A Randomised Controlled Trial Comparing Thermoformed and 3D-Printed Retainers in Young Adults: Evaluation of Post-treatment Stability and Patient Satisfaction Hui Shan Boo, Norhidayah Nor zahidah Mohd Tahir, Aufa Dahlia Bahar, Simon J. Littlewood, Saritha Sivarajan Clinical Oral Investigations, 2026 Introduction To compare post-treatment stability and oral health–related quality of life (OHRQoL) in young adults wearing thermoformed retainers (TFR) versus direct 3D-printed retainers (3DPR) over a six-month part-time retention period. Materials and methods This single-centre, two-arm parallel randomised controlled trial allocated 30 debonded orthodontic patients (≥ 18 years) to either TFR (Erkodur PETG, 1.0 mm) or 3DPR (NextDent Ortho Flex, 0.75 mm) in a 1:1 ratio. All retainers were worn part-time (8–12 h/day). Digital intraoral scans were obtained at baseline (T0) and six months (T2) using Trios 3, and post-treatment stability was assessed digitally using Little’s Irregularity Index, intercanine width, intermolar width, arch length, overjet, and overbite. OHRQoL was evaluated at both time points using the OHIP-14(M) questionnaire. Non-parametric tests were applied following the Shapiro–Wilk assessment, and analyses were conducted using an intention-to-treat approach. Results One dropout in the 3DPR group at T2. At T2, no significant between-group differences were found in Little’s Irregularity Index, intercanine width, intermolar width, arch length, or overjet ( p > 0.05). Overbite values were statistically higher in the TFR group at T2 ( p < 0.05); however, the difference was not clinically significant. Changes in post-treatment stability from T0 to T2 (ΔT2–T0) did not differ significantly between groups ( p > 0.05). Total OHIP-14(M) scores improved significantly from T0 to T2 in both groups (TFR p = 0.016; 3DPR p = 0.013), with no significant between-group differences at either time point ( p > 0.05). A small but significant difference was observed in the psychological disability domain at T2, with slightly higher scores in the 3DPR group ( p = 0.020). No harm was observed. Conclusions TFR and 3DPR demonstrated comparable post-treatment stability and similar improvements in OHRQoL after six months of part-time wear. Registration ClinicalTrials.gov (Identifier NCT05968625). Protocol: The protocol was published before trial commencement
Awareness and Knowledge of Dental Advertising Guidelines Among Recent Dental Graduates in Malaysia Vivian Ong, Yasmin Kamarudin, Saritha Sivarajan, Nor Azlida Mohd Nor, Joo Ming Cheong, et al. European Journal of Dental Education, 2026 Introduction Dental institutions often include advertising ethics as part of the undergraduate curriculum to instil professional standards. However, there is limited evidence on graduates' awareness and understanding of advertising guidelines in their subsequent practice. Objective To assess the awareness and knowledge of dental advertising guidelines among recent dental graduates in Malaysia and to compare the outcomes between those from public and private universities. Materials and Methods This cross‐sectional study was conducted in 2024 involving recent dental graduates from eight Malaysian universities. A newly designed and validated questionnaire was used to assess awareness and knowledge across seven domains of dental advertising ethics, including online professionalism, product recommendations, and the promotion of clinic facilities and treatments. Descriptive and inferential statistics were used to compare responses between graduates from public and private universities. Results In total, 253 participating graduates completed the online questionnaire. Awareness among public university graduates was significantly higher than that of their private counterparts ( p ‐value < 0.05). The mean knowledge score was 61.80%. The domain with the highest knowledge score was ‘online professionalism’ (71.30%), whereas the lowest‐scoring domain was ‘recommendation of specific products’ (46.77%). Public university graduates scored significantly higher in the domains of ‘description of clinic facilities’ and ‘advertisement of specific treatment’ ( p ‐value < 0.05). Conclusion Participants from public universities reported significantly higher awareness and performed better in specific domains related to dental advertising ethics. These findings highlight the importance of a standardised and comprehensive education on ethical advertising practices across all dental institutions.
Students' perception on flipped classroom with formative assessment: A focus group study Siti Adibah Othman, Yasmin Kamarudin, Saritha Sivarajan, Eunice Xinwei Soh, May Nak Lau, et al. European Journal of Dental Education, 2023 OBJECTIVE To explore students' perception on the implementation of flipped classroom (FC) combined with formative assessment during the undergraduate teaching of orthodontic wire-bending skills. METHODS Third-year undergraduate dental students were taught wire-bending skills via FC teaching method using a series of pre-recorded online video demonstrations. As part of the formative assessment, the students were given the results and assessment rubrics of their prior wire-bending assessment before every subsequent session. Purposive sampling method for focus group discussion was used to recruit eight students comprising four high achievers and four low achievers. Strengths, weaknesses, and suggestions for improvement of the FC with formative assessment were explored. Data were transcribed and thematically analysed. RESULTS Students perceived that FC allowed for a more convenient and flexible learning experience with personalised learning and improved in-class teaching efficiency. The pre-recorded online videos were useful to aid in teaching wire-bending skills but lacked three-dimensional representation of the wire-bending process. Students suggested better standardisation of instructions and access to the marking rubric before and after assessment. CONCLUSIONS FC teaching with continuous formative assessment and constructive feedback as a form of personalised learning was viewed favourably by students. The implementation of periodic individual feedback can further enhance their learning experience.
Students’ perception on flipped classroom in contrast to live demonstration for teaching orthodontic wire-bending skills: A focus group study May Nak Lau, Saritha Sivarajan, Yasmin Kamarudin, Siti Adibah Othman, Wan Nurazreena Wan Hassan, et al. Journal of Dental Education, 2022 OBJECTIVE This study aimed to explore students' perceptions of flipped classroom (FC) compared to live demonstration (LD) in transferring skills of fabricating orthodontic wire components for orthodontic removable appliances. METHODS Forty third-year undergraduate dental students were randomly assigned to two groups: FC (n = 20) and LD (n = 20). Students in group FC attended FC, while students in group LD attended LD. Both groups underwent a series of standardized teaching sessions to acquire skills in fabricating six types of orthodontic wire components. Eight students (four high achievers and four low achievers) from each group were randomly selected to attend separate focus group discussion (FGD) sessions. Students' perceptions on the strengths, weaknesses, and suggestions for improvement on each teaching method were explored. Audio and video recordings of FGD were transcribed and thematically analyzed using NVivo version 12 software. RESULTS Promoting personalized learning, improvement in teaching efficacy, inaccuracy of three-dimensional demonstration from online video, and lack of standardization among instructors and video demonstration were among the themes identified. Similarly, lack of standardization among instructors was one of the themes identified for LD, in addition to other themes such as enabling immediate clarification and vantage point affected by seating arrangement and class size. CONCLUSIONS In conclusion, FC outperformed LD in fostering personalized learning and improving the efficacy of physical class time. LD was more advantageous than FC in allowing immediate question and answer. However, seating arrangement and class size affected LD in contrast to FC.
Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review Saritha Sivarajan, Nor Nadia Zakaria, Noor Asyikin Azmily, Mang Chek Wey, Mohamed Abd El-Ghafour, et al. Australasian Orthodontic Journal, 2022 Objective The present systematic review aimed to determine cephalometric values that may be used as a guide in deciding between orthodontic camouflage and orthognathic surgery to treat a Class III malocclusion in adults. In addition, a secondary aim was to identify treatment complications and aesthetic perceptions by laypersons/orthodontists. Methods Without a language restriction, an electronic search of six databases and a hand search of three orthodontic journals were performed until September 2021. All studies comparing orthodontic camouflage and orthognathic surgery in Class III malocclusion patients, were included. Data extraction was carried out independently by two authors with disagreement resolved by a third author. The risk of bias related to individual studies was appraised using a modified version of the STROBE checklist. The results were summarised qualitatively, and no meta-analysis was undertaken due to the high heterogeneity between the studies. Results With the quality of evidence ranging from moderate to high, six retrospective studies were included. A cephalometric analysis comprising the Holdaway angle, overjet, the Wits appraisal, lower incisor inclination, the maxillary-mandibular ratio, overbite, gonial angle and an additional combination were used as a guide. No treatment complications were reported. One study examined the perception of facial profile attractiveness in borderline surgical Class III malocclusions and found no difference in outcome and significant improvements in both camouflage and surgical groups. Conclusion The existing evidence is insufficient to identify a cephalometric parameter threshold in deciding between orthodontic camouflage and orthognathic surgery. PROSPERO database protocol no. CRD42020165164.
The effect of live demonstration and flipped classroom with continuous formative assessment on dental students’ orthodontic wire-bending performance Saritha Sivarajan, Eunice Xinwei Soh, Nor Nadia Zakaria, Yasmin Kamarudin, May Nak Lau, et al. BMC Medical Education, 2021 Background Wire-bending skills is commonly taught through live demonstrations (LD) though flipped classroom (FC) method has gained popularity. Continuous formative assessment promotes personalised learning via closely monitored progress, with the identification of students’ strengths and weaknesses. This study aims to evaluate the effects of LD and FC teaching methods, supplemented with continuous formative assessment, on dental students’ learning of wire-bending skills for six types of removable orthodontic appliance components. A deeper understanding of the relative effectiveness between LD and FC teaching methods can help identify the most appropriate method to achieve student learning objectives, which is especially important given the current Covid-19 pandemic. Methods Forty third-year undergraduate dental students were randomly assigned into FC (n = 20) or LD (n = 20) cohort. Each student attended six teaching sessions, each to teach students’ competency in fabricating one type of wire component, for a total competency in fabricating six wire components over the course of six teaching sessions. Either LD or FC teaching methods were used. After each session, wire assignments had to be submitted. Wire assignments were then evaluated using a blinded wire-bending assessment protocol. As part of their formative assessment, the assessment results were distributed to students, lecturers, and technicians before the next session. After the first session (T0) and at the end of all six sessions (T1), students completed a self-reported questionnaire. Results The mean wire-bending scores for FC were significantly higher than LD for two of the six assignments, namely the Adams clasp (p < 0.01) and Z-spring (p = 0.03). Scores for both LD and FC increased significantly over time, which may be attributed to formative assessment. There was no statistically significant correlation between wire-bending scores and video usage. Students were satisfied with both teaching methods, according to T0 and T1 questionnaires. Conclusions Both LD and FC are equally effective in transferring practical orthodontic wire-bending skills and well-received by students. Continuous formative assessment may have enhanced students’ learning of orthodontic wire-bending skills. Further studies with control group are recommended to investigate the effect of formative assessment on teaching practical dental skills.
Comparing flipped classroom and conventional live demonstration for teaching orthodontic wire-bending skill May Nak Lau, Yasmin Kamarudin, Nor Nadia Zakaria, Saritha Sivarajan, Norhidayah @ Nor Zahidah Mohd Tahir, et al. Plos One, 2021 Flipped classroom may overcome weaknesses of live demonstration in teaching orthodontic wire-bending. This study aims to compare the effectiveness between flipped classroom and live demonstration in transferring skills for fabricating Adams clasp. Forty third-year undergraduate dental students were assigned to two groups. The students in group LD (n = 20) attended a live demonstration while students in group FC (n = 20) attended a flipped classroom. Both groups were taught on skills to fabricate Adams clasp in a standardised way. Each student from both groups were asked to submit an Adams clasp for a blinded quality assessment by two trained and calibrated assessors using a 18-item rubric, followed by validated students’ satisfaction questionnaires to evaluate their perceived satisfaction on the teaching method received. A crossover study was then conducted three weeks later where LD attended a flipped classroom while FC attended a live demonstration. Students’ satisfaction questionnaires were again collected from each student for blinded analysis. Mean scores for the quality of Adams clasp were 9.775 and 9.125 for LD and FC, respectively. No significant difference was detected between the two groups. Statistically significant association was found for one statement on the questionnaire, “I found the classroom arrangements conducive for the wire-bending activity” (p = 0.010). No significant differences were found between the two groups for other statements (p > 0.05). In conclusion, within the limitations of the study, flipped classroom is equally effective as conventional live demonstration in transferring orthodontic wire-bending skills for fabrication of Adams clasp. However, students perceived the classroom arrangements during the flipped classroom significantly more conducive for teaching orthodontic wire-bending.
Authors’ response Norliza Ibrahim, Muhammad Khan Asif, Saritha Sivarajan, Ng Heng Khiang Teh, Mang Chek Wey American Journal of Orthodontics and Dentofacial Orthopedics, 2021
Authors' response Mang Chek Wey, Mona M. Salah Fayed, Lorretha P. Ringgingon, Saritha Sivarajan American Journal of Orthodontics and Dentofacial Orthopedics, 2020
Response to the Letter Saritha Sivarajan, Jennifer Geraldine Doss, Spyridon N. Papageorgiou, Martyn T. Cobourne, Mang Chek Wey Angle Orthodontist, 2019
A Randomised Controlled Trial Comparing Thermoformed and 3D-Printed Retainers in Young Adults: Evaluation of Post-treatment Stability and Patient Satisfaction HS Boo, NN Mohd Tahir, AD Bahar, SJ Littlewood, S Sivarajan Clinical Oral Investigations 30 (4), 126 , 2026 2026.0
Accuracy of three-dimensionally printed retainers and aligners: A systematic review HS Boo, S Sivarajan, N @ Nor zahidah Mohd Tahir, AD Bahar Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie 87 (2 … , 2026 2026.0 Citations: 6
Awareness and Knowledge of Dental Advertising Guidelines Among Recent Dental Graduates in Malaysia V Ong, Y Kamarudin, S Sivarajan, NAM Nor, JM Cheong, MAMZ Adnan European Journal of Dental Education , 2026 2026.0
Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar … K Mohan, S Sivarajan, MN Lau, SA Othman, MMS Fayed Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie 85 (2 … , 2024 2024.0 Citations: 3
Students' perception on flipped classroom with formative assessment: A focus group study SA Othman, Y Kamarudin, S Sivarajan, EX Soh, MN Lau, NN Zakaria, ... European journal of dental education 27 (3), 419-427 , 2023 2023.0 Citations: 24
Students’ perception on flipped classroom in contrast to live demonstration for teaching orthodontic wire‐bending skills: A focus group study MN Lau, S Sivarajan, Y Kamarudin, SA Othman, WN Wan Hassan, ... Journal of Dental Education 86 (11), 1477-1487 , 2022 2022.0 Citations: 7
Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review S Sivarajan, NN Zakaria, NA Azmily, MC Wey, M Abd El-Ghafour, ... Australasian Orthodontic Journal 38 (2), 183-193 , 2022 2022.0 Citations: 3
Comparing flipped classroom and conventional live demonstration for teaching orthodontic wire-bending skill MN Lau, Y Kamarudin, NN Zakaria, S Sivarajan, NNZ Mohd Tahir, ... Plos one 16 (7), e0254478 , 2021 2021.0 Citations: 20
The effect of live demonstration and flipped classroom with continuous formative assessment on dental students’ orthodontic wire-bending performance S Sivarajan, EX Soh, NN Zakaria, Y Kamarudin, MN Lau, AD Bahar, ... BMC Medical Education 21 (1), 326 , 2021 2021.0 Citations: 35
Osseous evidence behind micro-osteoperforation Response N Ibrahim, MK Asif, S Sivarajan, NHK Teh, MC Wey AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS 159 (2), E83-E83 , 2021 2021.0
The global distribution of permanent canine hypodontia: A systematic review S Sivarajan, SA Mani, J John, FMM Salah, YA Kook, MC Wey Korean Journal of Orthodontics 51 (1), 55-74 , 2021 2021.0 Citations: 8
Dental Students' Perceptions of Learning Space: A Focus Group Study. LM Nak, S Sivarajan, ZY Mohd Yusof Archives of Orofacial Science 15 (2) , 2020 2020.0 Citations: 3
Distribution of mandibular trabeculae bone volume fraction in relation to different MOP intervals for accelerating orthodontic tooth movement NHK Teh, S Sivarajan, MK Asif, N Ibrahim, MC Wey The Angle Orthodontist 90 (6), 774-782 , 2020 2020.0 Citations: 8
Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: A 3-month study MK Asif, N Ibrahim, S Sivarajan, NHK Teh, MC Wey American journal of orthodontics and dentofacial orthopedics 158 (4), 579 … , 2020 2020.0 Citations: 17
MOPs and accelerated tooth movement: A biased conclusion? Response MC Wey, MMS Fayed, LP Ringgingon, S Sivarajan AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS 158 (2), 159-160 , 2020 2020.0
The effect of micro-osteoperforations on the rate of orthodontic tooth movement: a systematic review and meta-analysis S Sivarajan, LP Ringgingon, MMS Fayed, MC Wey American Journal of Orthodontics and Dentofacial Orthopedics 157 (3), 290-304 , 2020 2020.0 Citations: 71
Response to the Letter S Sivarajan, JG Doss, SN Papageorgiou, MT Cobourne, MC Wey The Angle Orthodontist 89 (5), 831-831 , 2019 2019.0
Mini-implant supported canine retraction with micro-osteoperforation: A split-mouth randomized clinical trial S Sivarajan, JG Doss, SN Papageorgiou, MT Cobourne, MC Wey The Angle Orthodontist 89 (2), 183-189 , 2019 2019.0 Citations: 125
HIGH RISK HABITS IN RELATION TO ORAL CANCER IN TWO SELECTED INDIAN COMMUNITIES IN MALAYSIA AND INDIA: A DESCRIPTIVE STUDY J Francis, S Sivarajan, R Esa, KH Awan THIRD MALAYSIAN POSTGRADUATE CONFERENCE (MPC) 2013, 243 , 2013 2013.0
RM, & Naimie, Z.(2022). Students’ perception on flipped classroom with formative assessment: A focus group study SA Othman, Y Kamarudin, S Sivarajan, EX Soh, MN Lau, NN Zakaria, ... European Journal of Dental Education 27 (3) , 0 Citations: 5
MOST CITED SCHOLAR PUBLICATIONS
Mini-implant supported canine retraction with micro-osteoperforation: A split-mouth randomized clinical trial S Sivarajan, JG Doss, SN Papageorgiou, MT Cobourne, MC Wey The Angle Orthodontist 89 (2), 183-189 , 2019 2019.0 Citations: 125
The effect of micro-osteoperforations on the rate of orthodontic tooth movement: a systematic review and meta-analysis S Sivarajan, LP Ringgingon, MMS Fayed, MC Wey American Journal of Orthodontics and Dentofacial Orthopedics 157 (3), 290-304 , 2020 2020.0 Citations: 71
The effect of live demonstration and flipped classroom with continuous formative assessment on dental students’ orthodontic wire-bending performance S Sivarajan, EX Soh, NN Zakaria, Y Kamarudin, MN Lau, AD Bahar, ... BMC Medical Education 21 (1), 326 , 2021 2021.0 Citations: 35
Students' perception on flipped classroom with formative assessment: A focus group study SA Othman, Y Kamarudin, S Sivarajan, EX Soh, MN Lau, NN Zakaria, ... European journal of dental education 27 (3), 419-427 , 2023 2023.0 Citations: 24
Comparing flipped classroom and conventional live demonstration for teaching orthodontic wire-bending skill MN Lau, Y Kamarudin, NN Zakaria, S Sivarajan, NNZ Mohd Tahir, ... Plos one 16 (7), e0254478 , 2021 2021.0 Citations: 20
Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: A 3-month study MK Asif, N Ibrahim, S Sivarajan, NHK Teh, MC Wey American journal of orthodontics and dentofacial orthopedics 158 (4), 579 … , 2020 2020.0 Citations: 17
The global distribution of permanent canine hypodontia: A systematic review S Sivarajan, SA Mani, J John, FMM Salah, YA Kook, MC Wey Korean Journal of Orthodontics 51 (1), 55-74 , 2021 2021.0 Citations: 8
Distribution of mandibular trabeculae bone volume fraction in relation to different MOP intervals for accelerating orthodontic tooth movement NHK Teh, S Sivarajan, MK Asif, N Ibrahim, MC Wey The Angle Orthodontist 90 (6), 774-782 , 2020 2020.0 Citations: 8
Students’ perception on flipped classroom in contrast to live demonstration for teaching orthodontic wire‐bending skills: A focus group study MN Lau, S Sivarajan, Y Kamarudin, SA Othman, WN Wan Hassan, ... Journal of Dental Education 86 (11), 1477-1487 , 2022 2022.0 Citations: 7
Accuracy of three-dimensionally printed retainers and aligners: A systematic review HS Boo, S Sivarajan, N @ Nor zahidah Mohd Tahir, AD Bahar Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie 87 (2 … , 2026 2026.0 Citations: 6
RM, & Naimie, Z.(2022). Students’ perception on flipped classroom with formative assessment: A focus group study SA Othman, Y Kamarudin, S Sivarajan, EX Soh, MN Lau, NN Zakaria, ... European Journal of Dental Education 27 (3) , 0 Citations: 5
Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar … K Mohan, S Sivarajan, MN Lau, SA Othman, MMS Fayed Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie 85 (2 … , 2024 2024.0 Citations: 3
Determination of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review S Sivarajan, NN Zakaria, NA Azmily, MC Wey, M Abd El-Ghafour, ... Australasian Orthodontic Journal 38 (2), 183-193 , 2022 2022.0 Citations: 3
Dental Students' Perceptions of Learning Space: A Focus Group Study. LM Nak, S Sivarajan, ZY Mohd Yusof Archives of Orofacial Science 15 (2) , 2020 2020.0 Citations: 3
A Randomised Controlled Trial Comparing Thermoformed and 3D-Printed Retainers in Young Adults: Evaluation of Post-treatment Stability and Patient Satisfaction HS Boo, NN Mohd Tahir, AD Bahar, SJ Littlewood, S Sivarajan Clinical Oral Investigations 30 (4), 126 , 2026 2026.0
Awareness and Knowledge of Dental Advertising Guidelines Among Recent Dental Graduates in Malaysia V Ong, Y Kamarudin, S Sivarajan, NAM Nor, JM Cheong, MAMZ Adnan European Journal of Dental Education , 2026 2026.0
Osseous evidence behind micro-osteoperforation Response N Ibrahim, MK Asif, S Sivarajan, NHK Teh, MC Wey AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS 159 (2), E83-E83 , 2021 2021.0
MOPs and accelerated tooth movement: A biased conclusion? Response MC Wey, MMS Fayed, LP Ringgingon, S Sivarajan AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS 158 (2), 159-160 , 2020 2020.0
Response to the Letter S Sivarajan, JG Doss, SN Papageorgiou, MT Cobourne, MC Wey The Angle Orthodontist 89 (5), 831-831 , 2019 2019.0
HIGH RISK HABITS IN RELATION TO ORAL CANCER IN TWO SELECTED INDIAN COMMUNITIES IN MALAYSIA AND INDIA: A DESCRIPTIVE STUDY J Francis, S Sivarajan, R Esa, KH Awan THIRD MALAYSIAN POSTGRADUATE CONFERENCE (MPC) 2013, 243 , 2013 2013.0