[Comparative study of zygomaticmaxillary buttresses osteotomies with or without midpalatal osteotomy in surgically assisted rapid maxillary expansion by using palatal distractor]

Assessment the efficiency of separating zygomaticmaxillary buttresses, with or without midpalatal suture osteotomy, on shape and size expansion of the maxilla using palatal distractor. Fourteen adult patients [ages between 18-25 years and no inborn deformities or congenital syndromes] with skeletal maxillary narrowness being clinically and radially assessed. The studied sample is separated to two groups; Group I: seven patients with bilateral zygomaticmaxillary buttress osteotomy, Group II: the previous procedure was repeated on another 7 patients but with midpalatal osteotomy. The expansion in group II has V shape vertically and horizontally, but that was not clear in group I [p=0.03]. Also the maxillary width immediately and 6 months after the expansion in group II increased statistically when compared with group I [p=0.00], and the percentage of skeletal maxillary expansion after 6 months in group I was 26.17%, but it was 61.88% in group II. We conclude that midpalatal osteotomy affects the shape of expansion and increases the percentage of skeletal maxillary expansion in adults

[ bone gain by application of bone grafts and GTR after surgical extracted lower 3[rd] molars]

The surgical exctration of the impacted lower third molars may cause a loss in the amount of the alveolar bone which covers the distal root of the adjacent lower second molars. The specimen of this study was [27] patients with [54] impacted lower third molars in similar impaction positions which is the crown of the 3[rd] molar touch the distal surface of the distal root of the adjacent lower 2[nd] molar, and its surgical extraction associated with minimum reveal of the distal root surface about [4] mm. the research done by application of bone graft which was a mixture of [Perio Glass] and [DFDBA] in equal amounts in the socket of the extracted molar, then coverage the graft with resorbable [GTR] of [ATRISORB] membranes to achieve maximum bone coverage of the denuded root. The clinical findings at 12 months after surgeries showed that the average of the bone gain was more at the study group [2.82 mm] than at the control group [0.26 mm], the average of attachment gain was 2.33 mm more at the study group than at the control group, the average of periodontal pocket reduction was 2 mm more at the study group than at the control group, and the average of gingival recession was 0.33 mm less at the study group than at the control group. We can conclude from this study that the application of bone graft [mixture of Perio Glass and DFDBA in equal amounts] in the socket of surgical extracted third molar and coverage of this graft with resorbable [ATRISORB] membrane are indicated to achieve maximum bone coverage of the denuded surface of the distal root of the second molar and improve its prognosis

[Assessment of oral health risk factors in haemodialysis patients at Aleppo university hospital]

The aim of this study was to assess the risk factors in dental and oral health in patients with end-stage renal disease undergoing haemodialysis at Aleppo University Hospital. Eighty-six patients undergoing haemodialysis for renal insufficiency were investigated using a questionnaire and examined clinically. Three indices were used [DMFT, the Plaque Index, Gingival index]. Data was analysed by using SPPS software [ANOVA, Kh2 and logistic regression]. Eighty six patients were examined [40 males 46.5%, 46 females 53.5%]. According to the date of haemodialysis, the sample was divided into three groups [less than one year 20.9%, between on and two years 19.8% and more than two years 59.3%]. 76.7% of the sample was not working. According to the caries index DMFT items [Decay, Missing, and Filling], the percent of carried teeth was the greater [39%], and the percent missing teeth was 33% and finally the dental treatment percent was the lower 28%. The number patients with candidiasis was nine, four of them were diabetic [p<0.01]. The oral mucosa lesions were significantly associated with tobacco and dental plaque accumulation [p<0.02]. These diseases were more in females than males. The correlation between the dental plaque accumulation and gingival inflammation was strongly significant [p<0.0001]. All patients with candidiasis have a plaque index value more than 2. It is very important to improve the oral health education in these patients. Access to Dental and oral treatment most be improved for them. Patients on haemodialysis most receive antibiotic prophylaxis prior to invasive dental treatment. They should be considered as high risk patients in dental clinics

Odontogenic maxillary sinus diseases. Clinical, radiographic, and pathologic study at Aleppo city

The specimen of this study was chosen from a survey of 11514 patients from the oral and maxillofacial surgery clinic at Aleppo city either for periodic recall or for therapeutic reasons. The primary clinical, radiographic and pathological diagnosis were recorded including age, sex, clinical symptoms and signs, the causative factor, extension into the surrounding anatomical structures, and the complications. The past medical and dental history, treatment offered, percentage of recurrence after treatment were also recorded. 138 patients have lesions in the maxillary sinus in which 31 cases [22.46%] caused by odontogenic factors, and 107 cases [77.53%] caused by non-odontogenic factors. The 31 cases which caused by odontogenic factors were divided to 20 infection lesions, 7 cystic lesions, and 4 tumors. And the 107 cases caused by non-odontogenic factors were divided to 9 cystic lesions, 60 infection lesions, 28 polyp lesions and 10 tumors. Relating to the 31 cases which caused by odontogenic factors, the study was shown that foreign body insertion to the sinus during teeth extraction or dental treatments are 12 cases which forms 8.69% in the all sinus patients, and forms 38.70% from the odontogenic cases. Periapical lesions extended to the sinus are 8 cases which forms 5.79% in the all sinus patients, and forms 25.80% from the odontogenic cases. Follicular Dentigerous cysts extended to the sinus are 7 cases which form 5.07% in the all sinus patients, and it forms 22.58% from the odontogenic cases. Tumors from dental origin extended to the sinus are 4 cases [2 cases ameloblastoma, 1 case cementoma and 1 case odontomama] which form 2.89% in the all sinus patients, and it forms 12.9% from the odontogenic cases. The results of this study were similar to other studies relating the non-odontogenic cases with some points of controversy which were revealed in the discussion, but the important matter that is the rate of odontogenic cases is too much more occurrence than other similar studies which done in the oral and maxillofacial surgery clinics and centers. The other studies were shown that odontogenic cases are between 8% and 11%, but our study shown that is 22.46%