty-two dentists and 259 dental students from three Malaysian dental schools were involved in this study. All participants were trained and calibrated to recognize oral potentially malignant disorders (OPMD) and oral cancer using “OralDETECT”, which is comprised of a series of pre-test, lecture, post-tests and review sessions. The percentage of correct answers (scores) for each test given by the participants was calculated and analysed using a paired t test. It was found that the overall percentage of diagnostic accuracy for both dental professionals and student groups increased to above 80% from the pre-tests to the final post-tests. There was a significant improvement in overall scores between the pre-tests and all three post-tests for the dental professional groups and the student groups. The diagnostic accuracy for individual OPMD and lesions suspicious of oral cancer also increased to above 80% for both groups. The results of our study demonstrate that the “OralDETECT” is an efficient and effective competency tool which can be used to train dental professionals and students for the early detection of OPMD and oral cancer. © 2020, American Association for Cancer Education.
    The 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... more
    The 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). 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. 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. 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.
    Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral... more
    Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral permanent canine (13) and premolars (14 and 15) have erupted. Upon radiographic examination, a mass which was diagnosed later to be compound odontome was detected. The treatment consisted of surgical removal of the odontome, extraction of the primary canine (63) and left permanent canine (23), and transplantation of the permanent canine (23). The management of this case and the literature related to autotransplantation are discussed.
    Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The... more
    Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The present study aims to determine the effectiveness of the training program “OralDETECT”, a spaced repetitive, test-enhanced learning tool with a corrective feedback mechanism for early detection of oral cancer. Thirty-two dentists and 259 dental students from three Malaysian dental schools were involved in this study. All participants were trained and calibrated to recognize oral potentially malignant disorders (OPMD) and oral cancer using “OralDETECT”, which is comprised of a series of pre-test, lecture, post-tests and review sessions. The percentage of correct answers (scores) for each test given by the participants was calculated and analysed using a paired t test. It was found that the overall percentage of diagnostic accuracy for both dental prof...