2024-03-29T00:15:51Z
https://edj.journals.ekb.eg/?_action=export&rf=summon&issue=10683
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Anatomy of a perforator flap based on the superficial circumflex iliac artery. A cadaveric study
Ahmed
Kosba
Mohamed
Fata
Gamal Eldin
Borhamy
Peter
Kessler
Ahmed
Habib
Introduction: The groin flap, based on the superficial circumflex iliac artery (SCIA), was the first successful free flap. It has mainly been used in lower-limb and hand reconstruction with few reports in the literature of its use in soft-tissue head and neck reconstruction.Methods: Five fresh cadaveric dissections were performed and the following parameters were recorded; the presence or absence of the SCIA, and if present, its branching pattern, the diameter of the SCIA and the length of the pedicle.Results: The superficial circumflex iliac vessels were absent in 40%. When present, the SCIA branches off separately from the femoral artery. A deep branch of the SCIA was found in 40%. The mean diameter at origin was 1.5 mm on average.Conclusion: The small vessel calibers and the short pedicle length along with the variable anatomy of the region make the SCIP flap a challenging reconstructive option.
Superficial circumflex iliac artery perforator flap
SCIP
head and neck cancer
free flap
2019
01
01
89
92
https://edj.journals.ekb.eg/article_71251_be298dda2d251b128af6347b245798d4.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
LASER VERSUS CONVENTIONAL SURGICAL TECHNIQUES TO UNCOVER DENTAL IMPLANTS IN THE SECOND-STAGE SURGERY
Ahmed
Temerek
Ali
Fahd
Ola
Rehan
Youssef
AbdElGhaffar
Hanaa
El-Shenawy
Statement of Problem: This review investigates laser benefits in second stage dental implant surgery as compared to conventional methods. Methods of Study: An electronic database search on PubMed, Cochrane library and LILACS for clinical studies in which laser was used for the second-stage implant surgery were selected and evaluated. Results: initial search yielded 136 studies, 15 were considered potentially relevant, out of which only three were finally selected. They studied the effect of laser on postoperative pain, the need for anesthesia and analgesia, hemostasis, time needed before impression and quality of it, duration of surgery and peri-implant soft tissue conditions. The results shows that the assessed studies are too limited in number beside exhibiting small sample sizes. They are clinically heterogeneous so that a solid conclusion cannot be reached. Conclusions: Researchers should be attracted to laser use to close a very obvious research gap. Randomized clinical trials are strongly recommended.
Laser
Implant surgery
Second-stage
Implant exposure
systematic review
2019
01
01
93
101
https://edj.journals.ekb.eg/article_71252_ade8ffd629dc1ddbb7e9150f7f4beb4b.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Effect of Osteon II Collagen with Hyaluronic Acid on Osseointegration of simultaneous placed implant in piezoelectric splitted posterior mandibular alveolar ridge (Clinical and radiographic study)
Abdel Aziz
Baiomy
Aim: The present study was designed to estimate clinically and radiographically effect of Osteon II Collagen with Hyaluronic Acid on osseointegration of simultaneous placed implant in posterior mandibular alveolar ridge after piezoelectric ridge splitting technique (RST) .Patients & methods: This study was carried out on twenty one patients with partial edentulous narrow posterior mandibular alveolar ridge. Patients were divided randomly into three equal groups (group I treated by piezoelectric RST and simultaneous implant placement into their ridge; without any bone graft, group II treated by piezoelectric RST and simultaneous implant placement into their ridge which was grafted by Osteon II Collagen, while group III treated by piezoelectric RST and simultaneous implant placement into their ridge; associated with placement of Osteon II Collagen when mixed with Hyaluronic Acid in splitted alveolar ridge. Alveolar ridge in all group covered by guided tissue regeneration membrane after implant placement and bone grafting. Patients were evaluated clinically to assess probing depth (PPD), and implant stability quotient (ISQ) then radiographically to assess alveolar ridge width, marginal bone level (MBL), and bone density measurement (BD) parameters at 3, 6, 9 &12 months. Results: Statistical analysis of PPD and ISQ results showed no significant difference between groups at the different intervals while MBL values showed that there is high statistical significant difference during 12 month interval when comparing group III vs. group II. On the same side, BD results showed that group III had highly statistical significant difference at all intervals when it was compared with group I. and at 6, 9 and 12 months when comparing G III vs. G II. Conclusion: The present study concluded that Osteon II Collagen with Hyaluronic Acid may be adjunctive tool to accelerate bone osseointegration around immediate placed dental implant in posterior mandibular alveolar ridge after piezoelectric ridge splitting technique.
2019
01
01
103
112
https://edj.journals.ekb.eg/article_71253_1c39128b7389c8726e6d90fec4d182c5.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Efficacy of sub-mucosal, intra-masseteric and intra-muscular routes of dexamethasone administration on post-operative complications following impacted mandibular third molar surgeries, comparative clinical trial
Nermine
Mahmoud
Purpose: The aim of the current study was to compare the efficacy of dexamethasone injection submucosally, intra-masseteric and intramuscular in surgical removal of mandibular third molars on post-operative swelling, mouth opening and pain.Patients and Methods: forty five patients with impacted mandibular third molars were selected to undergo surgical removal of mandibular third molars. Patients were randomly divided into three groups of fifteen each. Group I, taking sub-mucosal dexamethasone injection, Group II, taking Intra-masseteric dexamethasone injection and Group III, taking intramuscular dexamethasone injection, all patients were injected pre-operatively Assessment of swelling, mouth opening, and pain was done at intervals of 1st, 3rd, and 7th post-operative days.Results: our study showed no statistically significant difference between mean MMO as well as VAS in Group I and II; both showed statistically significant higher mean MMO and VAS than Group III. Significant reduction in pain and swelling in both sub-mucosal, intra-masseteric and intra-muscular but a greater immediate effect on trismus was seen in sub-mucosal and intra-masseteric routesConclusion: It can be concluded that pre-operative dexamethasone injection is an effective pharmacological agent to reduce post-surgical third molar removal sequelae such as pain, swelling and trismus.
antibiotics
corticosteroid
dexamethasone
post-surgery swelling
third molar extraction
2019
01
01
113
133
https://edj.journals.ekb.eg/article_71254_943bc2059eb484ed4b9ef53c73bd6226.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Patient-specific Computer modified titanium plate in Unilateral angle fractures
Khaled
Amr
Hussein
Hatem
Mohamed
Shehab
Purpose: Various treatment modalities have been stated to avoid faulty healing of the mandibular angle fracture and the subsequent functional and esthetic disasters. In this study, we aimed to design a new patient-specific titanium plate to overcome Champy’s acknowledged drawbacks and avoid splaying of the inferior border of the mandible.Patients and methods: This study included eight patients suffering from a displaced unilateral mandibular angle fracture with a mean age of 37 years. They all needed open reduction and internal fixation. Preoperative evaluation included the clinical examination through inspection of malocclusion and measurement of maximum inter-incisal mouth opening, along with the radiographic assessment through the screening panoramic view and the 3-D CT examination to determine the amount of displacement between the fractured segments. Computer mirroring of the intact side was done to virtually reduce the fractured side to design a patient-specific plate. This plate aimed to fit on the superior ventral surface of the external oblique ridge, namely; Champ’s osteosynthesis line. Downward extended lingual shelf and two buccal arms were added in the plate, to only immobilize the mandible lingually along with fixing both fractured segments buccaly with screws, while fixing the segments superiorly at Champy’s line with the standard plate shaft. The titanium PS-plate was processed and fixed in place using 2.0 screws through the standard intra-oral approach after Maxillo-mandibular fixation using ivy-loops. Immediate postoperative mandibular function was allowed. Postoperative clinical assessment of the occlusion and the Maximum inter-incisal opening (MIO) was performed at one week, 1 month and 3 months. Postoperative radiographic CT assessment was performed through measuring the linear inter-fragmentary gap between the fractured segments at the inferior mandibular border. Results: The surgeries in all cases were uneventful. Surgical site was normal with no signs of infection or dehiscence except in only one case, which showed primary intra-oral plate exposure. The preoperative parasthesia recorded in three patients was improved postoperatively, however without its complete disappearance. MIO was significantly improved over the follow-up period to reach a mean of 40.3 mm after 3 months. Radiographic examination, over the follow-up period, revealed the exact alignment of the fractured segments in normal position throughout the whole thickness of the mandible at the fracture line with no inferior border distraction. Conclusion: This study provided a newly designed plate capable of eliminating the splaying of the inferior border of the mandible in other literature-documented intra-oral plating techniques, which was also profitable in sparing the disadvantages of extra-oral approaches.
Mandibular Angle Fracture
Champy’s Plate
Computer-modified
2019
01
01
135
141
https://edj.journals.ekb.eg/article_71255_897e2e6dd4885cb046975391ec43b950.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Digitally-processed custom plate versus conventional plate fixation in Genioplasty
Khaled
Amr
Abd El-Monim
Gh.
Hussein
Hatem
Purpose: The fundamental position of the chin contributes to the aesthetic perception of the face and the subsequent esthetic disharmony when deficient or retruded. In this study, we aimed to verify differences in plate design used in fixation of chin after Genioplasty with relation to postoperative tissue relapse.Patients and methods: Sixteen patients suffering from a retruded chin affecting the facial esthetics which needed advancement Genioplasty were included in this study. They were selected from the outpatient clinic of the departments of oral and maxillofacial surgery and Orthodontics, faculty of Dentistry, Cairo University, with a mean age of 28 years. Facial analysis was performed through clinical intra and extra-oral photographs. Preoperative data from CT scans were documented. Digital planning was done to fabricate a cutting template and a positioning chin template. The patients were then divided into two groups; eight patients each. In Group A patients, custom digital plates designed on the computer software and processed from CAD data from titanium were used to fix the chin after Genioplasty. In group B patients, conventional titanium T-shaped plate was adapted and used in fixation of the chin. Postoperative patient satisfaction and any postoperative complications were recorded. Clinical evaluation including fragment mobility and/or parasthesia was documented on one week, one month, 3 months and 6 months postoperatively. CT scan was performed immediately postoperative and on 6 months to assess fixation and/or tissue relapse through measuring the linear Antero-posterior measurements and the transverse measurements.Results: All the patients were clinically satisfied and content about the new chin position and facial contour. All the surgeries went uneventful with no hardware exposure. Numbness of the lower lip was reported in all patients, which faded with time and reported full recovery later on. Radiographic CT scan measurements revealed the accurate postoperative measurements compared to the preoperative plan. The mean linear Pog-orbit-mental measurements showed net overall significant increase, however, with a statistical significant decrease from one period to another in each groups. In both groups, there were no statistical significant changes in mean Pog- Right mental plane and Pog- left mental plane transverse measurements. Statistical correlation between results of both groups showed no significant differences over the study period.Conclusion: This study recommended the use of digital planning of Genioplasty and template fabrication due to the documented exact pre-to-postoperative chin alignment. The specific custom plate design and processing proved to be an insignificant hassle which can be spared by using the conventional plate for fixation after Genioplasty.
Genioplasty
digital-design
Plate design
2019
01
01
143
150
https://edj.journals.ekb.eg/article_71256_6c004e5fa975fedb00d9050e389758a6.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Efficacy of Autologous Leucocyte-Platelet-rich Fibrin (L-PRF) versus Hydroxyapatite as a Graft Material for Socket Healing after Surgical Extraction of Impacted Mandibular Third Molars: A Comparative Clinical and Radiographic study
Sayed
Rashed
Ahmed
Elsharkawy
Amira
Zaied
Ali
Fahd
OBJECTIVE: The purpose of this study was to compare the efficacy of Leucocyte -platelet‑rich fibrin (L-PRF), and hydroxyapatite (HA) for reduction of pain and swelling, the incidence of dry socket, soft tissue healing, and bone regeneration after surgical removal of impacted mandibular third molar in human patients.Patients and Methods: Thirty-six patients (20 males and 16 females) requiring extraction of mandibular third molars were randomly grouped as L-PRF, HA, and Control‑treated. All the procedures were done on an outpatient basis without any complication such as lip numbness. The patients were assessed for postoperative pain, swelling and maximal inter-incisal distance on the 1st, 3rd and 7th postoperative days. Exposed bony socket wall (dry socket), as well as soft tissue healing (healthy granulation tissue Formation), were also assessed at 1st, 3rd, 7th and 14th day of postoperative periods depending on the standard methods. Assessment of daily and total analgesics consumption was done and Radiological assessment of the extraction site was done at 2 and 6 months interval. Results: Pain, swelling, interincisal distance, and soft tissue healing had statistically significant more improvement for L-PRF group compared to HA and control groups. Radiographic assessment showed comparatively lesser bone density values in PRF and control sites at 2 and 6 months than HA site. Conclusion: Our study showed that L-PRF is better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing post‑L-PRF placement in the extraction socket. Bone regeneration is induced quickly by HA as compared to PRF. However, study with a wide scale of clinical cases is very much essential to be more decisive regarding the efficacy of the graft materials.
Platelet‑rich fibrin
L-PRF
bone density
Hydroxyapatite
mandibular third molar surgical removal
2019
01
01
151
162
https://edj.journals.ekb.eg/article_71257_01edefd9e12e41ea0fd00ad855b2281a.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Assessment of three pharmacological agents following arthrocentesis for the treatment of internal derangement of the temporomandibular joint; a clinical study
Dalia
Radwan
Hesham
El- Hawary
Mohamed
Eissa
Moataz
Bahaa El- Din
Temporomandibular disorder (TMD) includes disorders of the temporomandibular joint (TMJ) and masticatory muscles and their associated structures. It is characterized by pain, joint sounds and restricted mandibular movement. Pharmacological agents commonly used for the treatment of TMDs include non-steroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, muscle relaxants, antidepressants, anticonvulsants and benzodiazepines.Objectives: In the present study, we compared the clinical outcome of intra-articular injections of NSAIDs, corticosteroids, Hyaluronic acid given after temporomandibular joint arthrocentesis. Materials and methods: Twenty-seven patients suffering internal derangement of the temporomandibular joint and not responding to conservative therapy were randomly classified into three equal groups. In group A joint lavage was followed by 1ml of piroxicam injection. In group B joint lavage followed by 1 ml of dexamethasone injection and in group C joint lavage was followed by 1 ml of Hyalgan injection. The treatment outcome was evaluated clinically by measuring the maximal mouth opening in mm at 2 weeks and 3 months postoperatively. Pain was measured using the Visual Analogue Scale at the study intervals. These data were statistically analyzed. Results: All drugs were able to demonstrate a reduction in pain intensity and improvement in mouth opening at 2 weeks and 3 months postoperatively. No significant differences in treatment success were found among the three groups (P > 0.05) through the study intervals. Conclusion: We concluded that arthrocentesis with Piroxicam, dexamethasone or Hyalgan are similarly effective and are promising methods in relieving the symptoms of TMJ with non-reducing disc displacement. Additional prospective studies are required to confirm the adequate dosage of each treatment protocol, frequency of the injections required and combination between those protocols and other modalities in order to achieve long-term results.
Arthrocentesis
internal derangement
piroxicam
dexamethasone
Hyaluronic acid
2019
01
01
163
170
https://edj.journals.ekb.eg/article_71258_dae04c6871a9cc50205fbc9c789143c2.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Pattern of impacted third molars and their associated radiographic pathological lesions in Makkah region: a retrospective radiographic survey
Ali
Barakat
Reda
Nofal
Background: In recent centuries the wisdom tooth impaction of both jaws considered a public health problem, because lack of space to erupt normally or even to appear in the oral cavity, this sequela may be due to insufficient activity of the jaws over the centuries. Aim of the Study: The purpose of this study was to determine the prevalence of impacted wisdom associated with pathologies in relation to angulation of impaction in an adult Saudi population in Mecca area, Materials and Methods: This is a cross sectional study in which records of 4000 patient’s panoramic radiographs between 2017 -2018 from OPG & CEPH X-Ray Department. Umm Al-Qura University-Dental College and Hospital were reviewed. Finally, 411 out of 4000 patient’s radiographs which showed impacted wisdom were selected. Data related to the type of impaction in both jaws and associated pathologies were then collected, tabulated and analyzed. Results: Panoramic radiographs of 4000 patients aged 25-60 years were examined. A total of 411 (10.27%) demonstrate the presence of at least one impacted third molar. The study demonstrates that the highest number of impactions related to mandibular arch followed by maxillary arch then the least common cases with impaction related to both jaws. For the angulation of the impacted third molars, the most common angulation was vertical folwed by mesioangular and distoangular angulations were the less common, while the least common angulation was Horizontal. The most angulated wisdom associated with pathologies was the mesioangular angulation followed by vertical then the least common pattern distoangular and horizontal. The other angulations were negligible. The most common radiographic features of lesions associated with the third molar were radiolucent lesions Followed by radiopaque lesions. And the least common lesions were mixed lesions. Conclusion: The radiographic features of impacted wisdom angulation could be correlated to their pathologies among all cases in Makkah region.
Radiography
Panoramic
Impacted Wisdom
prevalence
Pathology
2019
01
01
171
178
https://edj.journals.ekb.eg/article_71259_0da9776da5251fe90ad38c5c2408152e.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Biological behavior of 60/40 biphasic calcium phosphate and growth hormone mixture: in vivo study in dogs
Lama
El Marsafy
Rania
EI behairy
Ibrahim
Ahmed
Monazah
Khafagi
Grafting materials are important for ridge preservation procedures after tooth extraction. Ridge preservation prime value is the volume preservation for the healing sockets, which is needed for different ridge augmentation procedures. Objective: Determine the healing responses of (local growth hormone, and biphasic calcium phosphate mixture 60/40 in fresh extraction sockets of a canine model.Materials and Methods: Six mongrel dogs included in this study; they were divided into 2 groups according to the time of sacrifice (4 and 8 weeks). Each of these groups includes three animals. Animals subjected to extraction of the fourth premolar bilaterally, The right side treated with a mixture of 4 IU (1.6 mg) Growth hormone and biphasic calcium phosphate (a composite of hydroxyapatite HA and bèta-tricalcium phosphate TCP 1 x 0.15 ml (450-650 µm) in a granular form, while the left side left as a control. The healing extraction sockets were evaluated by surface electron microscope (SEM).Results: Scanning electron microscope examination showed homogenous new bone formation in both groups. Control group showed significant results as regard calcium phosphate ratio in the first month, while non-significant result was encountered in the second month between two groups. Conclusion:. Single local dose of growth hormone mixed with 60/40 biphasic calcium phosphate did not improve calcium phosphate ratio.
Calcium phosphate ratio
surface electron microscope
ridge preservation
biphasic calcium phosphate and dogs
2019
01
01
179
188
https://edj.journals.ekb.eg/article_71260_a17218e2673b91ec5b14191dd0e70399.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Clinical and radiographic evaluation of osseodensification versus osteotome for sinus floor elevation in partially atrophic maxilla: A prospective long term study
Shereen
Arafat
Mohamed
A Elbaz
Objectives: The current study was conducted to evaluate crestal sinus floor elevation with either osteotome or osseodensification in posterior atrophic maxilla.Material & methods: 24 crestal sinus floor elevations were performed for 24 patients with at least 5mm residual bone height. 12 randomly selected patients received osteotome sinus elevation (group 1), and 12 received osseodensification sinus elevation (group 2). The treatment outcome was evaluated at 6, 12 months of healing clinically and radiographicaly. Implant 1ry and 2ry stability, marginal bone loss, and bone gain were recorded and statistically analyzed.Results: group 2 showed significantly higher ISQ values immediately postoperatively and at 6 months. There was significant increase of bone height (bone gain) in both groups (P=0.001), and bone gain was 2.79±0.30 mm and 3.33±0.25 mm in group 1 &2 respectively.Conclusion: Osseodensification sinus floor elevation was superior to osteotome elevation regarding the 1ry & 2ry stability, and bone gain.
osseodensification
osteotome
sinus lift
atrophic maxilla
2019
01
01
189
195
https://edj.journals.ekb.eg/article_71261_ed987b0840ffacb78fc722592cb620ed.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Flapless Dental Implant Surgery as a Successful Patient Relevant Treatment Option: A 5-Year Retrospective Clinical and Radiographic Evaluation
Yousef
AbdElGhaffar
Ahmed
Temerek
Hoda
Hammad
Ali
Fahd
Background: Dental implants can be done with different surgical protocols. Each surgical protocol has its advantages and disadvantages. Aim: The aim of this study was to evaluate the implant flapless technique as a successful patient relevant treatment option. Methods: the files of 84 flapless implant patients were retrospectively reviewed and analyzed for success and failure. Results: A total of 238 dental implants were done by flapless technique. 224 (~ 94%) flapless dental implants were clinically and radiographically successful through the follow-up period. Fourteen (~ 6%) dental implants showed signs of failure for several reasons upon different time intervals and were analyzed. Conclusions: Minimally invasive flapless dental implants surgery offers a predictable patient focused successful outcome.
2019
01
01
197
204
https://edj.journals.ekb.eg/article_71263_178029a9a92ef9d6ba3a96045d1e57de.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Bone Height Changes In Maxillary Arch Opposing Four Implant Retained Mandibular Over Dentures Versus All-On-Four Hybrid Mandibular Prostheses A Prospective Randomized Clinical trial
Eatemad
Taha
Rehab
Elsharkawy
Azza
Metwaly
Aly
Fadl
Statement of the problem: Endosseous implants are being increasingly used for the retention of mandibular restorations in recent years. It has been suggested that there is a risk of maxillary bone resorption under complete dentures in patients wearing mandibular implant-retained overdentures as well as mandibular all-on-four hybrid prosthesis. However, there was little evidence-based information about the effect of these 2 treatment modalities on the maxillary bone changes.Patients and methods: This is a prospective parallel randomized controlled clinical study, in which forty eight implants were placed in mandibles of 12 completely edentulous male patients. Patients were randomly allocated into one of the two groups: group A, where 6 patients received 4 parallel implants with implant retained overdenture and group B, where 6 patients received 4 implants in the anterior part of the mandible, 2 axial implants in the center and 2 tilted implants at the distal ends with all-on four hybrid prosthesis. All patients received maxillary removable complete dentures. Radiographic evaluation was made using the CBCT to asses bone height changes that occur in the anterior and posterior maxillary areas 6 months and 12 months following denture insertion and functional loading in comparison to time of loading. Collected data were tabulated and statistically analyzed.Results: Comparison of radiographic bone changes under complete maxillary denture at the anterior and posterior maxilla, between group A and group B, showed no significant differences between the two groups at any time interval. However, pair-wise comparison of bone height changes over time for each group showed significant difference between immediate time point and 12- month post-loading time point in group A, both in anterior and posterior maxilla, where the P value was <0.05. On the other hand there was no significant difference between the same time points in group B, both in anterior and posterior maxilla.Conclusion: There is inevitable gradual bone loss in the maxillary arches under complete denture when opposed by four implant-retained mandibular over dentures or all-on-four hybrid mandibular prosthesis. Although the prosthesis type has no effect on the amount of bone loss, slower rate of bone resorption was found in all-on-four group throughout the study period both in anterior and posterior maxilla.
Bone changes
implant retained over denture
All-on-four hybrid prosthesis
2019
01
01
205
213
https://edj.journals.ekb.eg/article_71264_58bb80c2fce32ae81be16660cb760c1c.pdf
Egyptian Dental Journal
0070-9484
0070-9484
2019
65
Issue 1 - January (Oral Surgery)
Effect of Preoperative inhibition of Orbicularis Oris Muscle action On Philtrum length in primary Cleft Lip Repair
Rehab
Elsharkawy
Mamdouh
Aboulhassan
Hypothesis: Botulinum toxin injection before cleft lip repair will inhibit the Orbicularis Oris muscle action and decrease the tension applied on the wound edges during healing leading to improved esthetic outcome.Methods: Thirty two patients, under 6 months of age, with complete unilateral cleft lip, were enrolled in this double-blind, randomized, placebo-controlled prospective study. Patients were randomly divided into two equal groups; in the BTX group, botulinum toxin type A (BTX-A) was injected while in the Placebo group normal saline was injected in 4 points in the subjacent orbicularis oris muscle on both edges of the cleft, one week before the primary lip repair. At six-month follow up patients were assessed, in blinded fashion, for length of philtrum ridge both in cleft and non-cleft sides as well as for scar width. Collected data were tabulated and statistically analyzed.Results: Thirty patients completed the study. After 6 months, difference in philtrum length between cleft and non-cleft sides in the BTX group was significantly less than the placebo group (P=0.001). The scar width in the BTX group was also statistically significantly less than the Placebo group (P =0.001). Conclusions: Inhibition of orbicularis oris muscle during wound healing by BTX injection, before primary repair of unilateral cleft lip, safely and effectively reduced the difference in philtrum length between cleft and non-cleft sides and it also reduced the width of the scar.
2019
01
01
215
220
https://edj.journals.ekb.eg/article_71266_ab6c46713d85aeb85fce844d2c655c12.pdf