Madridge Journal of Dentistry and Oral Surgery

ISSN: 2639-0434

2nd International Conference on Dentistry

May 7-9, 2018, Rome, Italy
Scientific Session Abstracts
DOI: 10.18689/2639-0434.a2.002

Advancing Small-Diameter Nano Crystalline Commercially Pure Titanium Dental Implant

Carlos Nelson Elias* and Daniel JogaibFernandes

Instituto Militar de Engenharia, Brazil

In the last decades, several researches have been carried out to improve the surface quality of dental implants without any change in the commercially pure titanium (cpTi). In the present work are presented results of the researches of dental implants of nanocrystalline CPTi grade 4 (Ti Hard). Mechanical tests of compression and fatigue, animal and human tests were used. The results showed that Ti Hard has higher mechanical strength than conventional microcrystallinec p Tigrade4 (TiG4) without loss of biocompatibility. Implants made with Ti Hard showed higher static compressive strength (588.9±74.7N) than implants made with TiG4 (308.8±15.2N) and higher fatigue strength for 5 x 106 cycles (280N) than implants made with TiG4 (200 N). Based on this work it is possible to manufacture implants with small diameter without the need of ceramic materials such as zirconia, which does not present osseointegration.

Carlos Nelson Elias completed degree in Metallurgy from the Military Engineering Institute and a PhD in Materials Science. He received twice an award Scientist from the State of Rio de Janeiro (2004 and 2008), researcher at the Foundation for Research Support of the State of Rio de Janeiro - Brazil. Has experience in Materials Science, with emphasis in Physical Metallurgy and Biomaterials. Researches with dental materials, dental implants, and modification of dental implants surfaces, endodontic instruments, orthodontic appliances, coronary stents and orthopedic prostheses
Works Quote: Web of Science 1014 citations, h-factor 18, Scopus: 1257 citations, h-factor 19; Google Scholar: 3170 citations, h-factor 29 and Mendely: 1569 citations, h factor 21.

Effect of Type of Restorative Material on Porosities, Interfacial Gaps and Microhardness of Small Class I Restorations

Qasem D Alomari1*, Qoot Alkhubaizi2 and Mohammed Sabti2

1Kuwait University, Department of Restorative Sciences, Kuwait
2Kuwait University, Department of General Dental Practice, Kuwait

Purpose: This study compared microhardness, porosities and interfacial gaps of flowable, bulk-fill flowable, nanocomposite and bulk-fill composite in small class I cavities.

Methods and Materials: 40 human molars were divided into 4 groups (n=10). Standardized class I cavities were prepared with 4 mm depth using carbide round burs #8 (diameter 2.3mm). After selective etching, Single Bond Universal (3M ESPE) was applied and cured. In group 1 cavities were restored with Filtek Z350 XT Flowable (3M ESPE, St. Paul, MN, USA) in two layers and each layer was cured for 20 seconds. Group 2 cavities were restored with Filtek Bulk Fill Flowable Restorative (3M ESPE) as one layer and cured for 20 seconds. In group 3 cavities were restored with Filtek Z350 XT Universal Restorative (3M ESPE) in two layers and each layer was cured for 20 seconds. Group 4 cavities were restored with Filtek Bulk Fill Posterior Restorative (3M ESPE) as one layer and cured for 20 seconds. After finishing and polishing specimens were sectioned. One section was chosen randomly for the Vickers microhardness (HV) evaluation and the other section was used for assessment of porosities and interfacial adaptation (IA). IA was measured as the percentage of the gap length relative to the whole margin length.

Results: There was a statistical difference between the materials in HV on both pulpal and occlusal sides of the cavities with Filtek Bulk Fill Flowable Restorative presented the lowest and Filtek Z350 XT Universal Restorative the highest. The mean pulpal HV of all materials exceeded 80% of the occlusal HV. There was no statistical difference between the materials in porosities. IA percentage was found to be higher in bulk fill flowable materials compared to other materials.

Conclusion: Bulk fill resin composite materials have lower microhardness than their conventional counterparts. In small class I cavities the number of porosities was similar between bulk fill and conventional materials and the IA percentages were highest in bulk fill flowable composites.

Dr. Qasem Alomari graduated from University of Jordan in 1993. He received his Master Degree in Dental Science and Certificate in Operative Dentistry from University of Iowa (USA). In 2003, he completed the American Board of Operative Dentistry. Between 2000 and 2004 he was teaching Restorative Dentistry in Jordan University of Science and Technology. Since 2004 he is working at Kuwait University. He is now a Professor of Operative Dentistry and the Chairman of the Department of Restorative Science. Dr. Alomari has more than 30 publications and his topic of interest is resin composite materials and polymerization shrinkage.

School Dental Preventive Program in National Guard/Saudi Arabia

Abeer Alsubait

Ministry of National Guard Health Affairs, Saudi Arabia

School dental preventive program SDPP is a recent established dental preventive program occurred in Ministry of National Guard Health Affairs Saudi Arabia to provide preventive and curative care to the school going age children. SDPP has started in 2007 and is providing education, preventive and curative treatment to more than 15000 children. The program also includes school surveys and education about healthy nutrition programs by rationalizing the consumption of sugar and the quality of food provided to children in schools and reducing sugars and sugar-sweetened beverages. As well as fluoride and pit and fissure sealants and restorations for decayed teeth along with teaching proper brushing technique. SDPP encourages the effective use of portable dental units for the delivery of preventive care to children in schools without the need for children to go to dental clinics.

The program consist of four well prepared mobile clinics each one contain two well-equipped clinics with latest materials, in addition to clinics in king Abdul-Aziz medical city that receive difficult cases for comprehensive dental care that cannot be treated in mobile clinics.

SDPP works as a team which includes a director which supervise the whole structure. Under the supervision of director there come unit head male and female, operational manager and reasearch assistant unit. Under the unit head six general dentists (3 males, 3 females), male and female hygienist and eight dental assistant(4 males and 4 females). Operational manager looks after all the senitary and hygiene related staff.

After taking permission from school heads and the consent from the parents the team visits each school in morning and the minimum time to complete all the activities in one school takes 2-3 weeks at least. Each dentist looks pre-assigned five students and provides preventive care and simple fillings and if any extensive treatment like extraction, pulpotomy, pulpectopmy or orthodontics is needed dentists referred them to SDPP clinics arranged by SDPP unit head. Each dentist is encouraged to take 30 minutes for a particular student. Special referral system is there for medically compromised students, children with developmental, learning and behavioral problems. Also the referral system is allocated for children with congenital or acquired dental anomalies. Dental assistants are also assigned to disinfect and clean the unit before and after any procedure. Also, there is daily statistic sheet filled by the SDPP unit head.

Dr. Abeer Al Subait Consultant in Advanced general dentistry in King Abdulaziz Medical City, Ministry of National Guard, she got her master degree in public health from King Saud bin Abdulaziz university for health science, she is a lecturer in college of dentistry in king Saud bin Abdulaziz university for health science, currently she is a Director of School dental prevention Program in health affairs, ministry of national Guard, she participated in many social educational and oral health campaines activities, also she multiple published articles.

Aesthetic Management of Tooth Wear the MI Way

Brian Millar

Kingʼs College London, UK

Whether MI means maximum income, minimal intervention or my way of achieving predictable aesthetic outcomes in cases of tooth it makes no sense to cut more valuable tooth tissue away in a tooth wear situation.

With todayʼs adhesives and composites you will find this subject useful to planning and carrying out aesthetic changes in your practice. The lecture will cover how to obtain predictable outcomes through chair side planning methods with direct techniques. From the use of DSD, wax-ups and mock-ups where applicable to techniques to replace what is missing and carry out the occlusion corrections necessary to combine function with aesthetics while avoiding further tooth damage.


1. Planning cases at the chair side
2. Managing the aesthetics in anterior tooth wear situations with composite
3. Blending function with aesthetics
4. Correction the occlusion following tooth surface loss

Brian Millar completed BDS, FDSRCS, PhD, FHEA and professor of Blended Learning in Dentistry at Kingʼs College London and NHS Consultant in Restorative Dentistry at the Kingʼs College London Dental Institute at Guyʼs, Kingʼs and St Thomasʼ Hospitals. Specialist in Prosthodontics and in Restorative Dentistry.
Programme Director for the internationally popular MClinDent (Fixed & Removable Prosthodontics) and in the past set up the highly successful MSc programmes in Aesthetic Dentistry and also Advanced General Dental Practice by blended learning at the KCL Dental Institute. Over 36 years experience in clinical practice and currently an active specialist clinician in both hospital and private practice, particularly in treating tooth wear, aesthetic and occlusal problems utilising MI philosophies where possible. Experienced teacher to undergraduates and postgraduates and well-known provider of postgraduate education nationally and internationally at conferences through lectures, seminars, webinars and hands-on courses. Published over 180 papers, supervised over 200 PhD and Masters students, involved in setting up MOOCs with over 20,000 students. As well as the silencing the dental drill, research includes management of occlusal problems using MI techniques, bringing together aesthetics and function with a focus on tooth preservation.

Current Concepts in Clinical Management of Patients with Specialized Healthcare Needs

Robert Frare

New York University College of Dentistry, USA

According to the World Health Organization, about 15% of the worldʼs population lives with some form of disability. Dental patients will present with chronic medical conditionssuch as cardiovascular disease, diabetes, Alzheimerʼs disease, head and neck cancer, and developmental disabilities such as Autistic Spectrum Disorder and Down syndrome.

Dental providers must be prepared tomeet the needs of the changing demographics of our patient population.

Dr. Robert William Frare is a graduate of Tufts University School of Dental Medicine. His post graduate training includes a Fellowship for Developmentally Disabled Individuals at Stony Brook University School of Dental Medicine, General Practice Residencies with the Veterans Administration Hudson Valley Health Care System and Lutheran Medical Center in Brooklyn New York. He has been a Clinical Assistant Professor in the Department of Restorative Dentistry at Rutgers School of Dental Medicine, an Adjunct Clinical Instructor in the Departments of Pediatric Dentistry and Community Oral Health Sciences at Temple University Kornberg School of Dentistry, and is currently a full time Clinical Educator at New York University College of Dentistry in the Department of Oral & Maxillofacial Pathology, Radiology, & Medicine. He is an Editorial Board Member for multiple dental journals, a published author in a peer-reviewed Dental Journal, member of the Medical Reserve Corps, an associate in a pediatric dental practice, and maintains a private practice in the USA.

Use of Alternative Surgical Approaches in Full-Arch Rehabilitation of Borderline Cases in Oral Implantology: A Surgical-Clinical Study

Wilson Grigolli*, Conor Irwin and Regina Flanagan

Ratoath Dental Centre, Ireland

The presented study was developed focus on alternative surgical approaches toward the full-arch rehabilitation in subjects presenting one or more limiting factors for the conventional approach. Among these factors the presence of atrophic maxillary bone, dimensions and anatomy of the sinus cavities, reduced available bone tissue on the pre-maxillae area, presence of advanced periodontal disease and previous implant failures.

This clinical study presents alternative surgical approaches, in accordance with the international literature, demonstrating extremely high predictability and overall successful rates comparable with any conventional approach in highly favorable cases.

Concerning the prosthodontic rehabilitation, both, immediate loading and delayed loaded protocol were used, according the classic indications and hybrid prosthesis delivered at the final stage. The main find in this specific study is the team work and the experience is irreplaceable for more challenging cases. Standard procedures have a clear indication, and it is a mistake of judgment try to overextend their approaches.

Nowadays a considerable number of surgical techniques are available to be used in the field of the Surgical Oral Implantology; the real challenge is how to link them, according the biological circumstance of the patients, getting consistent predictable results and also matching their expectations.

Wilson Grigolli completed Bachelor of Dental Surgery; DMD is a Specialist in Oral Implantology, Oral Surgery and Periodontology. He treated More than 27,000 implants placed. He also Advanced implant surgeries, Zygoma implants and hospital surgeries. He received official Nobel Biocare lecturer and Special degrees in Periodontology, Oral Implantology, and Oral Surgery Master Degree in Periodontology – Ms. Doctoral degree in Oral Implantology – PhD. He is a Scientific Advisor in Ireland and Portugal, Registered at the Dental Council of Ireland and Registered at the Portuguese Dental Association.

Assessment of Discomfort Level among Orthodontic Patients at Initial Stage

Nadia W Al Nahas

King Saud University, Saudi Arabia

Patients undergoing orthodontic treatment experience varying degrees of pain during different stages of treatment. Placement of separators induces pain which increases to a peak level after 24 hours. Separators are used to create space for placement of band that later anchors the fixed orthodontic appliance. The different types of separators vary in the amount of pain they cause during separation, the effectiveness in separating teeth, and maintenance of the separation gained. The two types that are most commonly used are the elastomeric and spring-type stainless steel separators. Pain has been the prime reason for discontinuation of orthodontic treatment. Pain is usually initiated 4 hours after the application of the separator and increases over 24 hours, which then decreases within a 7-day period. Both elastomeric and spring separators showed comparative levels of pain and discomfort during the early phase of separation. Elastomeric separators were found to be more effective in tooth separation than spring separators.

NadiahWasef Ibrahim AlNahas, BDS, MSc, (SCFHS) Consultant in Dental Public Health at the College of Dentistry, King Saud University, Department of Periodontics & Community Dentistry. She had a degree of Bachelor of Dental Surgery from Cairo University, Egypt. Master of Public Health from the College of Dentistry, King Saud University, Riyadh, Saudi Arabia in 1998. Consultant in Public Health in Saudi Commission for Health Specialist (SCFHS) in 2006 and directed three courses in Dental Assistant Diploma Program in College of Dentistry, King Saud University from 2007 up to 2012 and Directed courses in Preventive and Public Health at the College of Dentistry, King Saud University since 1998 to present.

Can Orthodontic Retainers Cause Carious Lesions?

Hana Omar Albalbeesi

King Saud University, Saudi Arabia

Development of carious lesions along lower fixed retainer wire placed after orthodontic treatment was investigated clinically and radiographically. Seventy participants contributed and divided into forty experimental participants (20 males and 20 females with a mean age of 23.4 and 24.4 years, respectively) bonded with lower fixed retainer extended from right to left canine for a period ranging from one to six years. While the remaining thirty were control participants (15 males with a mean age of 24.6 years, and 15 femalesʼ mean age were 26.8 years). All participants were examined clinically and radiographically. Examiners filled a questionnaire concerning patientʼs oral hygiene, dietary habits, and frequency of fixed retainer detachment in the experimental group.

Out of the 240 bonded teeth that had been examined clinically and radiographically, only seventeen teeth had shown carious lesions. Both targeted groups showed insignificant caries incidence (P> 0.05). Comparison of both genders indicated that males had three times higher caries incidence than females but with insignificant difference (P > 0.05) in the experimental group. Central and lateral incisors showed higher carious frequency (37.5%) than canines (25%), and 20 % of the experimental group experienced retainer detachment. Surprisingly, the experimental group showed better significant difference (P< 0.05) than control group regarding oral hygiene status, with 61.8 % and 20.0 %, respectively. Additionally, both groups showed slight significant difference concerning frequency of scaling and prophylactic measures. Our findings showed no apparent damage and low carious risk to the teeth bonded with fixed retainer.

Hana Omar Albalbeesi has completed her M.Sc. Degree from Dental College, King Saud University, Saudi Arabia. She is a consultant of Orthodontics, in the Department for Pedodontics and Orthodontic Dentistry. She was a Director of the Dental Assisting Diploma Program (DADP) for 4 years, shehas many published papers concerning growth assessment, teeth impaction and diagnosis of different orthodontic problems, and she is involved in teaching of undergraduate students and oftenly Postgraduate students.

Enamel White Spot Lesions: Formation and Molecular Structure Analysis by Confocal Raman Microscopy in vitro

R Al-Obaidi*, H Salehi, A Desoutter, E Terrer, B Jacquot, B Levallois, H Tassery and F J G Cuisinier

Université of Montpellier, France

Introduction: White lesions are white opacities of outer enamel surface which represent an early phase of caries formation.

Materials & Methods: In this study; 20 human sound premolars were subjected to pH cycling procedure to induce WSLs in vitro. Besides; 3 teeth with naturally developed WSLs were used as a reference. All specimens were characterized by confocal Raman microscopy which has been used for the first time in this study to detect small changes in enamel structure and providing a high resolution chemical and morphological map based on phosphate peak intensity alterations at 960 cm-1. Enamel crystallinity is determined by measuring changes in ratio of intense phosphate peaks at 960/950 cm-1. In order to detect variations in carbonate content in different zones of each sample; ratio of intensities of PO43– to CO32- peak at (960/1070 cm-1) and that of CO32- to PO43– at (1070/960 cm-1) were calculated throughout the cross section of each sample.

Results: Lesion depth measurement was based on phosphate peak intensity alterations and found to increase linearly with gradual rise in number of cycles except for 8 cycleʼs lesion, where a considerable loss of enamel layer has taken place. A statistically significant difference (p< 0.05) was found between all examined groups.

Intact surface layer of the lesion was well crystallized then crystallinity decreased abruptly in lesion zone and started to increase gradually in the intermediate zone before it has reached to its maximum value in sound enamel beyond subsurface lesion. Reconstructed images derived from PO43–/CO32- & CO32-/PO43– ratios revealed a reduction in PO43–/CO32- ratio in lesion zone in comparison to sound enamel zone and the opposite is true for CO32-/PO43– ratio.

Conclusion: Our protocol is a reliable to reproduce WSLs in vitro in a relatively short period to test the efficacy of reminerlizing dental products. Confocal Raman microscopy can provide a high resolution chemical and morphological map of examined specimen, detecting even very small changes in its chemical composition. Data analysis of each acquired scan which comprising tenth thousands of single spectrum, is used to reconstruct different Raman detailed images. Therefore Raman microscopy could be considered as a superior alternative to Raman spectroscopy.

Keywords: White spot lesion (WSL), Phosphate peak, Crystallinity, KMCA (K-mean cluster analysis), nanoindentation (NI), mechanical properties.

Dr. Rand Al-Obaidi received her master degree of science in preventive dentistry from the University of Baghdad. She then worked at the University of Mustansiriya has assistant-lecturer and lecturer. Dr. Al-Obaidihas joined the University of Montpellier/Laboratoire Bioingénierieet Nanoscience (EA4203) as a PhD student after obtaining a scholarship from Iraqi government. Her research concerns the fabrication of enamel white spot lesions in vitro and their remineralization and characterization by advanced optical and mechanical techniques. Dr. Al-Obaidi hopes developing a dental diagnostic instrument based on Raman microscopy principles that will help the early diagnosis of these lesions and presenting a treatment mode that will facilitate the non-invasive treatment of this serious dental health problem.

Cleft Lip and Palate – The Role of Orthodontist

Siti Adibah Othman

University of Malaya, Malaysia

Clefts of the lip and palate are among the most common congenital birth anomalies. The average prevalence of cleft lip with or without cleft palate is 7.94 per 10, 000 live births internationally, and several studies have demonstrated that the incidence is highest among Asians. The aetiology of cleft lip and palate (CLP) is complex and multifactorial; hence the management, treatment as well as outcome assessment of these patients are challenging and involve many disciplines. The disturbances in dental and skeletal development caused by the clefting process itself can caused many problems to the dentofacial regions such as Class III skeletal pattern, crowding, hypodontia, microdontia, delay eruption, impacted teeth, abnormalities of the tooth size and shape, hypoplasia and supernumeraries. Individuals with CLP are also at risk for developing problems with social competence, personal adjustment and social rejection due to their visible facial and dental impairments. Thus, orthodontic treatment for these patients, which can help to restore the dentitions and improve their facial appearances, will be presented and discussed. The use of the anthropometric non-invasive systems of the 3-dimensional stereophotogrammetry technology in the evaluation of the outcome and planning will also be presented.

Dr. Siti Adibah Othman qualified as Bachelor of Dental Surgery from the University Malaya, Malaysia in 2000. She completed her Clinical Doctorate in Dental Surgery in Orthodontic at the University of Bristol and obtained her Membership in Orthodontics from the Royal College of Surgeon of Edinburgh in 2005. Having obtained the qualifications, she was appointed as Senior Lecturer at Department of Paediatric Dentistry and Orthodontics in University of Malaya from 2006 to 2011 and was appointed as Associate Professor in 2012. She is currently the Head of Department and the coordinator of the postgraduate orthodontic programme. She is actively involved in teaching of the undergraduates, postgraduates, reviewing of the curriculums and also actively treating orthodontic patients at the University of Malaya and at the University Malaya Specialist Centre. Besides that, she is also doing research and has published a few research papers in academic journals. Her areas of interest are orthodontics, clinical research, cleft lip and palate abnormalities and 3D imaging. She is member of World Federation of Orthodontists, Malaysian Association of Orthodontists, Malaysian Dental Association and the life member of the Cleft Lip and Palate Association of Malaysia. In 2013, she was awarded Membership in Orthodontics Ad Eundem from the Royal College of Surgeons of England, and being appointed as an examiner for the Membership of Orthodontics Examination of the Royal College of Surgeons of England for overseas diet.

Effect of Maxillary Expansion and/or Protraction on Oropharyngeal Airway in Individuals with Non-syndromic Cleft Palate with or without Cleft Lip

Najla Alrejaye1*, Jonathan Gao2 and Snehlata Oberoi2

1Ministry of National Guard Health Affairs, Saudi Arabia
2University of California, USA

Aim: To evaluate and compare oropharyngeal airway volume and minimal cross-sectional area (MCA) in non-syndromic individuals with cleft palate with or without cleft lip (CP/L) using cone beam CT (CBCT) before and after Phase I orthodontic maxillary expansion with or without protraction.

Method: This is a retrospective study of CBCT dataofpreadolescent individuals (ages, 8.7 + 2.6 years) with cleft palate with or without cleft lip (n=18) who underwent Phase I orthodontic maxillary expansion with or without protraction at University of California, San Francisco (UCSF). IRB approval was obtained for this study. Volume and MCA ofthe oropharyngeal airway were evaluated before and after orthodontic treatment using 3dMDvultus software. Five measurements were repeated to verify reliability. Changes in volume and MCA were analyzed using Wilcoxon signed-rank test at a level of significance of 0.05.

Results: The method was found to be reliable; the intraclass correlation coefficients between the double measurements were all over 0.9. There was a statistically significant increase in oropharyngeal airway volume after phase I orthodontic treatment, however, there was no statistically significant change in minimal cross-sectional area.

Conclusion: 3D imaging using CBCT and 3dMDvultus is reliable for assessing airway volume and minimal cross-sectional area. Phase Iorthodontic treatment with maxillary expansion with or without protraction may have an influence on increasing oropharyngeal airway volume in non-syndromic individuals with cleft palate with or without cleft lip.

Najla Alrejaye is a Diplomate of the American Board of Orthodontics. She earned her Bachelor of Dental Surgery (BDS) degree from King Saud University. She completed her residency in Orthodontics at Boston University, where she received her Doctorate of Science in Dentistry (DSc D) and Certificate of Advanced Graduate Studies in Orthodontics (CAGS). She completed a fellowship program in Craniofacial and Special Care Orthodontics at University of California, San Francisco. She is currently an Assistant Consultant at Ministry of National Guard Health Affairs, Saudi Arabia. Her goals are to contribute to the profession through clinical care, education, and scientific research; and to improve care for individuals with craniofacial anomalies.

New Zirconia Two-Part Soft Level Tissue: The Future...Today!!!

Thierry Page

University of Paris, France

This two-part soft level tissue dental implant shows physical properties similar or superior to titanium implants.

The fixture enables an easy surgical act and also ensures an unmatchable aesthetic result in a short space of time.

The use of these implants, in accordance with prosthetic planning, produces a way of working allowing their incorporation in any prosthetic reconstruction… without having to resort to a large number of complex, fragile and expensive accessories.

Introduction: With all the means currently at our disposal, the basis of our oral rehabilitation lies in the knowledge and respect of biological, physiological and biochemical factors upon which depends the metabolism of the stomatognathic system.

In the case of missing teeth - one or several - implants offer functional improvements which transform our handicapped patients by restoring their masticatory ability and psychological assurance which enable them to return to social and working life.

It is in this context that numerous difficulties are encountered in the case of missing teeth which have aesthetic considerations and more particularly how to deal with peri-implant soft tissue.

Three great pillars underpin all our rehabilitation work:
-the biological and physiological behavior of the surrounding tissue but also, and above all, that of the materials used,
-the aesthetic appearance of our artificial pillars and their underlying restoration,
-our clinical experience.

Learning objectives:

1. Demonstrate the biocompatibility of material zirconia with in vitro and in vivo tests.
2. Understand the difference of concept between osseointegration and osseocoaptation.
3. Highlight the aesthetic appearance of the zirconia implants.
4. Underline the special feature of PEKK® and its role in the flexibility of the final restoration.
5. Recognize the simplicity of both, surgical technique and prosthetic phase.

Dr. Thierry Page has been practicing zirconia Implantology since 2002 and was a pioneer in its introduction in South America, especially in Brazil. He has published on this subject in the United States, Latin America, Asia, the Middle East and Europe. Dr. Page holds a degree in Oral and Maxillofacial Implantology (Paris University), a Post Graduate Certificate in Parodontia and Implantology (NYU), a Mechanical Engineering Diploma in Oral Implantology (Troyes Technological University), an Advanced Certificate in Oral Surgery (Pennsylvania Institute), a European Certificate in Oral Implantology (Gothenburg University) and a Diploma in Maxillofacial Surgical Rehabilitation (Paris University).

Implant Placement in Deficient Esthetic Zones without Bone Graft

Kadhim Al Himdani

University of Paris, France

Objectives: The objective of this study is to show our clinical experience through which we obtained very satisfying durable esthetic results for different critical clinical situations of bone deficiency in esthetic zones without going through sophisticated, long, painful and costly procedures of ridge management like bone grafting, ridge preservation and distraction osteogenesis.

Materials & Methods: Our clinical study comprised 98 implants placed on 60 patients in sites with bone deficiency in the anterior zones of the maxilla and mandible. Proper Implant Selection (Macro-Geometric Design, Size and Number), Appropriate Surgical Approach and Procedure using the Manual Atraumatic Bone Appreciation Osteotomy(esthetic osteotomy) preparation, Proper Implant Orientation and Subcrestal Position, Adapted Prosthetic Restoration specially with the use of integrated abutment crowns are factors we took into consideration to avoid pre-operative ridge management and bone augmentation procedures, with 3 years follow-up. Cases with sites without bone deficiency were excluded. Xenografts were used simultaneously in a few cases to give hard and soft tissue support, yet implants osseointergration was independent from the grafting material.

Results: When following our proposed Minimally Invasive Esthetic Concept in sites with bone deficiency, survival rate of 95.9% and a success rate of 100% were reported.

Conclusion: Satisfying esthetic results in sites with bone deficiency can be obtained without pre-operative ridge management procedures. We highlight the significance of implant design, implant orientation and subcrestal position, surgical approach and procedure, and finally adequate prosthetic restoration and fixation;all these elements clinically proved their efficiency to overcome going through long, complicated, risky, painful, and costly procedures. Thus achieving the Minimal Invasive Implantology and shifting the conventional “Restoration-Driven Implant Placement” concept towards “Surgical-Driven Implant Placement”.

Dr. Kadhim Al Himdani completed B.D.S. Dental College, Baghdad University, Ph.D. Dental Science Oral Implantology University of Paris VII M.Sc. Paediatric Surgery, Medical College (Paris VII), M.Sc. Oral Surgery University (Paris VII). Member of French National Academy of Dental Surgery, Oral Implantologiste, Consultant Maxillofacial Department of Paris Hospitals (Cochin &Bretenneau Hospitals), Lecturer for M.Sc. of Surgical & Prosthetic Implantology (Paris V)

3D Printed Full Coverage Crowns – A Case Report and Laboratory Protocol

Tsanka Dikova1*, Iveta Katreva1, Dzhendo Dzhendov1, Tsvetan Tonchev1, Diana Pavlova2 and Maksim Simov2

1Faculty of Dental Medicine, Medical University of Varna, Bulgaria
2Medical University of Varna, Bulgaria

The additive technologies characterize with layered manufacturing of the objects from 3D model data. They ensure production of precise complex details from various materials with no waste. The purpose of the present case report is to demonstrate the implementation of additive technologies in everyday prosthetic practice for crowns and model fabrication and compare it to the conventional laboratory protocol.

Materials and methods: Two molar full coverage crowns of our patient need replacement. A polyvinylsiloxane impression is taken and scanned in 3 Shape D750 laboratory scanner instead of pouring a gypsum cast. The sequence of working procedures is tracked from 3D scanning, through computer aided design to layered structuring of the restorations – provisional crowns and press-ceramic patterns via stereolithography in 3D printer Rapidshape D30. The light curing polymer Next Dent Model is applied for the model production and Next Dent Cast- for the patterns.

Very precise models, provisional crowns and press-ceramic patterns are being fabricated via the CAD-CAM system where the CAM unit is stereolithographic 3D printer. Final press-ceramic crowns of high accuracy of fitting and margins are obtained. The most frequently applied additive technologies in the dentistry and the working principle of CAD-CAM systems are presented parallel to the stereolithographic approach. A comparison between conventional crown fabrication and 3D printing highlights the numerous advantages of the innovation – time and manpower saving, possibility for production of complex shapes of various materials, minimal risk of laboratory mistakes, dimensional stability of the patterns, high accuracy and precise margins of restorations.

Dr. Tsanka Dikova is associate professor at Faculty of Dental Medicine, Medical University-Varna, and Bulgaria. She teaches students in Dental medicine and dental technicians on dental materials and technologies for production of dental constructions. National expert in Materials Science since 2013 she had worked as Fulbright professor in the USA and Japan. Author of 3 books, 4 textbooks and more than 90 papers in the field of dental and implant materials, nanomaterials for medicine, application of lasers and additive technologies in dentistry. Guest lecturer in India, Turkey, Macedonia, China, Poland and France, Member of the Academy of Dental Materials

Glutathione-Dependent Enzymes are Biomarkers of Inflammatory Process in Patients with Phlegmons of Maxillofacial Area

Ludmila Gavriliuc1*, Dumitru Scerbatiuc2 and Valentin Topalo2

1Department of Biochemistry and Clinical Biochemistry, Nicolae Testemiţanu State University of Medicine and Pharmacy, Moldova
2Department of Maxillofacial Surgery and Oral Implantology, Nicolae Testemiţanu State University of Medicine and Pharmacy, Moldova

Introduction: Inflammation-destructive process, accompanying phlegmons, in the patients leads to the disturbances of the metabolic processes and an imbalance of the antioxidant defense system. Increased free radical generation and lipid peroxidation has been considered to play an important role in the pathogenesis of phlegmons. Glutathione-associated metabolism is a major mechanism for cellular protection against agents which generate oxidative stress and peroxide oxidation of lipids (POL).

Purpose: Of our investigation was examination of the glutathione enzymatic redox-system, including reduced glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GP) and glutathione S-transferee (GST), in the blood plasma and leucocytes in the patients with phlegmons of the maxillofacial area during treatment with complex therapy (traditional & antioxidants).

Material and methods: Twenty one patients (19-46 years) and twenty healthy subjects were examined. Patients were treated with comprehensive therapy included antioxidant therapy (AOT), preparation “Aevitum” (35 mg retinol acetate and 100 mg α-tocopherol acetate) during 7 days. The activities of all enzymes and content of GSH and protein were determined in blood plasma and leucocytes using spectrophotometric methods (Humalyzer 2000, DE). The results were calculated with the statistical Studentʼs method and Microstat: Microsoft Excel 2007 program. Spirmeanʼs method of correlation was used for examination of interrelation between the parameters.

Results: Inflammation process led to the metabolic imbalance of glutathione-dependent enzymes and intoxication that reflected the increase of the GSH content and activity of GP and GST in the blood plasma and especially in leucocytes in the patients with phlegmons before treatment. Complex therapy, including AOT, decreased activity of glutathione-dependent enzymes and content of GSH already in a week. Correlation analysis indicated a positive interrelation before treatment only between GR and GST in the blood plasma and leucocytes. A strong positive correlation between all parameters was indicated after complex therapy.

Conclusion: In a week the complex therapy, including AOT, partially has been corrected imbalance of the glutathione-dependent enzymatic redox-system. This fact was confirmed by the dynamics of activity of the enzymes, the reduction of inflammation period and treatment course duration, and the more effective improvement of the patientʼs health status. Glutathione and glutathionedependent enzymes may be biomarkers of the inflammation process in the patients with phlegmons of maxillofacial area, their activity may be the reflection of a degree of pathological process activity and use for its control during treatment (monitoring).

Keywords: Glutathione reductase; glutathione peroxidase; glutathione S-transferase; phlegmons

Ludmila Gavriliuc working as a Professor of Biochemistry and Clinical Biochemistry Department of Nicolae Testemitanu State University of Medicine & Pharmacy, Chisinau, Moldova. She graduated from the State Medical University, Medico-Biological Department, Specialty - Biochemistry, Moscow, Russia, and completed PhD (1978) and MD (1997) at the State Medical University, Moscow, Russia. She had the Scholarships in Russia, Italy, USA (01-08.2013, Fulbright Program U.S., Feist-Weiller Cancer Center, LSU HSC, and LA). She is author of 107 scientific and methodic peer-reviewed manuscripts and 6 books. Participation in Conferences: USA, GB, Spain, Romania, Russia. Areas of the scientific interests are clinical-diagnostics, oncology, hematology, dentistry, antioxidant therapy.

Anti-Bacterial Efficacy of Herbal Irrigants against Enterococcus faecalis

Rajeswari Gopal* Deivanayagam Kandaswamy, Madhan Rajan and Karthick soundarajan

Sri Ramachandra Medical College and Research Institute, India

Introduction: Infections play a key role in the development of periradicular diseases and also one of the reasons for the endodontic treatment failures. Mechanical preparation of the canal leads to disruption in the microbial configuration whereas canal irrigation with tissue-lytic and anti-microbicidal solutions results in a reduction in the microbial load. Herbal derivatives with anti-microbial properties are good alternatives for chemical irrigants as the former are free from toxic chemicals. This presentation highlights the efficacy of a herbal product as a canal irrigant to overcome the cytotoxicity of polypotent stem cells.

Aim: To determine the antimicrobial efficacy of herbal extracts as an intra-canal medicament against Enterococcus faecalis

Methods: The dried fruits of Piper nigrum L (long pepper), Piper longum L (black pepper), and Zingiber officinale Roscoe (ginger) were powdered and mixed separately with methylcellulose vehicle to get irrigant solution. An in-vitro study is carried out to evaluate the antibacterial efficacy of these organic irrigants against the Enterococcus faecalis, the most common organism in persistent infections. Real-time PCR technique is applied to assess the effectiveness by comparing with that of standard irrigants 2% chlorhexidine and saline. One way ANOVA with Tukeyʼs Post-Hoc test was used to interpret the results.


1. The herbal extract of dried ginger revealed high antibacterial efficacy against E.Feacalis, followed by black pepper and long pepper.
2. The microbicidal activity of chlorhexidine is only marginally superior to the herbal products in reducing the bacterial load.
3. The threshold limit to reach the efficacy is preferred with the herbal derivatives than with synthetic antimicrobial agents

Conclusion: The study results prove that the herbal irrigants bring the almost the near antibacterial efficiency of the chemical products. Hence to overcome the proven cytotoxic effects of the chemical irrigants, herbal substitutes should be formulated with acceptable standardization and drug control regulations.

Dr. K. Rajeswari Gopal completed BDS education from the prestigious, Faculty of Dental sciences, Sri Ramachandra University and post Graduation in Conservative Dentistry and Endodontics from the same university. She started professional academic career in the same university and currently hold the post of Assistant Professor and also the treasurer for the Indian Association of Conservative Dentistry and Endodontics. She has won Best oral presentation in regional and National conferences and currently holds six publications in Indexed journals.

Evaluation of an Innovative Computer-Assisted Sagittal Split Ramus Osteotomy to Reduce Neurosensory Alterations Following Orthognathic Surgery

Alauddin Mohammed Ahmad Hussein*, Hazem T. Al-Ahmad Mohammed, W. M Saleh Alaʼuddin and M. Hussein

Istishari Arab Hospital, Palestine

Background: Sagittal Split Ramus Osteotomy (SSRO) can be associated with postoperative neurosensory disturbances. This study aimed to evaluate the effectiveness of computer-assisted SSRO in reducing the incidence and severity of neurosensory alterations, using a surgical guide fabricated by computeraided design and rapid prototyping (to guide bone cutting lateral to the inferior alveolar nerve).

Methods: A prospective double-blind, randomized controlled, clinical trial of computer-assisted SSRO vs conventional SSRO (assigned in a split-mouth design) in eight patients, mean age 23 (range 18–30) years, who participated in one session preoperatively and three sessions at 1 week and 1, 3 and 6 months postoperatively. At each session, subjective oral sensation was scored and quantitative sensory tests were performed. Neurosensory changes were compared between the two sides.

Results: The results showed that on the computer-assisted SSRO sides, patients had lower postoperative abnormal thresholds for the Semmes–Weinstein monofilaments on lower lip and chin (p < 0.05 at 3 months) and for the two-point discrimination on lower lip (p < 0.05 at 1 week) and chin (p < 0.05 at 6 months), with fewer abnormal self-reported changes in lower lip sensation (p < 0.05 at 1 week) after surgery.

Conclusions: these findings imply that computer-assisted SSRO is associated with better levels of neurosensory function after surgery.

Dr. Alaa Hussein is a Specialist in Oral and Maxillofacial Surgery with over 11 years of experience. He is currently a Specialist and the Head of Oral and Maxillofacial Surgery Department at Istishari Arab Hospital. Prior to joining Istishari Arab Hospital in Ramallah, Dr. Hussein worked at the Arab American University – Jenin as the head of oral and maxillofacial surgery department/faculty of dentistry. Dr. Hussein graduated from the Faculty of Dentistry from the Arab American University - Israel. Then he continued his specialized training in Oral and Maxillofacial Surgery at Jordan University Hospital - Jordan.

Single-Needle Arthrocentesis (Shepard cannula) Vs. Double-Needle Arthrocentesis for Treating Disc Displacement without Reduction

Mohamed Ghoneim

Sinai University, Egypt

Objectives: To compare single- vs. double-needle arthrocentesis with visco-supplementation for treating disc displacement without reduction of the temporomandibular joint.

Methods: Fifty-six patients with a magnetic resonance imaging diagnosis of non-reducing disc displacement were included. Arthrocentesis with visco-supplementation was performed on patients in group I using the Y-shaped needle (Shepard cannula) technique; the standard double-needle technique was performed on patients in group II. Patients were evaluated on postoperative day 1, and 1, 3, and 6 months later, patient- and procedure-related parameters were assessed.

Results: In both groups, significant improvement in the baseline levels was achieved (p < 0.01). Both techniques were equally effective at reducing pain and increasing the maximal mouth opening. The single-needle technique was easier to perform and required a shorter operative time (p < 0.01).

Conclusion: Single-needle (Shepard cannula) arthrocentesis can be an alternative to the standard technique; however, it might add to the cost of the procedure.

Mohamed Moawad Ibrahiem Ghoneim currently working as a lecturer in Oral and Maxillofacial Surgery department, Faculty of Dentistry, Sinai University & he received a Bachelor degree in Dentistry, Master degree, and PhD in oral and maxillofacial surgery. He received residency program in oral, maxillofacial and plastic surgery from 2007 till 2016. He is a member in many researches, continuing education committees and certified clinical trainer and academic lecturer in oral and maxillofacial surgery. Private clinical practice is in temporomandibular joint disorders, Implantology and minor oral surgery.

A Comparative Study between Lidocaine and Methyl Salicylate Patches in Treatment of Myofascial Pain

Amr A El-Swify2*, Ahmed M Atef1, Mohammed A El- Sholkamy2 and Eman A El-Sharrawy2

1Department of Oral and Maxillofacial Surgery, Sinai University, Egypt
2Department of Oral and Maxillofacial Surgery, Suez Canal University, Egypt

Objectives: The aim of this study was to compare lidocaine versus methyl salicylate patches in treatment of myofascial pain.

Materials and Methods: thirty patients sufferred from myofascial pain in head and neck muscles were divided randomly into three groups: Group one (10 patients): was treated with methyl salicylate patch. Group two (10 patients): was treated through lidocaine patch. Group three (10 patients): was acted as a controlled group through the application of plain patches without any active ingredient. Each patient has received one patch that had replaced by the patient every 12 hours; the patient informed to remove the last patch 12 hours before the visit on day five. All evaluations (pain intensity, degree of mouth opening, range of motion, disability) repeated on day five (12 hours after removal of the last patch) and on day nine (after four days of follow up).

Results: Significant reduction in pain intensity, significant increase in mouth opening and lateral movement and significant improvement in quality of life with methyl salicylate and lidocaine patches.

Conclusions: Methyl salicylate and Lidocaine patches are effective in treatment of Myofascial pain.

Keywords: Myofacial Pain, Methyl Salicylate Patches, Lidocaine Patches

Professor Amr Ali El-Swify completed oral & maxillofacial surgery in Suez Canal University and he graduated at Cairo University where he got his PhD. He became the chair of the department of oral & maxillofacial surgery at faculty of dentistry in Suez Canal University from 2004 till 2009 then the chair of oral & maxillofacial department at Sinai University from 2010 to 2015. In 2015, he visited Taif University, KSA as a visitor-professor till 2017. He supervised 14 Master & doctorate thesisʼs in addition to, participating in 29 Master & PhD thesisʼs as a member of the referee committee.

Low Laser 908nm (Gallium-Aluminum-Arsenium) Application in Peri Implantitis, Infected Sockets, or Necrotic Bone

Maite Moreno Delgado

Dental Implant Center, USA

This presentation summarizes the protocol used to successfully overcome infected sockets and immediate placement of implants, as well as, infected implants that need to re-grow surrounding bone from peri-implantitis, or necrotic bone. This protocol is an alternative successful technique to resolve infected implants, infected sockets and necrotic bone, when patients seek fast and a predictable solution to their condition.

Applying a sterilized gauze with tetracycline (powder) of 500 mg. direct to bone (and or implant surface, when required) as a dressing for 15 min. Irrigating with saline solution and tetracycline, (509mg) while reestablishing the new bleeding and cleaning of previously bone. Then applying 908 nm. (gallium-aluminum-arsenium) low laser at 4000 Hertz of a .5 Watts power level with a distance of half an inch (Laserthech, Dentalaser LV, KVT 106 UP) With a diameter of 1.2 mm lens for 30 seconds in dental sockets, and for 2 minutes in necrotic bone areas. When applying the same current to the implant surface for 30 secs., implants are always irrigated with cold saline solution and Tetrex (500 mg.) to prevent overheating of metal and the surrounding bone to the implant surface. Osseo conductive materials are placed to fill the defect that include particles of demineralized bovine or synthetic bon (by MIS) along with plasma rich in growth factors. Bone Bond (MIS, Tel Aviv, Israel), synthetic bone (MIS, or bovine bone (Bio- Oss ®, Geitslicht, Switzerland ) with plasma rich in growth factors are placed to reconstruct the bone defect and help make a new bone bed. A Non reabsorbable collagen membrane is not required. This is an easy, fast, and predictable technique for implantologist that deal on everyday basis with periimplantitis, infected sockets, and necrotic bone tissues.

Results: In 98 % of the cases there was normal bone tissue growth around implants, or as bone augmentation in vertical or horizontal manner assessed with panoramic x rays or periapical x rays. The case where the bone did not grow in recent socket extraction site was in a patient that was a heavy consumer of drugs, and there were not enough walls to nourish the new bone bed.

Conclusion: Low laser application of 908 nm is a cost-effective treatment choice to predictably resolve cases of periimplantitis, infected sockets for immediate placement of implants and necrotic bone.

Maite Moreno Delgado is a Prosthodontist with a MS. degree from University of Michigan, who returned to Mexico since 1982. She is international member of the American College of Prosthodontist, Academy of OsseoIntegration, ADI (Academy of Dentistry International) and Pierre Fauchard Academy. She has written four books of Dentistry and participated in the Editorial Committee for Dental Tribune. Published one protocole of low laser 908nm eradication of bacterias in dentinal tubules in 2013 (ACP, las Vegas Nevada). Her evidence based new protocole for laser disinfection of peri timpatitis or bone tissue infections and necrosis, may help the practitioner face these conditions in a very cost effective fashion.

Analysis of Dental Implant Prosthesis Screws after One to Twenty Years in Chewing

Carlos Nelson Elias*, Heitor Cosenza and Francisco Roberto Cosenzaand Fábio Guerra

Instituto Militar de Engenharia, Brazil

One of the problems that exist is the loosening of the prosthesis screw on implants. However, there is no consensus among professionals as to how long the prosthesis screw maintains the union of the system. In the present study, screws removed from patients after 1 to 20 years of continuous use were collected. The surface morphology, deformation, galling, wear, cracks and surface defects of prosthetic retaining screws collected (n=14) from patients after long-term use were analyzed using a scanning electron microscope. All screws were removed due screw loosening and patient pain (n12) or screw fracture (n2). SEM images showed that the screws had plastic deformation due to the tightening and oral loads. Loosening of the screws may be attributed to the loss of preload due to plastic deformation, corrosion, grooves from manufacture processing, adherence of organic material to the surface and cyclic loading. Loosening of the screws is not correlated with time of use, but with plastic deformation and other wear processes. It is not possible to predict for how long a prosthetic screw can maintain the preload. The conclusion is that loosening or fracture of the screw is unpredictable and depends on loading conditions, patient care and the periodicity of retightening.

Carlos Nelson Elias completed degree in Metallurgy from the Military Engineering Institute and a PhD in Materials Science. He received twice an award Scientist from the State of Rio de Janeiro (2004 and 2008), researcher at the Foundation for Research Support of the State of Rio de Janeiro - Brazil. Has experience in Materials Science, with emphasis in Physical Metallurgy and Biomaterials. Researches with dental materials, dental implants, and modification of dental implants surfaces, endodontic instruments, orthodontic appliances, coronary stents and orthopedic prostheses. Works Quote: Web of Science 1014 citations, h-factor 18, Scopus: 1257 citations, h-factor 19; Google Scholar: 3170 citations, h-factor 29 and Mendely: 1569 citations, h factor 21.

Implant Placement Dilemma in the Esthetic Zone: Immediate or Delayed Protocol?

Aleksa Markovic

University of Belgrade, Serbia

Esthetic region is a zone in which expectations and possibilities collide. Clinician should bring the important decision on the appropriate time of implant placement. Immediate implant placement is particularlly challenging in the esthetic zone. Patient desire for reduced treatment time should be weighed against the possible risk factors. Protocol of immediate implant placement in conditions of unfavorable gingival biotypes, the lack of bone or soft tissue in patients with a high smile line lead to esthetic failure which is very important in the esthetic region.

Aleksa Marković DDS, MSc, PhD, is Associate Dean and University Professor of oral surgery and implantology at the University of Belgrade, Belgradeʼs School of Dentistry. He is Chairman of Belgrade ITI Scholarship Center, Chairman of Belgrade ITI Study Club, an ITI Felow and President of Serbian Society for Oral Implantology. Dr Marković has 19 - years experience in leading student courses from area of oral surgery, dental anesthesiology and dental implantology; postgraduate studies of oral surgery and implantology as well as basic and master courses of dental implantology. His area of research includes implant dentistry with focus on bone-implant interface regarding different loading conditions, surgical techniques and implant surface, then bone regeneration and the effects of low level laser treatment on the oral and periimplant tissues. He has authored or coauthored 50 articles in international journals of which 26 in CC journals, 3 textbooks and 3 monographs. Dr Marković has held 145 lectures at national and international scientific meetings. He has led several international research projects devoted to bone regeneration and implant loading. Dr. Marković received his dental degree with a specialization of oral surgery as well as a doctoral degree in bone regeneration and a master degree in local analgesia, all from University of Belgrade

Hearing Loss in Unilateral Cleft Lip and Palate

Jadranka Handzic

University Hospital Center Zagreb, Croatia

Background: Hearing loss associated with otitis media with effusion is usually finding in cleft lip and palate children. Severity of hearing loss (HL) is related to severity of structural defects in different cleft types.

Objectives: To found out if difference of the structural defect of cleft vs. non cleft side is accompanied with difference of HL in dependence of ear side and age.

Method: Study group included 101 children with repaired unilateral cleft lip and palate (UCLP); 27 right and 74 left sided, 33 girls and 68 boys, mean age of 6 years for both groups. By the help of tonal audiometry median hearing threshold (MHL) at 500, 1000, 2000, 4000Hz and average hearing loss across speech frequencies (AHL) compared for age subgroups 1-3y, 4-7, 8-12y.

Results: UCLP is more often in males (n=68 or 67%), than females (n=33 or 33%). Age of 1-3zr showed highest rate of ears HL. At age 4-7 (left) cleft side ears showed highest AHL than non cleft side ears. MHL was higher at 500Hz, 1000Hz. Right ears showed significant improvement of AHL until 7yr. across tested frequencies while left (cleft) side showed delay in improvement of MHL and AHL until 12yr. which were prominent mostly for 500Hz, 1000Hz.

Conclusion: Cleft side ears vs. none cleft side ears, showed higher severity of hearing loss in dependence with audiometric frequencies and aging.

Keywords: hearing, cleft palate

Jadranka Handžić graduated at Medical School University of Zagreb, took Master degree at 1987y. and PhD at 1989y. Residential program of Otolaryngology finished 1989 yr. sub-specialisit of Audiolog 2003yr. At 2000-2001 she spent academic year on Fulbright Scholarship at Cleft Palate-Craniofacial Centre and Dental School of Medicine, University of Pittsburgh and Childrenʼs Hospital Pittsburgh U.S.A at position as Adjunct Associate Professor of Oral Medicine. 2001-2002 she had Lester Hamburg- Research Fellowship in Department for Paediatric Otolaryngology Childrenʼs Hospital of Pittsburgh, Medical School University of Pittsburgh, U.S.A. From 2002 she was Assistant Professor of Otolaryngology and from 2008 Professor of Otolaryngology and Audiology.

Sub-Epithelial Connective Tissue Graft with and without Enamel Matrix Derivative in the Management of Periodontal Recession

Faustino Tino Mercado

Griffith University, Australia

Background: The aim of this study was to compare the effectivity and stability of subepithelial connective tissue graft (CTG) with and without enamel matrix derivative (EMD) in the treatment of Class I-II Miller periodontal recession defects.

Methods: This randomized clinical study was performed for 2 years at a private periodontal practice. 120 teeth divided into two groups: Group 1 (CTG with EMD - 68 teeth) and Group 2 (SCTG only - 52 teeth) were assessed. Clinical parameters such as Recession values (REC), Keratinized Tissue (KT) and probing depth (PD) were measured at baseline, 3rd and 24 months.

Results: Both treatments showed significant root coverage after 2 years. The mean periodontal recession decreased from 4.5 mm to .41 mm for Group 1 and 4.2 mm to .29 mm in Group 2. This result was not statistically significant. The mean KT increased from 1.5 mm to 2.5 mm in Group 1 and 1.6 mm to 1.9 mm in Group 2. This was statistically significant (p< .01). The mean PD measurement remained shallow at all times (1 mm – 1.3 mm) and not statistically significant in both groups.

Conclusion: CTG provide predictable result in achieving root coverage in Class I-II Miller periodontal recessions. The addition of enamel matrix derivative seems to provide higher amount of new keratinized tissue.

Faustino Tino Mercado finished his Postgraduate Diploma in Oral Pathology at the University of Queensland in 1997 and went on to finish his Masters in Dental Science in Periodontics in the same University in 2000. He was involved in the dental undergraduate and periodontal postgraduate training at the University of Queensland and more recently at the University of Sydney

Slip Rule & Aesthetic Outcome in Implantology

Kadhim Al Himdani

University of Paris, France

Definition: SLIP Rule is a Biologic Concept which height lite the Fundamental Factors that directly Influence the Tissue Response related to Aesthetic Stability, whatever the type of implant used or the Surgical Procedure Applied.

Objectives: The objective of this study is to show our clinical techniques through which we can obtain very satisfying durable aesthetic results for different critical clinical situations of bone deficiency in aesthetic zones without going through sophisticated, long, painful and costly procedures of ridge management procedures like bone grafting, ridge preservation and distraction osteogenesis. This presentation based on clinical retrospective study of the last 15 years on patients in sites with bone deficiency of the anterior zones of the maxilla and mandible. Cases with sites without bone deficiency were excluded. Xenografts were used simultaneously in a few cases to give hard and soft tissue support, yet implants osseointergration was independent from the grafting material. I introduced my S.L.I.P. rule whichcome to highlight the fundamental factors that governs the stability of aesthetic result after implant osseointegration. It could be summarized by;

(S) Represent Implant size in relation to ridge volume
(L) Represent the Level of the implant in relation to crestal level
(I) Represent the Implant abutment Interface
(P) Represent the well-structured Emergence Profile

Results: When we adapting our proposed with SLIP RULE in sites with bone deficiency in aesthetic zone survival rate of 94.5% were reported out of 347 implants placed.

Conclusion: Satisfying aesthetic results with bone deficiency can be obtained without pre-operative ridge augmentation procedures. We highlight the significance of implant design, implant orientation and sub-crestal position, surgical approach and procedure, active healing period and finally adequate prosthetic restoration and fixation; all these elements clinically proved their efficiency to overcome going through long, complicated, risky, painful, and costly procedures. Thus achieving the Minimal Invasive Implantology and shifting the conventional Restoration-Driven Implant Placement concept towards SLIP RULE Implant Placement.

Dr. Kadhim Al Himdani completed B.D.S. Dental College, Baghdad University, Ph.D. Dental Science Oral Implantology University of Paris VII M.Sc. Paediatric Surgery, Medical College (Paris VII), M.Sc. Oral Surgery University (Paris VII). Member of French National Academy of Dental Surgery, Oral Implantologiste, Consultant Maxillofacial Department of Paris Hospitals (Cochin & Bretenneau Hospitals), Lecturer for M.Sc. of Surgical & Prosthetic Implantology (Paris V).

Is Primary Stability the Gold Standard Factor in Implant Success

Joji Markose

Cosmo French Medical Centre, UAE

Primary implant stability has been acknowledged as an essential criterion for achievement of such osseointegration. Implant stability decreases during early weeks of healing, this is related to the biologic reaction of the bone to surgical trauma during the initial bone remodelling phase. This biologic process eliminates the decrease in primary stability and ensures consistency ofstability overtime without the drop during the healing period. Micromotion of dental implants may interfere with the process of osseointegration. Studies have reported that excessive micro motion interferes with osseointegration of implant. In traditional implant loading the healing occurs undisturbed for about 3 – 6 months. Micromotion is of limited importance in delayed loading implant protocol since the implant is submerged below the soft tissues. Where as in immediate loading or one stage surgery, micromotion is of more significant; however, the applied load is often reduced or even absent. So fundamental prerequisite for implant success is “no motion” at the time of insertion and following loading of the implant not the primary stability with heavy pressure surrounding the osteotomy site This lecture present 7 year retrospective cohort study to evaluate the implant survival ratesusing radiological and clinical assessments of implants placed without any primary stability.

Dr. Joji Markose received his undergraduate degree in Dentistry (B.D.S.) in 1995 from the Dr M.G.R Medical University of Chennai, India. In 2000, he obtained his masterʼs degree in Prosthodontics (M.D.S) from the Rajiv Gandhi University of Health Science Bangalore, India. In 2017 obtained his PhD in dental implants from Pacific University. In 2012 he received Associated Fellowship from AAID. Following his professional training from AAID (American Academy of Implant Dentistry 2006) and Masters implant course from University of Lose Angles (UCLA 2011) Dr. Joji practice in U.A.E for last 16 years, oriented towards Implantology, Prosthodontics, and Esthetic dentistry. He specialised in minimal invasive implant treatment and short implants. To date published over twelve articles and many lectures nationally and internationally in dental Implants.

Digital Approach to Immediate Implantology: The Solution for Com-Plex Cases with Bone Atrophy

Alessandro Palumbo

Studio Odontoiatrico Dott Alessandro Palumbo, Italy

Complex cases of bone atrophy of the jaws are difficult to treat for any Implantologist. Lack of resi-dual bone and the difficulty of getting new bone live and stable over time is a problem for the den-tist. Bone regeneration techniques are long, invasive, and with low successful success rates in short and especially long-term. Computer-assisted Implantology is a valuable help as it allows sub-millimeter accuracy to maximize the residual bone of the patient. We speak of the inter foramina area of the jaw, the sects and walls of the maxillary sinus, the Pterigoid area, etc. The three-dimen-sional analysis of the amount of residual alveolar and basal bone obtained from CBCT examination and digital navigation techniques allow us to locate all the little bone available. In addition to this fundamental aspect, it is also possible to have a virtual planning of the intervention keeping in mind the position of future prosthetic teeth. Navigation software allows you to locate the inclination leng-th and position of the implant using the maximum bone and keeping in mind the prosthetic emer-gency profile. The virtual project can be faithfully reported to the patient on the day of surgery th-rough a stereolithographic surgical guide. This guide, if the steps are correctly performed, allows to position the implant in the patientʼs mouth exactly in the residual bone.

Getting that same position by working with a free hand would not be possible for the same sur-geon. Furthermore C.A.I. allows these interventions to be minimally invasive quick and very well accepted by the patients. Almost always it is possible to load the fixtures immediately, allowing the immediate function of the prosthesis.

In this report, the author, who uses these methods since 2000, will exhibit atrophic cases of partial and total jaw with immediate loading of implants successfully treated with digital implantology. 15-year follow-up cases will also be shown.

Show the surgeon and prosthetist how complex cases of atrophies of the jaw can be solved using Computer Aided Implantology. C.A.I. : The simple solution for complex cases. Show clinical daily work of 15 with real clinical cases of unselected patients

Dr. Palumbo Alessandro was among the first in the world, thanks to the University of Louvain Bel-gium, to clinically use the computer-assisted Implantology technique on his private patients. He lo-ves innovations and minimal invasiveness for the patientʼs ultimate) well-being. He is one of the founders of the CAI Academy and has been tutor and speaker in courses and congresses in Italy and abroad. His first Dubai lesson on the subject was in 2015. Mentor of the CAI Academy of the Implant Academy and Mentor of the Nobel Biocare Program Free Professionals loving innovations in Pesca-ra Italy.

Rehabilitation of Very Atrophicmaxilla with Zigomatic Implants

Robert Cerovic

University of Rijeka, Croatia

Implant rehabilitation of the atrophic maxilla represents a considerable challenge. Rehabilitation of very atrophic maxilla can be achieved by using zygomatic implants. Today, zygomatic implants are usually placed using an immediate loading protocol and now a days are usually immediately loaded with a fixed bridge. Although these implants replace other augmentative methods of regeneration of the alveolar ridge, they are still suggested as a method to be used only when other options are exhausted. Indications for zygomatic implant insertion include: alternative for sinus augmentation, failed sinus augmentation, rehabilitation after tumor resection or trauma, failure of conventional implants, failure of previous bone grafts. Itis a very demanding surgical procedure requiring adequate surgical and implant oprostetic skills, knowledge and experience, as well as a method that shows a very high percentage of success.

Robert Cerovic employed at Clinical Hospital Centre Rijeka, Croatia at the Department of Maxillofacial Surgery as Head of the department, and Professor at the Department of Maxillofacial surgery, Faculty of Medicine, University of Rijeka. A regular member of the Croatian Society for Maxillofacial, Plastic and Reconstructive Surgery of the Head and Neck, Croatian Society for Dental Implantology and several international societies (IAOMS, AOCMF, EACMFS). An invited speaker and active participant in congresses and scientific meetings at home and abroad. Author and co-author in internationally recognized scientific publications. Deals with all areas in maxillofacial surgery. Over the past few years has been more intensively involved in orthognathic surgery and dental implantology with a special interest in surgical possibilities of reconstruction of the edentulous part of alveolar ridge.

Oral Health Statuse of Geriatric Population

Maryam Tabrizi

University of Texas Health Science Center at Houston, School of Dentistry, USA

Statement of the Problem: The aging population is growing historically faster than any age group. Currently, there are over 600 million individuals 60 y/o and over by 2050, this number will rise to 2 billion worldwide. Globally, poor oral health of elderly has been evident. Elderly are facing issues such as root carries, periodontal disease, xerostomia, and much higher risk for oral cancer. In addition, malnutrition presents at least 2 of 6 clinical characteristics, which could also be associated with general wasting (cachexia) usually linked to some chronic illness and oral health/dental problems.


1- Growth of the Aging Population
2- Connection between OH and other chronic diseases (CVD, Diabetes, renal failure, etc)
3- OH Preventive Measures (Primary/secondary & silver Diamine Fluoride SDF)
4- Minimally invasive caries treatment
5- Enhancing Quality of Life for the Aging Population

Methodology: This presentation is an outcome of a review over 30 years of literature (1984-2016) including evidence based clinical studies and treatments.

Facts & Conclusion: By the definition stablished by American Dental Association in 2014, Oral health is “a functional, structural, aesthetic, physiologic and psychosocial state of well-being and is essential to an individualʼs general health and quality of life”. Geriatrics with cognitive decline are at highest risk for poor oral health and consequently leading to malnutrition affecting millions of elderly living at home or nursing home facilities deficient in protein and calories. If minerals and vitamins included malnutrition in elderly may rise to over 46%, decreasing quality of life.

Dr. Tabrizi received a D.M.D from Temple University School of Dentistry in 1991. She practiced in Philadelphia as a general dentist over 20 years focusing on elderly and patients with health complications. She left private practice started teaching at Temple University as a full time faculty. In 2014, Dr. Tabrizi completing her Master in Public Health (MPH), and accepted a position as an assistant professor at the University of Texas, School of Dentistry at Houston. She is currently teaching geriatrics oral health and is actively serving in organizations such as; APHA, ADEA, SCDA, and National Institute of Aging.

Short Dental Implants as Promising Solution in Implant Dentistry

Hussein Labib1* and Joji Markose2

1Cairo University, Egypt
2Rajiv Gandhi University of Health Science, India

Osseointegrated implants have become a routine solution for treating edentulous patients. Dental implants have a favorable longterm prognosis when compared to conventional fixed prosthodontics.

The implant length is usually considered during the treatment planning and the length is decided based upon the existing bone. After teeth extraction the jaw bone volume is lost creating a real challenge to place implants with adequate length. Moreover and subsequent to poor bone volume; implant placement become risky as we have some important anatomical structures such as the nasal cavity, maxillary sinus mental nerve, mandibular nerve and lingual vascular bundle.

There are many surgical procedures to compensate for bone deficiency, such as sinus and/or ridge augmentation procedures. They are proven to be successful in providing sufficient bone quantity and quality for implant placement and prosthetic support; However, increased cost, surgical time, morbidity, and healing time are often associated with these procedures. Such limitations are more significant while treating elder group of patients where in addition to their normal delayed healing power; mostly they are suffering some co-morbidities and unfavorable systemic conditions which are negatively affecting the healing process after surgeries.

Hence implants with alternative length and diameter were introduced in response to clinical demands. In the last decade, use of short implants has become a growing interest among clinicians. Encouraging survival rates have been reported over time. Recent systematic reviews indicated that short implants have the same survival rates and degree of marginal bone loss as longer implants. Short implants bio compatibly transfers occlusal forces from abutment to surrounding bone. The entire design of short implant optimizes the effectiveness of each of the features within the available implants surface area and length. Short dental implants could be a reliable and predictable alternative solution for those cases with less than optimal ridge bone volume.

Keywords: Implant size, reliability of short dental implants, ridge bone volume, predictable survival rate.

Dr. Hussein Labib had obtained his B.D.S. from Cairo University in 1984. Dr. Hussein Labib holds three Master degrees; the first is in Oral Surgery from Cairo University (1992). By 2010 Dr. Hussein had finished his second MSc degree in implant dentistry from Warwick University in the United Kingdom. The last degree was MBA-HC in 2016 From Geneva Business school, Switzerland. Dr. Hussein Labib is a co-author of many published articles in the field of implants dentistry in the last few years.

Minimally Invasive Transcrestal Sinus Augmentation (MITSA)

Jaibin George

JJ Dental Care, India

Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants), which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patientʼs condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

Dr Jaibin George completed BDS, Masters in Oral Implantology. He works International Oral Implantologist and Professional Experience - Over 23 Years, Private Clinical practice in Cochin since 1993, Consultant Oral Implantologist National & International Front.

Role of Periodontist in Prevention of Misdiagnosis of Oral Lesions

Deepa D

Subharti University, India

Scientific advances in periodontology in the past 150 years have fundamentally changed how clinicians detect and treat periodontal diseases. Our understanding of etiology and pathogenesis of periodontal diseases has intensified and continues to evolve with advances in the technology involved in periodontal microbiology. In recent times, there is an outburst of emerging and re-emerging infections due to newer strains or resistant microbes developed to the existing treatments affecting even the young and immunocompetent individuals. This presentation will highlight the role of periodontist in the prevention of misdiagnosis of oral lesions.

Dr. Deepa D has completed her BDS from College of dental sciences, Davangere, Kuvempu University in 1998 and Masters of Dental Surgery in the speciality of Periodontology from Bapuji Dental College and hospital, Davangere, Rajiv Gandhi University of Health sciences, Karnataka, India. She is presently working as Professor in Periodontology at Subharti University, India. She has worked as co-investigator for World Health Organisation research project in 2006-2007 at Bapuji dental college and hospital. She is an active academician and has published 83 papers in national and international journals and has been serving as reviewer in journals of repute. Have 18 scientific presentations at National and 3 at international conferences at Dubai, Kualalumpur, Malaysia. Awarded –Best scientific presentation at the National evidence based dentistry conference, Gujarat, India and also National awards three times for essay competition during 2003, 2008 and 2016 organised by Indian Society of Periodontology. In 2016 she was an Organizing Committee member for the 2nd World Congress on Dental Research, Kuala Lumpur, Malaysia, where she was a keynote speaker. Invited guest speaker at academic events and recently at 42nd National conference of Indian Society of Periodontology held at Kolkata, 24th to 26th November 2017. She is also a life member of reputed speciality organisations of Periodontology and Implantology.

Could Stress be Linked to Periodontal Disease?

Hadir F Eldessouky

King Abdul Aziz University, Saudi Arabia

Ongoing studies and research into the systemic links between periodontal disease and overall health, is one of the subjects of greatest interest within dentistry and one that connects this field with medicine. New ideas and findings shine light on ways dental professionals can positively impact the lives of their patients.

The body produces immune cells to protect against bacteria, but when the body is under stress, this delicate balance is affected. Inflammation tends to increase due to stress, allowing bacteria to thrive and cause gingivitis, a precursor to periodontal disease. Our aim was toinvestigate the effect of stress on periodontal health in relation to inflammatory markers and alkaline phosphatase (ALP) in Gingival Crevicular Fluid (GCF) and cortisol in saliva. Twenty subjects were recruited for the study. A clinical examination included assessment of Plaque index, Probing Depth (PD) and clinical attachment levels. Saliva and GCF were collected for each subject for analysis of salivary cortisol and GCF (ALP) level as well as IL-1b, IL-6 and IL-10 levels. Subjects registered their perceived stress on a visual analogue scale (VAS).

Dr. Hadir Eldessouky was appointed as a full professor, Division of Periodontics, Department of Oral Medicine, Oral Diagnosis and Periodontics. Ain Shams University Egypt in June 2012. Dr. Eldessouky received her BDS & Masters degree (1994) from Alexandria University where she was appointed as lecturer. In 2002 Dr. Eldessouky received her PhD from Ain Shams University. Dr. Eldessouky joined Ain Shams University in 1998 where she was appointed as lecturer. In 2007 she was appointed as Associate Professor at Ain Shams University. From 2007-2009 she joined King Abdul Aziz university in Saudi Arabia as a visiting professor. Early 2007 Dr Eldessouky received her certificate as research ethicists from the school of Medicine, University of Maryland USA. Since then Dr. Eldessouky is an active member in the IRBs. In 2013 to date Dr. Eldessouky joined King Abdul Aziz University as a Professor of Periodontics. During her years of work Dr. Eldessouky mentored and supervised many PhD and Masters Theses. Dr. Eldessouky was the course director of 6th year Periodontics course for 3 years at King Abdul Aziz University and also gave several lectures both at Ain Shams University as well as King Abdul Aziz University. Dr. Eldessouky published more than 30 articles in National and International journals. Dr. Eldessouky has trained and mentored graduate students in the area of Periodontics throughout her career.

Regenerative Potential of Bovine Xenograft with Enamel Matrix Derivative in the Treatment of Peri-Implantitis

Faustino Tino Mercado

Griffith University, Australia

Background: Experimental and clinical studies show no reliable regenerative treatment of peri-implantitis. The aim of this study was to examine the regenerative capacity of combined xenograft and enamel matrix derivatives in the management of peri-implantitis clinically.

Methods: 30 patients diagnosed with peri-implantitis (minimal probing depth of 4mm and radiographic bone loss of 20%) were included in the study. Clinical measurements recorded included probing depths, recession, radiographic bone fill, presence of gingival inflammation and bleeding on probing.

Following surgical access, the implants were initiallydebrided with alow power ultrasonic machine. The implant surfaces were thendecontaminated with 24% EDTA beforethe defects were filled with acocktail of bovine xenograft enamel matrix derivative (EMD) and doxycycline powder. The defects were finallycovered with a resorbable membrane and connective tissue grafts were placed if necessary, particularly around anterior implants. The clinical measurements were repeated after 12, 24 and 36 months of healing.

Results: A reduction in mean probing depth from 8.9 mm to 3.5 mm was noted at the 36th month measurement. The mean initial radiographic bone loss of 57% was reduced to 14.5% after 24 months. These results were statistically significant. There was no statistically significant difference in the recession values between the initial and 36 month measurements. The clinical symptoms of peri-implantitis such as gingival inflammation and bleeding on probing also improved over this time.

Conclusion: Regenerative treatment of peri-implant it is using a combined mixture of bovine xenograft, EMD and doxycycline achieved promising results. The benefits of this protocol incorporating EMD should be tested in randomized clinical trials.

Faustino Tino Mercado finished his Postgraduate Diploma in Oral Pathology at the University of Queensland in 1997 and went on to finish his Masters in Dental Science in Periodontics in the same University in 2000. He was involved in the dental undergraduate and periodontal postgraduate training at the University of Queensland and more recently at the University of Sydney.

Temperature Rise on the External Root Surface Using Ultrasonic Tips during Removal of Broken Instruments

Moataz Mahran

Magrabi Dental Hospital, Saudi Arabia

This study was conducted in order to compare the amount of heat generated on the external root surface and the amount of lost dentin caused by three different types of ultrasonic tips.

Materials and Methods: The study was done in Magrabi Dental Center Research division, sixty extracted human mandibular first molars were used, and 3 mm fragments of Size 30 K- files were intentionally separated inside mesio-lingual canals.

Teeth were placed in eppendorf tubes containing alginate to simulate human body. Two fine thermocouples connected to a digital thermometer were connected to the mesial and distal aspect of the mesial root.

The amount of lost dentin thickness was assessed through comparing pre-and post – instrumentation CT scan at 0.5 mm from the separated instrument.

Form this study conclusions could be summarized as follows:

1. The assembly used in the study proved to be efficient in measuring the external root surface temperature in situation simulation simulating clinical conditions.
2. The material of the tips, the time of application and the power intensity affected both the amount of heat generated and the amount of removed dentin.
3. The size of the ultrasonic tips may be an influencing factor that affects the amount of the remaining mesial and distal dentin thickness.
4. There is a potential risk of root perforation during the use of the ultrasonic tips.

Keywords: Ultrasonic tips, broken instruments, Heat generation.

Dr. Moataz Mahran completed his B.D.S, M.S.C Endodontics. He was born in Alexandria, Egypt 1981and graduated from Ainshams University 2003 Cairo, Egypt. He received my Masterʼs degree in Endodontics from Ainshams University 2011 Cairo, Egypt. A private practitioner and Head of Endodontic Department at Magrabi Dental Hospital, Jeddah, Saudi Arabia my work is limited to Micro Endodontics with almost 30.000 canal have been treated. Member of the British Endodontic Society and Member of the European Endodontic Society.

Pseudo Class III Malocclusion

Fadia Al-Hummayani

King Abdulaziz University, Saudi Arabia

The treatment of deep anterior crossbite is technically challenging due to the difficulty of placing traditional brackets with fixed appliances. This case report represents a none traditional treatment modality to treat deep anterior crossbite in an adult pseudo class III malocclusion complicated by severely retruded, supraerupted upper and lower incisors. Treatment was carried out in two phases. Phase I treatment was performed by removable appliance “modified Hawley appliance with inverted labial bow” some modifications were carried out to it to suit the presented case. Positive overbite and overjet was accomplished in one month, in this phase with minimal forces exerted on the lower incisors. Whereas, phase II treatment was performed with fixed appliances (braces) to align teeth and have proper over bite and overjet and to close posterior open bite, this phase was accomplished within 11 months.

Dr. Fadia Al-Hummayani works as an Assistant Professor and Consultant Orthodontist. She teaches both the undergraduate, Saudi Board and Master dental students at King Abdulaziz University/ College of Dentistry. Completed her Masterʼs and Clinical Certificate in Orthodontics from King Saud University/Dental School, Riyadh, Saudi Arabia in 1999. She got the Assistance Professor position through research and publications in reputed journals in 2006. She won the Aesthetic Dentistry MENA Award 2010 as the best treated case in the Middle East and North Africa organized by Emirate Medical Association (EMA - Dental Society) and CAPP (Centre for Advance Professional Practices) in United Arab of Emirates, Dubai.

The Effect of Aloe Vera on the Treatment of Periodontal Ligament

Randa Mokhtar

British Dental College, Egypt

Periodontitis is the inflammation of the gingiva, periodontal ligaments and the supporting alveolarbone. It involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to loosening and subsequent loss of teeth. It is caused by microorganisms that adhere to and grow on the tooth surfaces, along with an overly aggressive immune response against these organisms. Treatment of periodontitis is either surgical or non-surgical approach. In the present study, we consider the non-surgical approach using a natural product which is Aloe Vera.

Aloe Vera (family: Liliaceae) has been used in traditional medicine for a long time. It is one of the most recognizable herbs in the world and the medicinal part is the succulent leaves. A topical skin gel provides wonderful healing support for the skin. It contains many important nutrients for the body including amino acids, B vitamins, and other nutrients that support general health. It also has pharmacological properties including antioxidant, wound healing, antibacterial, antifungal, and immuno-modulating effects. In the present study we used the anti-oxidant property of Aloe Vera in the treatement of periodontitis. The material of this study consisted of 40 male Wistarrats which were assigned to the ligature. All procedures of periodontal disease induction were performed under general anesthesia by intramuscular injection of a combination of 0.1ml ketamine hydrochloride (50 mg/ ml) and 0.05 ml xylaine hydrochloride (2 g/100ml) for each 100 g body weight. After anesthesia, sterile 4/0 silk ligature was placed around the maxillary and the mandibular molars. The rats with an average weight 120-150g were given Aloe Vera intraperitoneally in the dose of (300mg/kg), starting one day before the induction of periodontitis, and continuing for a total of 1 month and another group were given Aloe Vera extract (300mg/kg) using oral gavage, starting one day before the induction of periodontitis and continuing for a total of one month. For detection of proliferation and apoptosis, we used immunohistochemical markers (PCNA, Caspase-3). The area % of reacting PCNA and Caspase-3 immunoreaction was measured and tabulated.

The result of this study showed that there was a high significant difference between all groups in their epithelial thickness measurements and high significant difference between the oral and control groups.

The immunohistochemistry revealed that there was an overall high significant difference in the PCNA and Caspase-3 area % between the studied groups. In addition, there has been a high significant increase in the PCNA reaction in the oral and intraperitoneal groups versus the control group while, in Caspase-3 immunostaining there has been a statistically significant increase in the control group versus both the oral and the intraperitoneal groups. The histological, immunohistochemical and morphometric results of the present research have proved the efficacy of Aloe Vera in the treatment of periodontitis. However, oral administration of Aloe Vera proved to be more beneficial in the treatment of periodontits rather than administration of Aloe Vera via intraperitoneal route.

Randa Hassan Amin Mokatr completed her BDS, MSC Oral Biology, British University In Egypt. She was born in Brazil 1981 and Graduated from Ain Shams University Cairo Egypt 2003, received her Master Degree in Oral Biology Cairo University 2012.

Effect of Platelet Rich Plasma on Healing of Distracted Mandibular Segment

Amr A El-Swify

Department of Oral and Maxillofacial Surgery, Suez Canal University, Egypt

Objective: Recent efforts to improve wound healing have focused on autogenous sources of bioactive mediators, such as platelet rich plasma (PRP), which offers the potential to enhance bone healing, the aim of this work was to study the effect of platelet rich plasma on distraction osteogenesis.

Patients & Methods: Ten patients (7 females and 3 males), their ages ranged from 7 years to 23 years (mean of 14.45 years) were presented with bilateral mandibular hypoplasia. All patients were treated with bilateral mandibular distraction osteogenesis, using both intra& extra-oral unidirectional distractors. Platelet rich plasma was applied only at left site while the right site was considered as a control. The follow-up periods were 3, 6 months & one year using panoramic X- ray which was analyzed by special soft wares to determine amounts of formed bone and its gray level. Axial computerized tomography was used to measure bone density in House field units.

Results: gray level at right site was 101/256±6.50 while that of left site was 108.7±7.30 with no significant difference (P>0.05): Amount of formed bone at right site was 294185 pexils ±1.018,while that of left site was 366921.5 pexils ±1.70 with no significant difference (P >0.05) between right and left sites. The CT density at right site was 537.9HU±35.32 and that of left site was 501HU±53.37 with no significant difference ( P>.05).

Conclusion: Platelet rich plasma has no significant role in distraction osteogenesis as regard amount of formed bone and its density.

Professor Amr Ali El-Swify completed oral &maxillofacial surgery in Suez Canal University and he graduated at Cairo University where he got his PhD. He became the chair of the department of oral & maxillofacial surgery at faculty of dentistry in Suez Canal University from 2004 till 2009 then the chair of oral & maxillofacial department at Sinai University from 2010 to 2015. In 2015, he visited Taif University, KSA as a visitor-professor till 2017. He supervised 14 Master & doctorate thesisʼs in addition to, participating in 29 Master & PhD thesisʼs as a member of the referee committee.

Comparation between the Traditional Gingival Treatment with Er, Cr:YSGG Laser in the Treatment of Periodontitis

Anas Karkout and Hamada.O

Damascus University, UAE

Background: This study aims to evaluate the efficacy of Er, Cr:YSGG laser assisted periodontal therapy on the reduction of periodontal disease.

Methods: 72 patients with chronic periodontitis were included in the study and allocated into two groups each containing 36 patients. Conventional periodontal therapy was performed in group 1 and conventional periodontal therapy was performed in association with Er, Cr:YSGG application in group 2.

Periodontal parameters of probing depth, plaque index, clinical attachment level and bleeding on probing were measured with a periodontal probe. All values were taken before the treatment and after 3and 6 months of the treatment.

Results: All the parameters values at post-treatment were significantly decreased in group 2 (p < 0.05)

Conclusions: Er, Cr:YSGG laser assisted conventional periodontal therapy is very effective in improving periodontal healing compared to conventional periodontal therapy alone.

Keywords: Er, Cr:YSGG laser; chronic periodontitis; meta-analysis; non-surgical periodontal treatment; scaling and root planning.

Dr. Anas Karkout has been practicing Dental Laser since 2012. He has published on this subject in the Asia and the Middle East. Dr. Karkout was a guest lecturer in India, UAE, Lebanon and Syria. He holds a master degree in Dental Laser (Damascus University).

Clinical, Radiographic and Patient Acceptance Evaluation of Laser Compared to Formocresol Pulpotomies in Primary Molars

Amr Abdelaziz and Dina Hamdy Amin

Ain Shams University, Egypt

Introduction: Pulpotomy is still the most common treatment for deeply cariousand exposed symptom-free primary molars. Despite its high clinical success, formocresol as a pulpotomy medicament has the disadvantages of being carcinogenic, mutagenic and cytotoxic. On the other hand, there are many advantages of LASER compared to formocresol, like hemostasis, preservation of living tissues near the tooth apex, absence of vibrations and smells, satisfaction of children and parents are more guarantied. Concerning the use of laser in pulp therapy, one of its main advantages and perhapsactually more important is its safety compared to formocresol and its possible side effects, providing pulp therapy without the need to introduce chemicals into childrenʼs systems.

Aim of the study: The present study compared two different types of LASERs (diode LASER and Er: Cr, YSGG LASER) to the conventional formocresolpulpotomy in primary molars both clinically and radiographically, as well as evaluation of patient acceptance of different techniques.

Materials and methods: A total number of 42 primary molars were selected according to inclusion and exclusion criteria and allocated to three groups. In all groups, local anaesthesia was administered and access cavity preparation was performed using a high-speed contra-angle hand-piece. Coronal pulp tissue was amputated using sharp excavator and bleeding was controlled using sterile, saline- wetted cotton pellets on the radicular pulp stumps under slight pressure. After achieving complete haemostasis pulp stumps were treated according to each group:

Group1: (control group)
A cotton pellet that was moistened with 1:5 diluted formocresolwas placed over the pulp stumps for 5 minutes.

Group2: (Diode LASER group)
Pulp stumps were treated with Diode LASER (980 nm).

Group3: (Erbium:Chromium, YSGG LASER group)
Pulp tissues in this group were treated with Erbium:Chromium, YSGG LASER (2780 nm).

In all groups, reinforced zinc oxide eugenol cement was placed over the pulp stumps, and the tooth wa

s restored with glass ionomer and stainless steel crown.

Clinical and radiographic evaluation was performed before treatment, immediately after the pulpotomy procedure, at 6 and 12months.

Patient acceptance of different techniques was measured using Wong-Baker FACES pain rating scale and by directly asking the patients about the main discomforts and stress-triggers if present.

Results: Results showed no statistically significant difference between the three groups both clinically and radiographically as well as in patient acceptance of different techniques.

Conclusions: From the results of our study it was concluded that the diode and Er, Cr: YSGG LASERs can both be used as successful alternatives to formocresol with comparable success rates. The two types of LASERs are well accepted by the child dental patients as a pulpotomy technique.