The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101COMPARATIVE STUDY BETWEEN TWO DIFFERENT OSTEOSYNTHESIS DEVICES FOR FIXATION OF SUBCONDYLAR FRACTURE2212297439010.21608/edj.2017.74390ENHanan M.ShokeirAssociate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar UniversityShadia A.ElsayedLecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University0000-0002-3348-3382Ghada A.KhalifaAssociate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University.Journal Article20200227Statement of problem: Management of subcondylar fracture with proper reduction of temporomandibular joint position and function is a challenge, different osteosynthesis devices are used with great diversity in their types, numbers, positions, and results.<br />Purpose: Comparative study between the efficiency of single miniplate and single minidynamic compression plate in restoration of ramus height, condylar angulation, and tempromandibular joint function in subcondylar fracture cases.<br />Material and Method: 14 patients indicated for open reduction and fixation of subcondylar fractures were divided into two groups each of 7 patients. Group A: subcondylar fractures were fixed using 2.0 single miniplate along posterior border of ramus. Group B: a single 2.0-mm minidynamic compression plates (DCP), were applied along posterior border of ascending ramus for fracture fixation in the other seven patients. Intermaxillary fixation for 10 days was applied for both groups. Clinical and radiograhic follow up were performed at 1, 3, 6 months using panorama and CT. <br />Results: At 6 months postoperatively, there was an improvement of mandibular functions with improvement of inter-incisal opening from 19.1mm and 20.1 mm in group A and B respectively to 35.6mm and 30.8 mm. Which was significantly different (P value =0.04). The shortening in ramus height improved from 3.2mm and 5.2mm in group A and B to 0.8 mm and 0.6 mm, also sagittal angulation of condyle improved from 1.6º and 4.7º in both group respectively to 0.2º and 0.3º with no significant difference between two types of mini-plate. There were no signs of infection, malunion, nonunion or device failure in both groups. except for one case of group A, that suffered from malocclusion with displacements of the fractured segments immediately after the operations, that responded to elastic traction within 15 days.<br />Conclusion: Single 0.2 mm miniplate or mini DCP aided by intermaxillary fixation are successful devices in fixation of subcondylar fracture without complication, with superiority of mini DCP in proper condylar reduction and stable fixation.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101CLINICAL IMPACT OF MODIFIED LINGUAL SPLIT BONE TECHNIQUE USING PIEZOTOME ON POST-OPERATIVE SEQUELAE OF MANDIBULAR 3RD MOLAR REMOVAL2312407439110.21608/edj.2017.74391ENMohamed ZaghloolAmerAssociate Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mansoura UniversityJournal Article20200227Problem statement: Permanent nerve damage represented one of the most severe complications following third molar extractions. Such rate increases especially, following lingual split bone technique either during bone splitting or dissecting procedures. So, this study was directed to assess clinical impact of modified lingual split bone technique using piezotome versus conventional technique on postoperative sequelae following mandibular 3rd molar removal.<br />Patient and Methods: Eighteen patients of comparable surgical difficulty of impacted lower third molar representing a common pool divided randomly into two uniform equal groups. The 1st group contained nine patients subjected to tooth removal using conventional lingual split bone technique. While, the 2nd group contained nine patients treated by modified lingual split bone technique using peizotome. After recording the operation time, all patients were assessed postoperatively for pain, trismus, swelling at the 2nd and 7th day. Neurosensory deficit/paraesthesiae was assesed either at 7, 15 and 30 postoperative days. Postoperative symptom severity (PoSSe) scale and prognosis score of healing were assessed at the 7th postoperative day.<br />Results: Comparing both groups, a significant difference was recorded regarding to severity of pain after 48h (P=0.037). However, no significant difference was recorded among both groups with regard to severity of pain at 7th day postoperatively (P=0.169). Regarding to recorded inter-incisal distance and sum of facial swelling, a clear detectable significant differences were recorded between both groups at the 2nd and 7th day of follow up (P= 0.009, 0.005- 0.001, 0.001 respectively). A statistical significant differences were recorded between both groups after 7 and 15 days of follow up (p=0.035) regarding to two point discrimination. <br />Conclusion: Although, a remarkable improvement in the postoperative sequelae associated with piezotome versus conventional lingual split bone technique. However, such technique sensitive maneuver related to operator experience and device adoption can lead to a significant prolonged operation time making a restrictive insult to achieve optimal clinical outcomes among oral surgeons.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101THREE DIMENSIONAL MINIPLATE FIXATION IN THE MANAGEMENT OF MANDIBULAR FRACTURES2412487472310.21608/edj.2017.74723ENKhaled A.SaadAss. Professor, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta University.Ibrahim M.NowairLecturer, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta UniversityEmad F.EsaLecturer, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta UniversityJournal Article20200301The optimal management of the mandibular fractures continuous to evolve. Mandibular fractures at different anatomical areas predispose the patient to malocclusion and disfigurement of the face if not properly treated. The current understanding of the biomechanics and fracture healing of the mandible has influenced by the approach to open reduction and internal fixation of these fractures. The study reports if there is any significance in the outcomes of using 3D plating systems in the management of mandibular fractures. The different anatomical sites of mandibular fractures need different treatment modalities. The treatment of mandibular fractures has evolved from various forms of fixation. In our study we used three dimensional titanium miniplates yielding better results than the conventional miniplates. The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101VITALITY OF AUTOGENOUS BONE GRAFTS FOLLOWING DECONTAMINATION USING DIFFERENT ANTIMICROBIAL AGENTS AN EXPERIMENTAL STUDY IN A RABBIT MODEL2492617472510.21608/edj.2017.74725ENTamer Abd El-BariHamedAssistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University and Acting
Vice Dean, Faculty of Dentistry, October 6 University.Mohamed AhmedElsholkamyAssistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal UniversityMaggie AhmedKhairyAssistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, October 6 UniversityAhmed NabilFahmiLecturer of Oral Pathology, Faculty of Dentistry, October 6 University.Journal Article20200301Purpose: Autologous iliac crest bone grafting is an integral part of many orthopedic surgical procedures. So, the purpose of this study was to determine the postoperative morbidity after harvesting graft from the anterior iliac crest. <br />Patients and Methods: This study was conducted on (10) adult patients comprised of (7) males and (3) females, their ages ranged from 13 to 45 years in Oral & Maxillofacial Surgery Department, Faculty of dentistry, Tanta University. An approval of the trust ethical committee was obtained together with a written informed consent from all patients. The donor site was evaluated according to: presence of pain, presence of gait, presence of numbness of the hip of the operated leg, presence of haematoma at the donor site, residual scar, deformity of the bony contour, scar tenderness and presence of wound dehiscence or infection. <br />Results: Patients spent a median of 1.5 days in the hospital. No pain had been detected at the end of the follow up period. All patients walked normally through the follow up periods except patient no. (8) who suffered from walking difficulty through the first month postoperatively but the condition improved after 3 and 6 months postoperatively. Only one patient (case no. 3) had numbness in the outer aspect of the operated leg through the 1st month postoperatively but the numbness had been disappeared after 3 & 6 months postoperatively. Only one patient, case no. (8) showed presence of haematoma and superficial infection through the 1st month postoperatively, but with conservative treatment the condition was improved through late follow up. One patient had reported presence of residual scar with tenderness on palpation (case no. 8) but tenderness had disappeared after 3&6 months postoperatively. No bony deformity had been detected in the donor site in all patients. <br />Conclusion: Harvesting of bone from the anterior iliac crest is well tolerated and had minimal morbidity.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101DONOR SITE MORBIDITY AFTER HARVESTING OF BONE FROM ANTERIOR ILIAC CREST FOR MAXILLOFACIAL RECONSTRUCTION2632697473410.21608/edj.2017.74734ENAhmed S.NaguibLecturer, Oral and Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta University.Khalid A.SaadAssociate Professor, Oral and Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta University.Rafic R.BedirLecturer, Oral and Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta University.Journal Article20200301Aim of the study: The aim of the current study was to assess the vitality of autogenous bone grafts harvested from rabbits` calvaria following decontamination of the grafts using three different antimicrobial agents.<br />Materials and Methods: Autogenous bone grafts were harvested from the calvaria of twenty four white New Zealand male rabbits. The grafts were allowed a five minutes contact time with normal saline (Group I), 2% chlorhexidine (Group II), Clindamycine (Group III) and Oleozone gel (Group IV). The grafts were then reinserted into the previously created graft beds. Animals were sacrificed at 10 and 21 days post surgery, dual energy x-ray absorptiometry (DEXA) scans were performed for the skull of the rabbits and bone specimens were collected for histological examination.<br />Results: Histomorphometric analysis showed a superior results in favor of the ozone treated group represented as a significantly higher percentage of normal osteocytes and marked increase in area percentage of new bone formation. Additionally, DEXA scan revealed a significant increase in bone mineral density and bone mineral concentration of the ozone treated group compared to the other studied groups. <br />Conclusion: The ozone treated grafts showed a distinguished preservation of osteoblastic vitality, which may indicate a superior biocompatibility compared to chlorhexidine and clindamycin.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101NON-GRAFTED MAXILLARY SINUS LIFTING TECHNIQUE UTILIZING THERMOPLASTIC BIORESORBABLE SPACE MAINTAINING MESH2712827473510.21608/edj.2017.74735ENMamdouh SayedAhmedAssistant Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Faculty of
Oral and Dental Medicine, Cairo University.Journal Article20200301Non-grafted maxillary sinus floor elevation which is based on the concept of membrane elevation and support either by tenting technique or space maintaining mesh solved the problem of maxillary sinus pneumatization by creating a space for new bone formation with subsequent implant placement in the edentulous posterior maxilla. The aim of this study is to evaluate the predictability of new bone formation after sinus floor elevation using a bioresorpable mesh. Eight patients with sinus pneumatization were selected for implant placement in the edentulous posterior maxilla. Pneumatized sinuses were approached through lateral window technique and the membrane was elevated and sustained with a bioresorbable mesh. All patients were clinically and radiographically evaluated immediately and at 6 months postoperatively. At six months post-operatively, core bone biopsy was performed for histological examination of the formed bone using a trephine drill at the planned implant position. All patients showed uneventful healing and radiographic, clinical and histological evidence of new bone formation and it was concluded that the bioresorpable mesh was reliable and predictable as a space maintaining device.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101ALGORITHM IN THE MANAGEMENT OF LARGE ODONTOGENIC CYSTIC LESIONS OF THE MANDIBLE2832917473710.21608/edj.2017.74737ENYasserNabilAssociate Professor and Head of Oral and Maxillofacial Surgery, Specialized Dental Teaching Hospital, Cairo, EgyptJournal Article20200301Odontogenic cystic lesions are among most common diseases affecting maxillofacial region. There are two main lines of treatment for odontogenic cysts, enculation and marsupilization or a combination of them. Marsupilization has the advantage of being simple procedure with minimal surgical trauma. However it has many disadvantages including limited accessibility for cyst de-roofing and frequent irrigation in certain areas such as mandibular ramus region. The commonest marsupialization techniques uses an acrylic bulb that prevent the marsupialized opening from closure, this technique is extremely difficult or even impossible to use in inaccessible areas, as the ascending ramus of the mandible.It is very difficult for children to maintain the a large marsupialized area cleaned. The present study presents our 3 years follow up of the use of our algorism in the management of odontogenic cystic lesions, with the use of the marsupilization decompression tube which facilitate flexible hygienic method of decompressing large in accessible odontogenic lesions in adults and children.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101THE AMOUNT OF THE KERATINIZED TISSUE ON TRANS-MUCOSAL TECHNIQUE VERSUS PUNCH TECHNIQUE IN FLAPLESS IMPLANT SURGERY2932987473810.21608/edj.2017.74738ENMohamed A.KatamishAssociate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University.Journal Article20200301The aim : Of this study is to show which technique can be enhance the amount of keratinized tissue width (KTW) to improve the soft tissue profile after flapless implant placement.. <br />Materials: A 14 patients (6 women and 8 men) aged between 25-70 years with mean value (47.5 years) were enrolled in this study. First group consisted of seven patients in which implants were inserted through trans-mucosal flapless technique, while the second group consisted of seven patients in which implants were inserted via punch flapless technique then the normal flapless surgical protocol for implant insertion was used and implant was covered by healing cap screw. KTW measured immediately before and after the surgery and at the time of the prosthetic finalization (3-4 months) for maxillary anterior and premolar regions.. <br />Results: KTW at 1-2 mm (before) can be effectively increased, while no significant effect at <br />5 mm can expected. For the punch technique the mean value of KTW of 1-2 mm showed significant increase at 3-4 months postoperative ..The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101OUTCOME OF DENTAL IMPLANTS PLACED WITH HIGH INSERTION TORQUE2993067474010.21608/edj.2017.74740ENRamy RagabElbeialyLecturer, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo UniversityWaleed R.El-BeialyAssociate Professor, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University,
Associate Professor, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Future University in Egypt
(FUE)Journal Article20200301To determine the success rate of immediately loaded implants placed with high insertion torque. <br />Materials and methods: In this study, a total of 84 implants placed at high insertion torque in the mandible and immediately functional loaded with provisional prosthesis. Insertion toque, primary stability and secondary stability were recorded. <br />Results: All implants were osseointegrated under function. <br />Conclusion: Insertion torque and primary stability are considered the keys of success to immediate functional loading of dental implants.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101BONE REGENERATION POTENTIAL OF BETA TRI-CALCIUM PHOSPHATE AND PLATELET RICH FIBRIN IN LOCALIZED ALVEOLAR RIDGE DEFECT WITH IMMEDIATELY PLACED DENTAL IMPLANT (AN EXPERIMENTAL STUDY IN DOG)3073167474410.21608/edj.2017.74744ENAbeerKamalAssociate Professor of Oral and Maxillofacial Surgery, College of Oral and Dental Surgery, Misr University for
Science and Technology (MUST), Egypt.Reham AAMorsyAssociate Professor of Oral Pathology. Basic Dental Science Department, Oral and Dental Medicine Research
Division, NRC. Egypt.EmanKLecturer of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, British University in Cairo
(BUE), Egypt.Journal Article20200301Background: Augmentation of localized alveolar bone defect is one of major problems in implant dentistry. Beta tri-calcium phosphate (β-TCP) is considered a source of synthetic bone substitute for bone regeneration. If it is combined with platelet rich fibrin (PRF) with immediately placed dental implant it may encounter a promising result for bone formation.<br />Objective: The aim of the present study was to compare the regenerative bone potential around immediately placed dental implant in localized alveolar bony defect by the use of β-TCP alone or in combination with PRF.<br />Materials and Methods: Eight clinically healthy dogs were included in this study. Localized alveolar bone defect was created after extraction of the second mandibular premolar bilaterally. After immediate implants were inserted the defect was augmented with following: Group I: β-TCP. Group II: β-TCP with PRF. Group III: Control group without adding any material. <br />After 12 weeks, the animals were sacrificed and bone regeneration in the created defect was evaluated through histological examination, immunohistochemically and histomorphometric <br />analysis.<br />Results: Groups analysis demonstrated signs of bone regeneration with variable degrees. Histomorphometrically, the control group revealed the lowest mean area percentage. Group I: β-TCP and group II: β-TCP combined with PRF showed the highest mean area percentage and both were significantly higher than control group. However, no significant difference observed between group I and II. The results were supported by both histological and immunohistochemical analysis. The signs of bone maturation in group I & group II were more than control group.<br />Conclusion: Beta tri-calcium phosphate with platelet rich fibrin is a promising osteogenic bone substitute with high bone regenerative potential .It could be used as an alternative method for bone regeneration around dental implant in localized alveolar bone defect.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101THE EFFECT OF LOW INTENSITY ULTRASOUND THERAPY ON OSSEOINTEGRATION OF TITANIUM DENTAL IMPLANT PLACED IN THE ESTHETIC ZONE3173267474710.21608/edj.2017.74747ENAhmed A.A.H.El-FekeyLecturer of oral and maxillofacial surgery, Faculty of dental medicine, Al-Azhar UniversityJournal Article20200301Background: Endosseous dental implants may be considered as the most popular treatment option for partially and fully edentulous patients. It is generally accepted that implant success is primarily dependent upon or achieved by osseointegration, a direct contact between the implant surfaces and living bone and gum. For decrease the time of osseointegration there is a different modalities used as altering the surface and/or shape of the implant has been frequently researched and it has been shown that rough implant surfaces allow a higher percentage of bone-to-implant contact compared to implants with smooth surfaces. Also dual acid etching of titanium, engineering of dental pulp cells on various implant surfaces and biomimetic implant coatings containing bone morphogenetic protein-2. Other methods studied to enhance endogenous bone healing around biomaterials are different forms of biophysical stimulations such as pulsed electromagnetic fields and low intensity pulsed ultrasounds (LIPU). Ultrasound is a form of energy that is transmitted through biological tissues as high-frequency acoustic waves, which is widely used in medicine as a diagnostic, therapeutic and operative tool. <br />The aim of the present study was to evaluate The effect of low-intensity pulsed ultrasound on the osseointegration of titanium dental implants .<br />Patient and methods: Ten implants were placed in ten patients each one receives one implant. The patients were 6 males and 4 females ranged in ages from 25 to 40 years. All the implants were placed in maxilla. Observations were made postoperatively at time of implant placement then after one month, 3 months, 6 months and one year follow up periods for crestal bone loss and stability, Data analysis was performed in several steps. Initially, descriptive statistics for each case results. One way ANOVA followed by pair-wise Tukey post-hoc tests were performed to detect significance between preparation cases. Statistical analysis was performed using Graph-Pad Prism-4 statistics software for Windows. P values ≤0.05 are considered to be statistically significant in all tests.<br />Conclusion: From the a aforementioned review it became clear that Low-intensity pulsed ultrasound could be accelerate the osteointegration of dental implant .The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101IMMEDIATE IMPLANT PLACEMENT WITH CARBONATED NANOHYDROXY APATITE3273347474810.21608/edj.2017.74748ENAhmed A.A.H.El-FekeyLecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University, Cairo, Boys.Journal Article20200301mmediate implant considered the ideal solution in cases of loss of an individual tooth or teeth, to preserve the esthetic as well as to prevent ridge resorption. Uses of immediate implant in esthetic zone faced some problems as narrow ridge and labial bone dehiscence so, uses of nanohydroxy appetite bone substitute considered good choice to solve these problems especially during implant installation. These article presents to patients obtains the immediate implant with nanohydroxy appetite bone substitute around the implant and showing good results with decrease of osteointegration period. By x-ray evaluation, there is significant decrease in crestal bone loss as well as good healing period. Also, by clinical evaluation shows good aesthetics with predominant natural appearance.<br />This study aims to evaluate effect of immediate implant installation (frontier GMI) with carbonated nanohydroxy apatite bone substitutes for preservation of alveolar bone. So, this study is planned to assess efficacy of carbonated nanohydroxy apatite bone substitutes for preservation of alveolar bone and to assess the changes in the soft tissue profile after immediate dental implant placement with carbonated nanohydroxy apatite bone substitutes. For this purpose;ten implants were placed in ten patients each one receives one implant. The patients were 6 males and 4 females ranged in ages from 25 to 40 years. All the implants were placed in maxilla. Observations were made postoperatively at time of implant placement then after 1 month, 3 months and 6 months follow up periods for pain, crestal bone loss, stability, papillae height and mean probing depth.<br />Descriptive statistics of pain score results as function of investigation time was found that the pain score at baseline recorded the worst mean value (3.7) with minimum value (2) and maximum value (6), after 1 month the mean of pain score was (5) with minimum value (3) and maximum value (7), after 3 months the mean of pain score was (6.5) with minimum value (5) and a maximum value (8) while after 6 months the mean of pain score recorded the best mean value (8) with minimum value (7) and maximum value (9).Pair-wise Tukey’s post-hoc test showed non-significant (p>0.05) difference between (baseline and 1 month), (1 month and 3 months) and (3months and 6 months).The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101A NEW TECHNIQUE OF CLOSURE OF ORO-ANTRAL FISTULA BY USING PLATELET RICH FIBRIN MEMBRANE IN COMPARISON WITH BUCCAL ADVANCEMENT FLAP3353437474910.21608/edj.2017.74749ENWael Mohamed SaidAhmedLecturer of Oral & Maxiollofacial Surgery, Faculty of Dentistry, Mansoura University.Journal Article20200301Background: Platelet rich fibrin (PRF), a concentrate of platelets and leucocytes embedded in a fibrin matrix has many applications in the field of oral and maxillofacial surgery. However, its use in the closure of oroantral fistula (OAF) has not been reported.<br />Purpose: This study aimed to compare the efficacy of using PRF membrane with acrylic splint versus the traditional buccal advancement flap for closure of OAF.<br />Patients and methods: 20 patients with OAFs were included in this study. Patients were randomly divided into two equal groups. Closure of OAF for (group I) with the buccal advancement flap, while for (group II) with the PRF membranes was done. Patients were clinically evaluated for primary closure, pain, edema, and depth of the sulcus postsurgically. <br />Results: Patients were 14 males and 6 females, with a mean age of 42.6 years. 19 cases of OAFs occurred after extraction of upper posterior teeth and 1 case occurred after cyst enucleation. Uneventful healing occurred in 18 patients; 9 in each group. Postoperative pain and postoperative edema were significantly less in group II than in group I.<br />Conclusion: PRF membrane is an appropriate alternative technique for closure of OAF, with less postoperative pain and edema than buccal advancement flap technique.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101OUTCOME OF ARTHROSCOPIC LYSIS AND LAVAGE FOR INTERNAL DERANGEMENT OF THE TEMPOROMANDIBULAR JOINT3453537475110.21608/edj.2017.74751ENReem H.HossameldinLecturer of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Faculty of Oral and
Dental Medicine, Cairo UniversityMamdouh S.AhmedAssistant Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Faculty of
Oral and Dental Medicine, Cairo UniversitJournal Article20200301Background: Temporomandibular Joint (TMJ) diseases have been established to be differentiated between intra-articular and extra-articular problems. TMJ internal derangement categories are the diseases with orthopedic obstacles that require management which might require surgical intervention. Among different surgical interventions, TMJ arthroscopy has been proven to be one of the minimally invasive surgical approaches to tackle TMJ internal derangement. Arthroscopic surgery appears to be a safe, minimally invasive and effective method for treating internal derangements (ID) of the temporomandibular joint (TMJ). <br />Aim: the purpose of this study is to assess the outcome of using arthroscopic lysis and lavage for TMJ ID. <br />Patient and Method: This is a prospective, cohort (27-52y), single institutional clinical study. TMJ ID subjects who failed conservative treatment for two months were presented and treated at the oral and maxillofacial surgery department, faculty of oral and dental medicine, Cairo University. The primary outcome variable was the absence of joint pain at 6 months postoperatively. Secondary outcome variables included joint function and maximum inter-incisal opening (MIO). Patients were followed up for six months postoperatively. Statistical analyses included paired t test and Chi square test. <br />Results: 28 subjects (45;11 unilateral & 34 bilateral), with a mean age of 38.3 years. 24 (85.7%) were females. Successful outcome was seen in 64.4% of the studied subjects. Maximum painless inter-incisal opening as well as visual analog scale for joint pain and function showed a statistical significant improvement at the end of the follow up period.<br />Conclusion: This study showed that TMJ arthroscopic lysis and lavage is an effective and predictable treatment for TMJ ID patients who failed conservative treatment.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101SINUS FLOOR AUGMENTATION WITH SIMULTANEOUS IMPLANT PLACEMENT USING BIO-OSS WITH AND WITHOUT PRF: CLINICAL STUDY3553647475210.21608/edj.2017.74752ENShereen WagdyArafatLecturer of Oral & Maxillofacial Surgery. October University of Modern Sciences and Art.Ingy MohamedChehataLecturer of Oral & Maxillofacial Surgery. October University of Modern Sciences and Art.Ahmed MohamedHossamLecturer of Radiology. October University of Modern Sciences and Art.Journal Article20200301Objectives: This study was to assess and compare the long term influence of Bio-Oss graft with and without PRF clots as a filling material during a lateral sinus lift with simultaneous implantation. <br />Material and Methods: 12 sinus elevations performed on 10 randomly selected patients and were divided into 2 groups. Group A received Bio-Oss mixed with PRF (Platelet Rich Fibrin) as graft and PRF membrane, and group B received Bio-Oss only as graft and Bio-Oss collagen membrane. The treatment outcome was evaluated at 6 and 12 months of healing clinically and radiographically. Bone height and bone density were measured preoperatively, at 6 and 12 months postoperatively and statistically analyzed. <br />Results: Statistical analysis showed that the bone height and bone density increased significantly (p≤0.05) at 6, and 12 months postoperatively in both groups. By comparing the two groups, Group A showed statistically significant (P≤0.05) increase in bone height and density than group B. <br />Conclusion: The use of PRF mixed with Bio-Oss was more superior to Bio-Oss only as graft after sinus lift and simultaneous implant placement regarding bone height and bone density.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101ASSESSMENT OF SOFT TISSUE EXPANSION USING OSMED SELF INFLATING HYDROGEL PRIOR TO MANDIBULAR RIDGE AUGMENTATION3653747475310.21608/edj.2017.74753ENNader NabilElbokleAssistant professor of Oral & Maxillofacial surgery. Department of Oral and Maxillofacial Surgery, Faculty of
Oral and Dental Medicine, Cairo University, Egypt.Ingy MohamedChehataLecturer of Oral & Maxillofacial Surgery. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry,
October University of Modern Sciences and Art. Egypt.Journal Article20200301Objectives: This study was conducted to assess the ability of self-inflating tissue expander to produce proper amount and quality of mucosa prior to bone grafting and implants insertion and degree of bone graft survival in severely atrophied alveolar ridges. <br />Material and Methods: All patients included in this study were referred to the Department of Oral and Maxillofacial Surgery, Faculty of Oral & dental Medicine, Cairo University for rehabilitation with dental implants. Inclusion criteria comprised: Missing mandibular premolar or molar area with a buccal osseous and soft tissue defect. The adjacent teeth had to be uncompromised with healthy gingival conditions. The exclusion criteria were patients who did not need bone grafting before implant placement. There were 10 patients (6 men and 4 women), with a mean age of 32 years (range, 18-60 years), who fulfilled the inclusion criteria and were consecutively included in the study. All patients were healthy and had no systemic contraindications to implant placement. They received standard treatment planning and diagnosis and gave signed informed consent. All 10 patients had an osmotic soft tissue expander implanted in the area with osseous and soft tissue defect, prior to bone grafting using bovine bone graft. Linear and volumetric measurements of the bone grafts were recorded immediately following bone graft and 6 months post grafting using cone beam CT scans.<br />Results: 10 sites in 10 patients were treated with soft tissue expansion using self inflating hydrogels. Complications of soft tissue expansion were only perforation (two sites), and no infection was noted. Primary wound closure was easily attained during bone augmentation procedure with no incidence of graft exposure, infection, or loss. It also allowed for good vertical bone height gain for implant placement. Volumetric measurements showed that an average mean of 1.36 cm3 mandibular ridge augmentation was established immediately Post bone grafting and 1.19 cm3 6 months after bone grafting. These measurements concluded that only 15.7% bone resorption occurred 6 months after bone grafting indicating good survival of the xenogenic bone graft.<br />Conclusion: The use of Osmed self-inflating tissue expander prior to bone augmentation and implants insertion allowed sufficient amount of mucosa that can cover the grafts and implants without tension or compromise to the periosteum and ensued minimal bone graft resorption in severely atrophied alveolar ridges.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101MORPHOLOGICAL CHANGES IN THE TEMPOROMANDIBULAR JOINT (TMJ) AFTER MANDIBULAR LENGTHENING BY DISTRACTION OSTEOGENESIS A CLINICAL STUDY3753827475410.21608/edj.2017.74754ENAshrafGhanemAssociate Professor; Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Minia University, Egypt.HamedGadLecturer; Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Minia University, Egypt.Journal Article20200301The purpose of this study was to evaluate the morphological changes in the TMJ after mandibular body lengthening by distraction osteogenesis (DO). This study was conducted on 10 patients suffered from unilateral mandibular body deficiency and corrected through mandibular lengthening following standard distraction osteogenesis (DO). The impacts of DO on TMJs were examined and evaluated with magnetic resonance images through pre-operative- and post-distraction. The results revealed that; comparing pre-operative and post-distraction interpretation of TMJs magnetic resonance images; there was no morphological effect on TMJ following mandibular body distraction osteogenesis; on the other hand there was improvement of 4 cases suffered from anterior disk displacement with reduction (ADDWR) following mandibular body lengthening by distraction osteogensis (DO).The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101THE KEY: A PILOT STUDY OF A NOVEL TECHNIQUE FOR CONSERVATIVE EXTRACTION OF REMAINING ROOTS3833887475510.21608/edj.2017.74755ENTadros Ramsis MarcosKaiserBDS, Ain Shams University. CEO and Founder of Roman’s Clinic.Ahmed Tarek MostafaElsharkawyLecturer of Oral and Maxillofacial Surgery, Cairo University. Visiting Lecturer of Oral and Maxillofacial Surgery,
Ahram Canadian University.Journal Article20200301Objectives: The aim of the present study was to determine if the Key can be easily used to extract remaining roots, and to assess the clinical outcome.<br />Study design: Five patients with remaining roots not suitable for forceps extraction were enrolled in this study, and had their remaining roots extracted using a novel atraumatic extraction system “The Key”. Patients were evaluated clinically one week post-operatively.<br />Results: All the roots were successfully extracted, with average time 25 minutes. No patient complained from excessive intra-operative or post-operative pain, swelling or bleeding. All sockets evaluated one week post-operative showed uneventful soft tissue healing.<br />Conclusions: The Key may be successfully used for atraumatic extraction of remaining roots. Further studies are recommended with more number of cases, different surgeons, and comparison with other techniques.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101THREE DIMENSION RHOMBIC PLATES VERSUS TWO MINIPLATES FOR FIXATION OF UNILATERAL LOW SUBCONDYLAR MANDIBULAR FRACTURES3893987475710.21608/edj.2017.74757ENKhaled A.SaadAss. Professor, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta University.Ibrahim M.NowairLecturer, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta UniversityEmad F.EsaLecturer, Oral & Maxillofacial Surgery Dept., Faculty of Dentistry, Tanta UniversityJournal Article20200301This study was designed to evaluate the use of three dimension miniplates (rhombic) versus two miniplates for fixation of displaced low subcondylar mandibular fractures both clinically and radiographically. <br />Patients and methods: this study comprised 16 adult patients who required open reduction and internal fixation of the subcondylar fracture of the mandible via retromandibular approach. <br />The patients were randomly divided into two equal groups. Group (1) comprised (8) patients treated with three dimension rhombic plates and group (II) comprised (8) patients treated with two non-compression miniplates. All patients were evaluated clinically for intraoperative complications of hemorrhage and damage of the marginal mandibular branch of facial nerve. Postoperative complications as occulusal discrepancy, function of TMJ, presence of infection and parotid fistula formation were evaluated at intervals: immediately, one week, two and six weeks and three months. Radiographically, via panoramic views, CT scans at three and six months. <br />Results: none of the patients suffered from any major complication intra operatively and postoperatively. All patients showed great satisfactions about the results of their treatment by these means of internal fixation through the retromandibular approach. <br />Conclusion: open reduction and internal fixation of subcondylar fractures using three dimensional rhombic plates giving better and excellent stability and neutralizes the changing strains in the condylar region and associated with minimal morbidity when fixed via retromandibular approach allowing early restoration of function and avoids prolonged maxillomandibular fixation.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101EGYPTIAN TOTAL TMJ PROSTHESIS: A THREE-YEAR FOLLOW-UP OF 22 JOINTS3994057476010.21608/edj.2017.74760ENRamyEl-BeialyLecturer, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo UniversityWaleed R.El-BeialyAssociate Professor, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University,
Associate Professor, Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Future University in Egypt (FUE)Journal Article20200301The TemporoMandibular Joint (TMJ) is the unique structure that facilitates the complex articulation of the mandible to the base of the skull, through its upper bony component the glenoid fossa and eminence. TMJ can be severely compromised both anatomically and functionally by many etiologic factors, including but not limited to: developmental abnormalities, ankylosis, destructive arthritis, comminuted fractures, locally invasive pathosis as ameloblastoma or bengin tumors as Keratocystic Odontogenic Tumor (KCOT), or even malignancies. Reconstruction of the TMJ has been subject to extensive research and a wide variety of materials. As is the case with most reconstructions, autogenous grafts both vascularized and none, as chostochondral, fibula, radial, iliac crest and even scapula and metacarpal grafts have been employed especially in children and adolescents. Needless to point out, the well-known disadvantages of such grafts as their unpredictable outcome and donor site morbidity. On the other hand, alloplastic TMJ prosthesis that were introduced to overcome the autogenous graft disadvantages, had a very disappointing and rather scandalous debut with materials such as: vitalium, Proplast-Teflon (PTFE), Polymethylmethacrylate (PMMA) and Polydimethylsiloxane (silicone rubber); all of which turned out to be rather destructive than reconstructive. After learning from our mistakes and having a better understanding of the destructive forces the TMJ can have on prosthetic materials, ultra high molecular weight polyethylene (UHMWPE) and titanium separately or in combination have been employed with better outcomes and less failures/reactions. Custom made TMJ prosthetics using CAD/CAM and Rapid Prototyping using different manufacturing techniques are essentially valuable in cases of mandibular resections with disarticulation following disfiguring lesions. Tissue engineering of TMJ on scaffolds (natural/synthetic) using stem cells and bioactive molecules are prospective solutions, yet further research is necessary. In this study, we are rather addressing destructive lesions that are limited to TMJ, where stock TMJ prostheses provide results similar to the more expensive custom made and tissue engineered reconstruction solutions.The Egyptian Dental Association (EDA)Egyptian Dental Journal0070-948463Issue 1 - January (Oral Surgery)20170101USE OF POSTERIORLY BASED TONGUE FLAP IN RECONSTRUCTION OF INTRAORAL MAXILLARY SOFT TISSUE DEFECTS FOLLOWING EXCISION OF MAXILLARY BENIGN SOFT TISSUE TUMORS4074137476210.21608/edj.2017.74762ENGamal M.MoutamedAssociate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo
University, EgyptJournal Article20200301Aim of the study: The current study aimed to evaluate the efficacy of posterior-based tongue flap for reconstruction and restoring function and esthetics of intraoral posterior maxillary soft tissue defects following surgical excision of large maxillary benign soft tissue granulomas.<br />Patients and methods: This study was carried out on 10 female patients aged from 37 to 55 years (men age: 46) who had been planned for treatment with posterior-based tongue flap procedure for reconstruction of intraoral maxillary soft tissue defects following surgical excision of large maxillary benign soft tissue tumors and/or granulomas. The first sessions were carried out under general anesthesia and aimed to surgical excision of the tumor and reconstruction the soft tissue defects with posterior-based tongue flap. In the second session, the pedicle was divided under local anesthesia. Between the first and second sessions, the period of time needed was 15 to 21 days. The proximal part of the pedicle was returned to the donor site in the second session. Postoperative clinical follow up and recall was scheduled at 1, 3, 6, 9, and 12 months postoperatively.<br />Results: All the flaps survived but one flap had temporary venous congestion after flap division. No recurrence was noted. Good aesthetic and functional results were achieved. No post-operative wound dehiscence and wound infection were recorded. The soft tissue contour at the recipient sites was clinically satisfactory.<br />Conclusion: Despite the disadvantages of being an interpolation flap which requires a second session and good patient cooperation, posterior-based tongue flap is a choice for reconstruction of intraoral posterior maxillary soft tissue defects following surgical excision of large maxillary benign soft tissue tumors or granulomas with its highly vascular structure, good mobility, localization, texture match, and low donor area morbidity.