The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Effect of Biphasic Bone Graft Material (BGM) in combination with autologous platelet-rich fibrin (PRF) on bone regeneration in an odontogenic maxillary cyst: A randomized controlled clinical trial8298368611210.21608/edj.2020.24367.1038ENHeba M.Kameloral and maxillofacial surgery department,faculty of dentistry, cairo universitySherifA. Moneemoral and maxillofacial surgery department, faculty of dentistry,cairo universityNiveenAskaroral and maxillofacial surgery department, faculty of dentistry, cairo universityJournal Article20200220ABSTRACT<br /> Objectives: The purpose of this study was to assess the effect of SYMBIOS® biphasic bone<br /> graft material (BGM) in combination with autologous platelets rich fibrin (PRF) on the bone<br /> regeneration in the treatment of odontogenic maxillary cysts.<br /> Materials and methods: A total of twenty eight patients suffering from large maxillary<br /> odontogenic cysts were treated by enucleation and were randomly assigned into two groups.<br /> Each group was formed of fourteen patients. The bony defects were grafted by a combination<br /> of SYMBIOS® and PRF in group (A) and application of SYMBIOS® alone in group (B). Postoperative<br /> clinical and radiographic follow-up were performed. Pain and swelling scores were<br /> measured using VAS at 6 weeks postoperative follow up, while bone density of the bony defects<br /> were measured using cone beam computerized tomography (CBCT) at 9 months post-operative<br /> follow up.<br /> Results: Accelerated wound healing was observed in all cases without any signs of postoperative<br /> complications. On the 9th month post-operatively the bone density was increased by<br /> 45.03% in group (A) where is the results of group B.<br /> Conclusion: SYMBIOS®/PRF combination accelerated bone healing and improved the quality<br /> and quantity of regenerated bone rather than SYMBIOS® alone.https://edj.journals.ekb.eg/article_86112_aa62b03c5622fc012397a8be013eae80.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Iatrogenic fracture of lingual plate of bone and Displacement of Mandibular Third Molar into Submandibular Tissue Space. A Case Report.8378408611310.21608/edj.2020.26054.1075ENHussein Abdel MotelepKhalilMaxillofacial surgery department, Faculty of dentistry, Al Azhar University, Cairo, Egypt.Atef MohamedHasanenmaxillofacial surgery department, faculty of dentistry, Al Azhar University, Cairo, Egypt.Journal Article20200317Abstract: displacement of impacted third molar tooth or fragment during surgical extraction to adjacent tissue spaces such as submandibular or pterygomandibular is not a common complication. Retrieval of displaced tooth or fragment is complicated by difficult visibility, accessibility and instrumentation. Patient and methods: Referred male patient with displaced decapitated lower third molar tooth into submandibular tissue space. The displaced tooth was retrieved intra orally by raising lingual flap, using local anesthesia nerve block. The tooth was removed safely without complications and wound healing was normal. Conclusion: wisdom tooth removal must be done by an expert surgeon with adequate clinical and radiological assessment to avoid inadvertent complications. In case of iatrogenic displacement of the tooth or fragment into tissue space, computed tomography (CT) is a proper tool to estimate its exact location.<br /> Introduction: Surgical removal of impacted wisdom teeth is common surgical procedure with minimum complications of about 1% of cases which include bleeding, pain, swelling, infection and nerve parenthesis (lingual, inferior alveolar) either temporary or permanent. 1-4 Displacement of wisdom tooth or fragment into tissue space (submandibular or pterygomandibular) is uncommon complication in practice and in literature.5, 6 Iatrogenic displacement of wisdom occur due to lack of experience, improper preoperative clinical and radiographic estimation, improper treatment plan and uncontrolled application of force specially by elevators.7 This case report showing iatrogenic displacement of decapitated lower left wisdom retrieved surgically by intraoral lingual flap approach under local anesthesia.https://edj.journals.ekb.eg/article_86113_2279ead8f767f8e513d74233f0f52c2b.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401EVALUATION OF CRESTAL BONE CHANGES AROUND DELAYED IMPLANT IN RESPONSE TO DIODE LASER THEARAPY: A RANDOMIZED CONTROLLED CLINICAL TRIAL.8418518611410.21608/edj.2020.24407.1039ENSaleh AhmedBakryOral surgery department, Faculty of dentistry, Cairo university, EgyptHeba M.Kameloral and maxillofacial surgery department,faculty of dentistry, cairo universityJournal Article20200221Dental implants have become an essential part in the field of dentistry. One of the commonly used criteria for evaluation of dental implant success is the marginal bone changes around the dental implant. The aim of the study was to evaluate crestal bone changes around delayed dental implants subjected to low intensity laser application compared to dental implants without laser application.This was a randomized controlled clinical trial conducted on twelve patients with twelve missing premolar maxillary teeth which needed to be replaced with dental implants. The Patients were randomly divided into 2 groups. Group A (non-laser group) received endosseous root form implant, and the healing phase was left to progress spontaneously without any intervention while Group B (Laser group) received endosseous root form implant followed by low intensity laser application. Clinical parameters assessed were probing depth (PD) and the distance between implant shoulder and mucosa. Radiographic parameter measured using paralleling periapical x-ray was the distance between implant shoulder and bone, which represented crestal bone level. For the clinical parameters measured, including the PD and DIM, it was shown that the LLLT had no effect on the results as no significant difference in pocket depth was found between the two groups. For the DIB which was measured radiographically , the mean crestal bone loss was 0.4 mm after 6 months of implant placement in the Laser group versus 0.7mm after 6 months in the non-laser group. This result showed no statistically significant difference between the two groups.https://edj.journals.ekb.eg/article_86114_0b2eb53df96b571c834bbd04aa5cafb5.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401COMPARING THREE DIFFERENT SURGICAL GUIDES PROTOCOL ON THE MARGINAL BONE LOSS AROUND IMPLANTS IN IMPLANT ASSISTED MANDIBULAR OVERDENTURE.8538608611510.21608/edj.2020.24824.1052ENAhmed MostafaAbdelfattah Mohamed2a Sayed Abo Shady0000-0001-9911-7644Mahmoud El Moutassim-BellahEl HomossanyOral and Maxillofacial Prosthodontics, Faculty of Dentistry, Ain Shams University, cairo, Egypt0000-0002-1790-4626Journal Article20200227Aim of the study: This study was conducted to assess the efficacy of different guided surgery protocols on mean marginal bone loss around implants in implant assisted mandibular overdenture.<br /> Materials and methods: Twenty-one edentulous patients were selected for this study. They were randomly divided into three different groups. In the first group implants were placed by free hand technique. In the second group partial limiting surgical guide was used; the surgical guide was used for pilot drilling. In the third group completely limiting surgical guide was used; the surgical guide was used for the whole drilling sequence. Mean marginal bone loss was measured using CBCT at 6 months, 12month and 18 months interval. Results were collected and tabulated for statistical analysis.<br /> Results: One-way ANOVA test showed no statistical significance between the three groups in all time intervals. <br /> Conclusion: Within the limitation of this study, no statistically significant differences could be found between the guided groups and the free hand group at the 18 months follow-up period.https://edj.journals.ekb.eg/article_86115_7581a728101eae987afdc3b876125762.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Low intensity pulsed Ultrasound therapy versus dry needling for inactivation of myofascial trigger points: Randomized Clinical Study8618728611610.21608/edj.2020.25184.1056ENNermeen HassanienSorourOral surgery department,faculty of oral and dental medicine, Cairo universityAmira A.ZaiedLecturer of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum UniversityMohamed FaridShehabAssociate Professor of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo UniversityJournal Article20200304Objectives: This study aims to compare between the effect of low intensity pulsed ultrasound (US) therapy and dry needling in the treatment of myofascial pain syndrome. <br /> Patients and methods: Twenty patients with myofascial pain syndrome were included in this prospective, comparative study. Patients were randomized into two groups as US group (n=10) and dry needle group (n=10). Low intensity pulsed ultrasound was applied 3 times per week for 5 minutes in each session for 4 weeks in the US group. Each trigger point exposed to 12 sessions over 4 weeks. In dry needle group ,3 treatment sessions a week for 4 weeks; each session took 50 seconds. Treatment effectiveness was evaluated with Visual Analog Scale (VAS), pain pressure threshold using algometer, and maximum interincisal opening (MIO). These parameters in both groups were evaluated at baseline, 2 weeks, and 3 months postoperative. Results: The treatment results demonstrated insignificant difference between both groups regarding VAS throughout the study. Pain Pressure Threshold of dry needle group was significantly higher than ultrasound group at base line and 2 weeks postoperative. MIO in ultrasound group was significantly higher than dry needle group after 3 months postoperative. Conclusion: In myofascial pain syndrome, the effect of low intensity pulsed ultrasound and dry needle are the same in reducing pain at rest. Both treatments elevate pain pressure threshold after 3 months, and ultrasound improved maximum mouth opening better than dry needle after 3 months.https://edj.journals.ekb.eg/article_86116_744aeace642746ac2a75c82537512c4e.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Flowable platelet rich fibrin a new trend for enhancing bone augmentation results in maxillary sinus floor augmentation. (Radiographic and histologic evaluation)8738818611710.21608/edj.2020.24131.1030ENHesham SayedAbdelmoneimOral and Maxillofacial surgery, Faculty of Dentistry , Cairo University, Egypt.Radwa T.ElsharkawyLecturer of Oral Biology, Faculty of Dentistry, Future University in EgyptJournal Article20200216Flowable PRF enriched and vibrant bioactivity, simplified preparation, high healing potentials and easy incorporation with other biomaterials were the key aspects to stimulate the applications of flowable PRF in various medical fields. <br /> The current study aimed to evaluate if flowable PRF has superior bone augmentation properties over the conventional PRF in sinus floor augmentation procedures. In this study 18 maxillary sinuses were augmented, which were divided into 2 groups, group A maxillary sinuses were augmented using a mixture of xenograft bone substitute, group B maxillary sinuses were augmented using a mixture of xenograft bone substitute and flowable PRF.<br /> Results: Clinically flowable PRF showed ease of preparation and improved the handling and manipulation of the bone graft particles. Radiographic results showed that Group A average gained bone height of 10.4±1.2 mms while in group B mean gained bone height was 11.6±1.9 mms, bone densities results of both groups showed that bone density units of group A were 578 ± 56 Hounsfield Units(HU), while group B calculated augmented bone densities were 586.2 ± 68 HU. Histologic evaluation stated that group I and group II revealed a lot of similarities regarding the amount and the quality of the newly formed bone.<br /> There by concluding that flowable PRF resulted in similar results to that of the conventional PRF, however the ease of preparation, application and manipulation emphasizes its benefits and recommends its application.https://edj.journals.ekb.eg/article_86117_e806771ad2ff6375159b1d1adfc7dc63.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Evaluation of Injectable platelet rich fibrin for the management of Tempromandibular joint internal derangement. (clinical evaluation)8838918611810.21608/edj.2020.24129.1029ENHesham SayedAbdelmoneimOral and Maxillofacial surgery, Faculty of Dentistry , Cairo University, Egypt.Usama AbdeltawabTeamaLecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo UniversityJournal Article20200216Temporomandibular joint (TMJ) disorders are utterly described by joint dysfunction and/or pain. Temporomandibular joint internal derangement is the most frequently reported temporomandibular disorder. Several methods have been used for the management of TMJ internal derangement ranging from conservative occlusal splints and physiotherapy, to minimally invasive arthrocentesis and to open joint invasive surgical procedures. All of which aim to restore function and relief affected joints pain. Current study aimed on clinically evaluating the effect of using injectable platelet rich fibrin as an injection drug in the temporomandibular joint following arthrocentesis procedure. Results of our study revealed that the injectable PRF group was superior to the normal arthrocentesis group in pain relief, rapidity and amount of regain of the maximum mouth opening and in the resolution of the joint noise. Concluding that intra-articular PRF injection of the TMJ was a significantly effective treatment method for the treatment of internal derangement of the temporomandibular joint.https://edj.journals.ekb.eg/article_86118_195b2444dfbe13f917107e6c0c33a281.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401The use of Buccal Pad of Fat Versus Leukocyte-Platelet Rich Fibrin for Closure of Oroantral Communication8939038611910.21608/edj.2020.23993.1012ENNermineRamadanOral surgery department; faculty of dentistry; october 6 university; giza , egypt0000-0002-0209-5731Journal Article20200213Introduction: extraction of maxillary posterior teeth is considered one of the main cause of Oroantral communication (OAC) due to the close proximity of the roots to the maxillary sinus. <br /> Aim of study: Evaluation of Buccal Pad of Fat versus Leukocyte Platelet Rich Fibrin (L-PRF) in the management of oroantral communication. <br /> Materials and Methods: This study was carried out on twelve patients with oroantral communication. They were divided into two equal groups, six patients in each. In Group I, the patients were treated with buccal fat pad technique. While in group II, the patients were managed with L-PRF technique for OAC closure.<br /> Patients were followed up for 1,3,5,7 days post-operative then weekly for 4 weeks. <br /> Results: There was significant difference between the two groups regarding pain, and swelling however, no significant difference between both groups regarding infection during different follow up periods. No recurrence for the oroantral communication was observed in all patients of both groups after 4 weeks postoperatively. <br /> Conclusion: The goal of closing an oroantral communications was to prevent infection of the maxillary sinus through separating the oral cavity from maxillary sinus .https://edj.journals.ekb.eg/article_86119_37beb0acd42e8c6cbd621afd6f24409a.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Three dimensional accuracy of mandibular reconstruction by pre-bent reconstruction plate using intra oral versus extra oral approaches following mandibular resection in patients with extensive ameloblastoma 9059178612010.21608/edj.2020.24777.1047ENFatma IbrahimMohamedOral and Maxillofacial Surgery department, faculty of dental medicine, Al Azhar University, Cairo EgyptJournal Article20200227Purpose: This prospective study aimed to compare the intraoral placement of the pre-bent reconstruction plate with that inserted via the extraoral approach, to evaluate their impact on the three-dimensional (3D) position of the proximal segment<br /> Patients and methods: Patients were divided into two equal groups. In group 1, the mandible was reconstructed with a pre-bent reconstruction plate via an intraoral approach. In group 2, an extraoral approach was used. The primary outcome variables were the need for intraoperative plate readjustment, the time needed for plate insertion, total operation time, difficulties encountered during surgery, and the postoperative stability of the proximal segment. Distances between corresponding anatomical landmarks on the mandibular angle and condyle as well as the intercondylar angle (ICA) and B`XC angle, were measured. The difference between the pre- and postoperative measurements was used to evaluate the reconstruction accuracy. <br /> Results: Thirty patients were enrolled in this study. In group 1, four plates required minor readjustment. In group 2, only two cases required re-adaptation. The intraoral insertion of the pre-bent plates revealed a decrease in the linear measurements, resulting in mandibular compression. On contrary, the extraoral approach showed increase in the measurements, resulting in widening of the mandible. However, this width difference was statistically insignificant. Concerning the ICA and B`XC angle, no significant difference could be ascertained between the two groups. <br /> Conclusion: Intraoral approach is more conservative procedure, thereby achieving the best esthetic outcomes and resulting in a more accurate 3D mandibular reconstruction.https://edj.journals.ekb.eg/article_86120_9ca8802321ba6a6cadaf55d46a982ada.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Facial nerve and temporomandibular joint functional evaluation after subcondylar fractures Osteosynthesis by rhomboid-plate versus conventional miniplates9199298612110.21608/edj.2020.23998.1013ENAbdel Aziz BaiomyAbdullahoral and maxillofacial surgery department, dental medicine faculty, Al-Azhar university, Assuit0000-0002-5446-2820Shadia AbdelhameedElsayedDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.0000-0002-3348-3382Mohamed AshrafAbdelfattahDentist at Hearing and Speech Institute General, Organization of Teaching Hospitals and Institutes, Cairo, EgyptJournal Article20200214Aim : This study was conducted to assess the function of temporomandibular joint (TMJ) and the facial nerve after subcondylar fractures Osteosynthesis by three-dimensional 3D-rhomboid plate compared with conventional double miniplates. Patient and methods: 20 patients suffering from unilateral displaced subcondylar fractures were divided randomly into two equal groups. Group, I was reduced and fixed by two miniplates while Group II was reduced and fixed by 3D-rhomboid plate. All patients were diagnosed according to Temporomandibular Dysfunction Diagnostic Research Criteria and classified according to the Helkimo Index. Facial nerve affection was assessed by Hause Brackmann facial nerve grading system. Radiographic evaluation was done using multi-slice CT and Orthopantomogram via condylar morphology scale (CMS) assessment. Postoperative occlusion and masticatory muscles were also assessed. All data collected and statistically analyzed. Results: Results showed non statistically significant difference between groups, regarding mandibular mobility and occlusion status however, TMJ, muscular pain, facial nerve affection, and CMS parameters showed comparable values between both groups in favor of Rhomboid plate group. Conclusion: From the results from the current study we can conclude that 3D-rhomboid plate had good functional TMJ and facial nerve outcomes in comparable to standard two miniplates in management of high subcondylar fracture. <br /> .https://edj.journals.ekb.eg/article_86121_699be25d17d05678a927c4f1a30e523d.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Subciliary Versus Subtarsal Approach for The Management Of Infraorbital Rim And Orbital Floor Fractures. An Anthropometric Analysis9319428612210.21608/edj.2020.24782.1049ENFatma IbrahimMohamedOral and Maxillofacial Surgery department, faculty of dental medicine, Al Azhar University, Cairo EgyptJournal Article20200227Purpose: the aim of this study was to assess the anthropometric changes of the morphology of the lower eyelid after the use of the subciliary (SCA) and subtarsal (STA) approaches in patients with infraorbital rim and orbital floor fractures.<br /> Patients and methods: Twenty-six patients with orbital floor and infraorbital rim fractures were included in the study. They were divided equally into two groups. In group 1, the fractures of the orbital floor and infraorbital rim were approached via the stepped SCA, whereas in group 2, they were approached via the STA. All the cases were evaluated for the anthropometric changes in the morphology of the lower eyelid and the esthetic outcomes of the scars as well as the postoperative lower eyelid complications (LLCs). A paired sample t-test was used to analyze the difference between the operated and non-operated sides.<br /> Results: The two approaches provided adequate exposure of the infraorbital rim and orbital floor. STA provided rapid access to the field. The anthropometric analysis revealed that there was no significant difference between the two approaches, except for the Eye fissure index (EFI) and lower iris coverage (LIC) measurements. The SCA had a significant increase in the EFI than the STA. Furthermore, the SCA showed a significant decrease in the measurements of the LIC. <br /> Conclusion: The STA is a minimally invasive incision that provides adequate and direct exposure to the orbital floor and infraorbital rim fractures with more stable periorbital architecture and anthropometric measurements with the minimal incidence of postoperative complications.https://edj.journals.ekb.eg/article_86122_c756865ed2ec4483c03f72c13e6464bc.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401CLINICAL AND RADIOGRAPHIC OUTCOMES OF RADICULAR CYST ENUCLEATION USING PIEZOSURGERY VERSUS CONVENTIONAL SURGERY9439508612310.21608/edj.2020.24071.1023ENMarwa GamaleldinNoureldinOral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt0000-0003-3532-9685Lydia N.MelekOral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Egypt.Journal Article20200215Abstract<br /> AIM: The study was intended to evaluate the effectiveness of piezosurgery in enucleation of radicular odontogenic cysts in comparison to the conventional technique.<br /> METHODS: Fourteen patients who had radicular cysts associated with non-vital teeth, were operated at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University. The patients were randomly divided into 2 groups;1) the study group in which cyst enucleation was using piezosurgery, 2) control group in which the cysts were removed using the conventional technique. The following were assessed; operation time, hemorrhage control and field visibility, ease of operation, neurosensory evaluation and radiographic percentage of change in bone defect volume.<br /> RESULTS: The piezosurgery group showed a statistically significant control over heamorrhage and a clearer, more visible field when compared to the conventional group. The difference between the times required for cyst enucleation in both groups was statistically significant, with longer time recorded with piezosurgery. No complications were observed with the piezosurgery technique. However, with the conventional technique, 2 patients complained of neurosensory involvement which was resolved over time. Also, with piezosurgery, there was a significant reduction of bone defect volume than the conventional surgery, 3 months after the operation in comparison to the preoperative baseline value.<br /> CONCLUSIONS: Piezosurgery proved to be more effective for cyst enucleation than the conventional method. The piezosurgery was more efficient for preserving important anatomical structures while providing a clearer field of surgery. Also, better early healing potential of the bone defect resulting from cyst enucleation was detected.https://edj.journals.ekb.eg/article_86123_5ab2f15478aca628d2c7b885d98dfa9b.pdfThe Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948466Issue 2 - April (Oral Surgery)20200401Is it enough to just increase the height of sub-antral bone during maxillary sinus augmentation or dose its depth matter?9519598612410.21608/edj.2020.24209.1037ENMai AhmedHaggagOral and Maxillofacial Surgery, Dentistry, Mansoura University, Mansoura, EgyptJournal Article20200217Purpose: Many techniques for maxillary sinus floor elevation have been used prior to implant placement in case of sever sinus pneumatization. Two-stage lateral-window sinus lifting using titanium micromesh without bone grafting was carried out in the present study. The purpose of the study was a trail to solve a question, if it is enough to just increase the height of sub-antral bone or it is also important to elevate the Schneiderian membrane medio-laterally as much as possible to accommodate for dental implants later.<br /> Materials and Methods: Seven patients (11 sinuses) were included. A titanium micromesh was shaped in a tick shape and placed into the sinus through a lateral window to maintain the elevated membrane in place. Immediate, 6-months and 9-months postoperative cone beam computed tomography (CBCT) were performed to evaluate the relation between the medio-lateral extension of the mesh and the amount of the gained bone. <br /> Results: When the height of the formed bone was related to the depth of the titanium mesh, no significant difference could be observed at either 6 or 9 months. However, when the depth of newly formed bone was compared against the depth of the titanium mesh, a high significant difference was noted at both 6 and 9 months.<br /> Conclusion: At least two thirds of the sinus depth must be elevated to obtain adequate bone width for future implantation.https://edj.journals.ekb.eg/article_86124_8a0bb59be12c053ff845082b937e8d5f.pdf