ORIGINAL_ARTICLE
An aggressive central giant cell granuloma of maxilla: Diagnostic dilemma, Precise differential diagnosis and successful traditional surgical approach: A case report
Abstract Central Giant Cell Granuloma (CGCG) is a benign, proliferative, intraosseous and non-odontogenic lesion of unknown etiology accounting for approximately 10% of all benign lesions of the jawbones. Lesion usually occurs in patients younger than 30 years, is more common in females than males, and is more common in mandible than maxilla. The clinical feature of CGCG ranges from a slow growing asymptomatic swelling to a rapidly enlarging aggressive lesion. CGCG of the jaws are histologically benign lesions characterized by the presence of giant cells in the richly vascularized stroma of the spindle cells. Differential diagnosis should be performed with other lesions that have multinucleated giant cells (MGCs). Definitive diagnosis relies on correct interpretation of clinical, radiographical and histopathological data. The treatment of CGCG ranges from curettage to resection. Alternative treatments are worthy of consideration, although surgical excision remains the treatment of choice. The aim of this presented case highlights a diagnostic challenge of an aggressive CGCG arising from the maxilla and to discuss a precise differential diagnosis, as well as the surgical approach and follow up which is decisive for successful conventional surgical treatment with no lesion recurrence.
https://edj.journals.ekb.eg/article_118770_d4506458f6c77528dc332eb342cbc49a.pdf
2020-10-01
2075
2083
10.21608/edj.2020.40494.1226
Keywords: Central giant cell granuloma
aggressive and non-aggressive form
Differential diagnosis
traditional surgical treatment
Recurrence follows up
Abdurahman
Elmezwghi
pathol.2010@gmail.com
1
Oral Pathology Dept. Faculty of Dentistry. University of Tripoli. Tripoli-Libya.
AUTHOR
Nuri
Alarabi
nurialarabi@yahoo.com
2
Oral and Maxillofacial Dept. Faculty of Dentistry. University of Tripoli. Tripoli -Libya
AUTHOR
Abeer
Elsagali
dr_ab_hs@yahoo.com
3
Oral and Maxillofacial Surgery Dept. Faculty of Dentistry. University of Tripoli. Tripoli-Libya
AUTHOR
Salma
Zariba
salmazariba.sz@gmail.com
4
Oral maxillofacial Surgery Dept. Faculty of Dentistry. University of Tripoli. Tripoli-Libya
AUTHOR
Najia
BenGharbia
bennaj66@yahoo.com
5
Oral and Maxillofacial Dept. Faculty of Dentistry. University of Tripoli. Tripoli-Libya.
AUTHOR
Nesrin
Musa
nesrinmosa@gmail.com
6
Oral and Maxillofacial Surgery Dept. Faculty of Dentistry. University of Tripoli. Tripoli-Libya.
AUTHOR
ORIGINAL_ARTICLE
Extraction of Maxillary Teeth Without a Palatal Injection: A Randomized Control Trial
ABSTRACT Purpose: The aim of this research was to assess the clinical effectiveness of buccal infiltration of 4% Articaine hydrochloride in comparison to routine buccal and palatal infiltration during the extraction of maxillary molars. Patients and Methods Current research were carried out on 200 patients where study group included 100 patients, and 100 were controls. Unilateral extractions were made to patients in the research group. All patients were injected with 1.8 ml of 4% Articaine hydrochloride with 1:100.000 epinephrine in the buccal vestibule of chosen tooth for removal without performing palatal injection. The maxillary tooth was removed after 8 minutes. One hundred participants in the control group were subject to the same procedure with palatal injection. Upon extracting, every patient completed a face pain scale (FPS) and visual analog scale (VAS). Results: According to the FPS and VAS scores, the difference in pain rates was statistically non-significant (p>0.05) when compared with permanent maxillary dental removal with or without palatal injection. Conclusion: Permanent maxillary tooth extraction is possible when 1.8 mL of 4% Articaine is deposited in the buccal vestibule of the tooth without palatal anesthesia.
https://edj.journals.ekb.eg/article_118771_0c75a4df574ac71b6707d2adfd8325ac.pdf
2020-10-01
2085
2090
10.21608/edj.2020.37339.1188
Key words: Articaine 4%
Pain
palatal injection
Mohammad
Shuman
showmadrill@gmail.com
1
oral and maxillofacial surgery faculty of dentistry Al-Azhar university Assiut branch
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of bone healing of odontogenic maxillary cystic defects grafted with hemihydrated calcium sulphate granules Versus biphasic calcium phosphate granules: A Randomized Controlled Clinical Trial
Objectives: This study aims to compare between the effect of hemihydrated calcium sulphate bone graft granules and biphasic calcium phosphate granules on bone healing of maxillary cystic defects. Patients and methods: Twenty patients (15 males, 5 females; age range, 16 to 40 years with an average of 25 years) with maxillary cystic lesions were included in this prospective, comparative study. Patients were randomized into two groups as group 1 in which the cystic defects were grafted with hemihydrated calcium sulphate bone graft granules (n=10) and group 2 in which the cystic defects were treated with biphasic calcium phosphate granules(SYMBIOS) (n=10). Postoperative assessments were performed for both groups, clinically through detection of any signs of infection, inflammation, or graft rejection; and radiographically. Radiographic assessment was performed by using cone beam computed tomography (CBCT) preoperative and at 6 months postoperatively for measurement of relative bone density and dimensional changes of the cystic cavity. Results: The radiographic results demonstrated a statistical insignificant difference between the medians (IQR) of relative dimension and density changes of cystic defects in both groups after 6 months. Conclusion: Both bone grafts granules have the same effects on bone filling of cystic defects. Also, both grafts are similar in reducing dimensions of cystic cavities during healing.
https://edj.journals.ekb.eg/article_118773_c3b840374603f0ceca985c5ad9aa3b6b.pdf
2020-10-01
2091
2100
10.21608/edj.2020.41356.1238
Key Words: Maxillary cysts
hemihydrated calcium sulphate bone graft
Biphasic bone graft
Nermeen
Sorour
sorour_nermeen@yahoo.com
1
Oral surgery department,faculty of oral and dental medicine, Cairo university
LEAD_AUTHOR
Ali
Fahd
2
Lecturer of Oral and Maxillofacial Radiology, South Valley University
AUTHOR
Heba
Kamel
drhebakamel@gmail.com
3
Associate Professor of Oral and Maxillofacial Surgery, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Comparison of lag-screw versus miniplate for osteosynthesis of anterior mandibular fracture: A Randomized Control study
ABSTRACT Objective: The aim of this study was to evaluate the outcome of mandibular fractures fixation in order to compare lag screw technique with standard miniplates. Methods: This prospective randomized comparative study was conducted on 20 patients with mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated into two groups. Group 1: two lag screws were used for fracture osteosynthesis in 10 patients. Group 2: two miniplates were used for fracture osteosynthesis in 10 patients. The surgery was done by the same surgical team who did not involve within the research work. The time for hardware fixation was recorded intraoperatively. Patients were assessed clinically and radiographically for fracture stability, malocclusion, masticatory efficiency, mouth opening, paresthesia, pain, edema, infection, wound dehiscence, malunion/ununion and hardware loosening. A repeated measure ANOVA were used to evaluate the different between lag screw and miniplates. Results: Hardware fixation time showed a highly significant (p < 0.001*) difference between group-1 Lag screw with an average of 15.80±0.80 minutes and group-2 miniplates with an average of 20.01±0.823 minutes. The difference in interfragmentary distance between lag screw and miniplates treatments were nonsignificant (p>0.05). regarding occlusion, fracture stability, mastication biting efficiency and postoperative complications a non-significant (p < 0.05) difference between both groups as revealed. Conclusions: According to the result of this prospective study it is concluded that, the internal fixation of anterior mandibular fractures with lag screws osteosynthesis is simple, successful, achieving rapid fixation with minimal complications.
https://edj.journals.ekb.eg/article_118775_b9887c3b1fcbd87171221bdad825d3a3.pdf
2020-10-01
2101
2110
10.21608/edj.2020.38226.1198
Key words: mandibular fracture
osteosynthesis
miniplates
Lag screw
Mohammad
Shuman
showmadrill@gmail.com
1
oral and maxillofacial surgery faculty of dentistry Al-Azhar university Assiut branch
LEAD_AUTHOR
ORIGINAL_ARTICLE
Assessment of Mandibular Ascending Ramus Cortical Plates for Reconstruction of Atrophic Maxillary Ridges Versus Chin Cortical Plates [A Randomized Clinical Trial]
Aim of the study: Assessment of the quality and quantity of horizontal bone gain upon using the rami cortical blocks versus chin blocks for horizontal augmentation of atrophic maxillary ridges Patients and Methods: Twenty operation sites in 18 patients suffering from partial edentulism in the maxilla with an inadequate bone width to allow favorable implant placement were selected from the outpatient clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University. They were classified after being included in the study into (10 chin group candidate) & (10 ascending ramus candidate). Results: A total of 20 atrophic sites (cases) in 18 patients ranging from 29-54 years old with a mean of 43.4 years were included in the present study (Table 2). The enrolled subjects were randomly divided by alternation into two groups. 10 sites received autogenous block graft harvested from the mandibular symphysis (symphyseal group). Other 10 sites received autogenous block graft harvested from the ascending ramus (ramus group). Conclusion: Thus within the limits of this study the following could be concluded: Ascending ramus onlay blocks showed significant better results than symphyseal onlay blocks regarding both the quality and stability of the grafted volume of bone. Ramus graft harvesting is a more sensitive procedure as compared to symphyseal block graft and requires certain level of surgical skill and experience to be performed successfully.
https://edj.journals.ekb.eg/article_118776_79593a7078e64c23fd3f84656184b3de.pdf
2020-10-01
2111
2123
10.21608/edj.2020.38289.1199
Mandibular Ascending
>Ramus Cortical Plates
Ahmed
Zayed
ahmed.zayed@dentistry.cu.edu.eg
1
Master Degree in Dental Implantology
LEAD_AUTHOR
Nevien
Askar
niveenaskar71@gmail.com
2
Professor of Oral and Maxillofacial surgery Cairo University
AUTHOR
Mohamed
Abdel Rasoul
zokasur@live.com
3
Lecturer of Oral and Maxillofacial surgery Cairo University
AUTHOR
ORIGINAL_ARTICLE
A randomized controlled trial of the use of tissue expander followed by autogenous bone graft versus autogenous bone graft only for reconstruction of anterior region of the mandible
Introduction: Soft tissue expansion with percutaneous distensible expanders gained popularity for reconstructive surgery in the face and neck. Purpose: The aim of this study was to compare by using tissue expander with autogenous bone graft versus autogenous bone graft only for reconstruction of anterior region of the mandible. Materials and Methods: The study included 20 patients with anterior mandibular bony defects. Patients were randomly divided into 2 groups. Patients in group I, underwent mandibular augmentation with tissue expander followed by autogenous bone graft. While in group II, autogenous bone graft was used only. Preoperative and six months postoperatively; computed tomography and lateral cephalometric views had been performed in all cases in both groups. Cephalometric points, landmarks and measurements are recoded to compare between both groups regarding pre and post-operative results. Results: In both groups, comparison between pre and post-operative variables showed; significant difference of the mandible in the anteroposterior direction and non-significant change in the vertical measurements. Soft tissue profile showed significant increase in the position of the upper and lower lip and soft tissue pogonion. While, the nasolabial angle, the pronasale, and soft tissue A point showed non-significant changes. Comparison between both groups showed significant improvement of the horizontal direction of the mandible, mandibular length and soft tissue profile in group I than group II. P-value (> 0.05) was considered non-significant. Conclusion: Tissue expansion has become a popular procedure in the reconstruction of face and neck lesions.
https://edj.journals.ekb.eg/article_118777_e9ebf6d4c4565c05fab285dd76de80bb.pdf
2020-10-01
2125
2136
10.21608/edj.2020.38424.1205
Mandibular continuity defect
CBCT
tissue expander
autogenous bone graft
cephalometry
Baha Eldeen
Tawfik
drbahaaeldin1234@gmail.com
1
Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, (boys), Al-Azhar University Cairo, Egypt.
AUTHOR
Amany
El-sayed
dr.amany_khalifa@hotmail.com
2
Assistant Professor, Department Oral and Maxillofacial Surgery, Faculty of Oral &amp; Dental Medicine, Modern University for Technology &amp; Information, Egypt
LEAD_AUTHOR
Raafat
Mohamed
raafatghetany@yahoo.com
3
Assistant Professor, Department of Orthodontics, Faculty of Dental Medicine, (boys), Al-Azhar University Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Clinical and Radiographic Evaluation of Immediate Non-functional loaded Implants in Osteoporotic Patients
Purpose: To compare success rate as well as difference of marginal bone loss around immediately placed non-functionally loaded implants in osteoporotic patients versus non-osteoporotic patients. Material & Methods: The present study was conducted on 12 patients, six of them were osteoporotic and the other six were normal healthy patients. Both groups underwent immediate post extraction implantation, with a total of 16 implants. Each patient was a candidate for single tooth replacement in the mandibular arch at the premolar area. CBCT was performed at the intervals of immediately after implant installation and 6 months postoperatively. This is to determine radiographic bone loss from initial surgery. Periotest was used to determine the implant mobility at the intervals of immediately after implant installation and 6 months postoperatively. Results: The marginal bone level (flushed implant-bone crest to implant apex) baseline records at time of implant placement was used for all cases as a reference. And then, measurements were taken again after six months to detect the change in the marginal bone level for both groups. After 6 months, the mean marginal bone loss of the osteoporotic group was slightly higher than the normal group but yet not of significant difference. There was no statistically significant bone loss difference between the two groups at the buccal and lingual surfaces either in coronal or sagittal sections. Conclusion: The results of this study suggest that dental implants inserted immediately following extraction in osteoporotic patients do present success rates nearly equivalent to those implants placed in normal patients.
https://edj.journals.ekb.eg/article_118779_0a8afcbc2bb39bb266007171eada6752.pdf
2020-10-01
2137
2145
10.21608/edj.2020.40360.1219
Implant
Osteoporosis
BONE LEVEL CHANGES
Mahmoud
El Arini
mahmoud.elarini@gmail.com
1
OMFS, Faculty of oral and dental medicine, Future University, Cairo, Egypt
LEAD_AUTHOR
Mohammed
Hamed
mohomran@dent.bsu.edu.eg
2
OMFS, Faculty of oral and dental medicine, Beni-suef University, Beni-suef, Egypt
AUTHOR
ORIGINAL_ARTICLE
A Histomorphometric meta-analysis of sinus elevation with various grafting materials
Several grafting materials have been used in the sinus floor augmentation procedures including autogenous bone(AB), Xenograft (Bio-Oss), inorganic bovine bone (ABB), platelet rich fibrin (PRF) , plasma rich fibrin (PRF), hydroxy appatite (HA), calcium sulfate and pegen P15 used AB as a comparator and the other six materials as interventions. Up to now a subject of controversy in maxillofacial surgery and dentistry is what is the most appropriate graft material for sinus floor augmentation. Materials and Methods: The literature searches were performed using PubMed search. The search covers only English, human and RCT literatures. For analyzing the quality and quantity of bone. After search strategy on PubMed we found 336 articles then after applying the inclusion and exclusion criteria the remaining RCT articles which met the criteria are 2 studies, which measures the bone quality only by Histomorphometric and no included RCT paper using CBCT. Results: In the remaining 2 articles the comparison occur between 2 materials which are autogenous bone and Bio-Oss using Histomorphometric analysis on 48 patients, which gives result in the first study AB=37.7 ± 31.3%, Bio-Oss=41.7 ± 26.6% and in the second study AB=42.74 ± 2.10%, Bio-Oss=24.90 ± 5.76%. Conclusion: The bone quality formed by Bio-Oss is less than autogenous bone by 17.1% so that the autogenous bone remains the gold standard grafting material.
https://edj.journals.ekb.eg/article_118780_104145695040b528bab94082b08a07c1.pdf
2020-10-01
2147
2152
10.21608/edj.2020.39328.1208
A Histomorphometric:
>
Amr
Elbalka
amrelbalka83@gmail.com
1
Cairo univeristy
LEAD_AUTHOR
Ibrahim
Abdallah
ibrahim.abdallah@dentistry.cu.edu.eg
2
Oral Maxillofacial Surgery, Cairo University
AUTHOR
Tarek
Elghareeb
t.elghareeb@dentistry.cu.edu.eg
3
Oral Maxillofacial Surgery, Cairo University.
AUTHOR
ORIGINAL_ARTICLE
Effect of Mineralized Plasmatic Matrix And Titanium Granules As Graft Materials for Immediate Implant Placement
Objectives: This study was conducted to compare and assess the effect of mineralized plasmatic matrix (MPM) versus titanium granules (Tigrans) as bone regenerative materials during immediate implant placement. Material and Methods: A total of 12 patients with 12 implants have been included in this study, patients were divided into 2 groups. Group I received Mineralized Plasmatic Matrix (MPM), and group II received Titanium granules (Tigran) as bone regenerative materials for immediate implant placement. Clinical and radiographic outcomes of the treatment were assessed at 3 and 6 months of implant placement. Results: Statistical analysis of the two groups bone densities showed a significant increase (P ≤ 0.05) at 3 months postoperatively (Group I=105.17 ±18.88. Group II=101.07±10.81) , and at 6 months postoperatively (Group I=713.83 ±28.52HU.Group II=658.83±37.16HU) in comparison to the immediate implant placement data (Group I=84.43 ±8.63. Group II=85.48±8.61). Comparing the Mean of bone height between the two groups there was no statistically significant difference (P ≥ 0.05) between them at any of the time intervals Conclusion: The use of MPM and Tigran was successful as bone regenerative material for immediate implant placement regarding bone height and bone density.
https://edj.journals.ekb.eg/article_118781_27e4ce40af2363cddd15639db7a53f0e.pdf
2020-10-01
2153
2164
10.21608/edj.2020.40806.1236
Immediate implant
Titanium granules
Tigran
MPM
bone regeneration
ingy
chehata
ishehata@msa.eun.eg
1
Assistant professor of Oral & Maxillofacial surgery. Faculty of Dentistry. October University of Modern Sciences and Art. Egypt
LEAD_AUTHOR
ghada
monim
ghadaabdelmonim81@gmail.com
2
lecturer of oral and maxillofacial surgery. faculty of dentistry. cairo university
AUTHOR
Shaimaa
Refahee
smr11@fayoum.edu.eg
3
Lecturer,oral and maxillofacial department. faculty of dentistry, fayoum university
AUTHOR
ORIGINAL_ARTICLE
THE EFFECT OF SINGLE VERSUS MULTIPLE INTRA-ARTICULAR INJECTION OF SYNOVIAL FLUID MESENCHYMAL STEM CELLS ON RAT TEMPOROMANDIBULAR JOINT WITH INDUCED ARTHRITIS. BIOCHEMICAL AND HISTOLOGIC ANALYSIS
Introduction: Osteoarthritis (OA) is the most common chronic musculoskeletal disorder. Nowadays, the role of synovial fluid mesenchymal stem cells (SF MSCs) is increasingly attributed to the treatment of Temporomandibular joint osteoarthritis. This study aimed to compare single versus multiple intra-articular injection of SFMSCs in terms of macroscopic, biochemical, and histological analysis. Material & methods: 18 young adult male 200–300 grams albino rats were used in the current study divided randomly into 3 equal groups. Group (A) comprised control in which OA was induced with no treatment, group (B) comprised MSCs single intra-articular injection group, and group (C) comprised MSCs multiple intra-articular injection group. Biochemical and histologic analysis were performed. Results: histological findings showed that both groups B, C showed regeneration of meniscus and retrodiscal tissues, but group C was superior in regeneration compared to group B. Biochemical analysis showed that TNF-α and IL-1B had the highest value in the control group, followed by the single injection group, while the lowest value was found in multiple injections group respectively. Conclusion: Multiple Intra-articular SF MSCs is a potential disease-modifying therapy for patients suffering from TMJ-OA.
https://edj.journals.ekb.eg/article_118782_4ba75478f8e22f882fd83294499b1ffd.pdf
2020-10-01
2165
2172
10.21608/edj.2020.41265.1239
SFMSCs
osteoarthritis
TMJ
meniscus
Cytokines
Shereen
Arafat
shereenwa@yahoo.com
1
Oral Surgery Department, Faculty of Dentistry, MSA University
LEAD_AUTHOR
Samah
Kamel
sabdelaziz@msa.eun.eg
2
Oral Biology Department, Faculty of Dentistry, MSA University
AUTHOR
ORIGINAL_ARTICLE
Management of Temporomandibular Joint Arthritis using Low Level Laser Therapy method
Background: Many studies have recommend using low-level laser therapy (LLLT) in pain reduction in acute and chronic musculoskeletal pain. Objective: To clinically evaluate the effectiveness and validity of (LLLT) for management symptoms of temporomandibular joint (TMJ) arthritis. Methodology: A clinical study included patients with TMJ arthritis signs and symptoms, were randomly categorized into two groups of ten patients each. Patients of the first group were subjected to pre adjusted (LLLT) over four weeks together with NSAIDs. Patients were evaluated clinically according to following groups: (T1) before any treatment (T2) after six sessions of laser therapy application. (T3) after 12 laser therapy sessions applications. (T4) one month after the last session application. The second group received only (NSAIDs). They were evaluated at the same time intervals of the first group. Evaluation criteria were: • Maximum mouth opening which measured in mm using ruler. • Presence or absence of pain at TMJ area. The VAS method was used to quantify pain at TMJ area with palpation. Results: Evaluation of maximum mouth opening in mm showed highly marked significant clinical improvement In (LLLT and NSAIDs) group. The same clinical improvement was noted in (NSAIDs) group.Comparison of results between the two groups showed a marked significant clinical improvement in pain reduction in favor of the (LLLT and NSAIDs) group during all evaluation periods. Same clinical improvement in pain reduction in favor for (LLLT and NSAIDs) group was noted in (VAS).Conclusion. (LLLT) in patients with TMJ arthritis is safe and effective technique to be used.
https://edj.journals.ekb.eg/article_118783_8476fc5c91b570eebb6eb34e5cbeab1f.pdf
2020-10-01
2173
2177
10.21608/edj.2020.43447.1270
Temporomandibular joint
TMJ
Arthritis
LLLT
Raafat
Riad
raafatriad5@gmail.com
1
Associate Professor Military Medical Academy
LEAD_AUTHOR
ORIGINAL_ARTICLE
Thermoplastic versus Conventional Heat Cured Denture Bases for Implant - Retained Mandibular Overdenture
Objective: The aim of this study was to compare radiographically thermoplastic and conventional heat cured acrylic resin as denture base material for mandibular conventional type implant retained complete overdentures and evaluate the effect of this difference on the implants stability. Materials and methods: Fourteen edentulous patients were selected to construct two implants retained mandibular overdenture. The patients were equally divided into two groups according to material of denture base: group I, patients with thermoplastic resin constructed by injection moulding technique; and group II, patients with denture bases constructed by conventional heat curing acrylic resin. Radiographic and implant stability parameters were evaluated 1 year study. Results: There was no statistically significant difference between the thermoplastic and conventional heat cured denture bases for implant retained mandibular overdenture in bone resorption and stability of the implants. Conclusion: There was no statistically significant difference between the thermoplastic and conventional heat cured implant overdenture bases. Both denture bases have beneficial effect on implant osseointegration and stability.
https://edj.journals.ekb.eg/article_118784_efab2a49d70c222749bebc012704ac77.pdf
2020-10-01
2179
2185
10.21608/edj.2020.43448.1271
Edentulous mandible
overdenture
Implants
thermoplastic resin
Raafat
Riad
raafatriad5@gmail.com
1
Associate Professor Military Medical Academy
LEAD_AUTHOR
Ahmed
Meselhy
moselhyaa@gmail.com
2
Lecturer, Prothodontics – Military Medical Academy
AUTHOR
Mahmoud
Alaswad
alaswad88@gmail.com
3
BDS, MSD Faculty of Dentistry, Suez Canal University (2011)
AUTHOR