volume-43-issue-1-2018

THE IMPACT OF GENDER ON CHILD DENTAL ANXIETY IN A SAMPLE OF EGYPTIAN CHILDREN (A CROSS-SECTIONAL STUDY)

Ann E Gaber, Amani M Khalil, Dalia M Talaat

> Show Abstract

INTRODUCTION: Despite the recent developments in the dental equipment and treatment procedures, dental fear and anxiety (DFA) are relatively common among children and adults. Relating dental fear and anxiety to gender is a controversial issue in scientific literature.
OBJECTIVES: The aim of this study is to examine the impact of gender on the child’s dental anxiety in a sample of Egyptian children.
MATERIALS AND METHODS: One hundred and twenty-six children 6-10 years old (60 boys and 66 girls), at the Department of Pediatric Dentistry, Faculty of Dentistry Alexandria University were asked to participate in the study. Children answered the Child Fear Survey Schedule – Dental Subscale (CFSS-DS).
RESULTS: About forty-six percent of the children in the studied sample were non-anxious, 30.2% were potentially anxious and only 23% were very anxious. Girls were significantly more dentally anxious than boys. (p=0.02).
CONCLUSIONS: The level of DFA was affected by the child gender where girls were more dentally anxious than boys. Injection was identified as the most fearful item in the dental visit.
KEYWORDS: Dental anxiety, dental fear, child gender, CFSS-DS.


> PDF
1

EFFECT OF AUTOGENOUS DENTIN GRAFT COMBINED WITH PLATELET RICH PLASMA ON ALVEOLAR BONE HEALING AFTER TOOTH EXTRACTION IN RABBIT

Ahmed A. Saleh, Samia S. Abd El Rehim, Khadiga Y. Kawana, Saeeda M. Osman

> Show Abstract

INTRODUCTION: Alveolar ridge preservation strategies are indicated to minimize the loss of ridge volume that typically follows tooth extraction. Dentin and bone are mineralized tissues and almost similar in chemical components. Particulate dentin has a plenty of growth factors such as bone morphogenetic proteins (BMP) that can induce new bone formation. Platelets play a fundamental role in hemostasis and are a natural source of growth factors. Mixture of particulate dentin and platelet-rich plasma can have an osteoinductive effect during different stages of bone healing.
OBJECTIVES: To investigate the biological effect of autogenous dentin graft combined with platelet rich plasma on alveolar bone healing following tooth extraction in rabbit.
MATERIALS AND METHODS: Seven healthy male New Zealand rabbits weighing 3kg (±250 g) were included in this study. The upper right incisor of each rabbit was extracted .The root of each incisor was used as a source of dentin. Root dentin was ground into powder by means of mortar and pestle.2 ml blood were taken from each rabbit. Platelet rich plasma was separated from other blood components by centrifuge machine. The left and right lower first premolars were extracted at the same time .The sockets of the lower right first premolars were filled by the mixture of dentin and platelet rich plasma (study group) while sockets of the lower left premolars were left to heal spontaneously (control group). Comparison of the healing features between the two groups was made histologically and histomorhometrically after 6 weeks.
RESULTS: New bone formation was noticed in the sockets loaded with dentin and platelet rich plasma mixture. The newly formed bone was significantly higher when compared to that in the control group.
CONCLUSIONS combination of dentin and platelet rich plasma induces new bone formation.
KEYWORDS: Bone regeneration, platelet rich plasma, histomorphometry, particulate dentin.


> PDF
6

EXPRESSION OF INTERLEUKIN-10 AND ITS VALUE AS A POTENTIAL MARKER IN ORAL SQUAMOUS CELL CARCINOMA

Maggi N. Ali, Taissir A. Omar, Sahar M. El Sheikh,Gamal A. Swaify, Amira I. Fayad

> Show Abstract

INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the commonest malignancy in oral cavity. Dysregulated inflammatory processes could impose a cancer risk. Cytokines are inflammatory mediators that can induce cell proliferation. Interleukin-10 is a pleiotropic cytokine which has a dual role in cancer pathogenesis. It contributes to tumor growth and in other cases to tumor rejection.
OBJECTIVES: To evaluate and correlate the expression of IL-10 in different histopathological grades of OSCC, as well as to assess its serum and salivary levels.
MATERIALS AND METHODS: Immunohistochemical (IHC) study using the IL-10 antibody was done on 20 surgical specimens and 5 normal mucosal tissues taken from OSCC patients and healthy individuals, respectively. Serum and salivary levels of IL-10 were also measured with a human IL-10 ELISA Kit in both patients and controls.
RESULTS: OSCC biopsies showed immunoreactivity to IL-10, while normal tissues were immunonegative. The IHC staining intensity was directly proportional to the grading of OSCC. Conversely, it showed no significant correlation to the disease stage. The difference in the serum and salivary IL-10 levels in patients and controls was not statistically significant. However, there was a significant correlation between IL-10 tissue expression and its serum and salivary levels in OSCC patients.
CONCLUSIONS: IL-10 is expressed in OSCC biopsies. Additionally, the levels of IL-10 in tissue, serum and saliva were correlated to each other. This could reflect the same way of regulation of IL-10 in different parts of the body.
KEYWORDS: OSCC, Cytokines, IL-10, Imunohistochemistry, ELISA.


> PDF
11

EVALUATION OF SHEAR BOND STRENGTH OF NANOPARTICLES GLASS CARBOMER AND HIGH VISCOSITY GLASS IONOMER IN PRIMARY TEETH DENTIN (IN VITRO STUDY)

Noha Y Mohammed, Ali A Sharaf, Dalia M Talaat, Seham A Hanafi

> Show Abstract

INTRODUCTION: Different techniques can be utilized in vitro to evaluate the durability of the bond strength to tooth structure. Shear bond strength test is one of these methods which have been widely used. Glass carbomer has been introduced with claims of improved physical characteristics in comparison with conventional GICs.
OBJECTIVES: The aim of the study was to compare and evaluate the shear bond strength of glass carbomer to primary dentin versus a high viscosity glass ionomer (Fuji IX GP)
MATERIAL AND METHODS: Twenty primary molar teeth extracted for orthodontic purposes or exfoliated by normal shedding were collected according to specific criteria from public hospitals in Alexandria and outpatient clinic of the Faculty of Dentistry, Alexandria University. Crown surfaces of the included teeth were mounted in acrylic blocks then, ground with water-cooled silicon carbide abrasive papers successively to obtain flat dentin surfaces. The prepared specimens (n=20) were divided into two groups according to the glass ionomer cement (GIC) bonded to the dentin surface (10/ each group): group I (Fuji IX GP) and group II (Glass Carbomer). Shear bond strength (SBS) between dentin surface and the bonded material was measured using a universal testing machine.
RESULTS: The results revealed that, Fuji IXGP group recorded the highest mean SBS value (6.624) while, Glass Carbomer recorded mean value (2.870). There was a highly significant difference in shear bond strength values between both groups (p= 0.000).
CONCLUSIONS: The high viscosity glass ionomer was higher in shear bond strength than glass carbomer glass ionomer and this finding may be salutary in GICs selection by dental practitioners.
KEY WORDS: Shear bond strength, Aging, Glass Carbomer, Primary Dentin.


> PDF
17

EFFECT OF NEOSTIGMINE ADMINISTRATION ON THE ULTRASTRUCTURE OF THE PAROTID SALIVARY GLAND IN RATS WITH INDUCED DIABETES

Sally S. Sakr, Gehan A. Elba, Samia S. Omar, Sahar S. Karam

> Show Abstract

INTRODUCTION: Neostigmine is parasympathomimetic drug. It is commonly used for treatment of myasthenia gravis, glaucoma, urinary retention, xerostomia, and post-operative ileus. Parasympathomimetic drugs increase the rate of salivation. Dry mouth is a frequent clinical complain among diabetic patients.
OBJECTIVES: The present study is designed to investigate the effect of neostigmine administration on the ultrastructure of the parotid salivary gland in rats with induced diabetes.
MATERIALS AND METHODS: Twenty one adult male rats were divided into three equal groups (seven rats each) Group I: Control group, Group II: Induced diabetes group (with no treatment), Group III: Induced diabetes group (with Therapeutic doses of Neostigmine which were administered intramuscularly every other day for one month. Diabetes was induced by a single intravenous injection of Streptozotocin. After one month all rats were sacrificed and the parotid glands were excised and processed for scanning electron microscopy. Histomorphometric analysis of the number of the intra-cellular vacuoles was done, and the data obtained were statistically analyzed.
RESULTS There was a statistically significant difference between the studied groups regarding the diameter of secretory granules, as it was increased in neostigmine treated group and decreased in diabetic group. Also there was restoration of the density and organization of the nerve distribution adjacent to secretory acini in neostigmine treated group.
CONCLUSIONS: The ultrastructural findings noticed in this study substantiate the use of Neostigmine in cases of diabetes associated xerostomia.
KEYWORDS: Neostigmine, Parotid Gland, Diabetes,


> PDF
22

SOFT TISSUE HEALING AROUND IMMEDIATELY PLACED DENTAL IMPLANTS AUGMENTED WITH AMNIOTIC CHORION MEMBRANE VERSUS CONNECTIVE TISSUE GRAFT (A CLINICAL AND HISTOLOGICAL STUDY)

Norai A. Zayed,Ahmed M. Hommos, Sahar SH. Karam, Rania A. Fahmy

> Show Abstract

INTRODUCTION: The Amnion Chorion Membrane (ACM) has favorable regenerative properties which facilitates its use for covering immediate dental implants.
OBJECTIVES: To evaluate clinically and histologically the effect of Amnion Chorion membrane in augmenting immediately placed dental implants compared to connective tissue graft (CTG)
MATERIALS AND METHODS: This study was conducted clinically on eighteen upper hopeless anterior/premolar teeth scheduled for extraction and immediate implant placement. Patients were divided into two groups: in the first group, nine immediate implants were covered with ACM, and in the second group nine immediate implants were covered with CTG. Keratinized mucosal width (KMW), keratinized mucosal thickness (KMT) and healing score were recorded for both groups at 7 , 14 , 30 and 90 days
RESULTS: The KMT showed an increase by 26% in the test group while in the control group it decreased by 6.5% by the end of the study period. Regarding the healing scores both groups showed marked improvement throughout the study, lower values of healing scores were noted in the test group. Clinical results were confirmed by histological examination which revealed that oral mucosa of both groups showed parakeratinized gingival epithelium. The connective tissue of the test group showed more regularly arranged ,thick bundles.
CONCLUSIONS Both treatment modalities were satisfactory but the ACM offered more positive results concerning the mucosal thickness and healing scores.
KEYWORDS: Immediate implants, ACM, Connective tissue graft, Soft tissue


> PDF
27

STICKY BONE IN DEHISCENCE DEFECT AROUND DENTAL IMPLANT

Waleed M. Atial, Abdel Aziz F. Khalil, Lydia N. Melek

> Show Abstract

INTRODUCTION: Back in time dentists used to place implants in locations with sufficient bone-dimensions only, with less regard to placement of final definitive restoration but most of the times, the placement of implant is not as accurate as intended and even a minor variation in comparison to ideal placement causes difficulties in fabrication of final prosthesis. The use of bone substitutes and membranes is now one of the standard therapeutic approaches. In order to accelerate healing of bone graft over the bony defect, numerous techniques utilizing platelet and fibrinogen concentrates have been introduced in the literature..
OBJECTIVES: This study was designed to evaluate the efficacy of using Autologous Concentrated Growth Factors (CGF) Enriched Bone Graft Matrix (Sticky Bone) and CGF-Enriched Fibrin Membrane in management of dehiscence defect around dental implant in narrow maxillary anterior ridge.
MATERIALS AND METHODS: Eleven DIO implants were inserted in six adult patients presenting an upper alveolar ridge width of less than 4mm determined by cone beam computed tomogeraphy (CBCT). After implant placement, the resultant vertical labial dehiscence defect was augmented utilizing Sticky Bone and CGF-Enriched Fibrin Membrane. Three CBCTs were made, pre-operatively, immediately post-operatively and six-months post-operatively. The change in vertical defect size was calculated radiographically then statistically analyzed.
RESULTS: Vertical dehiscence defect was sufficiently recovered in 5 implant-sites while in the other 6 sites it was decreased to mean value of 1.25 mm ± 0.69 SD, i.e the defect coverage in 6 implants occurred with mean value of 4.59 mm ±0.49 SD. Also the results of the present study showed that the mean of average implant stability was 59.89 mm ± 3.92
CONCLUSIONS: The combination of PRF mixed with CGF with bone graft (allograft) can increase the quality (density) of the newly formed bone and enhance the rate of new bone formation.
KEYWORDS: Sticky bone,dental implant, dehiscence, defect


> PDF
35

CLINICAL AND RADIOGRAPHIC STUDY OF HEALING OF MANDIBULAR FRACTURES USING PLASMA RICH FIBRIN MEMBRANE WITH MINIPLATE FIXATION

Amany M. Al Rayess, Mostafa M. El Dibany, Lydia N. Melek

> Show Abstract

INTRODUCTION: The development of bioactive surgical additives to regulate the inflammation and increase the speed of the healing process is one of the greatest challenges in clinical research. Various materials and techniques have been developed to enhance the process of fracture bone healing and to fasten it.
Numerous techniques using autologous platelet concentrates have been developed and applied; platelet rich fibrin [PRF] being one of them, one that is completely autogenous in nature, simple and relatively inexpensive with a specific three-dimensional architecture of the fibrin. PRF has also shown increased levels of numerous cytokines and growth factors that influence bony regeneration.
OBJECTIVES: The aim in this study was to compare between fracture healing using miniplates with and without PRF membrane in bilateral mandibular fractures clinically and radiographically.
MATERIALS AND METHODS: all twelve patients had bilateral mandibular fractures. Each patient was treated as follows: (Study Group): The mandibular fracture on the right side was treated by using the conventional 2.0 mm miniplates and screws with placement of PRF membrane. (Control Group): The mandibular fracture on the left side was treated by using the conventional 2.0 mm miniplates and screws. Follow-up was carried out every week during the first month, then at three months, and six months postoperatively.
RESULTS: none of the patients in either of the groups had an infection or signs of nonunion within the follow- up period. There was no statistically significant difference in the mean value of pain score between the fractures in the two groups. In both groups, edema was limited to the area of operation and resolved completely by the end of 4th week postoperatively. On immediate, 3 and 6 months postoperatively, the
mean bone density in the study group was statistically significantly higher than the control group, but the percentage change in the bone density
from immediate postoperative to 3 months, immediate postoperative to 6 months and from 3 to 6 months was not statistically significant
comparing the two groups
CONCLUSIONS: PRF application on the fracture line in the mandible may be helpful in improvement of the fracture healing but comparing the two groups, the pattern of improvement was nearly the same along time.
KEYWORDS: Alveolar bone, Fish oil, Induced rheumatoid arthritis, Freund's complete adjuvant


> PDF
41

EVALUATION OF THE ZYGOMATIC BUTTRESS AS A DONOR SITE FOR RIDGE AUGMENTATION PRIOR TO IMPLANT INSERTION IN THE ESTHETIC ZONE

Mohamed M. Solaiman, Ahmed S. EL Mahallawy , Nagy E. Hassan

> Show Abstract

INTRODUCTION: Traumatic loss of teeth in the esthetic zone commonly results in significant loss of buccal bone. This leads to reduced esthetics, problems with phonetics and reduction in function. Single tooth replacement has become an indication for implant-based restoration. In case of lack of bone volume the need of surgical reconstruction of the alveolar ridge is warranted. Several bone grafting techniques have been described to ensure sufficient bone volume for implantation.
OBJECTIVES: Evaluation of using the zygomatic buttress as an intraoral bone harvesting donor site for pre-implant grafting.
MATERIALS AND METHODS: Twelve patients were selected with limited alveolar ridge defect in the esthetic zone that needs bone grafting procedure prior to dental implants. Patients were treated using a 2-stage technique where bone blocks harvested from the zygomatic buttress region were placed as onlay grafts and fixed with osteosynthesis micro screws. After 4 months of healing, screws were removed for implant placement
RESULTS: Harvesting of 12 bone blocks were performed for all patients indicating a success rate of 100% for the zygomatic buttress area as a donor site. Final rehabilitation with dental implants was possible in 11 of 12 patients, yielding a success rate of 91.6%. Three patients (25%) had postoperative complications at the donor site and one patient (8.3%) at the recipient site. The mean value of bone width pre-operatively was 3.64 ± .48 mm which increased to 5.47 ± .57 mm post-operatively, the increase in mean value of bone width was statistically significant (p < 0.001). CONCLUSIONS: Harvesting of intraoral bone blocks from the zygomatic buttress region is an effective and safe method to treat localized alveolar ridge defect before implant placement. KEYWORDS: Zygomatic buttress, autogenous bone graft, dental implant, esthetic zone.


> PDF
48

EVALUATION OF ALVEOLAR OSTEOTOMY FOR CORRECTION OF VERTICAL BONE RESORPTION IN ANTERIOR MANDIBULAR RIDGE USING A MIXTURE OF TWO GRAFTED MATERIALS

Passent A. Younis, Ahmed M. Elsabbagh, Riham M. Eldibany

> Show Abstract

INTRODUCTION: Extensive loss of alveolar bone and teeth in the anterior mandible presents a complex problem for reconstruction. Alveolar osteotomy technique with the use of mixture of hydroxy apatite and beta-tricalcium phosphate together with injectable PRF is one of the reliable methods to restore vertical ridge deficiencies.
OBJECTIVES: : Evaluate vertical ridge augmentation using sandwich osteotomy technique in anterior atrophic mandible and the use of hydroxy apatite, beta-tri-calcium phosphate mixed with injectable PRF as a grafting material.
MATERIALS AND METHODS: This study was conducted clinically on 8 patients indicated for vertical ridge augmentation by sandwich technique osteotomy and fixation of the osteomatized segment by micro-plates and screws, and the placement of Ha- BTCP mixed with I-PRF as interpositional graft material. Patients were evaluated clinically and radiographically by using panoramic radiograph and cone beam computed tomography (CBCT).
RESULTS: In this study no severe pain was recorded postoperatively. No signs of inflammation or swelling were observed in almost all of the patients along the follow up period. Vertical bone height gain of the residual ridge was satisfactory and prepared the ridge to receive final prosthesis successfully.
CONCLUSIONS Sandwich osteotomy technique with Ha- BTCP mixed with I-prf is a reliable method to restore vertical ridge deficiencies in anterior mandible.
KEYWORDS: Sandwich technique, Hydroxy apatite- beta-tricalcium phosphate, Injectable-PRF, vertical ridge atrophy.


> PDF
55

THE USE OF ULTRA-SHORT DENTAL IMPLANTS IN ATROPHIC POSTERIOR RIDGES

Ahmed O. Gonna, Ragab S. Hassan, Magued H. Fahmy

> Show Abstract

INTRODUCTION: Reduced alveolar bone in posterior arches is often a complication for regular dental implant placement, which leads to a longer, more complicated and unpredictable bone grafting procedures or nerve repositioning surgeries.
OBJECTIVES: : In this clinical case series, placing 4-mm long Global D implants supporting a fixed dental prosthesis in atrophic resorbed posterior, arches were evaluated for 6 months.
MATERIALS AND METHODS: In nineteen dental arches, 43 dental implants were placed and a screw retained Fixed dental prostheses were attached to two or three dental implants. All implants were placed in adequate amount of bone. No bone grafting procedures were implemented. A minimum torque of 25 Ncm was used to place the dental implants.
RESULTS Forty-three dental implants were inserted. Three dental implants failed before loading. 17 Fixed dental prostheses were delivered. One patient didn’t show up for follow up and dropped out of the study. Forty-one implants were eligible for examination and follow up. At 6 month-post–insertion, the survival rate reached 92.7%. No patients suffered from any complications or side effects after implant surgeries. The mean change in the marginal bone loss around implant was found to be 0.22 mm with SD of 0.43 mm p<0.01. CONCLUSIONS: This study shows that 4 mm trans-mucosal dental implants with roughed sand blasted large grit acid etched surfaces can be safely used to support fixed partial prosthesis in atrophic posterior ridges. Further and longer follow up is needed for these types of implants. KEYWORDS: bone loss, crown-implant ratio, jaw bone atrophy, short implants.


> PDF
62

THE USE OF AUTOGENOUS BONE WITH AND WITHOUT PLATELET RICH FIBRIN AROUND IMMEDIATELY PLACED DENTAL IMPLANT

Abla I. Elkhawass, Magda M. Saleh, Saeeda M. Osman

> Show Abstract

INTRODUCTION The success of implant therapy depends primarily on appropriate treatment planning, case selection, properly performed implant placement surgery and good implant to bone adhesion. This can be achieved by several types of grafts around the implant.
OBJECTIVES: To evaluate clinically and radiographically the use of autogenous bone graft with and without platelet rich fibrin around immediately inserted implants and to evaluate implant stability by resonance frequency analysis device (Osstell).
MATERIALS AND METHODS: Clinical trial on 14 patients indicated for maxillary anterior teeth extraction selected from the outpatient clinic in oral and maxillofacial surgery department, Alexandria University were divided into two groups. In group A: the implant was inserted with autogenous bone collected from freshly extracted socket mixed with platelet rich fibrin as a filling of the gap, while in group B: the implant was inserted with autogenous bone collected from freshly extracted socket as filling of the gap.
RESULTS clinical and radiographical evaluation of the implants showed good osseointegration between the bone and the immediate implant in both groups.
CONCLUSIONS: The results show that the harvested autogenous bone may be useful when small amount of bone is required and that the PRF helps in bone formation and osseointegration in a short period of time.
KEYWORDS: Immediate implant, autogenous bone, Platelet rich fibrin.


> PDF
68

TRANSCRESTAL MAXILLARY SINUS FLOOR ELEVATION USING THE BALLOON TECHNIQUE WITH SIMULTANEOUS IMPLANT PLACEMENT

Ahmed M.Qassem, Nagy P.Hassan,Magued H.Fahmy

> Show Abstract

INTRODUCTION: Rehabilitation of the maxilla using implants is frequently problematic because of the pneumatization of the maxillary sinus into the alveolar ridge. When only a few millimeters of augmentation are needed in conjunction with simultaneous implant placement, an indirect sinus lift is effective. This study describes transcrestal sinus lift using the sinus balloon technique and DASK (Dentium Advanced Sinus Kit) drills for implant placement in patients with an atrophic maxillary posterior area with synthetic bone graft, to evaluate the bone height achieved and the implant success rate.
OBJECTIVES: To evaluate clinically and radiographically the simultaneous implant placement and grafting with synthetic bone graft after Schneiderian membrane elevation using the maxillary sinus balloon technique and DASK drills.
MATERIALS AND METHODS A total of 13 patients with missing posterior maxillary teeth (premolars or molars) and with limited bone height below the floor of the maxillary sinus received an implant and grafting with synthetic bone graft after maxillary sinus lifting using a maxillary sinus balloon technique and DASK drills.
RESULTS: Cone beam computerized tomography 6 months postoperatively showed statistically significant increase in bone height and density. The mean preoperative vertical bone height value was (5.97 ± 1.17 mm), while the mean 6 months postoperative vertical bone height value was (10.45 ± 1.56 mm). The mean preoperative implant bone density value was (349.6 ± 1265.9 HU), while the mean postoperative implant bone density was (771.1 ± 239.1 HU).
CONCLUSIONS: Sinus balloon and DASK drills are an acceptable tool for indirect sinus lifting with simultaneous implant placement.
KEYWORDS: Transcrestal approach, sinus balloon technique, DASK drills, implants.


> PDF
73

EVALUATION OF THE OSTEOINDUCTIVE POTENTIAL OF FREEZE-DRIED HUMAN AMNIOTIC MEMBRANE (EXPERIMENTAL STUDY)

Aliaa O. Kamal, Sherif S. Ayad, Ragab S. Hassan, Samir R. Nouh, Dina A. Nagy

> Show Abstract

INTRODUCTION: Bone regeneration represents an important challenge in oral surgery. Several means have been employed to improve bone healing, each having several advantages and disadvantages. The search for new materials and methods is an ongoing process.
OBJECTIVES: The aim of the present study was to evaluate the bone inductive effect of the freeze-dried human amniotic membrane (FDAM) as a novel biomaterial for bone regeneration.
MATERIALS AND METHODS: Twelve adult male dogs were involved in this study. Bilateral critical-sized mandibular defects were created in each dog. One defect was left uncovered as a control. The other defect was covered with a double layered sterile freeze-dried human amniotic membrane (FDAM) to serve as a study. At each of three time points - 4, 8, and 12 weeks - four dogs were euthanized and their mandibles were harvested en bloc and osteotomy sites were submitted for histochemical examination to evaluate bone healing.
RESULTS: The tissue samples were obtained after 4, 8, and 12 weeks for histochemical examination. The FDAM was found to enhance the blood supply to the defect area in the study group and gave rise to bone induction (P ˂0.001).
CONCLUSIONS: Our study findings indicate that the FDAM has the potential for the enhancement of bone healing and bone induction.
KEYWORDS: Amniotic membrane, freeze-dried, bone regeneration, critical-sized bone defect.


> PDF
80

EVALUATION OF THE USE OF ZIRCONIA POROUS SCAFFOLD IN THE REPAIR OF OROANTRAL FISTULA

Karim E. Mokhtar, Ahmed S. Elmahallawy‚ Adham A. Elashwah

> Show Abstract

INTRODUCTION: There is a variety of treatment modalities for oroantral defects based on repair of soft tissue component only of the defect. However, bone regeneration is needed to allow for later restoration of the missing tooth.
OBJECTIVE: The aim of this study was to evaluate the efficacy of zirconia porous scaffold in oroantral defects.
MATERIALS AND METHODS: This study was conducted on ten patients suffering from oroantral defects of more than three weeks duration and having a width of at least five millimeters (mm). The patients were treated with placement of a custom made zirconia porous scaffold along with buccal advancement flap after a virtual surface for bone model was reconstructed from the cone-beam computed tomography and printed by stereolithography 3D printing method.
RESULTS: Clinically, there was a significant improvement in wound healing in 80% of the cases across the follow up period with only 20% of the patients the wound didn’t heal due to infected wound margins and the full scaffold was lost prior to the end of the follow-up period and required further treatment later on. Pain intensity decreased throughout the follow-up period with the maximum pain intensity was only immediately postoperative. Radiographically, there was a significant increase in bone density from the baseline by 41.2 percentage change.
CONCLUSION: Zirconia porous scaffold is a biocompatible material that enhances new bone formation in closure of oroantral fistulas through its high porosity and clear interconnected porous surface which are a suitable environment for osteoblastic activity.
Keywords: Oro-antral fistula, Zirconia scaffold, Bone model.


> PDF
87

COMPARATIVE STUDY BETWEEN OSSEOINTEGRATION AROUND NANOSTRUCTURE IMPLANT AND SANDBLASTED IN IMMEDIATE PLACEMENT (EXPERIMENTAL STUDY)

Aya F. Barakat , Ahmed S. El-Mahallawy, Tarek M. Aly, Sahar K. Shafik

> Show Abstract

INTRODUCTION: The quality of the implant surfaces is one of the major factors that influences wound healing at the implantation site and subsequently affects osseo-integration.
OBJECTIVES: Evaluation of the osseo-integration around nano-structured dental implant and around sandblasted type histologically.
MATERIALS AND METHODS: This experimental study was done on 6 healthy mongrel dogs, all dogs were healthy as documented by a veterinarian report, and kept under the same nutritional and environmental conditions in the animal house at the Physiology Department, Faculty of Medicine, Alexandria University. All dogs were divided into 2 groups: group A received nanostructured dental implant in the left side, group B received sandblasted dental implant in the right side. Afterwards the dogs were sacrificed at 3 and 6 weeks after implant insertion.
RESULTS In group A the osseo integration of all implants was noted. New bone formed in direct contact with the implant surfaces and the threads. But in group B one experimental animal preserved the implant in its place while the others were displaced from the bone with fibrous tissue interface.
CONCLUSIONS: There is significant increase in the bone healing around nano dental implants as opposed to sandblasted implants.
KEYWORDS: Osseo integration, Nano dental implants, sandblasting implants, immediate implant, experimental study.


> PDF
94

EFFICACY OF USING PLATELET CONCENTRATES IN THE MANAGEMENT OF HORIZONTAL RIDGE DEFECTS (EXPERIMENTAL STUDY)

Souzy K. Anwar, Mona E. Lotfy, Gehan S. Kotry,Sahar S. Karam4

> Show Abstract

INTRODUCTION: The use of platelet concentrates remains controversial. Several techniques for platelet concentrates are available and each method leads to a different product with different biology and potential uses. Platelet rich fibrin (PRF) is an autologous biomaterial composed of a fibrin clot matrix entrapping leukocytes, cytokines, living progenitor cells, and platelets capable of releasing various growth factors. One of the recent platelet concentrates is the mineralized plasmatic matrix (MPM) which has a different way of preparation. It creates a stable homogeneous single-moldable compound.
OBJECTIVES: The aim of this experimental study was to compare the effect of PRF to MPM when combined with biphasic calcium phosphate alloplast in treating horizontal critical sized ridge defects in a canine model.
MATERIALS AND METHODS: A split mouth design was carried out using the third and fourth mandibular premolars of two healthy mongrel dogs. A total of eight horizontal critical sized ridge defects were surgically created. The defects on the left side (group I); were managed with MPM composite, MPM compact layer, then collagen membrane. On the right side (group II); defects were managed with PRF mixed with biphasic calcium phosphate alloplast followed by the application of PRF compact strips, then collagen membrane. The dogs were sacrificed after 4 weeks. Samples were dissected and prepared for histological evaluation.
RESULTS: Histological results showed that quality of bone formed in MPM group was superior to PRF. This was evident with the formation of well-organized compact bone in MPM specimens versus immature woven trabecular bone in PRF ones.
CONCLUSIONS: The fibrin network that is produced in the MPM composite allows for its homogeneity. This offers a very good stability for the graft which was found to be more effective in enhancing wound healing during guided bone regeneration of horizontal ridge defects.
KEYWORDS: Platelet Rich Fibrin, Mineralized Plasmatic Matrix, Guided bone regeneration, Horizontal ridge defects, Biphasic calcium phosphate


> PDF
99

EVALUATION OF THE USE OF ULTRASONIC ACTIVATED POLY-D-L-LACTIC ACID PINS AND MESHES FOR HORIZONTAL SOFT TISSUE AUGMENTATION AROUND DENTAL IMPLANTS

Eman A.S. El-Mahalawy, Ahmad M. Hommos, Gehan S. Kotry

> Show Abstract

INTRODUCTION: Horizontal ridge defects are a common consequence of tooth loss. They present an esthetic problem, especially if the edentulous site is in the maxillary esthetic zone and indicated for implant placement.
A novel system using ultrasonic waves to activate pins and meshes made of completely resorbable poly-D-L-lactic acid has been recently introduced. It is commonly used in the augmentation of alveolar ridge defects, but has not been tried for guided soft tissue augmentation.
OBJECTIVES: clinical evaluation of the efficacy of ultrasonic activated poly-D-L-lactic acid pins and meshes for guided soft tissue augmentation of horizontal defects present around dental implants.
MATERIALS AND METHODS: study comprised of eight patients having localized horizontal soft tissue defects around dental implants. ‘Guided soft tissue augmentation’ technique was applied to manage these defects using ultrasonic activated poly-D-L-lactic acid pins and meshes. Patients recorded visual analogue scores for the first two weeks post-operatively. The augmented defects were evaluated for soft tissue thickness and pink esthetic score at one and three months post-operatively.
RESULTS: there was a statistically significant increase in soft tissue thickness and fill in all treated defects together with an improvement of the pink esthetic score when compared to the baseline values. Patients had a mean visual analogue score of (0.0 ± 0.0) as of the fifth post-operative day.
CONCLUSIONS: augmentation of horizontal soft tissue defects using ultrasonic activated poly-D-L-lactic acid pins and meshes is a less invasive and effective clinical procedure to increase soft tissue thickness around dental implants together with the reconstruction of gingival contours to match those of adjacent natural teeth.
KEYWORDS: dental implants, esthetics, horizontal ridge defects, SonicWeld®, soft tissue


> PDF
105

PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA

Amr M. Emera, Tarek M. Aly, Samraa A. Elsheikh

> Show Abstract

INTRODUCTION: Osteotomies done for implant placement has been classically performed using drills of various shapes to conform the site to the implant’s geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis, representing a significant risk for failed osseointegration. As an alternative, ultrasonic drilling for implant placement allows precise and effective bone cutting without damaging adjacent soft tissues.
OBJECTIVES: This study evaluated the effect of Piezoelectric drilling in decreasing the peri-implant marginal bone loss as well as increasing the implant stability values throughout a 6 months healing period.
MATERIALS AND METHODS: A clinical and radiographic study with a split-mouth design was carried out on 10 patients. Each patient received two implants in both sides of anterior maxilla, one implant was placed with piezoelectric drilling (study group) and the other was placed with conventional drilling (control group). Assessments included measurements of implant stability using Osstell and measurements of the linear changes in the peri-implant marginal bone using cone beam computed tomography images. Measurements were done immediately post-operative, at 3 months and 6 months.
RESULTS: The clinical and radiographical results of the Piezoelectric study sides were better than the conventional control sides. Marginal bone loss was significantly lower in the study group. Implant Stability Quotient (ISQ) values were significantly higher in the study group at the immediate time of placement and at 6 months.
CONCLUSIONS:Within the limitations of this clinical trial, it can be concluded that the piezoelectric drilling for implant placement in
the anterior maxilla is a successful option for reducing marginal bone loss and increasing implant stability throughout the healing period.
KEYWORDS: Ultrasonic/piezoelectric drilling, piezotome, implants, maxilla.


> PDF
111

EVALUATION OF THE USE OF ALVEOLAR BLOCK FROM MAXILLARY TUBEROSITY FOR AUGMENTATION OF ANTERIOR MAXILLARY DEFECTS

Mohamed A. Aboushara, Mostafa M. Eldibany, Nagy P. Hassan

> Show Abstract

INTRODUCTION: Maxillofacial bone defects occur for various reasons as infections, tumor and cysts or physiologic loss of bone after extraction of teeth. There are a lot of controversies among dental practitioners in the material used for filling of bone defects to increase the volume of bone in favor of good placement of the implant. Autogenous bone is the gold standard for bone reconstruction due to osteogenic, osteoinductive, and osteoconductive properties.
OBJECTIVES: The aim of this study was to evaluate clinically and radiographically the efficiency of using maxillary tuberosity as a block bone graft for augmentation of anterior maxillary defects.
MATERIALS AND METHODS: Twelve patients with anterior maxillary bone defects were treated with bone graft harvested from the maxillary tuberosity with an age range of 20 and 50 years old. Piezotome 2 was used for bone harvesting from the tuberosity. Osteosynthesis microscrews were used to fix the block graft in place.
RESULTS: Bone density and width showed statistical significant difference detected by cone beam computed tomography (CBCT).
CONCLUSIONS: The large and accessible maxillary tuberosity is a reliable source to use as autogenous bone block for augmentation of jaw defects
KEYWORDS: Autogenous bone graft, maxillary tuberosity, guided bone regeneration (GBR), piezosurgery


> PDF
111

EFFECT OF GENISTEIN AND OXALIPLATIN ON CANCER STEM CELLS IN ORAL SQUAMOUS CELL CARCINOMA: AN EXPERIMENTAL STUDY

Ahmed M. Hussein, Sahar M. El-Sheikh, Zeinab E. Darwish, Khaled A. Hussein, Ashraf I. Gaafar

> Show Abstract

INTRODUCTION: Squamous cell carcinoma is one of the malignant diseases that affect the oral cavity worldwide. One of the theories regarding oral carcinogenesis is that tumor growth is dependent on cancer stem cells. Markers specific for these cells as CD44 have been investigated in hope of developing a deeper understanding for their role in carcinogenesis. Genistein, as chemopreventive agent, has been shown to suppress the growth of several tumors. Oxaliplatin is a chemotherapeutic compound that did show a range of antitumor activity.
OBJECTIVES: This research was carried out to study the effect of genistein, oxaliplatin either alone or in combination during experimentally DMBA induced hamster buccal pouch carcinogenesis using CD44 antibody as a marker.
MATERIALS AND METHODS: A total of 100 young Syrian hamsters distributed into groups as follows: 4 normal animals examined for the histology of the normal pouch mucosa and 96 animals divided into; group I, as a control group, in which pouches were painted with a heavy mineral oil only; group II were painted with DMBA mixed in a heavy mineral oil. These animals were randomly divided into 4 subgroups as following: group IIA only painted with DMBA; group IIB where genistein was orally administrated; group IIC were injected with oxaliplatin; and group IID in which both genistein and oxaliplatin were given.
RESULTS: Both genistein and oxaliplatin provided a significant reduction in carcinogenesis process of DMBA induced oral squamous cell carcinoma. Moreover, they provided a significant decrease in the proliferation and activity of cancer stem cells as measured by the CD44 antibody.
CONCLUSIONS: Genistein provides a chemoprevention role and the oxaliplatin produces a chemotherapeutic effect during the process of carcinogenesis. The combined action of both agents was better than the effect of each agent alone.
KEYWORDS: Genistein, Oxaliplatin, Cancer stem cells, CD44.


> PDF
117