volume-43-issue-3-2018

COMPARATIVE STUDY OF PRIMARY STABILITY BETWEEN IMMEDIATE PLACED IMPLANTS AND DELAYED IMMEDIATE PLACED IMPLANTS IN MANDIBULAR SINGLE ROOTED TEETH

Mohab M. Magdy, Sherif S. Mohamed , Hala R. Ragab

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INTRODUCTION: The timing of implant placement after tooth extraction has been a matter of discussion in dental implant treatment. Primary stability of the implant placed can be measured by the resonance frequency analysis (RFA) which is used to compare the primary stability of immediate and delayed immediate placed implants.
OBJECTIVES: This study was designed to compare between primary stability of immediate placed implants and delayed immediate placed implants using resonance frequency analysis device in mandibular single rooted teeth.
MATERIALS AND METHODS: Ten patients were selected from Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University divided into two groups, Group A: Five patients indicated for extraction of single rooted teeth had undergone implant placement immediately after tooth extraction (Immediate implant placement). Group B: Five patients indicated for extraction of single rooted teeth had undergone implant placement two weeks after tooth extraction (Delayed immediate implant placement).
RESULTS: For group A patients the average mean and standard deviation of the primary stability of the placed implants was 61.75 ± 8.21 ISQ units while for group B patients the average mean and standard deviation of the primary stability of the placed implants was 67.38 ± 11.59 ISQ units. After comparing these results it was shown that the average mean and standard deviation of the primary stability of all cases of group B is greater than the average mean and standard deviation of the primary stability of all cases of group A, which results in a t-value (student t-test) of 0.792 and the p- value of the study was 0.458 which is statistically insignificant.
CONCLUSIONS: There is no significant difference between the primary stability of immediately placed implants and delayed immediate placed implants.
KEYWORDS: Primary stability, Immediate placed implants, Delayed immediate placed implants.


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PREVALENCE OF THE OCCUPATIONAL HAZARDS AMONG MINISTRY OF HEALTH DENTISTS, ALEXANDRIA, EGYPT

Sherihan I. Yehia, Mona K. El Kashlan , Wafaa E. El-Din

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INTRODUCTION: Dentists are exposed to various hazards due to their occupation. Identifying the most prevalent ones is required to develop preventive measures and coping strategies in order to reduce the effect of such hazards in the future.
OBJECTIVES: to assess the prevalence of the different occupational hazards among the Ministry Of Health dentists, in Alexandria.
MATERIALS AND METHODS: A sample of 900 dentists working in the different Ministry of Health facilities was randomly selected from the eight health districts of Alexandria governorate. A final sample of 750 dentists participated in the study with response rate of 83.33%. They were asked to complete a structured questionnaire, specially designed for the study, in order to assess their exposure to the different occupational hazards.
RESULTS: Most of participants suffered from stress (85.9%), followed by musculoskeletal disorders (85.6%) and 63.9% experienced a type of percutaneous injury. Furthermore 51.3% were exposed to radiation hazards, 44.4% and 42.66% were exposed to eye injuries and chemical hazards, respectively. The least prevalent hazard was hearing impairment where it was reported by only 8.8% of the study participants
CONCLUSIONS: Rheumatoid arthritis is an important risk factor for alveolar bone loss. The treatment of the RA induced rats with fish oil not only prevented the alveolar bone resorption and stimulated new bone formation, but also reduced relatively the level of rheumatoid factor in the blood.
KEYWORDS: Prevalence, occupational hazards, dentistry, Ministry of Health, Egypt.


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INFLUENCE OF OCCLUSAL LOADING LOCATION ON THE STRAIN DEVELOPED AROUND IMPLANTS WITH TWO DIFFERENT CREST MODULE DESIGNS (IN VITRO STUDY)

Marwan A. Aggag, Yousreya A. Shalaby,Mohammed S. Nassif3, Amir S. Azer

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ABSTRACT
INTRODUCTION: Mechanical overload is thought to be one of the major causes of implant complications. The addition of micro threads increase linear length of coronal implant surface available for biologic width and allows some stress transfer and relieve the crestal stress and strain concentration in the coronal region.
OBJECTIVES: Was to compare the influence of occlusal loading location on the strain developed around implants with two different crest module designs.
MATERIALS AND METHODS: Ten Polyurethane test blocks in which implants were fixed at the maxillary left first premolar area. Specimens were divided into two parallel groups (n=5), Group (I) -implants, with micro threads, Group (II) implants with wide-groove threads. Strain gauges were connected to a strain meter to record the developed strain. A universal testing machine was used for load application up to 100 N. The data were statistically analyzed (p≤0.05).
RESULTS: Group I exhibited the lower mean micro-strain values (260.0 ± 192.6 με) than Group II (513.2 ± 108.2 με).There was statistically significant difference between both groups(p > 0.05).
CONCLUSIONS: Crest module designs affected the stress pattern induced around dental implants.
KEYWORDS: Implant, Crest module, Micro threads, Macro threads, Strain gauge.


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THE EFFECT OF COMPLETE AND PARTIAL CONTOUR ZIRCONIA COPINGS ON THE FRACTURE RESISTANCE OF ALL CERAMIC RESTORATIONS

Islam M Abdel Raheem,Sanaa H Abdel Kader, , Fayza H Al Abbassy,

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ABSTRACT
INTRODUCTION Veneer chipping is a common failure of zirconia based restorations, especially in the presence of high occlusal loads. Modifying zirconia design may influence veneer chipping.
OBJECTIVES: Purpose of this study was to evaluate fracture resistance of complete and partial contour zirconia crowns.
MATERIALS AND METHODS: Twenty standardized epoxy resin dies, prepared to receive zirconia based crowns, were divided into 4 groups, 5 specimens each. Zirconia framework designs were: (a) Full contour zirconia crown (FC), (b) Partial contour zirconia coping with buccal veneering (PC), (c) Anatomically reduced zirconia coping with palatal and proximal collar (ARD) and (d) half mm zirconia coping without collar (CON) (control group). Dual scanning technique was done for the test groups to fabricate zirconia copings with the use of standardized resin patterns, while normal scanning was made for the control group. After milling and sintering of zirconia specimens, veneering was done for all desired surfaces. All crowns were adhesively luted to their corresponding dies, and subjected to thermal cycling and mechanical loading corresponding to one year clinical service. Single load to fracture was applied to all the specimens. Type of failure was recorded for each specimen, investigated visually then by using Stereomicroscope and SEM.
RESULTS: Complete and partial contour zirconia restorations showed high resistance to fracture. The presence of collar was insignificant for increasing fracture resistance, but had an influence on the fracture extension toward the proximal surface of the veneered restorations.
KEYWORDS: Zirconia- Complete contour – Partial contour- Fracture resistance- Veneer chipping- Veneered zirconia.


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MICRONUCLEI AS BIOMARKERS OF GENETIC DAMAGE IN ORAL SQUAMOUS CELL CARCINOMA

Nancy A. Shaaban, Hanaa S. Raslan, Omneya R. Ramadan, Ahmed MA. Habib, Eiman I. Zaki

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ABSTRACT
INTRODUCTION: Oral cancer is a major health problem, causing high morbidity and mortality rates. Oral Squamous Cell Carcinoma (OSCC) accounts for 90-95% of all oral malignancies. The prognosis of OSCC is often poor due to the late discovery of most lesions, after they have reached a large size. Here comes the role of biomarkers of genetic damage that can have excellent use in early diagnosis of cancer. Micronuclei are small extranuclear bodies formed by chromosome fragments or whole chromosomes that lag behind at anaphase and are not incorporated into the resulting daughter nuclei but are covered by a nuclear membrane and resemble a small nucleus. Many investigators have already called micronuclei (MN) an upcoming biomarker of tumorogenesis. More than 90% of human malignancies originate from epithelial cells. Thus the MN test in exfoliated buccal epithelial cells could be used as an objective, non-invasive tool for biomonitoring the genetic damage in high risk human populations and for screening cellular alteration in OSCC cases.
OBJECTIVES: To assess the degree of genetic damage in the oral squamous cell carcinoma lesions using micronuclei as biomarkers.
MATERIALS AND METHODS: A total of thirty four participants; seventeen OSCC patients and17 healthy control subjects were included. Cytological smears were taken from the lesion of the OSCC cases as well as from the buccal mucosa of the control group subjects using a cytobrush. Cytological smears were stained using Papanicolaou stain and the number of micronucleated (MNed) cells per 1000 cells was determined for each subject.
RESULTS: There was a statistically significant difference between the number of MNed cells in the cytological smears of OSCC cases and those of the healthy control subjects.
CONCLUSIONS: The number of MNed cells increases significantly in cancer patients thus they can be considered as an important biomarker for genetic damage.
KEYWORDS: OSCC, MNi, genetic damage, early diagnosis, Pap stain.


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EFFECT OF TWO POLISHING TECHNIQUES ON SURFACE ROUGHNESS OF THREE DIFFERENT DENTURE BASE MATERIALS (AN IN VITRO STUDY)

Mai S. El-Din,Amr M. Badr,Emad M Agamy,Gehan F Mohamed

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ABSTRACT
INTRODUCTION: A direct link was found between surface roughness, the accumulation of plaque and the adherence of microorganisms concerning acrylic resins. However, the surface properties of the new thermoplastic materials remain questionable especially after using the conventional finishing and polishing techniques. Studying surface properties of each material makes the recommendation of the proper techniques easier.
OBJECTIVES: This in vitro study intended to compare three types of denture base materials in regarding to the effect of different polishing techniques on their surface roughness.
MATERIALS AND METHODS: 36 specimens were incorporated in this study. 12 specimens were in each group. 3 groups were formed: Group A: Heat cured Polymethylmethacrylate (PMMA). Group B: Thermoplastic Polyamides. Group C: Thermoplastic Acetal. Dimensions of specimens were (20×20×3 mm) with projection at the side. Statistical analysis was carried out using two way analysis of variance (ANOVA).
Statistical significance was defined at P≤0.05. RESULTS: Technique no. 1 showed a high significant value in compared to technique
no.2 for polishing the tested materials. CONCLUSIONS: PMMA was the highest affected group followed by thermoplastic acetal and
the last affected group was thermoplastic polyamide. Prepolishing rubberizing with rubber bur improves the polishing procedure.
RESULTS: Remarkable improvement in the histology and the ultrastructure of the alveolar bone of rats in Group III was observed. Moreover, hematological values revealed significant decrease in the inflammatory condition of rats with induced RA after fish oil treatment.
CONCLUSIONS: Rheumatoid arthritis is an important risk factor for alveolar bone loss. The treatment of the RA induced rats with fish oil not only prevented the alveolar bone resorption and stimulated new bone formation, but also reduced relatively the level of rheumatoid factor in the blood.
KEYWORDS: Polymethylmethacrylate. Polyamides. Acetal. Surface roughness. Finishing. Polishing.
Abbreviations: Polymethylmethacrylate: PMMA.


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THE DIFFERENCES BETWEEN ACQUA AND CONVENTIONAL DENTAL IMPLANTS

Esraa F. Shams, Ahmed A. Sharara, Ahmed O. Sweedan

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ABSTRACT
INTRODUCTION: Missing teeth were a problem in the 1950s and 1960s till the real use of titanium dental implants to restore teeth. Scientists tried hard over many years to improve the surface treatment of the dental implant in order to improve the function and longevity of it and to reduce the chances of its failure. New materials and techniques are used to change the surface texture, component, and its surface energy.
OBJECTIVES: Evaluation of the delayed placement of ACQUA dental implant versus the conventional type for replacement of maxillary premolar teeth.
MATERIALS AND METHODS: Study was conducted on 14 patients. Patients were divided equally into two groups. Group “A” patients received ACQUA Alvium Neodent dental implant while group “B” patients received conventional Alvium dental implants. All Patients had missing maxillary premolars teeth. Patients were between 27- 48 years old. All patients were operated under local anesthesia. The surgical stent was checked for proper seating in the planned site of the dental implant. A full thickness mucoperiosteal flap was performed. Follow-up was done daily for the first week, then weekly for the first month, then monthly for six months.
RESULTS: Clinically no edema was shown in all patients. Other clinical parameters were recorded during the follow-up period as the gingival index, implant stability, and presence or absence of infection. Radiographic results showed that there was a significant difference between ACQUA and conventional Alvium dental implant which proved the higher initial stability of ACQUA Alvium Implants compared to conventional ones. Marginal bone height did not show any significant difference between ACQUA implants and conventional implants.
CONCLUSIONS: ACQUA dental implant showed more primary stability than conventional Alvium implant. Additionally, ACQUA showed more bone intensity compared to the other type.
KEYWORDS: ACQUA dental implant, Conventional Alvium, Comparison, Osstell, CBCT.


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EFFECT OF AUTOGENOUS BONE MARROW MESENCHYMAL STEM CELLS IN HEALING OF MANDIBULAR OSSEOUS DEFECTS GRAFTED WITH BETA TRICALCIUM PHOSPHATE IN DOGS

Amira S. Eissa1, Sahar Sh. Karam2, Samia S. Omar3, Mohamed I. Sayed4

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ABSTRACT
INTRODUCTION: Bone defect above critical size does not heal completely by itself and thus represents major clinical challenge to reconstructive surgery. Tissue engineering is a new approach for the repair of osseous defects. β tricalcium phosphate (β-TCP) loaded with autogenous bone marrow derived mesenchymal stem cells (BMSCs) is suggested to have a promising osteogenic characteristics that support its potential in tissue engineering to repair bone defects.
OBJECTIVES: was to evaluate the efficacy of autogenous (BMSCs) by its transplantation into local defects using (β-TCP) as a carrier.
MATERIALS AND METHODS: Ten male Mongrel dogs weighing 25 Kg were used in this study. Right and critical size bone defects (CSDs) were performed intraorally at the mandibular premolar area by the aid of trephine bur, of 6mm outer diameter and 5mm inner diameter. Right side bone defects (Experimental) were filled with mixture of (β-TCP) and (BMSCs) which was taken from bone marrow aspirate concentrates (BMACs) from the same animal. Meanwhile, the left side bone defects (control) were left empty for healing spontaneously. The effect of (BMSCs) was assessed histologically as well as histomorphometrically after 6 weeks.
RESULTS Greater amount of bone formation was noticed in (CSDs) filled with (β-TCP) and (BMSCs). The amounts of new bone formed in the defects filled with (β-TCP) and (BMSCs) were significantly greater than those formed within the defects that were left empty. CONCLUSIONS: Autogenous (BMSCs) has excellent osteogenic characteristics and can be added to bone grafts following surgical and periodontal surgeries to enhance bone regenerative capacity.
KEYWORDS: Antifungal activity, Candida albicans, photocatalytic nano-titanium dioxide, silicone elastomer.


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EVALUATION OF USING MINERALIZED PLASMATIC MATRIX IN OSSEOUS REGENERATION (EXPERIMENTAL AND HISTOMORPHOMETRIC STUDY ON RABBITS)

Marwa A. Ghanem, Ahmed A. Sharara, Ahmed O. Sweedan, Nesma M. Khalil

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ABSTRACT
INTRODUCTION: The use of platelet concentrates is recent and its efficiency remains controversial. The mineralized plasmatic matrix (MPM), is the latest innovation of platelet concentrates (i.e. PRP and PRF). A new concept of fabricating growth factors-enriched bone graft matrix has been introduced since 2010. It utilizes altering the centrifugation speed and time to produce much larger, denser and richer fibrin matrix containing growth factors, known as Sticky bone. MPM combines the best of both worlds; its mineral phase qualifies it as an osteoconductive scaffold for bone formation while its platelet concentrate phase grants it an osteoinductive property by the slow release of growth factors.
OBJECTIVES: To evaluate the effectiveness of using MPM, compared to the use of bone graft alone, to assess the exact effect of each in enhancing the osteogenic differentiation and bone formation.
MATERIALS AND METHODS: Ten healthy adult white Albino New Zealand rabbits, after creating two osseous defects in the right femur in each. The defects (upper and lower) were divided in to two groups according to the material used for filling:
Group A (Control): in the upper defect, bone graft only was added in the lateral side of the right femur.
Group B (Study): in the lower defect, MPM was addedin the lateral side of the right femur.
After 2 &8 weeks respectively postopertively,sacrification of the rabbits was done.
RESULTS: Data collected from histologicalresults revealed that MPM enhanced bone formation where increased amount of new bone formation was observed in the study group in relation to the control group. At the end of the experimental period,the defect area was almost filled with mature bone which occupied a greater surface area in the study group. Histomorphometric analysis revealed that there was increase in the mean percentage of bone surface area in the study group in comparison to the control group. This increase was statistically significant in the 8 weeks period.
CONCLUSIONS: MPM proved its effeciency in enhancement of osseous regeneration.
KEYWORDS: Platelet rich fibrin (PRF), MPM (Mineralized plasmatic matrix), Platelet rich plasma (PRP), bone graft, osseous regeneration.


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IMMUNOHISTOCHEMICAL EXPRESSION OF TLR-4 AND ITS CORRELATION TO VARIOUS GRADES OF ORAL SQUAMOUS CELL CARCINOMA

Enas M. Omar, Taissir A. Omar, Sahar M. El-Sheikh, Sahar E. Riad 2 PhD, Ghada M. Mourad3 PhD, Marwa M. Afifi4PhD

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ABSTRACT

INTRODUCTION: Oral cancer is a major health problem, causing high morbidity and mortality rates. Oral squamous cell carcinoma (OSCC) accounts for 90-95% of all oral malignancies. During the last decade, significant evidence has suggested that inflammation plays an important role in tumorigenesis, and microenvironment-derived signals which are important constituents in all tumors. Toll-like receptors (TLRs) are classical signals that play a key role in the innate immune system. They drive the inflammatory response and control the cellular proliferation and survival by stimulating the immune cells and promoting integrated processes of inflammation and tissue repair. This can predict that TLR-4 may be of great significance in tumors. Hence, this study is to evaluate and correlate the expression of TLR-4 in various grades of oral squamous cell carcinoma (OSCC).
OBJECTIVES: To evaluate and correlate the expression of TLR-4 in different histopathological grades of OSCC
MATERIALS AND METHODS: An immunohistochemical (IHC) study using the TLR-4 antibody were done on 50 surgical specimens and 10 normal mucosal tissues taken from OSCC patients and healthy individuals, respectively. The staining were performed using a Labeled Strept-Avidin Biotin complex method (LSAB)
RESULTS: TLR-4 was expressed in human OSCC biopsies and the expression level was correlated with the tumor differentiation. Higher expression was detected in the well and the moderately differentiated squamous cell carcinomas than the poorly differentiated ones. CONCLUSIONS: TLR-4 expression could be a prognostic factor in oral squamous cell carcinoma cases as expression was detected in the well and moderately differentiated higher than poorly differentiated squamous cell carcinomas.
KEYWORDS: Oral squamous cell carcinoma, TLR-4


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EXPRESSION OF TLR4 IN ORAL SQUAMOUS CELL CARCINOMA AND ITS CORRELATION WITH LYMPH NODE METASTASIS (An Immunohistochemical Study)

Hayat A. Youssef, Taissir A. Omar, Hamed A. Fouad, Sahar M. El-Sheikh, Samar El Achy, Marwa M. Afifi.

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ABSTRACT

INTRODUCTION: Oral squamous cell carcinoma (OSCC) accounts for more than 90% of all oral cancers with high mortality and morbidity rates. Lymph node (LN) metastasis is one of the most important factors in the treatment and prognosis of patients with OSCC. It reduces the overall survival by nearly half. Toll like receptors (TLRs) are evolutionarily conserved proteins and major type of receptors involved in both innate and adaptive immunities and defense against pathogens. TLR4 was the first member of the TLR family to be discovered. It was verified that TLR4 is expressed in many types of tumors including OSCC. The correlation between the expression of this receptor and the presence of nodal metastasis has been studied. Involvement of TLR4 in the invasion and metastasis potentials may thus suggest the use of this protein as a prognostic marker for OSCC and may provide a new insight in the treatment strategy.
OBJECTIVES: The aim of the present study was to assess the expression of TLR4 in the primary tumor of OSCC and correlate it with the lymph node status.
MATERIALS AND METHODS: TLR4 expression was calculated in 30 OSCC cases. The specimens were taken from the primary tumor of 15 cases proved to have positive lymph nodes and another 15 cases with negative lymph nodes. Immunohistochemical (IHC) staining was performed using the Labeled Strept-Avidin Biotin complex method (LSAB), using the anti-TLR4 antibody.
RESULTS: TLR4 was expressed in the OSCC cases and was significantly higher in cases with positive lymph node metastasis than those without.
CONCLUSIONS: TLR4 expression could be used as a prognostic marker for OSCC as an indicator for metastasis.
KEYWORDS: Oral squamous cell carcinoma, TLR4, lymph node metastasis.


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A COMPARATIVE STUDY OF TLR7 EXPRESSION IN DIFFERENT HISTOLOGICAL GRADES OF ORAL SQUAMOUS CELL CARCINOMA (An Immunohistochemical Study)

Nermine G. El-Bahey, Taissir A. Omar, Hamed A. Fouad, Sahar M. El-Sheikh, Radwa A. Mehanna, Marwa M. Afifi.

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ABSTRACT
INTRODUCTION: Oral squamous cell carcinoma (OSCC) accounts for the sixth most prevalent malignant neoplasm worldwide, representing 90% of all oral cancers. Despite advances in the detection and treatment, the unsatisfactory prognosis for OSCC has remained stable for decades. To date, cancer research is focused on improving cancer treatment methods using immunotherapy. The Toll-like receptors family (TLR) has served that purpose. These are a family of pattern recognition receptors (PRRs) that represent essential components of the host’s immune responses. The expression of some TLRs, including TLR7, in different tumors has been confirmed in various studies. The clarification of the TLR7 expression and role in OSCC may thus provide new strategies and prospects for more effective cancer diagnosis and treatment.
OBJECTIVES: To evaluate the expression of TLR7 in human OSCC and correlate it with the different histopathological grades of the tumor.
MATERIALS AND METHODS: The TLR7 expression was examined in 10 normal mucosal and 30 OSCC tissue samples. The immunohistochemical (IHC) staining with the anti-TLR7 antibody was performed using the Labeled Strept-Avidin Biotin complex method (LSAB).
RESULTS: TLR7 was expressed in all OSCC cases and showed significant difference in its expression among the different grades of the tumor, with a higher expression noted in the more differentiated tumors.
CONCLUSIONS: The expression of TLR7 in OSCC may be used as a prognostic marker.
KEYWORDS: Oral squamous cell carcinoma, Toll-like receptor 7, immunohistochemistry.


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THE THERAPEUTIC EFFECT OF CAMPTOTHECIN IN INDUCED ORAL SQUAMOUS CELL CARCINOMA (EXPERIMENTAL STUDY)

Hend M. Helmy, Zeinab E. Darwish, Sahar M. El-Sheikh, Marwa M. Afifi

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ABSTRACT
INTRODUCTION: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, affecting over 400,000 patients, and leading to over 200,000 deaths annually. Camptothecin (CPT), is a potent widely used chemotherapeutic drug. It shows a significant antitumor activity against various types of cancer. It inhibits the activity of DNA topoisomerase I enzyme (TOP I) during the S phase of the cell cycle leading to persisting single-stranded DNA breaks.
OBJECTIVES: To study the therapeutic efficacy of CPT chemotherapeutic drug against induced oral squamous cell carcinoma (OSCC). Also the study will evaluate the treatment, by the use of proliferative immune-histochemical marker (PCNA).
MATERIALS AND METHODS: Squamous cell carcinoma will be chemically induced in thirty Syrian hamsters. Then they will be divided into two groups, 15 per each. One group will be treated with CPT, The other group will be treated with saline as negative control group.
RESULTS: CPT treated animals showed significant results over the control group.
CONCLUSIONS: CPT induced apoptosis in tumor cells and enhanced survival rates in comparison to control group.
KEYWORDS: Oral squamous cell carcinoma, hamsters, Camptothecin.


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