Changes in Lip Length and Strain after En-masse Retraction with Maximum Anchorage in Female Patients with Bimaxillary Protrusion

Aim: The aim of the study is to evaluate the effect of en-masse retraction with maximum anchorage on the lip length, lip strain, and interlabial gap in adult female patients with bimaxillary protrusion. Materials and Methods: Thirteen patients underwent initial records including photographs, study casts, and cephalometric x-rays. En-masse retraction was performed using friction mechanics, with the use of temporary anchorage devices and power chains after the extraction of first premolars. The soft tissue was analyzed using lateral cephalometric radiographs before and after retraction. Results: The results showed that en-masse retraction had a significant effect on reducing lip strain, increasing lip length, and reducing interlabial gap. Conclusion: The findings suggest that en-masse retraction can be an effective tool in improving the soft tissue profile in patients with bimaxillary protrusio

Simultaneous 3D reconstruction and implant placement using allogenic laminar bone membranes in atrophic Mandible. A comparative clinical study

Objective: to compare the outcome of allogenic bone sheets clinically and radiographically in posterior mandibular vertical augmentation in Luhr class III cases with simultaneous implant placement using autogenous versus xenografts. Patients and methods: this study was based on a total of 12 implants placed in 4 patients, 2 of which were males and 2 females. Patients were divided into 2 groups, both treated with implants placed with exposed threads 3 mm crestally and covered buccolingually with the laminar bone membrane; group 1 received autogenous bone obtained from the same surgical site using 4.5 diameter ACM bur mixed with PRP and packed around the crestally exposed implant threads. Group 2 received xenograft bone particles mixed with PRP and packed around the crestally exposed implant threads in the same manner. Results: CBCT was done pre-operatively, immediate post-operatively and 4 months post-operatively for each implant to compare the bone gain radiographically. In group 1, the mean amount of residual bone height pre-operatively was 7.8 mm (SD 0.86) and increased to 14.44 mm (SD 1.75) and 14.1 mm (SD 1.85) immediate and 4 months post-operatively, respectively. The mean amount of bone gain after 4 months was 6.3 mm, denoting a minimal amount of graft loss during the first 4 postoperative months was 0.27 mm (less than 2%). In group 2, the mean amount of residual bone height pre-operatively was 8.37 mm (SD 0.99) and increased to 12.86 mm (SD 1.75) and 12.53 mm (SD 1.65) immediate and 4 months post-operatively, respectively. The mean amount of bone gain after 4 months was 4.16 mm, denoting a minimal amount of graft loss during the first 4 postoperative months was 0.33 mm (less than 3%). Upon comparing bone gain in both groups, Group I (Autogenous) had a bone gain of 6.33 mm versus 4.16 mm for Group II (Xenograft). Denoting more gain in Group I (autogenous). While the amount of graft loss between the immediate and 4 months postoperative CBCT was less than 2% and less than 3% in the autogenous versus the xenograft group respectively . Conclusion: Cases initially lacking keratinized mucosa will need soft tissue intervention along with this technique. Exposure after 4 months appeared to have been too early, which lead to bone loss and exposed threads. Bilateral augmentation has led to patients using the grafted edentulous sites for mastication early following soft tissue healing, prior to prosthetics, which might suggest that tooth-bounded posterior edentulous sites might be a better candidate for such technique. Results were clinically different than radiographically in the CBCT, so longer lag time is recommended before loading. Keywords: mandibular atrophy, bone graft, implants, laminar bone sheet

Biomarker characteristics of the Turonian–Eocene succession, Belayim oilfields, central Gulf of Suez, Egypt

We are grateful to the Belayim Petroleum Company (PETROBEL) for providing the samples for this study. Gratitude is also expressed to STRATOCHEM Services, New Maadi, Cairo, Egypt for supporting GC–MS analyses. Two anonymous reviewers and the Editor are thanked for their critical comments and suggested revisions that improved the text.Peer reviewedPublisher PD

Effect of low-level diode laser bio-stimulation on implant stability before, during and after immediate implants in mandibular molars. (A randomized clinical study)

Introduction: Tooth loss can affect the person’s life dramatically. Tooth loss is accompanied by bone loss in all dimensions, so preservation of the bone is mandatory for placement of dental implant. Immediate implant can preserve alveolar bone. Due to difference in shape between the implants and extracted roots a gap appears between the immediately placed implant and the extraction socket resulting in jumping distance, Bone grafts are commonly used to fill this gap, recent studies suggest that jumping gaps shouldn’t always be grafted. Low level bio stimulation has stimulatory effect on bone cells so it can be used in immediate implants to increase bone formation around the implants. Patients and methods: this study was carried in the hospital of future university. A total of twelve patients with non-restorable mandibular molar participated in this study. A total of twenty implants were placed immediately in mandibular molar region without bone grafting, thew were divided equally into two groups. Surgical technique was similar for both groups. After immediate implant placement with primary stability of 35 N, both groups received custom made healing collar using flowable composite to seal the jumping distance. The study group (intervention) received a total of 60J/cm2 .10J/cm2 3 days before extraction, another 10J/cm2 at the fresh socket, another 10 J/cm2 after osteotomy, another 10J/cm2 after implant placement, another 20J/cm2 at the follow up visit with 3 days interval. After six weeks secondary implant stability was measured for both groups using Resonance Frequency Analysis device (RFA). Prosthetic phases started for implants that showed sufficient secondary stability. Results: All implants enrolled in this study showed sufficient secondary stability except for one totally avulsed implant from the control group. Study group showed more stability upon measuring using Resonance frequency analysis device after six weeks of implant placement. The study group has shown a higher secondary stability compared to control group, the mean implant stability quotient value of study (71.89±2.67) was significantly higher than control (62.43±8.62). Conclusion: Based on the results of our study we concluded that low level diode laser 980nm has a stimulatory effect on bone formation when applied before, during and after immediate implant placement, According to this study 60J/cm2 is recommended dose and it also gave better soft tissue healing result

Parents’ Acceptance to Alveolar and Nasoalveolar Molding Appliances during Early Cleft Lip and Palate Care: A Call for High-Quality Research

AIM: Acceptance and compliance of the parents are an essential pillar in the success of pre-surgical infant orthopedic (PSIO) treatment. The aim of this systematic review is to evaluate the burden of care associated with the alveolar molding (AM) and nasoalveolar molding (NAM) appliances as experienced by the parents with unilateral complete cleft lip and palate (UCLP) infants. METHODS: An electronic search was carried on by two reviewers in eight search engines, as well as a manual search till July 2019. Randomized controlled trials (RCTs) comparing AM/NAM appliances to controls in infants with UCLP were selected. Risk of bias was evaluated using Cochrane risk of bias assessment tool for RCTs. RESULTS: One RCT was included in the qualitative analysis. Non-significant differences were found in the amount of mothers’ satisfaction between the intervention and control groups. CONCLUSIONS: Insufficient low-quality evidence is available regarding the effects of AM and NAM on parents’ satisfaction and burden of care. No conclusions can be withdrawn from the existing studies. High-quality research is needed to elucidate the degree of parents’ acceptance to the molding appliances. PROSPERO registration number: CRD42016043174

Revisiting the Factors Underlying Maxillary Midline Diastema

Aim. The aim of this study is to analyze the etiological factors underlying the presence of maxillary midline diastema in a sample of orthodontic patients. Materials and Methods. One hundred patients who fulfill the inclusion criteria were selected from 1355 patients seeking orthodontic treatment. The pretreatment orthodontic records were analyzed. The width of the maxillary midline diastema was measured clinically with a digital caliper at two levels: the mesioincisal angles of the central incisors and five millimeters from the incisal edge. The two measurements were averaged, and patients with diastema of more than 0.5 millimeter in width were enrolled. Results. Diastema is a multifactorial clinical finding with more than one underlying etiological cause. The interrelationship between the familial pattern of midline diastema and the microdontia, macroglossia, labial frenum, and alveolar cleft conforms was clear. The effect of a mesiodens and the upper lateral incisor whether bilaterally missing, unerupted, or peg shaped was minimal. Conclusion. Etiological factors underlying maxillary midline diastema are interconnected. Using a checklist as a guide during handling maxillary midline diastema is important in the different stages of treatment

Computer Guided Versus Conventional Maxillary Sinus Augmentation Using Allogenic Bone Blocks with Simultaneous Implant Placement in Severely Pneumatized Sinuses

Background: Maxillary sinus lifting is a complex procedure with reported complications in the literature where the presence of sinus septa further complicates the procedure, they including membrane perforation, bleeding. Aim: The aim of this study is to decrease the incidence of membrane perforation which is the most common reported complication, and to determine whether the use of surgical guides could decrease the incidence of membrane perforation. Materials and methods: A total of 12 cases where blindly divided into 2 groups; Group (A) computer guided maxillary sinus lifting and Group (B) conventional sinus lifting, both groups received allogenic bone blocks for sinus augmentation with simultaneous implant placement. Cone beam CT was performed pre operatively for planning the number and position of implants to be placed and for fabrication of the surgical guide. Results: In all cases the Schneiderian membrane was successfully elevated except for one case in Group (A) where membrane perforation occurred and 2 cases in Group (B) Conclusion: The use of surgical guide in sinus lifting procedures decreases the incidence of membrane perforation working time and improve implant positioning. Keywords: surgical guide, maxillary sinus lifting, allogenic bone blocks, simultaneous implant