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. 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. 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 < 0.001) and longer illness duration (p = 0.048). Only 1% (n = 6) had healthy gums. Levels of decay and periodontal disease were greatest in those aged between 45 and 64 years, coinciding with the onset of tooth loss. Dental disease in people with schizophrenia deserves the same attention as other comorbid physical illness. The disparity in oral health is most marked for dental decay. Possible interventions include oral health assessments using standard checklists designed for non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth and early dental referral.

Objectives: To investigate, using a split-mouth randomized clinical design, the effect of micro-osteoperforation (MOP) on mini-implant supported canine retraction using fixed appliances. Materials and Methods: Thirty subjects (seven males and 23 females) with a mean age of 22.2 (3.72) years were randomized into three canine retraction groups: Group 1 (MOP 4-weekly maxilla/8-weekly mandible; n = 10); Group 2 (MOP 8-weekly maxilla/12-weekly mandible; n = 10) and Group 3 (MOP 12-weekly maxilla/4-weekly mandible; n = 10) measured at 4-week intervals over 16 weeks. Subjects also completed pain (5-point Likert scale) and pain impact (Visual Analogue Scale) questionnaires. The primary outcome was the amount of canine retraction over 16 weeks at MOP (experimental) and non-MOP (control) sites. Results: Mean overall canine retraction was 4.16 (1.62) mm with MOP and 3.06 (1.64) mm without. After adjusting for differences between jaws, all MOP groups exhibited significantly higher canine distalization than the control group: 0.89 mm more (95% confidence interval [CI] = 0.19 to 1.59 mm; P = .01) in the MOP-4 group, 1.08 mm more (95% CI = 0.49 to 1.68 mm; P = .001) in the MOP-8 group and 1.33 mm more (95% CI = 0.55 to 2.10 mm; P = .002) in the MOP-12 group. All subjects reported pain associated with MOP with 60% classifying it as moderate and 15% severe. The main impact of this reported pain was related to chewing and speech. Conclusions: MOP can increase overall mini-implant supported canine retraction over a 16-week period of observation but this difference is unlikely to be clinically significant.

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. One hundred and nine subjects participated in this research, 54 Malay men and 55 Malay women, aged 20–30 years old with healthy BMI and with no adverse skeletal deviation. Twenty-three facial landmarks were identified on 3D facial images captured using a VECTRA M5-360 Head System (Canfield Scientific Inc, USA). Two angular, 3 ratio and 17 linear measurements were identified using Canfield Mirror imaging software. Intra- and inter-examiner reliability tests were carried out using 10 randomly selected images, analyzed using the intra-class correlation coefficient (ICC). Multivariate analysis of variance (MANOVA) was carried out to investigate morphologic differences between genders. ICC scores were generally good for both intra-examiner (range 0.827–0.987) and inter-examiner reliability (range 0.700–0.983) tests. Generally, all facial measurements were larger in men than women, except the facial profile angle which was larger in women. Clinically significant gender dimorphisms existed in biocular width, nose height, nasal bridge length, face height and lower face height values (mean difference > 3mm). Clinical significance was set at 3mm. Facial soft tissue morphological values can be gathered efficiently and measured effectively from images captured by a non-invasive stereo-photogrammetry 3D camera. Adult men in Malaysia when compared to women had a wider distance between the eyes, a longer and more prominent nose and a longer face.

The aim of this study was to compare the effects of stepwise mandibular advancement versus maximum jumping and extended treatment versus early retention. The material was obtained prospectively and consisted of lateral cephalograms taken at the start (T0), after initial (T1), and at the end (T2) of treatment, from two groups of consecutively treated skeletal Class II patients who had undergone therapy with headgear activators. The first headgear activator group, HGA-S (n = 24; mean age 11.9 ± 1.2 years), was treated for 13 months and had 4-mm mandibular advancement every 3 months. The second headgear activator group, HGA-M (n = 31; mean age 11.2 ± 1.5 years), had maximum jumping, 6–8 mm interincisal opening, for a total of 15.4 months, and with reduced wear for the last 6.9 months. The dropout over 12 months was 41 and 46 per cent, respectively. Pre-treatment growth changes were obtained as a reference. An independent t-test was used to determine differences in baseline dentofacial morphology between the groups, a paired t-test for intra-group comparisons, and an independent t-test to evaluate differences between the groups. The results, in both groups, showed enhanced mandibular prognathism during the initial phase (T0–T1), followed by normal growth (T1–T2), and lower face height enhancement throughout treatment (T0–T2). For both groups, the mandibular plane and occlusal angle increased, possibly enhanced by ‘extrusion’ of the lower molars. For both groups, maxillary forward growth was restrained only during the initial phase, but the effect remained significant at T2 for the HGA-S group. In the HGA-M group, the lower incisors were protruded, while in the HGA-S group, they were unaffected. The findings indicate that both modes of mandibular jumping resulted in skeletal and dental effects. The length of active treatment seemed to be decisive in maintaining the treatment effects; stepwise advancement had less dental effects.