Although deliberate hypotension during surgery may potentially cause organ ischaemia, in particular of the myocardium and cerebrum, it is widely used as an adjuvant technique in oral and maxillofacial surgery aimed at reducing blood loss and improving the surgical field. Deliberate hypotension was reported as the fourth commonest cause...

Pyogenic granulomas are common benign fibrovascular growths of the oral cavity that are non-neoplastic in nature. They may also present as skin lesions. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Tooth avulsion, frequently of the maxillary central incisors, occurs most often in children from 7 to 9 years of age, when the periodontium surrounding the immature erupting teeth is loosely structured, providing minimal resistance to extrusive forces. Falls against hard objects, including those incurred during sports activities, are one...

Ameloblastoma is a benign but locally invasive tumour that affects the jaws. Although it is commonly regarded as a homogeneous group of tumours, detailed investigations have proven its clinicopathologic diversity. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Schimmelpenning syndrome (SS) is characterised by specific skin manifestations, skeletal defects, and central nervous system abnormalities, such as mental deficiency and seizures. Happle has shown that a clinical entity known as “epidermal nevus syndrome”, formerly used as an alternative term to SS, does not exist. This article is available only...

Secondary alveolar bone grafting, which was pioneered in Europe, was reported in the German literature at the beginning of this century. However, it was not until the 1970s that secondary or delayed bone grafting became popular in the United States. This article is available only as a PDF. Please click...

The current explosion of molecular biology encompassing genetics, morphogenesis, teratogenesis and pharmacogenomics for targeted drug therapy is about to have a profound impact upon the practice of medicine in the next century. A new discipline of molecular medicine is becoming a feature of clinical practice. This article is available only...

Most of the mucocutaneous diseases are confined to the stratified squamous epithelia and thus may involve oral, genital and other mucosae and skin. Most of these conditions are acquired and have an immunological basis but there is often a hereditary predisposition. This article is available only as a PDF. Please...

Form follows function and adaptation to physiologic demands dictates skeletal form. In the oro-facial region, tooth loss leads to atrophy of the alveolar arches in all planes. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Cranial bone defects can be a result of trauma, congenital defects, infection or iatrogenically induced by surgery. Even for patients with sufficient hair to cover the affected site, hair styling may not be sufficient to mask off the deficient external cranial contour. This article is available only as a PDF....

There are a variety of pathological conditions that present in the oral cavity. While clinical and radiographic examination will suggest a provisional diagnosis, histological examination is often required to confirm or exclude a suspected diagnosis. This article is available only as a PDF. Please click on “Download PDF” on top...

Multiple segment osteotomy (MSO) orthognathic surgery serves to combine total or segmental maxillary and mandibular correction of dentofacial deformities with concurrent diastematic procedures to provide immediate repositioning of dental-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to...

Craniofacial development is a complex multidimensional process that depends in large part on growth in the cranial base at several growth centres posteriorly and a suture anteriorly. Coordinated development of these sites produces the normal shape of the skull. This article is available only as a PDF. Please click on...

Cleft palate morphology and palatal dimensional changes due to growth and treatment have been analysed by numerous quantitative techniques. Many of these methods, however, produce two-dimensional measurements of the three-dimensional cleft palate deformity. This article is available only as a PDF. Please click on “Download PDF” on top to view...

Distraction osteogenesis is rapidly becoming a mainstream treatment modality for the early management of the patient with mandibular hypoplasia. Following early clinical experience with external distracters, intraoral buried internal distracters have been developed that offer specific advantages over the external device. This article is available only as a PDF. Please...

Apart from the nasal bone, the mandible is the most commonly fractured bone in the face. It is also the 10th most often broken bone in the body. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Acoustic neuroma (vestibular schwannoma) patients have greatly benefited from technical advances in neurosurgery. In fact, the evolution of acoustic neuroma surgery is a microcosm of the development of neurosurgery overall. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The mandible is a unique bone in the human skeleton and occupies a prominent position in the craniofacial region. Traumatic injury to the face, especially in the lower third, may result in fractures of the mandible. This article is available only as a PDF. Please click on “Download PDF” on...

The spread of human immunodeficiency virus (HIV) disease has pursued a relentless course since it was first recognised in the early 1980s and if current trend continues, it is most likely to carry on well into the 21st century. Asia and South Asia are expected to shoulder the greatest...

In the last decades, the exponential growth in the sophistication of the medical/dental knowledge and technologies has made the current dental curriculum more cramped and inevitably compartmentalised. This paradigm shift has caused, globally and regionally, a great demand on dental schools to produce dentists who can differentiate the quality...

The name “Orthopaedic Surgery” is derived from the words “orthos” (meaning straight or to straighten) and “paido” (meaning child). Thus, it is not unexpected that paediatric orthopaedics was the first discipline within Orthopaedics to develop as a subspecialty. This article is available only as a PDF. Please click on “Download...

Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia, unerupted teeth, supernumerary permanent teeth, aplasia or hypoplasia of the clavicles, and other skeletal anomalies, such as hypoplastic iliac wings and brachydactyly. This article is available...

A 19-year-old Indian male with a past history of “Ludwig’s angina” was seen at the Accident and Emergency Department of National University Hospital complaining of an acute swelling at the floor of the mouth for 2 days. The patient was seen the day before in an outpatient clinic and...

The floor of the mouth takes form as early as in the fourth week of gestation with the downward growth and subsequent degeneration of the ectoderm surrounding the peripheral of the tongue, forming the lingual sulcus separating the tongue and the floor of the mouth. The anterior boundary is...

Ameloblastoma is a true neoplasm of enamel organ type tissue which does not undergo differentiation to the point of enamel organ. This type of tumour occurs mostly in the mandible and grows slowly with variable clinical and histological characteristics, but it is histologically benign. This article is available only as...

Six patients with unusual presentations of head and neck disease were presented for diagnosis by discussants at the conference. Images were accompanied by brief details and the differential diagnosis was explored by the discussants. This article is available only as a PDF. Please click on “Download PDF” on top to...

The Internet is a global network of networks that connect computers all over the world, so that anyone from any point in the network can communicate with others on the network through a service provider. The Transmission Control Protocol/Internet Protocol (TCP/IP) and the World Wide Web (www) technology have...

Bisphosphonates are commonly prescribed for the treatment (and prevention) of postmenopausal and corticosteroid induced osteoporosis, Paget’s disease, hypercalcemia associated with malignancy and osteolysis (and bone pain) associated with metastatic bone disease (e.g. in metastatic breast and prostate cancers). This article is available only as a PDF. Please click on “Download...

Recurrent aphthous stomatitis (RAS) is a common condition of the oral mucosa of unknown aetiology. Several predisposing factors have been suggested including haematinic deficiencies, reactions to foodstuffs and local trauma. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Human immunodeficiency virus (HIV) infection is a major global health problem. It is estimated that the number of people living with HIV infection in India, by the end of 2002, is 4 to 5 million. This article is available only as a PDF. Please click on “Download PDF” on top...

Betel quid/areca nut use has been common in South and Southeast Asia and the Asia Pacific region for a long time and is common among migrated communities in Africa, Europe and North America. Because of its ancient history, its use is socially acceptable among all sections of society, including...

The primary function of the immune system of the mouth is to protect the teeth, jaws, gingivae and the rest of the oral mucosa against infection. The oral immune system is part of an extensive and specialised compartmentalised mucosa-associated lymphoid tissue (MALT). This article is available only as a PDF....

The practice of Dentistry in Singapore has advanced rapidly, with the development and recognition of several specialty practices, coupled with the support of established specialty training programmes abroad as well as locally. In this respect, the Academy of Medicine, Singapore (AMS) had led and played a pivotal role in...

Deformity refers to distortion of any part of the body. The term dentofacial is related to the dental arches and their effects on facial contours. Dentofacial deformity has been described as a deformity that affects primarily the jaws and dentition, although the mid and lower faces are also affected. This...

In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the necessary answers through physical examination of the patient and investigations either at the bedside or the laboratory. We engage in research activities into the patient’s...

Diabetes mellitus (DM) is a common and growing global health problem. It is highly prevalent in Asian communities. Hong Kong, Pakistan, and Singapore are among the countries with the highest prevalence of diabetes in the adult population. This article is available only as a PDF. Please click on “Download PDF”...

A record of Diagnostic Radiology would be incomplete without reference to Wilheim Roentgen, who discovered the rays that he could not comprehend; hence, X-rays. The day was Friday, 8 November 1895, as he worked on cathode ray tubes at the University of Wurzburg, Germany. These rays penetrated opaque substances,...

In looking at the history of orthopaedic education in Singapore, one must place our local setting in the worldwide perspective. Officially, the academic Department of Orthopaedic Surgery in Singapore (in what was then the University of Malaya, now the National University of Singapore) was only set up in 1952,...

The Straits and Federated Malay States Government Medical School was founded in 1905. Dr Chen Su Lan, 1 of the 7 graduates in the first class to qualify in March 1910, reminisced in 1965 on his training experiences: “Among the ‘killer’ diseases were malaria (there were 20 deaths a...

Physiology is the study of normal function in the body and how genes, proteins, organ systems interact to maintain health. It provides a foundation for the health sciences profession and life science research. Physiology education in Singapore dates back to 3 July 1905, when the Federated Malay States Government...

During the growth and development of a person, the facial structures are primarily dependent on the genetic makeup and secondarily on the environmental factors. If the facial structures grow abnormally or disproportionately, a dentofacial deformity occurs. This article is available only as a PDF. Please click on “Download PDF” on...

The mandibular advancement device (MAD) consists of upper and lower splints attached to the teeth and postures the mandible forward. The rationale for use of the MAD is that the forward movement of the mandible moves the tongue forward since the tongue is attached to the genial tubercles of...

Vertigo has been said to be the greatest “heartsink” symptom in medicine. That certainly is a possibility but every specialty has its similar conditions, and vertigo is no worse than low back ache or nocturnal cramps. However, the main reason for this problem is not the symptom but the...

Tropical countries such as Singapore, although without well-defined influenza seasons, are also affected by influenza epidemics and pandemics. Twenty per cent of Singapore’s population is clinically infected by seasonal influenza annually, and excess mortality over the past decade was about 14.8 per 100,000 person-years – comparable to temperate United...

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. Modern day FM began its existence as a “counterculture” to the disease-and-body-part focus of the hospital specialties in the 1960s. This article is available only as a PDF. Please click on “Download PDF”...

A history of the Chapter of Pathologists would be incomplete without a history of the specialty of Pathology in Singapore. Pathology is in fact the first specialty practiced in Singapore. This was due to the seriousness of the public health situation and infections like water borne diseases in Singapore...

The Academy of Medicine, Singapore was duly founded in 1957 as the professional corporate body of medical and dental specialists in Singapore. The Chapter of Surgeons was inaugurated in 1966 by the Master of the Academy of Medicine, Professor K Shanmugaratnam, as one of the first two Chapters of...

Paediatrics is among one of the earliest specialties to develop in Singapore and its early development has been documented on various occasions.1-4 At the end of the 1980s, there were some 100 practising paediatricians who were trained either locally or overseas. They formed the core group of paediatric specialists...

Fibromyalgia syndrome (FMS) has been referred to as a medically unexplained syndrome;1,2 a rheumatological entity described in rheumatology textbooks and taught to all training rheumatologists,3 and lately with newer development in research particularly in neurophysiology, as a central sensitivity syndrome.4 Due to its lack of objective findings on physical...

Osteomas are benign, slow-growing tumours of the bone which may be classified as solitary or multiple. Multiple osteomas are mainly associated with Gardner’s syndrome while solitary osteomas can be further classified as peripheral, central or extra skeletal depending on the origin. This article is available only as a PDF. Please...

Man’s innate curiosity to study the internal organs of the human body dates back to the time of Hippocrates where basic speculums were invented to peer into the buccal cavity and vagina. The first instruments used to intubate the oesophagus and stomach in the 16th and 17th centuries were...

Coronavirus disease 2019 (COVID-19) is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was first reported to the World Health Organization (WHO) as pneumonia of unknown aetiology in the Chinese city of Wuhan on 31 December 2019. Since then, COVID-19 has spread across the globe and...

The process of delivery of health care is complex and includes aspects which concern the clinician, the patient and the treatment process itself. Training imparts skill and knowledge to the clinician. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...