Prince Philip Dental Hospital Research Articles

An analysis of patient dose received during cone-beam computed tomography in relation to scan settings and imaging indications as seen in a dental institution in order to establish institutional diagnostic reference levels.

To investigate the dose-area product (DAP) of cone-beam computed tomography (CBCT) examinations for different scan settings and imaging indications, and to establish institutional diagnostic reference levels (DRLs) for dose optimisation. A retrospective analysis of the DAP values of 3568 CBCT examinations taken from two different devices at the Prince Philip Dental Hospital, Hong Kong between 2016 and 2021 was performed. Patient- (age, gender, and imaging indication) and imaging-related (CBCT device, field-of-view (FOV), and voxel size) were correlated with the DAPs. The indication-oriented third-quartile DAP values were compared with DRLs from the UK, Finland, and Switzerland. The obtained third-quartile DAPs lower than the national DRLs and those for which no national DRLs have been proposed were used to establish institutional DRLs. In the investigated CBCTs, the DAP value for large FOV scans was significantly lower than medium/small FOVs. CBCTs with a small voxel size exhibited a significantly higher DAP than those with a medium/large voxel size. CBCTs for endodontic, periodontal, orthodontic, or orthognathic evaluation exhibited a significantly higher DAP than other indications. Twelve indication-oriented institutional DRLs were established and five of them were lower than the national DRLs: third molars (229 mGy×cm2), jaw cysts/tumours (410 mGy×cm2), maxillary sinus pathology (520 mGy×cm2), developing dentition (164 mGy×cm2), and periapical lesions (564 mGy×cm2). CBCT examinations for endodontic, periodontal, orthodontic, or orthognathic evaluation may deliver a higher radiation dose to the patient than other imaging tasks. A periodic review of the patient dose from CBCT imaging and establishment of institutional DRLs for specific clinical settings are needed for monitoring patient dose and to optimise indication-oriented scanning protocols.

Prevalence and morphological characteristics of disto-lingual roots in mandibular first molars: a cone beam CT study with diagnostic and therapeutic implications.

High prevalence of disto-lingual roots (DLR) at the mandibular molar in Chinese can complicate the management of periodontitis. This study assessed the prevalence and morphological features of mandibular first molar DLR and furcation entrances in a Hong Kong population by analysis of cone beam computed tomography (CBCT). CBCT including the mandibular 1st molar region were identified from the Prince Philip Dental Hospital archive and analyzed by a single investigator. Morphologic features and location of DLR were studied and presented as 95% confidence intervals. A total of 398 CBCTs with 716 mandibular first molars were analyzed. The prevalence of DLRs in mandibular first molars on subject based was 20.1% (95% C.I. 16.2-24%). DLR was located 44.5° ± 8.9° (95% C.I. 42.8-46.1°) to the mid-lingual of the mandibular first molar, with a bucco-lingual width 3.3 mm ± 0.5 mm (95% C.I. 3.2-3.4 mm). The mesial furcation entrance was located 4.0 mm ± 0.9 mm (95% C.I. 3.8-4.2 mm) apical to the cemento-enamel junction (CEJ) while the distal was 5.2 mm ± 1.3 mm (95% C.I. 5.0-5.4 mm) from the CEJ. The surface area of the DLR was 106.9 mm2 ± 41.2 mm2 (95% C.I. 98.9-114.8 mm2). Chinese population has a high prevalence of DLRs. The present information is critical for understanding the morphological features of DLR and guide diagnosis and treatment of stage III periodontitis as well as for secondary prevention and supportive care of stage II periodontitis. Little is known about the location and morphology of disto-lingual roots of mandibular 1st molars, yet they are frequently present in patients with Chinese ethnic background, thus complicating diagnosis and treatment. The present study utilized CBCT to analyze the prevalence and morphological features of the mandibular first molar DLR and furcation entrance. It is the first study reporting on the position of the DLR, degree of separation of the furcation, and the surface area of the DLR.

Image retake rates of cone beam computed tomography in a dental institution.

To investigate the frequency and reasons for retaking cone beam computed tomography (CBCT) scans in an oral and maxillofacial radiology imaging clinic in a dental institution. A retrospective cohort chart audit of the patient image database was performed for 1737 patients attending the Diagnostic Imaging clinic at the Prince Philip Dental Hospital from February 2016 to May 2019, and the rate of, and reasons for, CBCT image re-exposure was tallied. Patient demographics (age and gender) and CBCT acquisition parameters (CBCT unit, field-of-view (FOV), scanned region of interest, and exposure time) were recorded and correlated to retake analysis. The retake rate was 4.6% (80/1737). The most common reasons for re-exposure were incomplete FOV coverage (57.5%) and motion artifacts (27.5%). Patients under 12 years of age had a significantly higher risk for motion artifacts. CBCT for the temporomandibular joint (TMJ) had a significantly higher risk for incomplete FOV coverage. Children (less than 12 years of age) demonstrate a higher frequency of retakes, principally due to motion artifacts. TMJ CBCT examinations have a higher frequency of retakes due to an incomplete FOV coverage. Information regarding the frequency and reasons for CBCT retakes is beneficial to identify procedures, practices, or patients susceptible to additional radiation exposure and implement appropriate and specific quality control protocols.

The perceptual and behavioral influence on dental professionals from the noise in their workplace

A long-term exposure to the high-frequency dental noise is a potential hazard to the health of dental professionals and the quality of oral health service provisions. This study aims to thoroughly investigate the influence of an acoustic environment on the perceptions and behaviors of dental professionals. A multidimensional sound quality assessment that comprises the objective measurements of the acoustic and psychoacoustic metrics in different statistical levels and a self-administrated questionnaire was conducted in the Prince Philip Dental Hospital of Hong Kong. The results indicate that the dental professionals’ noise sensitivity and job-performance drops are mainly affected by loudness of noise. Moreover, two types of health risk perceptions, loudness-related and sharpness-related, were found to be associated with a health state of dental professionals. Also, a higher chance of having health-mediated avoidance was found for the dental professionals who had a worse health state and worked in a noisier workplace. These findings provide new knowledge on the development of a health-supportive acoustic environment.

Is there a need for postoperative antibiotics after third molar surgery? A 5-year retrospective study.

Randomized controlled trials might be reporting a higher postoperative infection rate for third molar surgery compared to other study designs due to unclear criteria for the classification of "infections". The aim of the present retrospective study was to assess the infection rate after third molar surgery with and without postoperative antibiotic prescription. Case records of patients who underwent third molar extractions at the Prince Philip Dental Hospital in Hong Kong between 3 July 2012 and 22 June 2017 were evaluated retrospectively. Data extraction was performed for indications, clinical and radiographic findings, antibiotic treatment, postoperative complications, and treatment for postoperative infection. The odds ratio (OR) for postoperative infection was estimated. In total, 1615 extracted over 5years from 992 patient records were included in the final analysis. Antibiotics were prescribed postoperatively for 44% of the extractions. The overall infection rate was 2.05%. There was no significant difference in infection rates between the groups which underwent extractions with or without antibiotics (OR=.68; P=.289). We found a significantly higher risk for infections with increasing age (P=.002). Infection rates after third molar extraction is minimal in the current setting, with no significant benefit from postoperative antibiotic prescription.

Prevalence, characteristic features, and complications associated with the occurrence of unerupted permanent incisors.

This study examined the prevalence, characteristic features, and complications associated with the occurrence of unerupted permanent incisors among children and adolescents attending a university dental teaching hospital. A retrospective review was performed of the clinical records of children and adolescents who attended the Prince Philip Dental Hospital, Hong Kong between 2005 and 2014. All patients who had at least one unerupted permanent incisor tooth were included. A total of 266 subjects with 320 unerupted permanent incisors were identified. The prevalence of unerupted permanent incisors among children and adolescents was 2.0%. Permanent maxillary central incisors (70.6%) were the most commonly affected teeth. The most common cause for unerupted incisors were dilacerations (n = 83, 36.7%) for maxillary central incisors; developmental dental anomalies (n = 22; 30.6%) together with unfavorable root development (n = 22; 30.6%) for maxillary laterals incisors; and abnormal tooth/tissue ratio (n = 11, 50.0%) for mandibular incisors. A majority of unerupted incisors presented with complications the most common being ectopic/displacement/rotation of the unerupted incisors (46.6%), loss of space (36.9%) and midline shift (27.5%). In conclusion, the causes were distinct for different manifestations of unerupted permanent incisors. As the majority of unerupted incisors presented with complications, a systematic and organized method of history taking as well as clinical and radiographic examinations is mandatory in the diagnosis of unerupted permanent incisors.

Orthognathic Relevant Scales of FACE-Q: Translation and Validation for Hong Kong Chinese Patients.

Background:A validated questionnaire is needed to study a more holistic outcome assessment including postsurgical aesthetic satisfaction and psychosocial changes in orthognathic patients. The aim of this study was to determine the reliability and validity of 9 orthognathically relevant translated FACE-Q scales among Hong Kong Chinese orthognathic patients.Methods:Two hundred fifty adult Cantonese-speaking patients of 18 years or older who underwent orthognathic treatment were recruited in the Prince Philip Dental Hospital of Hong Kong. Nine of an overall of 40 independent FACE-Q scales were selected and translated into Hong Kong Chinese. The reliability, validity, and test–retest reliability were examined using Cronbach’s alpha, paired t test and Pearson’s correlation coefficients.Results:The Hong Kong Chinese version of the 9 FACE-Q scales was obtained by forward-backward translation. One hundred eight male (mean age, 25.57 ± 4.49) and 142 female (mean age, 24.61 ± 4.54) patients were recruited for the reliability and validation process. The internal consistency (0.89–0.97) and the test–retest reliability (0.73–0.90) were found to be high. The validity of the translated questionnaires was comparable with that of the original FACE-Q.Conclusion:The results presented here prove that the 9 translated FACE-Q scales are reliable and valid instruments for research and clinical purposes in Hong Kong Chinese orthognathic patients.

Dental Environmental Noise Evaluation and Health Risk Model Construction to Dental Professionals.

Occupational noise is unavoidably produced from dental equipment, building facilities, and human voices in the dental environment. The purpose of this study was to investigate the effect of occupational noise exposure on the dental professionals’ health condition. The psychoacoustics approach noise exposure assessment followed by the health risk assessment was carried on at the paediatric dentistry clinic and the dental laboratory in the Prince Philip Dental Hospital of Hong Kong. The A-weighted equivalent sound level, total loudness, and sharpness values were statistically significantly higher for the noise at the laboratory than that at the clinic. The degree of perceived influences and sharpness of noise were found to have the impacts on the dental professionals’ working performance and health. Moreover, the risk of having a bad hearing state would a have 26% and 31% higher chance for a unit increment of the short-term and long-term impact scores, respectively. The dental professionals with the service length more than 10 years and the daily working hours of more than eight showed the highest risk to their hearing state. The worse the hearing state was, the worse the health state was found for the dental professionals. Also, the risk of dissatisfaction would be increased by 4.41 and 1.22 times for those who worked at the laboratory and a unit increment of the long-term impact score. The constructed health risk mode with the scientific and statistical evidence is hence important for the future noise management of environmental improvement.

Noise level and its influences on dental professionals in a dental hospital in Hong Kong

Noise is recognized as one of the major indoor environmental issues in dental settings. This study presents the noise measurements and questionnaire surveys conducted in the clinics for pediatric dentistry and laboratories in the Prince Philip Dental Hospital in Hong Kong. Noise level and octave noise spectrum were measured at 60 locations distributed around the working areas. Totally, 60 valid questionnaires were collected, of which 30 were completed by dental surgery assistants and 30 by laboratory technicians. Data were coded and analyzed statistically using SPSS 19.0. The average noise levels in the dental clinics and laboratories were 62.6 dB(A) and 67.7 dB(A), respectively, which are well below the limit of 85 dB(A) for causing hearing loss. Statistical analysis shows that there is a significant difference in hearing status (condition of hearing ability) between different gender, age and occupation groups. Among others, noise generated by the equipment operated by others presents a principal influence on dental professionals. Importantly, suddenness and frequency of noise occurrence, rather than noise level, produce a significant influence on dental works. Most dental professionals work routinely and do not take any precautions or actions against noise at work. Practical application: The findings of this study should first increase the understanding of acoustical environment in dental settings for clinicians and its influence on dental professionals and second help designers and engineers improve the acoustical environment in dental settings.

Two-dimensional and three-dimensional postsurgical temporomandibular joint condylar remodelling following vertical subsigmoid osteotomy setback surgery

Background: Vertical subsigmoid osteotomy (VSSO) for ramus setback has been suggested to exert less stress onto the condylar head causing more positive bone remodelling changes in the postoperative phase. However, it is unclear if the setback amount has any effect on the remodelling pattern. Objectives: This study aims to compare the postsurgical quantitative and qualitative condylar remodelling changes in various setback magnitudes using two-dimensional (2D) and threedimensional (3D) radiography. Methods: Retrospective pre- and postoperative radiographic data of patients with mandibular prognathism that had undergone VSSO from 2007 to 2012 at the Prince Philip Dental Hospital were traced. 130 postero-anterior and lateral cephalographs, along with 174 cone-beam computed tomography (CBCT) scans were retrieved. 2D and 3D radiographic tracing were performed to measure the condyle-ramal morphometric values. Pre- and postoperative CBCT rendered condyle ramus segments were superimposed based on stable growth registration points to observe zonal and topographic changes. Findings and Conclusion: 2D radiographic tracing did not show significant condyle-ramal changes in different setback magnitudes. 3D radiographic tracing showed significant changes in axial condylar depth with more setback. Topography analysis also showed that in the postero-superior condylar surface, more bone deposition was found in larger setback. In the axial plane, the bone formation proportion at the condylar head was significantly increased in mid-anterior and posteromedial zones with larger setback except in the group with setback between 4.1–6 mm. In general the condylar remodelling pattern after VSSO for mandibular setback was considered to be stable despite various setback magnitudes.

Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver's Perceived Quality of Communication with Paediatric Dental Visits.

Patients’ perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient’s perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver’s perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients’ demographic information and the caregiver’s perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes ‘disease / treatment’, ‘treatment procedure related instructions’, ‘preparation for examination’, ‘positive reinforcement / reassurance’, and ‘family / social history’ from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme ‘Positive reinforcement / reassurance’: ‘number of related words’ (p = 0.002), ‘number of related utterances’ (p = 0.001), ‘percentage of the related words in total number of words’ (p = 0.005), ‘percentage of the related utterances in total number of utterances’ (p = 0.035) and ‘percentage of time spent in total time duration’ (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver’s involvement, such as clinicians’ mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians’ communication skills for improving patients’ clinical experiences and treatment satisfaction.

Dental anxiety in Hong Kong preschool children: Prevalence and associated factors

Background: This study is designed to determine the prevalence of dental anxiety and contributing factors in Hong Kong preschool children. Methods: All first-time visitors between the ages of three and five to the Prince Philip Dental Hospital, Hong Kong between were recruited between August 2014 and June 2015. Questionnaires on background information, parent’s self-reported Modified Dental Anxiety Scale (MDAS), and parental proxy of the Modified Child Dental Anxiety Scale (MCDAS) were completed by parents. An oral examination was carried out to assess and record the caries experience and oral hygiene status of the child. The child’s dental anxiety level was rated using the Clinical Anxiety Rating Scale (CARS). Ordered logistic regression analysis was performed to assess the association of parent’s and children’s characteristics with the CARS scores. Results: Among 299 children, the mean CARS score reported was 1.16 (SD 1.06) with only 8% of the subjects rating 3 or above, indicating those who were uncooperative and demonstrated real behavioural problems that might interfere with dental procedures. Data analysis showed that the child’s age (p=0.004, OR=0.659, 95%CI=0.497-0.872), the child’s previous dental experience (p=0.013, OR=0.518, 95%CI=0.307-0.867), parental proxy MCDAS score (p=0.002, OR=2.439, 95%CI=1.376-4.353), and the dental attendance pattern of the parents (p=0.013, OR=0.530, 95%CI=0.321-0.870) were associated with the CARS scores. Conclusion: Dental behavioural management problems are not prevalent in Hong Kong preschool children, but such problems are associated with both the parent’s and child’s characteristics such as the child’s age, previous dental experience, and dental attendance pattern of the parents.

Bone stability around implants in elderly patients with reduced bone mineral density - a prospective study on mandibular overdentures.

The purpose of this prospective clinical study was to determine whether reduced bone mineral density (BMD) is correlated with a higher risk for dental implant therapy in an elderly patient population. Seventy-nine patients recruited at the Prince Philip Dental Hospital were provided with 2-implant-supported mandibular overdentures. Skeletal BMD was recorded before the implant therapy. The World Health Organization Osteoporosis Diagnosis Classification (femoral neck score) was utilized to define the osteoporosis status of patients. Periapical radiographs were taken with a special radiographic holder at the time of implant loading (baseline) and at follow-up examinations. The mesial and distal marginal bone levels of each implant were measured. The mean marginal bone loss (mMBL) and greatest marginal bone loss (GBL) of four implant sites at patient level were recorded for data analysis. Clinical examination including plaque score (PI) and bleeding on probing (BOP) was recorded. Of the 79 patients recruited in the study, the survival rate of implant was 98.7%. Sixty-three patients (79.7%) were finally available for data collection and statistical analyses. The mean follow-up time was 62.9 (SD=15.2) months with the mean MBL 0.65mm (SD=0.67) and mean GBL 1.25mm (SD=0.83), respectively. The average BOP and PI of patients were 49.6% (SD=30.8) and 47.4% (SD=37.4). Only BOP was found significantly correlated with mMBL (r=0.321, P=0.01). Skeletal BMD was not associated with marginal bone loss (mean MBL: r=-0.094, P=0.466; mean GBL: r=0.04, P=0.761). Within the limits of this study, osteoporosis was not a contraindication for implant therapy, and reduced skeletal BMD was not associated with increased marginal bone loss around implants or other complications in an elderly population.

The communal consultation: video-recorded student consultations.

Medical EducationVolume 50, Issue 5 p. 573-574 Really Good Stuff The communal consultation: video-recorded student consultations Michael Botelho, Corresponding Author Michael BotelhoCorrespondence: Michael Botelho, Department of Oral Rehabilitation, Oral Rehabilitation, University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital rd, Hong Kong SAR, China. Tel: 00 852 2859 0412; E-mail: botelho@hku.hkSearch for more papers by this author Michael Botelho, Corresponding Author Michael BotelhoCorrespondence: Michael Botelho, Department of Oral Rehabilitation, Oral Rehabilitation, University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital rd, Hong Kong SAR, China. Tel: 00 852 2859 0412; E-mail: botelho@hku.hkSearch for more papers by this author First published: 13 April 2016 https://doi.org/10.1111/medu.13047Citations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume50, Issue5May 2016Pages 573-574 RelatedInformation

Dental anomalies associated with buccally‐ and palatally‐impacted maxillary canines

The aim of the present study was to determine the association of both buccally- and palatally-impacted canines with other dental anomalies. This retrospective study was conducted on a population of 533 southern Chinese children and adolescents who had impacted maxillary canines that had been treated in the Paediatric Dentistry and Orthodontics Clinic, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong. Descriptions of the impacted canine and other associated anomalies were obtained from the case notes and radiographs. Clinical photographs and study casts were used, where available. A total of 253 (47.5%) patients with impacted maxillary canines were diagnosed with other dental anomalies. Microdontia was the most frequently-occurring anomaly reported in these patients, with the maxillary lateral incisor the most commonly affected tooth. Other odontogenic anomalies that were associated with both buccally- and palatally-impacted canines included hypodontia, supernumerary teeth, transposition of other teeth, enamel hypoplasia, other impacted teeth, and dens invaginatus. Both buccally- and palatally-impacted canines were found to be associated with other odontogenic anomalies.

Implant dentistry in undergraduate dental curricula in South-East Asia: forum workshop at the University of Hong Kong, Prince Philip Dental Hospital, 19-20 November 2010.

This paper reports on the discussions arising from a 2-day forum on implant dentistry education in South-East Asia. The 10 institutions present represented undergraduate and postgraduate dental curricula from seven countries, including Hong Kong, Indonesia, Malaysia, Taiwan, Thailand, the Philippines, and Singapore. While not aiming to reach consensus as in other such conferences, the outcome was positive in establishing realistic goals in university education in implant dentistry for curriculum leaders and developers.

Depression and diffuse physical symptoms in southern Chinese with temporomandibular disorders

The study investigated the experience of depressive symptoms and the relationship with diffuse physical symptoms reporting in southern Chinese seeking professional care for temporomandibular disorders (TMD) in Hong Kong. Eighty-seven new patients [77 females/10 males; mean age 39.3 years (SD 12.7)] referred to the specialist TMD clinic at the Prince Philip Dental Hospital, Hong Kong participated in this study. The Research Diagnostic Criteria (RDC)/TMD history questionnaire was used to derive Axis II psychological data. Psychological status was assessed through depression and non-specific physical symptoms (NPS) scores (pain items included and excluded) measured with RDC/TMD Axis II instruments; 42.5% of patients experienced moderate/severe depression symptoms; 59.8% and 57.5% had moderate/severe NPS scores when pain items were included and excluded, respectively. Strong, positive and statistically significant correlations were noted between depression scores and the NPS scores that included pain items (r = 0.80) and those that did not (r = 0.80). The correlations remained consistent and were of similar magnitude when male patients were excluded from the computation and also when the possible effect of patient age was controlled. While taking into account the modest patient sample which was related to a low rate of treatment seeking, depressive symptoms were common and similar to other western and Chinese patient groups. NPS reports were higher than in Singapore Chinese patients. There appeared to be a clear association between depression and diffuse physical symptoms. The findings should be considered in the holistic care of Chinese people with TMD.

An introduction to orthodontics, 3rd edition (2007)

Author: Laura Mitchell. Publisher: Oxford University Press, Oxford, UK Price: £42.99 ISBN: 978-0-19-856812-4 This is a new edition of Dr Mitchell's readily understandable and well-illustrated textbook. This is used as the basis both at the undergraduate and postgraduate level at the Orthodontic Discipline, Prince Philip Dental Hospital, Hong Kong. For more than 10 years, this textbook has been the core of the …

Diagnostic sub‐types, psychological distress and psychosocial dysfunction in southern Chinese people with temporomandibular disorders

The study aimed to assess the distribution of temporomandibular disorders (TMD) sub-types, psychological distress and psychosocial dysfunction in southern Chinese people seeking treatment for TMD using Research Diagnostic Criteria for TMD (RDC/TMD) and investigate potential cross-cultural differences in sub-type prevalence and psychosocial impact. Eighty-seven consecutive patients (77 females; 10 males) with a mean age of 39.3 years (s.d. 12.8) newly referred to the specialist TMD clinic at the Prince Philip Dental Hospital, Hong Kong over a 20-month period took part in the study. RDC/TMD history questionnaire and clinical assessment data were used to derive Axis I and II findings. Group I muscle disorders were the most common and found in 57.5% of patients. Group II (disc displacement) disorders were found in 42.5% and 47.1% of the right and left temporomandibular joints (TMJ) respectively. Group III disorders (arthralgia/arthrosis/arthritis) were revealed in 19.5% and 23.0% of right and left TMJ's respectively. In the Axis II assessment, 42.5% of patients had moderate/severe depression scores, 59.7% had moderate/severe somatization scores and based on graded chronic pain scores 15.0% had psychosocial dysfunction (grade III and IV). While acknowledging the small sample size, the distribution of RDC/TMD Axis I and II diagnoses was fairly similar in Chinese TMD patients compared with Western and other Asian patient groups. However, in Chinese patients, myofascial pain with limited jaw opening and TMJ disc displacement with reduction were more common and a significant number experienced psychological distress and psychosocial dysfunction. The findings have implications for the management of TMD in Chinese people.

A Measure of Gold

Since its founding in 1954, the Society of Anaesthetists of Hong Kong has set fundamental aims to assure professionalism of the specialty, uphold the honor and status of anesthetists, provide appropriate anesthetic training, establish close liaison with professional partners worldwide and educate the lay public about anesthesia.